Toxicity and efficiency study of plant extracts-based bleaching agents

Objectives Tooth bleaching is one of the most required dental esthetic treatments. However, it can generate side effects like oral irritation, enamel alteration, tooth sensitivity, especially caused by hydrogen peroxide, the main bleaching component of the commercial products. Therefore, development of new tooth bleaching agents, based on natural products, with comparable esthetic results and lower side effects is needed. The aim of this study was to evaluate the biological effects and bleaching efficacy of four experimental bleaching agents, derived from fruit juices, against the commercially available Opalescence (Ultradent, USA). Materials and methods Organic acid composition of the gels was characterized by HPLC. Bleaching efficiency was tested by spectrophotometry on composite restorative materials. Biological testing was done in vitro, on human fibroblasts. Cells were exposed to dilutions of the bleaching gel-conditioned medium. Viability was measured by MTS, apoptosis by FACS–AnnexinV FITC/Propidium iodide, NF-kB activation by western blot, malondyaldehide, and superoxide dismutase activity by spectrophotometry. Results All gels exhibited physical stability and dental bleaching capabilities. Experimental gels induced significantly better viability and apoptosis rates, lower lipid peroxidation, and increased antioxidant defense, compared to Opalescence. Conclusions The studied experimental gel formulations exhibited a good safety profile in vitro, as well as bleaching efficiency on restorative composite materials. Clinical relevance These data open new possibilities for the use of new natural products in dental bleaching treatments that can insure significant esthetic results and lower side effects.