A new non-vital tooth bleaching method using titanium dioxide and 3.5% hydrogen peroxide with a 405-nm diode laser or a halogen lamp

To establish a safer and more effective bleaching method for discolored pulpless teeth, we examined bleaching from the pulpal dentin side using a 3.5% hydrogen peroxide solution containing titanium dioxide. The twenty bovine blood-stained discolored enamel-dentin plates of 1.0 mm enamel thickness and 2.0 mm dentin thickness were used. The bleaching agent was applied to the dentin side that was then irradiated with a 405-nm diode laser (800 mW/cm2) or a halogen lamp (720 mW/cm2) for 15 minutes. The bleaching effect was assessed by spectrophotometric measurement of the color of the specimens from the dentin and enamel side for every 5 minutes, and then dentin or enamel surface was examined with a scanning electron microscope. The 3.5% hydrogen peroxide solution containing titanium dioxide proved to have a strong bleaching effect. The color difference after laser irradiation was higher than that after halogen lamp irradiation, however, there was no significant difference between them. No changes in the enamel surface morphology were found and open dentinal tubules with no smear layer were clearly observed at the pulpal dentin surface in both groups