Journal of Conservative Dentistry
Home About us Editorial Board Instructions Submission Subscribe Advertise Contact e-Alerts Login 
Users Online: 284
Print this page  Email this page Bookmark this page Small font sizeDefault font sizeIncrease font size
 


 
Table of Contents   
ORIGINAL ARTICLE  
Year : 2014  |  Volume : 17  |  Issue : 6  |  Page : 550-554
The comparison of the effects of different whitening toothpastes on the micro hardness of a nano hybrid composite resin


1 Department of Conservative Dentistry and Endodontics, Vydehi Institute of Dental Sciences and Research Centre, Bangalore, Karnataka, India
2 Department of Mechanical Engineering, Reva Institute of Technology and Management, Bangalore, Karnataka, India

Click here for correspondence address and email

Date of Submission15-May-2014
Date of Decision09-Aug-2014
Date of Acceptance23-Aug-2014
Date of Web Publication13-Nov-2014
 

   Abstract 

Aim: The aim of this study was to compare the micro hardness of a nanohybrid composite resin after brushing with two herbal and one non-herbal whitening toothpastes.
Materials and Methods: We divided Eighty disk-shaped specimens of a nanohybrid composite (Tetric N Ceram, Ivoclar Vivadent, Asia) into 4 groups of 20 specimens each: Groups A, B, C, and D. Group A was control, Group B was brushed with Colgate total advanced whitening (Colgate-Palmolive (India) Limited), Group C with Salt and Lemon, Dabur (Dabur International Limited, Dubai, UAE), and Group D with HiOra Shine, Himalaya (The Himalaya Drug Company, India). The specimens were polished using medium, fine, and superfine discs (Sof-lex, 3M, ESPE, USA) and subsequently placed at 37°C in distilled water. They were brushed for 2 minutes twice daily with a soft motorized toothbrush (Colgate 360 sonic power battery-operated tooth brush, Colgate Palmolive, India) for 30 days. The samples were rinsed under running water to remove the toothpaste and stored in distilled water at 37°C until the readout was taken on the Vickers's hardness tester for microhardness.
Results: The results revealed that the difference among the groups was statistically significant (P < 0.001). Tukey's test showed that reduction in microhardness for Group B was significantly higher than that for Group C and Group D (P < 0.001).
Conclusion: Within the limitations of this study, non-herbal whitening toothpaste had a greater impact on the microhardness of nanohybrid resin composite than herbal whitening toothpastes.

Keywords: Abrasives in toothpaste; herbal toothpaste; microhardness; resin composites; tooth whitening; Vickers hardness test

How to cite this article:
Nainan MT, Balan AK, Sharma R, Thomas SS, Deveerappa SB. The comparison of the effects of different whitening toothpastes on the micro hardness of a nano hybrid composite resin . J Conserv Dent 2014;17:550-4

How to cite this URL:
Nainan MT, Balan AK, Sharma R, Thomas SS, Deveerappa SB. The comparison of the effects of different whitening toothpastes on the micro hardness of a nano hybrid composite resin . J Conserv Dent [serial online] 2014 [cited 2019 Oct 21];17:550-4. Available from: http://www.jcd.org.in/text.asp?2014/17/6/550/144593

   Introduction Top


Tooth discoloration can be treated professionally with in office or home bleaching. [1] Whitening toothpastes have gained in popularity for treating extrinsic stains. Whitening toothpastes contain abrasive particles such as natural calcium carbonate, silica micro granules, and small percentages of H 2 O 2 and carbamide peroxide. Baking soda has also been introduced in some toothpastes to combat halitosis and as an antibacterial agent. Most of these components are strong abrasives that remove pellicle along with dental stains. [2] Most of the commercially available whitening toothpastes are meant to be used with an aid of a toothbrush. Studies have shown that movements of abrasive agents with the aid of toothbrush bristles will alter the roughness and mechanical properties of restorative materials. [3],[4],[5]

Patients who desire teeth whitening may have existing composite restorations. Ingredients in the whitening toothpaste can alter the surface characteristics of composites. [4] Nanofill composites were introduced to reduce polymerization shrinkage and higher resistance to traction, compression and fracture as well as improving optical properties, reducing attrition, and greater retention of gloss. Composite resin materials undergo a series of physical changes because of the polymerization reaction and subsequent interaction with reagents exposed to them. This process may cause the softening of the resin matrix and reduction of stain resistance. [6],[7],[8]

Hardness is commonly correlated to physical properties of composite resins such as mechanical strength, rigidity, and resistance to intraoral softening. [9] Microhardness is an important property of the restorative material that correlates with strength, proportionality limit, wear resistance, and hence, surface roughness and color stability.

Several studies have noted significant changes in the hardness of composite resins exposed to bleaching agents. [10],[11] According to Khamverdi et al. the use of whitening toothpaste reduces the surface hardness of microhybrid composite resins. [12] In our study, very little research was done to evaluate the effects of herbal whitening toothpastes on the microhardness of composite.

Ideally, a restoration must provide a smooth and regular surface, but this is not always possible as the composite restoration are frequently subjected to certain deleterious actions in the oral cavity through abrasion (brushing), attrition, and erosion (citrus drinks, citrus fruits, soft drinks, etc.). The brushing with toothpaste is the main method of oral hygiene, bringing many benefits in addition to a reduction in the incidence of caries.

Studies have shown that the movement of agents associated with tooth brushing can cause damage to the brushed substrate and are capable of altering the surface and properties of the restorative material.

Thus, the aim of this study was to compare the microhardness of a nanohybrid composite resin after brushing with two herbal and one non-herbal whitening toothpaste.


   Materials and methods Top


Cylindrical-shaped rubber moulds with disk-shaped specimen wells (2-mm thickness and 15-mm diameter) were used to prepare 80 composite specimens. The material used in this study was a nanohybrid composite resin (Tetric N Ceram, Ivoclar Vivadent, Asia). Initially, the moulds were slightly overfilled with the restorative material, which were covered with a plastic matrix strip (mylar strip, Sammit products, India), and a glass slab was used to apply pressure to extrude excess material. The composite resin specimens were light cured (Spectrum 800, DENTSPLY,) for 60 seconds. Prior to photo curing of each composite specimen, a light intensity meter was used to make sure the intensity of the light source was 450 mw/cm 2 .

The specimens were polished using medium fine and superfine polishing discs in a sequential manner (Sof-lex, 3M, ESPE, USA). The polished specimens were cleaned in distilled water for 2 minutes to remove any surface contaminants. All discs were stored in 37°C distilled water for 24 hours.

The 80 specimens were randomly divided into 4 groups (A,B,C, and D) of 20 specimens each and subjected to tooth brushing for 2 minutes twice daily with a motorized tooth brush (Colgate 360 sonic power battery operated tooth brush, Colgate Palmolive, India) for 30 days. Group A was the controlled group where no paste was used with the toothbrush. For Groups B, C, and D Colgate total advanced whitening toothpaste (Colgate-Palmolive (India) Limited), salt and lemon toothpaste (Dabur International Limited, Dubai, UAE), and HiOra Shine toothpaste (The Himalaya Drug Company, India) were used, respectively.

Vickers hardness test was performed for all the specimens using a 10-N load and a 15-second dwell time at room temperature (Fuel instruments and engineering Pvt. Ltd, India).

Vickers hardness test method

Microhardness value of each composite specimen was calculated in the following way. A 136° pyramidal diamond indenter was used on each specimen to form a square indent. The indenter was pressed into the sample with an accurately controlled test force. The force was maintained for a specific dwell time of 15 seconds. The size of the indent was determined optically by measuring the two diagonals of the square indent. The Vickers hardness number is a function of the test force divided by the surface area of the indent. The average of the two diagonals is used in the following formula to calculate the Vickers hardness.

Hardness value = constant × test force/indent diagonal squared

Where the constant is a function of the indenter geometry and the units of force and diagonal. [13]

Data were analyzed by one way ANOVA and Tukey's tests. Mean and standard deviations were calculated. Statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0, and R environment ver.2.11.1 were used for the analysis of the data, and Microsoft Word and Excel have been used to generate graphs, Tables etc.


   Results Top


95% CI implies that the expected mean values will always be in the interval of 95% Confidence Interval Or Population values will be within this interval of 95% CI [Table 1] and [Table 2] and [Figure 1].
Table 1: Comparison of micro hardness of experimental groups (Dabur, Colgate, and Himalaya) with control group (One-way ANOVA test)

Click here to view
Table 2: Pair wise comparison of microhardness using Post-hoc Tukey's test

Click here to view
Figure 1: Microhardness values of test and control groups F = 159.650; P < 0.001**

Click here to view


Interpretation of results

  1. One-way Anova test showed statistically significant difference in reduction of microhardness among the groups (P < 0.001**) Control > Himalaya > Dabur > Colgate.
  2. Post-hoc Tukey's test showed that:
    1. All the experimental groups showed significant reduction in micro hardness compared with the control group. (P < 0.001 for all intergroup comparison).
    2. Maximum reduction in micro hardness was seen in Group B when compared with Group C and Group D (P < 0.001 and P < 0.001, respectively).
    3. Group C showed more reduction in microhardness than Group D (P < 0.001).



   Discussion Top


Patients with composite restorations may opt for tooth whitening regimens. The use of over-the-counter whitening toothpastes is one such option. Such patients may have aesthetic restorations in their mouth. The effects of such products on the properties of the existing restorations need to be investigated thoroughly before their use can be advocated.

Nanocomposites are commonly used for restorations as they provide good aesthetics and longevity. A recent study has recommended nanocomposite as the restorative material of choice when bleaching has to be done after restoration. Hence, nanocomposite material was used in this study. [14]

The testing procedure was standardized using a motorized toothbrush to deliver uniform brushing strokes. Hardness of the toothbrush has a positive effect on the alteration of surface hardness of the resin composite on which it is used. [12] Considering this, a soft toothbrush was used in this study. However, a toothbrush simulator machine would have been a better option in delivering standardized strokes with uniform pressure. [15] A single operator performed the polishing procedures to minimize variation. The prepared specimens were stored in water as storing in artificial saliva is known to form a surface protective salivary layer on the restorative material and may influence the results. [16]

Hardness is a surface property of a restorative material to resist deformation. Vickers hardness test is one of the micro hardness tests that are commonly used to test the surface hardness of restorative materials. [12]

For a predetermined load, the Vickers indentations are twice the depth when compared to knoop indentations. The diagonal of the Vickers indentation is almost one-third the length of the longest diagonal of the knoop indentation. The Vickers hardness test is less sensitive to surface effects and textures (surface conditions) and more sensitive to measurement errors when equal loads are applied due to its shorter diagonals. Thus, Vickers hardness tester was chosen for this study. [17]

The results showed a significant reduction in microhardness of experimental groups compared to the control groups. The maximum reduction in microhardness was demonstrated by Colgate Total Advanced whitening and the least reduction in micro hardness was observed for Himalaya Group. Salt and lemon toothpaste showed intermediate values.

Whitening toothpastes have a mechanical abrasive action due to the abrasives included in it. The range of abrasives can be categorized into four groups, namely carbonates, phosphates, silica, and other agents such as alumina, clays, and oxides. Previous studies have revealed that silica is more abrasive than other agents are, such as sodium bicarbonate, calcium phosphate, and calcium carbonate with a Moh's hardness number of 2.5-5.0. [18]

Colgate Total Advanced whitening paste contains silica as the abrasive and can explain the reason why it has maximum effect on the microhardness. [19],[20] Salt and Lemon toothpaste contains sodium chloride (salt) whose Moh's hardness number 2.5, lesser than that of silica. This explains why it has shown lesser reduction microhardness than Colgate total advanced whitening paste. [21] According to the manufactures, HiOra-Shine toothpaste is an herbal teeth-whitening agent containing natural enzymes that gently dissolve the stains on the surface of the teeth, and it does not contain harsh abrasives [Table 3]. [22]
Table 3: Composition of pastes

Click here to view


Salt and lemon toothpaste contains lemon extract and citric acid while HiOra shine toothpaste contains malic acid, tartaric acid, and racemic acid. [23],[24] Previous studies have shown that dentifrices, which have neutral or acidic pH, produced more abrasion than those with a basic pH. [25] However, in this study, Colgate Total Advanced toothpaste with a basic pH of 9.68 showed more abrasive properties (alteration in microhardness of composite) than the other two pastes with acidic pH. [26] Therefore, it can be suggested that the abrasive properties of whitening toothpastes can cause more alteration in the microhardness of the substrate to which it is exposed rather than the acidic content of the herbal toothpaste.

The results also conflict with the results of the studies showing no difference or improvement in microhardness. [27] However, the result supports earlier findings of reduction in microhardness of composites with whitening toothpastes. [12]

Previous studies have indicated that soft toothbrushes cause more abrasion as they retain more toothpaste in their fine bristles. [28] This factor needs to be considered in analyzing the results of this study.

The effect of herbal toothpastes on color stability, surface roughness, and other properties in comparison to regular whitening toothpastes are being investigated further using a toothbrush simulator machine.


   Conclusion Top


According to the result of this study, the use of whitening toothpastes causes reduction in the microhardness of resin composite. Both abrasives and acids included in the whitening toothpaste can affect the microhardness of the composite. Herbal toothpastes cause lesser reduction in microhardness compared to the non-herbal whitening toothpastes. However, the whitening or bleaching effect has to be weighed against the abrasiveness of whitening toothpaste in future studies.

Patients need to be educated about opting for professional tooth whitening under the guidance of a dental professional, where the parameters can be controlled, rather than relying on over-the-counter products.


   Acknowledgement Top


The authors would like to thank Dr. K. P. Suresh (Ph.D (Biostatistics) Scientist (SS), Project Directorate on Animal Disease Monitoring and Surveillance (PDADMAS) Hebbal, Bangalore 560024) for statistical analysis.

 
   References Top

1.
Pruthi G, Jain V, Kandpal HC, Mathur VP, Shah N. Effect of bleaching on color change and surface topography of composite restorations. Int J Dent 2010;2010:695748.  Back to cited text no. 1
    
2.
Wedad YA. Effect of bleaching agents and whitening tooth pastes on color stability and micro hardness of restorative materials. Pak Oral Dent J 2007;27:249-56.  Back to cited text no. 2
    
3.
Momoi Y, Hirosaki K, Kohno A, McCabe JF. In vitro toothbrush- dentifrice abrasion of resin-modified glass ionomers. Dent Mater 1997;13:82-8.  Back to cited text no. 3
    
4.
Tanoue N, Matsumura H, Atsuta M. Wear and surface roughness of current prosthetic composites after toothbrush/dentifrice abrasion. J Prosthet Dent 2000;84:93-7.  Back to cited text no. 4
    
5.
Tanoue N, Matsumura H, Atsuta M. Analysis of composite type and different sources of polymerization light on in vitro toothbrush/dentifrice abrasion resistance. J Dent 2000;28:355-9.  Back to cited text no. 5
    
6.
Martin N, Jedynakiewicz NM, Fisher AC. Hygroscopic expansion and solubility of composite restoratives. Dent Mater 2003;19:77-86.  Back to cited text no. 6
    
7.
Oderholm KJ, Zigan M, Ragan M, Fischlschweiger W, Bergman M. Hydrolytic degradation of dental composites. J Dent Res 1984;63:1248-54.  Back to cited text no. 7
    
8.
Yap AU, Low JS, Ong LF. Effect of food-simulating liquids on surface characteristics of composite and poly acid modified composite restoratives. Oper Dent 2000;25:170-6.  Back to cited text no. 8
    
9.
Uhl A, Mills RW, Jandt KD. Photoinitiator dependent composite depth of cure and Knoop hardness with halogen and LED light curing units. Biomaterials 2003;24:1787-95.  Back to cited text no. 9
    
10.
Cooley RL, Burger KM. Effect of carbamide peroxide on composite resins. Quintessence Int 1991;22:817-21.  Back to cited text no. 10
    
11.
Bairley S, Swift EJ Jr. Effect of home bleaching products on composite resins. Quintessence Int 1992;23:489-94.  Back to cited text no. 11
    
12.
Khamverdi Z, Kasraie Sh, Rezaei-Soufi L, Jebeli S. Comparison of the effects of two whitening toothpastes on micro hardness of the enamel and a microhybrid composite resin: An in vitro study. J Dent (Tehran) 2010;7:139-45.  Back to cited text no. 12
    
13.
Available from: www.instron.us/wa/applications/test_types/hardness/vickers.aspx [Last accessed on 2014 Sep 8].  Back to cited text no. 13
    
14.
Hajizadeh H, Ameri H, Eslami S, Mirzaeepoor B. The effect of bleaching on toothbrush abrasion of resin composites. J Conserv Dent 2013;16:17-20.  Back to cited text no. 14
[PUBMED]  Medknow Journal  
15.
Ana CD, Cecília SA, Maria DC, Marcos AJ. Evaluation of surface roughness of a nanofill resin composite after simulated brushing and immersion in mouth rinses, alcohol and water. Mat Res 2010;13:77-80.  Back to cited text no. 15
    
16.
Attin T, Hannig C, Wiegand A, Attin R. Effect of bleaching on restorative materials and restorations-A systemic review. Dent Mater 2004;20:852-61.  Back to cited text no. 16
    
17.
Fuentes V, Tolledano M, Osorio R, Carvalho RM. Microhardness of superficial and deep sound human dentin. J Biomed Mater Res A 2003;66:850-3.  Back to cited text no. 17
    
18.
Hefferren JJ. Historical view of dentifrice functionality methods. J Clin Dent 1998;9:53-6.  Back to cited text no. 18
    
19.
Dental Product Spotlight Whitening toothpastes. J Am Dent Assoc 2001;132:1146-7.  Back to cited text no. 19
    
20.
Available from: www.ingredientpal.com/colgate-total-toothpaste-ingredients-list [Last accessed on 2014 Sep 8].  Back to cited text no. 20
    
21.
Available from: www.azom.com/article.aspx?ArticleID=3473 [Last accessed on 2014 Sep 8].  Back to cited text no. 21
    
22.
Available from: www. store.himalayahealthcare.com/healthcare/hiora-shine-toothpaste.htm [Last accessed on 2014 Sep 8].  Back to cited text no. 22
    
23.
Available from: www.amazon.com/Dabur-Herbl-Toothpaste-Salt-Lemon/dp/B0054RYRLC [Last accessed on 2014 Sept 8].  Back to cited text no. 23
    
24.
Available from: www.gardenherbs.org/simples/grapes.htm [Last accessed on 2014 Sep 8].  Back to cited text no. 24
    
25.
Hengtrakool C, Kukiattrakoon B, Kedjarune-Leggat U. Effect of naturally acidic agents on micro hardness and surface micro morphology of restorative materials. Eur J Dent 2011;5:89-100.  Back to cited text no. 25
    
26.
Majeed A, Grobler SR, Moola MH. The PH of various tooth whitening products on the south African market. SADJ 2011;66:278-81.  Back to cited text no. 26
    
27.
Nathoo SA, Chmielewski MB, Kirkup RE. Effects of Colgate platinum professional tooth whitening system on micro hardness of enamel, dentin and composite resins. Compend Suppl 1994:S627-30.  Back to cited text no. 27
    
28.
Toshimitsu S, Hideaki K, Yasuyuki A, Werner JF, Masafumi K. Tooth brush abrasion of resin composites with different filler concepts. World J Dent 2012;3:184-93.  Back to cited text no. 28
    

Top
Correspondence Address:
Mohan Thomas Nainan
Epip Area, Whitefield, Bangalore - 560 066, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-0707.144593

Rights and Permissions


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

Top
 
 
 
  Search
 
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  
 


    Abstract
   Introduction
    Materials and me...
   Results
   Discussion
   Conclusion
   Acknowledgement
    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed2542    
    Printed43    
    Emailed0    
    PDF Downloaded249    
    Comments [Add]    

Recommend this journal