Inflammatory response of human dental pulp to at-home and in-office tooth bleaching

Publicado em 05-07-2016

Maysa Magalhães VAZ, Lawrence Gonzaga LOPES, Paula Carvalho CARDOSO, João Batista de SOUZA, Aline Carvalho BATISTA, Nádia Lago COSTA, Érica Miranda TORRES, Carlos ESTRELA
Publicado em
Tooth bleaching. Inflammation. Dental pulp. Microscopy. Immunohistochemistry.


Tooth bleaching is a technique of choice to obtain a harmonious smile, but bleaching agentes may damage the dental pulp. Objetive: This study evaluated the inflammatory responses of human dental pulp after the use of two bleaching techniques. Material and Methods: Pulp samples were collected from human third molars extracted for orthodontic reasons and divided into three groups: control – no tooth bleaching (CG) (n=7); at-home bleaching with 15% carbamide peroxide (AH) (n=10), and in-office bleaching with 38% hydrogen peroxide (IO) (n=12). Pulps were removed and stained with hematoxylin-eosin for microscopic analysis of inflammation intensity, collagen degradation, and pulp tissue organization. Immunohistochemistry was used to detect mast cells (tryptase+), blood vessels (CD31+), and macrophages (CD68+). Chi-square, Kruskal-Wallis, and Mann Whitney tests wer used for statiscal analysis. The level of significance was set at p<.05. Results: The inflammation intensity and the number of macrophages were significanthy greater in IO than in AH and CG (p<0.05). The results of CD31+ (blood vessels per mm2) were similar in CG (61.39±20.03), AH (52.29±27.62), and IO (57.43±8.69) groups (p>0.05). No mast cells wer found in the pulp samples analyzed. Conclusion: In-office bleaching with 38% hydrogen peroxide resulted in more intense inflammaion, higher macrophages migration, and greater pulp damage then at-home bleaching with 15% carbamide peroxide, however, these bleaching techniques did not induce migration of mast cells and increased the number of blood vessels.