This study aimed to assess the viability of dental cells following time-dependent carbamide peroxide teeth-whitening treatments using an in-vitro dentin perfusion assay model. 30 teeth were exposed to 5% or 16% CP gel (4 h daily) for 2-weeks. The enamel organic content was measured with thermogravimetry. The time-dependent viability of human dental pulp stem cells (HDPSCs) and gingival fibroblast cells (HGFCs) following either indirect exposure to 3 commercially available concentrations of CP gel using an in-vitro dentin perfusion assay or direct exposure to 5% H2O2 were investigated by evaluating change in cell morphology and by hemocytometry. The 5% and 16% CP produced a significantly lower (p < 0.001) enamel protein content (by weight) when compared to the control. The organic content in enamel varied accordingly to the CP treatment: for the 16% and 5% CP treatment groups, a variation of 4.0% and 5.4%, respectively, was observed with no significant difference. The cell viability of HDPSCs decreased exponentially over time for all groups. Within the limitation of this in-vitro study, we conclude that even low concentrations of H2O2 and CP result in a deleterious change in enamel protein content and compromise the viability of HGFCs and HDPSCs. These effects should be observed in-vivo.

The successful management of patients with amelogenesis imperfecta has traditionally involved use of conventional more destructive methods. Amelogenesis imperfecta has a prevalence of 1:700 to 1:14,000, according to the populations studied. 1 The affected enamel can be hypomineralized and/or hypoplastic, causing the affected individual aesthetic concerns as well as potential sensitivity. In this case, the author aims to present a minimally invasive full mouth reconstruction of a patient affected by amelogenesis imperfecta using a combination of direct and indirect methods. CPD/Clinical Relevance: The clinical management of amelogenesis imperfecta can provide clinicians with challenges that are not faced daily. In this case report, minimally invasive management of such patients will be demonstrated.