Colour Change of Enamel after Application of Averrhoa bilimbi

Abstract

Teeth discoloration is mainly treated with dental bleaching. Use of chemical bleaching has side effects, so it is important to find an alternative natural dental bleaching agent. Averrhoa bilimbi contains peroxide and oxalate acid that possess tooth whitening properties. Objective: To determine the change in color of dental enamel after the application of Averrhoa bilimbi and 10% carbamide peroxide. Methods: Samples were 20 post-extracted of the two tested materials premolars (10 specimens each for Averrhoa bilimbi and carbamide peroxide application). After the application, the specimens were incubated at 37ºC for 2 hours, washed and soaked in aquadest before further incubated for another 14 days. The colour changed was observed by 5 independent observers using shade guide. Results: Quantitative and qualitative analyzes were performed. Qualitatively, A3 color has changed into C1, A2, D2, B2 and B1 in the Averrhoa bilimbi group. A more significant color change in the 10% carbamide peroxide group (p=0.005) compared to Averrhoa bilimbi group (p=0.005) were observed. The difference of resulted enamel colour change was statistically significant (p=0.002). Conclusion: Averrhoa bilimbi had a good prospect as dental bleaching agent since its application effectively resulted in a slight enamel colour change although its whitening properties was still lower than 10% carbamide peroxide. ABSTRAKPerubahan warna email setelah aplikasi Averrhoa bilimbi. Perubahan warna gigi terutama diatasi dengan melakukan perawatan pemutihan gigi. Penggunaan agen pemutih kimia dapat menyebabkan efek samping, sehingga perlu ditemukan agen pemutih gigi alternatif berbahan dasar alam. Averrhoa bilimbi mengandung peroksida dan asam oksalat yang memiliki kemampuan memutihkan gigi. Tujuan: Menganalisis perubahan warna email gigi setelah aplikasi Averrhoa bilimbi dan karbamid peroksida 10%. Metode: Penelitian ini menggunakan 20 gigi premolar pascaekstraksi (masing-masing 10 spesimen untuk aplikasi Averrhoa bilimbi dan karbamid peroksida 10%). Setelah aplikasi, spesimen diletakkan di inkubator 37°C selama 2 jam, kemudian dicuci dan direndam dalam akuades, dan diinkubasi kembali selama 14 hari. Perubahan warna diamati oleh 5 pengamat menggunakan panduan warna. Hasil: Hasil pengamatan dianalisis secara kualitatif dan kuantitatif. Perubahan warna email gigi setelah aplikasi dengan Averrhoa bilimbi dari A3 menjadi C1, A2, D2, B2, dan B1. Perubahan warna gigi secara homogen dari A3 ke B1 terjadi dalam aplikasi karbamid peroksida 10%. Perubahan warna yang lebih jelas terjadi pada kelompok karbamid peroksida 10% (p=0,004) dibandingkan kelompok Averrhoa bilimbi (p=0,005). Perbedaan perubahan warna yang terjadi pada kedua kelompok tersebut berbeda bermakna (p=0,002). Simpulan: Averrhoa bilimbi memiliki prospek yang baik sebagai bahan pemutih gigi karena penggunaannya dapat menimbulkan perubahan warna email, namun efektivitasnya masih di bawah 10% karbamid peroksida.

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