Effects of Hydrogen Peroxide With Cassava Extract Addition as Bleaching Material on Human Enamel- An in Vitro Study

Abstract

BACKGROUND Bleaching procedures can lead to loss of minerals and morphological changes of the enamel. In order to minimize the damage on enamel, there is a need to develop natural ingredients from cassava tubers as additives for bleaching material because it contains calcium, phosphate and enzymes. The aim of this study is to evaluate the difference of morphology and elements of the enamel after bleaching with different concentrations of hydrogen peroxide and hydrogen peroxide with cassava extract as additive material. MATERIALS AND METHODS Six third molars were used in this study by first causing teeth discolouration. And then, the teeth were cut in the mesio-distal direction and buccal surface was divided into 4 Groups, Group I was bleached with hydrogen peroxide 10%, Group II was bleached with a mixture of hydrogen peroxide and 10% cassava extract, Group III was bleached with hydrogen peroxide 35% and Group IV was bleached with a mixture of hydrogen peroxide 35% and cassava extract. Changes in enamel morphology were observed by a Scanning Electron Microscope (SEM) and Atomic Force Microscope (AFM), whereas elements of enamel were analysed with Energy Dispersive X-Ray (EDX). Statistical analysis was performed by ANOVA Test. RESULTS The results showed that in all Groups, there were significant differences in the Ca and P elements, while the chemical elements C and O had no significant differences. In Group II and Group IV there was reduction of damage to the enamel, and morphology as seen through the SEM and AFM as compared to Groups I and III. CONCLUSION Adding cassava extract as additive material to bleaching material can increase the mineral on enamel and decrease the effects on enamel morphology.