and H
2
O
2
. Then, as a second step, H
2
O
2
reacts into H
2
O and O, which takes elec-
trons from the substance to bleach [3-13]. The bleaching efficacy is influenced by
the application time and the concentration of the effective agent. Such application
of the bleaching agents is performed in offices by clinicians (with relatively higher
concentration of H
2
O
2
) or at home by patients themselves (relatively lower con-
centration of H
2
O
2
) [3-14]. Commercially available bleaching products range from
3% to 9.5% for hydrogen peroxide (which can be converted to a range from 6% to
over 19% carbamide peroxide). Although the above discussion is regarding the
discolored natural teeth and whitening of such stained teeth, some patients under-
going the nightguard bleaching (e.g., for 8-h treatment) are likely to have some
metallic restorations (i.e., amalgam, crowns made of gold or porcelain fused to a
base metal, fixed or removable prosthodontic bridge or partial denture frameworks
made of base alloys, and/or titanium implant fixtures). Recently, it was found that
exposure of amalgam to common bleaching agents caused an increase in mercury
levels in the solutions [3-16].
The conscientious health-care provider needs to know the consequences of the
effects of fluoride agents and bleaching agents on various dental metallic materials
intraorally. While it is acknowledged that tarnishing of the metallic dental materi-
als is the visible consequence of these treatments, the implications on biological
effects and the structural integrity of the components are unclear. Clinicians need
to understand the potentially corrosive nature of the commercially available fluo-
ride and bleaching treatments on intraoral metals, and know when and where to use
them [3-17]. The discoloration efficacy of fluoride treatment agents (2.0% NaF
with pH 7.0, 0.4% SnF
2
with pH 7.0, and 1.23% APF with pH 3.5) was tested on
Ti-6Al-4V and 17Cr-4Ni PH (precipitation hardening) type stainless steel, and
bleaching agents (10% carbamide peroxide) were applied on CpTi (grade 2), 70Ni-
15Cr-5Mo, type IV gold alloy (70Au-10Ag-15Cu), and Disperalloy amalgam. The
degree of discoloration on these treated alloys was examined by a colorimeter and
naked eyes. After the baseline measurements of three L* (lightness), a* (position
on the red/green axis), and b* (position on yellow/blue axis), comparisons were
made with the Commission Internationale d’Eclairage (CIE-L*a*b) color system,
and the value of E* (defined as the Euclidean distance) can be calculated by
[(L
i
⫺L
f
)
2
⫹ (a
i
⫺a
f
)
2
⫹ (b
i
⫺b
f
)
2
]
1/2
, where subscripts “i” and “f” indicate the intial
value and final value, respectively. It was found that (i) all tested metallic materials
exhibit discoloration to various degrees, ranging from 10 to 18 in E*, (ii) the tooth
brashing between each treatment for both fluoride and bleaching treatments indi-
cate a remarkable reduction in the degree of discoloration (i.e., E* reduced to
2⫺8) of all tested materials, and (iii) results on naked eyes evaluation performed by
three clinicians did not agree well with those in the lower range of E*, whereas
when the discoloration advanced, both evaluations agreed well [3-17].
Chemical and Electrochemical Reactions 27
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