Effects of Bleaching Protocols on the Esthetic Outcome and Surface Integrity of Enamel Treated With an Ammonia-Free Silver Fluoride Solution
JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, cilt.38, sa.9, ss.1754-1765, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 38 Sayı: 9
- Basım Tarihi: 2026
- Doi Numarası: 10.1111/jerd.70136
- Dergi Adı: JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1754-1765
- Anahtar Kelimeler: ammonia-free silver fluoride, color stability, enamel surface roughness, laser-activated bleaching, teeth bleaching
- İstanbul Üniversitesi Adresli: Evet
Özet
Objective To investigate the effects of three bleaching protocols on the color stability and surface roughness of enamel previously treated with a water-based, ammonia-free silver fluoride solution (Riva Star Aqua). Materials and Methods Eighty-eight human enamel/dentin specimens were demineralized and treated with Riva Star Aqua, divided into four groups (n = 22): Control (no bleaching), home bleaching with 15% hydrogen peroxide (HP), in-office bleaching with 40% HP, and laser-activated bleaching with 46% HP. Color differences (Delta E-00) were measured at different stages, and the surface roughness (Ra) was evaluated before and after bleaching. Data were analyzed using two-way repeated measures ANOVA and Fisher's PLSD test (alpha = 0.05). Results The application of Riva Star Aqua caused perceptible discoloration in all groups. Following bleaching, all three active protocols resulted in significant color correction compared with the control group (p < 0.05). The final color differences (Delta E-00 Final) for Opalescence Boost (6.82 +/- 0.49), Opalescence Home (8.84 +/- 0.42), and Laser White 20 (8.83 +/- 0.37) were statistically comparable (p < 0.05). At the same time, the control group showed significantly high Delta E-00 Final (10.75 +/- 0.29). Regarding surface roughness, all bleaching groups showed a significant increase in Ra values (p < 0.05) compared to baseline, with significant differences between Laser White 20 and the other bleaching protocols (p < 0.05). Conclusion Bleaching effectively reversed the discoloration caused by ammonia-free silver fluoride. While all tested protocols achieved comparable final color correction, the laser-activated protocol resulted in significantly less alteration of surface roughness than the conventional in-office and at-home bleaching protocols.