Journal of dentistry · 2026
Bleaching-induced enamel alterations: salivary recovery, methodological limitations, and insights from human in situ and in vivo studies. A scoping review.
СтатьяScoping ReviewНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
de Boa Patrick Wesley Marques, de Bessa Mariana Silva, Barbosa Bárbara Faria de Sá, de Oliveira Francisca Jennifer Duarte, Favoreto Michael Willian, Borges Boniek Castillo Dutra
Аннотация
OBJECTIVES: To map the available evidence on enamel morphological alterations and mineral dynamics following tooth bleaching, identify patterns of demineralization and remineralization, evaluate the reversibility of bleaching-induced changes, assess protective strategies, and explore methodological factors influencing the interpretation of enamel damage.
METHODS: A comprehensive search was conducted in PubMed/MEDLINE, Embase, Scopus, Cochrane Library, SciELO, Google Scholar, and Web of Science. Four independent reviewers screened studies according to predefined eligibility criteria. Only human in situ and in vivo studies were included. Data were synthesized into three chronological windows: immediate post-bleaching (up to 24 h), short-term recovery (>24 h to 14 days), and long-term follow-up (>14 days).
RESULTS: Twenty-four studies were included (21 in situ and 3 in vivo). Surface and mineral assessments employed diverse methodologies, including microhardness testing, profilometry, SEM, AFM, Nano-CT, EDS, Raman spectroscopy, and ATR-IR spectroscopy. Evidence supports a biphasic response in which bleaching induces immediate superficial mineral depletion, increased roughness, and reduced microhardness, particularly with acidic formulations. However, these alterations appear largely reversible under physiological conditions. Human saliva emerged as a key factor promoting mineral recovery and restoration of enamel properties, with recovery typically occurring between 7 and 15 days after treatment. Bioactive additives further reduced initial alterations and enhanced recovery. Whitening dentifrices showed a less favorable profile due to their abrasive mechanism. Methodological factors, particularly enamel grinding and polishing, may contribute to overestimation of bleaching-induced damage.
CONCLUSIONS: Current human evidence suggests that enamel alterations following tooth bleaching are predominantly transient and strongly influenced by salivary remineralization in the oral cavity. Future studies should prioritize biologically representative protocols and non-destructive analytical approaches.
CLINICAL SIGNIFICANCE: Human in situ and in vivo evidence suggests that enamel alterations associated with tooth bleaching are predominantly transient and largely reversed by salivary-mediated recovery. These findings support the clinical safety of contemporary bleaching protocols and highlight the potential benefits of bioactive strategies to accelerate enamel recovery during treatment.
METHODS: A comprehensive search was conducted in PubMed/MEDLINE, Embase, Scopus, Cochrane Library, SciELO, Google Scholar, and Web of Science. Four independent reviewers screened studies according to predefined eligibility criteria. Only human in situ and in vivo studies were included. Data were synthesized into three chronological windows: immediate post-bleaching (up to 24 h), short-term recovery (>24 h to 14 days), and long-term follow-up (>14 days).
RESULTS: Twenty-four studies were included (21 in situ and 3 in vivo). Surface and mineral assessments employed diverse methodologies, including microhardness testing, profilometry, SEM, AFM, Nano-CT, EDS, Raman spectroscopy, and ATR-IR spectroscopy. Evidence supports a biphasic response in which bleaching induces immediate superficial mineral depletion, increased roughness, and reduced microhardness, particularly with acidic formulations. However, these alterations appear largely reversible under physiological conditions. Human saliva emerged as a key factor promoting mineral recovery and restoration of enamel properties, with recovery typically occurring between 7 and 15 days after treatment. Bioactive additives further reduced initial alterations and enhanced recovery. Whitening dentifrices showed a less favorable profile due to their abrasive mechanism. Methodological factors, particularly enamel grinding and polishing, may contribute to overestimation of bleaching-induced damage.
CONCLUSIONS: Current human evidence suggests that enamel alterations following tooth bleaching are predominantly transient and strongly influenced by salivary remineralization in the oral cavity. Future studies should prioritize biologically representative protocols and non-destructive analytical approaches.
CLINICAL SIGNIFICANCE: Human in situ and in vivo evidence suggests that enamel alterations associated with tooth bleaching are predominantly transient and largely reversed by salivary-mediated recovery. These findings support the clinical safety of contemporary bleaching protocols and highlight the potential benefits of bioactive strategies to accelerate enamel recovery during treatment.