Evaluation of Hydroxyl Radical Diffusion and Acidified Thiourea as a Scavenger during Intracoronal Bleaching

• Hydrogen peroxide and sodium perborate resulted in the greatest production and diffusion of hydroxyl radicals and should be used with caution.
• Sodium perborate and water consistently had the lowest level of hydroxyl radical diffusion compared with other groups and may be the safest bleaching protocol.
• The use of acidified thiourea with hydrogen peroxide did not reduce the amount of hydroxyl radical diffusion to the external tooth surfaces, whereas the use of neutral thiourea did compared with hydrogen peroxide alone.

IntroductionThe diffusion of hydroxyl radicals in intracoronal bleaching is associated with a risk of invasive cervical resorption. The use of acidified thiourea has been recommended as a scavenger of residual radicals generated during intracoronal bleaching. The aims of this study were to quantify hydroxyl radical diffusion to external root surfaces after intracoronal bleaching with commonly used materials and to evaluate the effect of using acidified thiourea with hydrogen peroxide (H2O2) on hydroxyl radical diffusion.MethodsEighty-two human premolars were prepared, stained, root filled, and allocated to experimental and control groups as follows: group 1: sodium perborate (SP) and water (n = 21), group 2: H2O2 (n = 21), group 3: acidified thiourea and H2O2 (n = 21), group 4: neutral thiourea and H2O2 (n = 10), control group 1: negative control (water) (n = 10), and control group 2: positive control (SP and H2O2) (n = 10). Materials were placed into the pulp chamber, sealed, and placed in 5 mmol/L terephthalic acid at 37°C for 48 hours. Hydroxyl radicals were quantified using a fluorescence microplate reader and high-performance liquid chromatography with fluorescence detection.ResultsThe H2O2 and SP mixture resulted in the greatest hydroxyl radical diffusion and was significantly greater than SP and water (P < .05) and H2O2 (P < .05). The addition of acidified thiourea resulted in higher radical diffusion, whereas the addition of neutral thiourea resulted in lower diffusion than H2O2 alone.ConclusionsThe SP and water mixture resulted in the lowest hydroxyl radical diffusion, and the H2O2 and SP mixture resulted in the greatest. Although the addition of acidified thiourea to H2O2 did not reduce radicals detected, the addition of neutral thiourea had a positive effect.