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SUMMARY Objective: The purpose of the study was to evaluate the effect of bleaching on teeth with white spot lesions. Methods and Materials: Carious lesions with standardized whiteness were produced on the buccal and lingual surfaces of human premolars by pH cycling. Specimens were subjected to four experimental conditions (n=20/group) as follows: group 1, control; group 2, caries formation followed by remineralization using fluoride-containing casein phosphopeptide–amorphous calcium phosphate (CPP-ACP; Tooth Mousse Plus, GC, Tokyo, Japan); group 3, caries formation followed by bleaching using 10% carbamide peroxide; and group 4, caries formation followed by both bleaching and remineralization. The CIE L*a*b* color values were measured with a spectroradiometer, the mineral content was measured with electron probe microanalysis (EPMA) on the cross-sectional surface of each specimen, and the Knoop hardness test was carried out along the EPMA scan line. Two-way analysis of variance was performed with Tukey post hoc comparison. Results: The change in the CIE color values was not significantly different between the caries-formed (ΔE*=7.03) and the bleached enamel (ΔE*=7.60). Bleaching of the carious enamel extended the whiteness (ΔE*=3.38) without additional mineral loss (p&amp;lt;0.05). The remineralization treatment significantly increased the calcium (Ca), phosphate (P), and fluoride content of the subsurface lesion area (p&amp;lt;0.05). The cross-sectional microhardness values correlated well with the Ca and P content (R&amp;gt;0.80). Conclusions: Bleaching reduced the color disparities between sound and carious enamel without deteriorating the chemical and mechanical properties. The application of CPP-ACP paste enhanced mineral deposition in the subsurface lesion area of carious enamel.

Bleaching Effects on Color, Chemical, and Mechanical Properties of White Spot Lesions