Comparative efficacy of titanium dioxide nanoparticles loaded carboxymethyl cellulose and hydrogen peroxide gel on tooth whitening: An in-vitro study

Document Type : Research Paper


1 Department of Oral and Maxillofacial Medicine, School of Dentistry, North Khorasan University of Medical Sciences, Bojnūrd, Iran

2 Department of Advanced Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnūrd, Iran

3 Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnūrd, Iran


Objective(s): In this study we evaluated the photocatalytic activity and dye degradation of blue light-activated and UV-activated carboxymethylcellulose gel containing titanium dioxide nanoparticles and compared with 40% hydrogen peroxide bleaching effect to reach to a new strategy that has most efficiency with minimal side effects.
Materials and Methods: The effective concentration of carboxymethylcellulose gel containing TiO2 nanoparticles was determined. The color of the main samples was measured at first, after staining with coffee and after the bleaching process by colorimeter. E1, E2, E3 were recorded and ΔE1, ΔE2 were calculated. Samples were divided into eight groups, each containing six. In three groups, the bleaching effect of CMC gel containing TiO2 nanoparticles irradiated with UV-C was investigated after one, two, and three times exposure to the teeth. In the other three groups, the bleaching effect of CMC gel containing TiO2 nanoparticles irradiated with light cure was investigated after one, two, and three times exposure to the teeth. The results were compared with two control groups CMC and H2O2.
Results: The effective concentration of carboxymethylcellulose gel containing TiO2 nanoparticles was 20%. ΔE2  result for H2O2 control group was 6.34 and for CMC control group was 2.54. The values of ΔE2 in groups were exposed once, twice and three times to CMC gel containing TiO2 nanoparticles that were activated by UV were 3.83, 4.19, 4.42 respectively and ΔE2 results in groups were exposed once, twice and three times to CMC gel containing TiO2 nanoparticles that were activated by blue-light were 4.45, 5.03, 5.55 respectively. 
Conclusion: The greatest value of ΔE2 belonged to the bleached group with hydrogen peroxide gel with ΔE2: 6.34 and after that related to the group activated three times with blue light with ΔE2: 5.55.  All groups except the CMC control group showed ΔE2 higher than 3.3. 


1.    Joiner A. The bleaching of teeth: a review of the literature. J Dent. 2006;34(7):412-419.
2.    Kurzmann C, Verheyen J, Coto M, Kumar RV, Divitini G, Shokoohi-Tabrizi HA, et al. In vitro evaluation of experimental light activated gels for tooth bleaching. Photochem Photobiol Sci. 2019;18(5):1009-1019.
3.    Affairs ADACoS. Tooth whitening/bleaching: treatment considerations for dentists and their patients. Chicago: ADA. 2009.
4.    Mondelli RFL, Francisconi AC, Almeida CMd, Ishikiriama SK. Comparative clinical study of the effectiveness of different dental bleaching methods-two year follow-up. J Appl Oral Sci. 2012;20(4):435-443.
5.    Hanks C, Fat J, Wataha J, Corcoran J. Cytotoxicity and dentin permeability of carbamide peroxide and hydrogen peroxide vital bleaching materials, in vitro. J Dent Res. 1993;72(5):931-938.
6.    Zhang F, Wu C, Zhou Z, Wang J, Bao W, Dong L, et al. Blue-light-activated nano-TiO2@ PDA for highly effective and nondestructive tooth whitening. ACS Biomater Sci Eng. 2018;4(8):3072-3077.
7.    Buchalla W, Attin T. External bleaching therapy with activation by heat, light or laser—a systematic review. Dent Mater J. 2007;23(5):586-596.
8.    Marson FC, Sensi LG, Vieira LCC, Araújo E. Clinical evaluation of in-office dental bleaching treatments with and without the use of light-activation sources. Operative Dentistry. 2008;33(1):15-22.
9.    Bernardon JK, Sartori N, Ballarin A, Perdigão J, Lopes G, Baratieri LN. Clinical performance of vital bleaching techniques. Oper Dent. 2010;35(1):3-10.
10.    Alomari Q, El Daraa E. A randomized clinical trial of in-office dental bleaching with or without light activation. Compend Contin Educ Dent. 2010;11(1):E017-24.
11.    Kugel G, Papathanasiou A, Williams 3rd AJ, Anderson C, Ferreira S. Clinical evaluation of chemical and light-activated tooth whitening systems. Compendium of continuing education in dentistry (Jamesburg, NJ: 1995). 2006;27(1):54-62.
12.    Noruzi S, Vatanchian M, Azimian A, Niroomand A, Salarinia R, Oroojalian F. Silencing SALL-4 Gene by Transfecting Small Interfering RNA with Targeted Aminoglycoside-Carboxyalkyl Polyethylenimine Nano-Polyplexes Reduced Migration of MCF-7 Breast Cancer Cells. Avicenna J Med Biotechnol. 2021;13(1):2.
13.    Oroojalian F, Orafaee H, Azizi M. Synergistic antibaterial activity of medicinal plants essential oils with biogenic silver nanoparticles. Nanomed J. 2017;4(4):237-244.
14.    Akhlaghi M, Taebpour M, Sharafaldini M, Javani O, Haghiralsadat BF, Oroojalian F, et al. Fabrication, characterization and evaluation of anti-cancer and antibacterial properties of nanosystems containing Hedera Helix aqueous extracts. Nanomed J. 2021.
15.    Cuppini M, Leitune VCB, de SOUZA M, Alves AK, Samuel SMW, Collares FM. In vitro evaluation of visible light-activated titanium dioxide photocatalysis for in-office dental bleaching. Dent Mater J. 2019:2017-2199.
16.    Dudefoi W, Moniz K, Allen-Vercoe E, Ropers M-H, Walker VK. Impact of food grade and nano-TiO2 particles on a human intestinal community. Food Chem Toxicol. 2017;106:242-249.
17.    Ahmed MA, El-Shennawy M, Althomali YM, Omar AA. Effect of titanium dioxide nano particles incorporation on mechanical and physical properties on two different types of acrylic resin denture base. World J Nano Sci Eng. 2016;6(3):111-119.
18.    Omidi M, Malakoutian M, Choolaei M, Oroojalian F, Haghiralsadat F, Yazdian F. A Label-Free detection of biomolecules using micromechanical biosensors. Chinese Phys Lett. 2013;30(6):068701.
19.    Rahimizadeh M, Eshghi H, Shiri A, Ghadamyari Z, Matin MM, Oroojalian F, et al. Fe (HSO 4) 3 as an efficient catalyst for diazotization and diazo coupling reactions. J Korean Chem Soc. 2012;56(6):716-719.
20.    Tabari K, Hosseinpour S, Parashos P, Khozestani PK, Rahimi HM. Cytotoxicity of selected nanoparticles on human dental pulp stem cells. Iran Endod J. 2017;12(2):137.
21.    Rashidi A, Omidi M, Choolaei M, Nazarzadeh M, Yadegari A, Haghierosadat F, et al., editors. Electromechanical properties of vertically aligned carbon nanotube. Adv Mat Res 2013: Trans Tech Publ.
22.    Epling GA, Lin C. Photoassisted bleaching of dyes utilizing TiO2 and visible light. Chemosphere. 2002;46(4):561-570.
23.    Vinagre A, Ramos JC, Rebelo C, Basto JF, Messias A, Alberto N, et al. Pulp temperature rise induced by light-emitting diode light-curing units using an ex vivo model. Materials. 2019;12(3):411.
24.    Kossatz S, Dalanhol A, Cunha T, Loguercio A, Reis A. Effect of light activation on tooth sensitivity after in-office bleaching. Oper Dent. 2011;36(3):251-257.
25.    Haghi M, Hekmatafshar M, Janipour MB, Gholizadeh SS, Faraz M, Sayyadifar F, et al. Antibacterial effect of TiO2 nanoparticles on pathogenic strain of E. coli. Int J Adv Biotechnol Res. 2012;3(3):621-624.
26.    Komatsu O, Nishida H, Sekino T, Yamamoto K. Application of titanium dioxide nanotubes to tooth whitening. Nano biomedicine. 2014;6(2):63-72.
27.    Schneider SL, Lim HW. A review of inorganic UV filters zinc oxide and titanium dioxide. Photodermatol Photoimmunol Photomed. 2019;35(6):442-446.
28.    Hebeish A, Hashem M, Abd El-Hady M, Sharaf S. Development of CMC hydrogels loaded with silver nano-particles for medical applications. Carbohydr Polym. 2013;92(1):407-413.
29.    Benchabane A, Bekkour K. Rheological properties of carboxymethyl cellulose (CMC) solutions. Colloid Polym Sci. 2008;286(10):1173.
30.    Han S, Wang T, Li B. Preparation of a hydroxyethyl–titanium dioxide–carboxymethyl cellulose hydrogel cage and its effect on the removal of methylene blue. J Appl Polym Sci. 2017;134(23).
31.    Tano E, Otsuki M, Kato J, Sadr A, Ikeda M, Tagami J. Effects of 405 nm diode laser on titanium oxide bleaching activation. Photomed Laser Surg. 2012;30(11):648-654.
32.    Martín J, Ovies N, Cisternas P, Fernández E, Junior OO, De Andrade M, et al. Can an LED-laser hybrid light help to decrease hydrogen peroxide concentration while maintaining effectiveness in teeth bleaching? Laser Phys. 2015;25(2):025608.
33.    Eimar H, Siciliano R, Abdallah M-N, Abi Nader S, Amin WM, Martinez P-P, et al. Hydrogen peroxide whitens teeth by oxidizing the organic structure. J Dent. 2012;40:e25-e33.
34.    Kishi A, Otsuki M, Sadr A, Ikeda M, Tagami J. Effect of light units on tooth bleaching with visible-light activating titanium dioxide photocatalyst. Dent Mater J. 2011;30(5):723-729.
35.    Rengifo-Herrera JA, Blanco MN, Pizzio LR. Photocatalytic bleaching of aqueous malachite green solutions by UV-A and blue-light-illuminated TiO2 spherical nanoparticles modified with tungstophosphoric acid. Applied Catalysis B: Environmental. 2011;110:126-132.
36.    Al-Dawery SK. Photo-catalyst degradation of tartrazine compound in wastewater using TiO2 and UV light. J Eng Sci Technol. 2013;8(6):683-691.
37.    Suyama Y, Otsuki M, Ogisu S, Kishikawa R, Tagami J, Ikeda M, et al. Effects of light sources and visible light-activated titanium dioxide photocatalyst on bleaching. Dent Mater J. 2009;28(6):693-699.
38.    Mitoraj D, Kisch H, editors. Surface modified titania visible light photocatalyst powders. Solid State Phenom. 2010: Trans Tech Publ.
39.    Suemori T, Kato J, Nakazawa T, Akashi G, Igarashi A, Hirai Y, et al. Effects of light irradiation on bleaching by a 3.5% hydrogen peroxide solution containing titanium dioxide. Laser Phys Lett. 2008;5(5):379.
40.    Hofmann N, Hugo B, Klaiber B. Effect of irradiation type (LED or QTH) on photo‐activated composite shrinkage strain kinetics, temperature rise, and hardness. Eur J Oral Sci. 2002;110(6):471-479.
41.    Usumez A, Özturk N. Temperature increase during resin cement polymerization under a ceramic restoration: effect of type of curing unit. Int J Prosthodont. 2004;17(2).
42.    Eldeniz AU, Usumez A, Usumez S, Ozturk N. Pulpal temperature rise during light‐activated bleaching. J Biomed Mater Res A / J Biomed Mater Res B Appl Biomater. An Official Journal of The Society for Biomaterials, The Japanese Society for Biomaterials, and The Australian Society for Biomaterials and the Korean Society for Biomaterials. 2005;72(2):254-259.
43.    Oberholzer T, Makofane M, du Preez I, George R. Modern high powered led curing lights and their effect on pulp chamber temperature of bulk and incrementally cured composite resin. Eur J Prosthodont Restor Dent. 2012;20(2):50-55.
44.    Thomas M, Naikoo GA, Sheikh MUD, Bano M, Khan F. Effective photocatalytic degradation of Congo red dye using alginate/carboxymethyl cellulose/TiO2 nanocomposite hydrogel under direct sunlight irradiation. J Photochem Photobiol A Chem. 2016;327:33-43.