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. 2025 Apr 4;29(4):221.
doi: 10.1007/s00784-025-06298-1.

The Effect of Whitening Agents (Whitening Rinse and Carbamide Peroxide) on Stained Flowable and Packable Composite Aligner Attachments

Ezgi Atik  1 , Ülkü Tuğba Kalyoncuoğlu  2
Affiliations

The Effect of Whitening Agents (Whitening Rinse and Carbamide Peroxide) on Stained Flowable and Packable Composite Aligner Attachments

Ezgi Atik et al. Clin Oral Investig. .

Abstract

Background: This study aimed to verify the effects of whitening agents on the color stability of aligner attachments made from flowable and packable composite resins after staining with coffee and wine.

Methods: Two composite groups were used for attachment preparation on epoxy resin master models: G-ænial Universal Injectable flowable (Group 1, N = 42) and G-ænial Posterior packable (Group 2, n = 42). Initial staining of samples was performed with coffee and red wine respectively, with a total period of 6 days representing 6 months of consumption. After staining, each main group was randomly divided into 3 groups related to distilled water as the control (Distilled Water (DW), n = 14) and whitening agents (Whitening Oral Rinse (WR), n = 14) (Carbamide Peroxide 22% (CP), n = 14) for a 14-day test period. Before staining (T0), after staining (T1), and after whitening (T2), color measurements were made with Vita Easy Shade V. ΔE00 formula was used to determine color differences between T0-T1 (ΔE001), T1-T2 (ΔE002) and T0-T2 (ΔE003) color measurement periods. Also, attachments' whiteness change before and after whitening procedures was calculated using the Whiteness Index for Dentistry (WID) formula considering as ΔWID1 = WID(T2) - WID(T0) and ΔWID2 = WID(T2) - WID(T1).

Results: After immersion in staining solutions, ΔE001 values of Group 2 were significantly higher than of values of Group 1 (p < 0.001). In Group 1, ΔWID2 values in the WR and CP groups were found to be significantly higher than measurements in the DW group (p = 0.049 and p = 0.001). In Group 2, the value of ΔE002 for subgroup CP was significantly higher than that for DW group (p = 0.023). Also, the ΔE003 measurement of the WR group was higher than the measurement of the CP group (p < 0.001). In Group 2, the ΔWID1 measurement of the CP group was lower than the measurements of the DW (p < 0.001) and WR (p = 0.014) groups. According to ΔWID2 measurement in Group 2, CP measurements were higher than DW (p < 0.001) and WR (p = 0.024) measurements. Statistically significant differences were determined between the composite types for DW, WR, CP whitening types in terms of ΔE003 and ΔWID1 measurements and between the composites for CP whitening type in terms of ΔWID2 measurements (p < 0.05). For all significant differences, measurements for Group 2 were found to be higher than for Group 1.

Conclusion: The color change of packable composite was more pronounced than that of the flowable composite after staining. Between whitening and staining stages, especially in packable composite group, carbamide peroxide whitening agent significantly effected the color and whiteness of the attachments compared to control distilled water group.

Keywords: Bleaching; Color; Composite attachment; Whiteness index.

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Conflict of interest statement

Declarations. Ethics approval: The study protocol did not need ethical approval since it was not performed on human materials Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Experimental flowchart and groups
Fig. 2
Fig. 2
Box plot of the distribution of ΔE002 measurements according to composite and whitening agent groups
Fig. 3
Fig. 3
Box plot of the distribution of ΔE003 measurements according to composite and whitening agent groups
Fig. 4
Fig. 4
Box plot of the distribution of ΔWID1 measurements according to composite and whitening agent groups
Fig. 5
Fig. 5
Box plot of the distribution of ΔWID2 measurements according to composite and whitening agent groups
See this image and copyright information in PMC

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