{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:59:12Z","timestamp":1790031552962,"version":"4.0.1"},"reference-count":66,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:00:00Z","timestamp":1710201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["310683\/2022\u20100"],"award-info":[{"award-number":["310683\/2022\u20100"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88887.489995\/2020\u201000"],"award-info":[{"award-number":["88887.489995\/2020\u201000"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88887.649870\/2021\u201000"],"award-info":[{"award-number":["88887.649870\/2021\u201000"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although several studies indicate the harmful effects of bleaching on pulp tissue, the demand for this procedure using high concentrations of hydrogen peroxide (HP) is high.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the influence of bleaching on the pulp tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic searches were conducted (PubMed\/MEDLINE, Scopus, Cochrane Library and grey literature) until February 2021. Only in\u00a0vivo studies that evaluated the effects of HP and\/or carbamide peroxide (CP) bleaching gels on the inflammatory response in the pulp tissue compared with a non\u2010bleached group were included. Risk of bias was performed according to a modified Methodological Index for Non\u2010Randomized Studies scale for human studies and the Systematic Review Centre for Laboratory Animal Experimentation's RoB tool for animal studies. Meta\u2010analysis was unfeasible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1311 studies, 30 were eligible. Of these, 18 studies evaluated the inflammatory response in animal models. All these studies reported a moderate\u2010to\u2010strong inflammatory response in the superficial regions of pulp, characterized by cell disorganization and necrotic areas, particularly during the initial periods following exposure to 35%\u201338% HP, for 30\u201340\u2009min. In the evaluation of human teeth across 11 studies, seven investigated inflammatory responses, with five observing significant inflammation in the pulp of bleached teeth. In terms of tertiary dentine deposition, 11 out of 12 studies noted its occurrence after bleaching with 35%\u201338% HP in long\u2010term assessments. Additionally, three studies reported significant levels of osteocalcin\/osteopontin at 2 or 10\u2009days post\u2010treatment. Other studies indicated an increase in pro\u2010inflammatory cytokines ranging from immediately up to 10\u2009days after bleaching. Studies using humans' teeth had a low risk of bias, whereas animal studies had a high risk of bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Despite the heterogeneity in bleaching protocols among studies, High\u2010concentrations of HP shows the potential to induce significant pulp damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010concentrations of bleaching gel increases inflammatory response and necrosis in the pulp tissue at short periods after bleaching, mainly in rat molars and in human incisors, in addition to greater hard tissue deposition over time. However, further well\u2010described histological studies with long\u2010term follow\u2010up are encouraged due to the methodological limitations of these studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Registration<\/jats:title><jats:p>PROSPERO (CRD42021230937).<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.14061","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T12:49:26Z","timestamp":1710247766000},"page":"630-654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Influence of dental bleaching on the pulp tissue: A systematic review of in\u00a0vivo studies"],"prefix":"10.1111","volume":"57","author":[{"given":"Mariana Viana","family":"Donato","sequence":"first","affiliation":[{"name":"Restorative Dentistry, School of Dentistry Universidade Federal de Minas Gerais (UFMG)  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5866-7137","authenticated-orcid":false,"given":"Alexandre Henrique","family":"dos Reis\u2010Prado","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry Universidade Federal de Minas Gerais (UFMG)  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Guimar\u00e3es","family":"Abreu","sequence":"additional","affiliation":[{"name":"Child's and Adolescent's Oral Health, School of Dentistry Universidade Federal de Minas Gerais (UFMG)  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara Cancella","family":"de Arantes","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry Universidade Federal de Minas Gerais (UFMG)  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Goto","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8611-3070","authenticated-orcid":false,"given":"Hebertt Gonzaga dos Santos","family":"Chaves","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry Universidade Federal de Minas Gerais (UFMG)  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2348-7846","authenticated-orcid":false,"given":"Luciano Tavares Angelo","family":"Cintra","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6126-1760","authenticated-orcid":false,"given":"Andr\u00e9 Luiz Fraga","family":"Briso","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella Faria da Cunha","family":"Peixoto","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry Universidade Federal de Minas Gerais (UFMG)  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5459-353X","authenticated-orcid":false,"given":"Francine","family":"Benetti","sequence":"additional","affiliation":[{"name":"Restorative Dentistry, School of Dentistry Universidade Federal de Minas Gerais (UFMG)  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(99)80152-6"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-019-03009-5"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13049"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13190"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1590\/0103-6440201802177"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2017.04.013"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.12891"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-017-2278-9"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1590\/0103-6440201300225"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708-8240.2007.00123_1.x"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0264865"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2010.0048"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-7757-2019-0384"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1590\/1807-3107BOR-2015.vol29.0026"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2008.09.013"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2008.05.003"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2013.08.007"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1590\/0103-6440201600329"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-775720150393"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.12692"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(79)80033-3"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2009.12.002"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.5395\/rde.2020.45.e20"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/154411130301400406"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1258\/la.2009.008120"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pbio.3000411"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2014.10.007"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.12852"},{"key":"e_1_2_12_30_1","first-page":"298","article-title":"Tooth bleaching induces changes in the vascular permeability of rat incisor pulps","volume":"26","author":"Ferreira V.G.","year":"2013","journal-title":"American Journal of Dentistry"},{"key":"e_1_2_12_31_1","first-page":"363","article-title":"Pulp reaction to vital bleaching","volume":"29","author":"Fugaro J.O.","year":"2004","journal-title":"Operative Dentistry"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210338"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-43"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13711"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/0960327118817103"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2591.2010.01713.x"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.2341\/19-223-C"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-013-1366-6"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12827"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12152"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2013.629"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.5395\/rde.2016.41.1.44"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.colsurfb.2019.04.006"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/jicd.12401"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2008.08.034"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.2341\/13-352-L"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.2341\/12-335-C"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-775720150154"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijdr.IJDR_688_16"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.02.003"},{"issue":"8","key":"e_1_2_12_52_1","first-page":"421","article-title":"The pH of tooth\u2010whitening products","volume":"66","author":"Price R.B.","year":"2000","journal-title":"Journal (Canadian Dental Association)"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.3389\/fdmed.2021.689537"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.2341\/15-266-C"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0099-2399(80)80166-X"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1590\/0103-6440201302282"},{"key":"e_1_2_12_57_1","first-page":"8","article-title":"Evaluation of in\u2010office tooth whitening treatment with violet LED: protocol for a randomised controlled clinical trial","volume":"4","author":"Santos A.E.C.G.D.","year":"2018","journal-title":"BMJ Open"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9969(95)98810-L"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345810600051701"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-7757-2017-0367"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2013.02.006"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-013-1034-4"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-020-03258-9"},{"key":"e_1_2_12_65_1","first-page":"36","article-title":"Council directive 2011\/84\/EU, amending directive 76\/768\/EEC concerning cosmetic products","volume":"283","author":"The Council of The European Union","year":"2011","journal-title":"Official Journal of the European Union"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2016.01.028"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-775720160137"}],"container-title":["International Endodontic Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iej.14061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T08:12:12Z","timestamp":1714983132000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iej.14061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,12]]},"references-count":66,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/iej.14061"],"URL":"https:\/\/doi.org\/10.1111\/iej.14061","archive":["Portico"],"relation":{},"ISSN":["0143-2885","1365-2591"],"issn-type":[{"value":"0143-2885","type":"print"},{"value":"1365-2591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,12]]},"assertion":[{"value":"2022-08-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}