{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:07:39Z","timestamp":1789027659396,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To critically evaluate current and emerging intracoronal bleaching agents and to provide an evidence\u2010informed framework for clinical decision\u2010making in the postsodium perborate era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Overview<\/jats:title>\n                    <jats:p>The declining availability of sodium perborate, particularly within the European Union, has substantially altered contemporary intracoronal bleaching practice. A narrative review was conducted using a structured PubMed\/MEDLINE literature search and manual reference screening. Evidence regarding bleaching efficacy, biological safety, peroxide diffusion, cervical root resorption, dentin\u2010related effects, restorative implications, regulatory developments, and emerging bleaching materials was critically synthesized. Hydrogen peroxide, carbamide peroxide, and sodium percarbonate all achieve clinically relevant whitening but differ in biological characteristics and the strength of supporting evidence. Hydrogen peroxide remains effective but raises greater concerns regarding peroxide diffusion and concentration\u2010dependent biological effects. Carbamide peroxide is supported by extensive contemporary clinical evidence and long\u2010term outcome data, whereas sodium percarbonate represents a promising borate\u2010free alternative currently supported primarily by laboratory and ex\u00a0vivo studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among currently available intracoronal bleaching agents, carbamide peroxide is supported by one of the largest bodies of contemporary clinical literature and represents one of the most extensively documented contemporary alternatives to sodium perborate. Sodium percarbonate shows considerable potential but requires prospective clinical validation before more definitive clinical recommendations can be made.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>This review provides an evidence\u2010informed framework for selecting contemporary intracoronal bleaching agents to achieve predictable esthetic outcomes in the postsodium perborate era while identifying priorities for future clinical research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.70269","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:26:52Z","timestamp":1789025212000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implications of European Union Sodium Perborate Restrictions for Intracoronal Bleaching Procedures: A Narrative Review"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3953-9145","authenticated-orcid":false,"given":"Marco M.","family":"Herz","sequence":"first","affiliation":[{"name":"Department for Conservative Dentistry University of T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3059-5626","authenticated-orcid":false,"given":"Christian","family":"Meller","sequence":"additional","affiliation":[{"name":"Department for Conservative Dentistry University of T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8039-9888","authenticated-orcid":false,"given":"Christian","family":"Klein","sequence":"additional","affiliation":[{"name":"Department for Conservative Dentistry University of T\u00fcbingen  T\u00fcbingen Germany"},{"name":"Healthcare Center Meller Zahngesundheit Schlauzahn MVZ GmbH  Waiblingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"\u00d6sterreicher","sequence":"additional","affiliation":[{"name":"Department for Conservative Dentistry University of T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"4","key":"e_1_2_15_2_1","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1834-7819.2009.01158.x","article-title":"Internal Bleaching of Teeth: An Analysis of 255 Teeth","volume":"54","author":"Abbott P.","year":"2009","journal-title":"Australian Dental Journal"},{"issue":"4","key":"e_1_2_15_3_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.joen.2007.12.020","article-title":"Nonvital Tooth Bleaching: A Review of the Literature and Clinical Procedures","volume":"34","author":"Plotino G.","year":"2008","journal-title":"Journal of Endodontics"},{"issue":"2","key":"e_1_2_15_4_1","first-page":"105","article-title":"Five\u2010Year Follow\u2010Up of Internal Bleaching","volume":"10","author":"Glockner K.","year":"1999","journal-title":"Brazilian Dental Journal"},{"issue":"5","key":"e_1_2_15_5_1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1046\/j.1365-2591.2003.00667.x","article-title":"Review of the Current Status of Tooth Whitening With the Walking Bleach Technique","volume":"36","author":"Attin T.","year":"2003","journal-title":"International Endodontic Journal"},{"key":"e_1_2_15_6_1","first-page":"1292","article-title":"Aktuelles Aus Der Forschung Zum Thema \u2018Zahnaufhellung\u2019","volume":"92","author":"Attin T.","year":"2002","journal-title":"Zahn\u00e4rztliche Mitteilungen"},{"issue":"1","key":"e_1_2_15_7_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/j.1600-9657.1988.tb00288.x","article-title":"Incidence of External Root Resorption and Esthetic Results in 58 Bleached Pulpless Teeth","volume":"4","author":"Friedman S.","year":"1988","journal-title":"Endodontics & Dental Traumatology"},{"issue":"2","key":"e_1_2_15_8_1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/j.1834-7819.1994.tb01378.x","article-title":"Incidence of Invasive Cervical Resorption in Bleached Root\u2010Filled Teeth","volume":"39","author":"Heithersay G. S.","year":"1994","journal-title":"Australian Dental Journal"},{"issue":"12","key":"e_1_2_15_9_1","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/S0099-2399(07)80199-3","article-title":"Cervical Root Resorption Following Bleaching of Endodontically Treated Teeth","volume":"16","author":"Madison S.","year":"1990","journal-title":"Journal of Endodontics"},{"issue":"3","key":"e_1_2_15_10_1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/S0099-2399(06)81310-5","article-title":"Effect of Different Protective Base Materials on Hydrogen Peroxide Leakage During Intracoronal Bleaching In\u00a0Vitro","volume":"18","author":"Rotstein I.","year":"1992","journal-title":"Journal of Endodontics"},{"key":"e_1_2_15_11_1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1186\/s12903-022-02300-4","article-title":"Evaluation of the Penetration of Intracoronal Bleaching Agents Into the Cervical Region Using Different Intraorifice Barriers","volume":"22","author":"Sakall\u0131 B.","year":"2022","journal-title":"BMC Oral Health"},{"issue":"2","key":"e_1_2_15_12_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.joen.2021.10.011","article-title":"Comparison of the Bleaching Efficacy of Different Agents Used for Internal Bleaching: A Systematic Review and Meta\u2010Analysis","volume":"48","author":"Frank A. C.","year":"2022","journal-title":"Journal of Endodontics"},{"issue":"4","key":"e_1_2_15_13_1","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/iej.13711","article-title":"Present Status and Future Directions\u2010Managing Discoloured Teeth","volume":"55","author":"Kahler B.","year":"2022","journal-title":"International Endodontic Journal"},{"key":"e_1_2_15_14_1","first-page":"59","article-title":"Regulation (EC) No 1223\/2009 of the European Parliament and of the Council of 30 November 2009 on Cosmetic Products","volume":"342","author":"European Commission","year":"2009","journal-title":"Official Journal of the European Union"},{"key":"e_1_2_15_15_1","volume-title":"Identification of Substances of Very High Concern (SVHC): Sodium Perborate and Other Borate Compounds","author":"European Chemicals Agency","year":"2008"},{"key":"e_1_2_15_16_1","volume-title":"Opinion on Hydrogen Peroxide, in Its Free Form or When Released, in Oral Hygiene Products and Tooth Whitening Products","author":"Scientific Committee on Consumer Safety","year":"2010"},{"key":"e_1_2_15_17_1","first-page":"29","article-title":"Regulation (EU) 2019\/831 of 22 May 2019 |ANNEXES II, III and V to Regulation (EC) No 1223\/2009 of the European Parliament and of the Council on Cosmetic Products","volume":"137","author":"European Commission","year":"2019","journal-title":"Official Journal of the European Union"},{"issue":"7","key":"e_1_2_15_18_1","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/j.1365-2591.2004.00829.x","article-title":"An In\u00a0Vitro Comparison of the Bleaching Efficacy of 35% Carbamide Peroxide With Established Intracoronal Bleaching Agents","volume":"37","author":"Lim M. Y.","year":"2004","journal-title":"International Endodontic Journal"},{"issue":"1","key":"e_1_2_15_19_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/00004770-200001000-00006","article-title":"Bleaching Effect of Sodium Percarbonate on Discolored Pulpless Teeth In\u00a0Vitro","volume":"26","author":"Kaneko J.","year":"2000","journal-title":"Journal of Endodontics"},{"key":"e_1_2_15_20_1","doi-asserted-by":"crossref","first-page":"1447459","DOI":"10.3389\/fdmed.2024.1447459","article-title":"In Vitro and Ex\u00a0Vivo Comparison of Reactive Oxygen\u2010Releasing Granules for Internal Tooth Bleaching","volume":"5","author":"Mayer R. M.","year":"2024","journal-title":"Frontiers in Dental Medicine"},{"issue":"5","key":"e_1_2_15_21_1","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1111\/iej.13035","article-title":"Sodium Percarbonate as a Novel Intracoronal Bleaching Agent: Assessment of the Associated Risk of Cervical Root Resorption","volume":"52","author":"Zoya A.","year":"2019","journal-title":"International Endodontic Journal"},{"issue":"5","key":"e_1_2_15_22_1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S0099-2399(06)81299-9","article-title":"Effect of Various Types of Sodium Perborate on the pH of Bleaching Agents","volume":"19","author":"Weiger R.","year":"1993","journal-title":"Journal of Endodontics"},{"issue":"5","key":"e_1_2_15_23_1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1046\/j.1365-2591.2002.00497.x","article-title":"In Vitro Comparison of Different Types of Sodium Perborate Used for Intracoronal Bleaching of Discoloured Teeth","volume":"35","author":"Ari H.","year":"2002","journal-title":"International Endodontic Journal"},{"issue":"6","key":"e_1_2_15_24_1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1111\/j.1365-2591.1994.tb00275.x","article-title":"Radicular Penetration of Hydrogen Peroxide During Intra\u2010Coronal Bleaching With Various Forms of Sodium Perborate","volume":"27","author":"Weiger R.","year":"1994","journal-title":"International Endodontic Journal"},{"issue":"7","key":"e_1_2_15_25_1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/j.1365-2591.2004.00838.x","article-title":"Extraradicular Diffusion of Hydrogen Peroxide and pH Changes Associated With Intracoronal Bleaching of Discoloured Teeth Using Different Bleaching Agents","volume":"37","author":"Lee G. P.","year":"2004","journal-title":"International Endodontic Journal"},{"key":"e_1_2_15_26_1","first-page":"1","volume-title":"Ullmann's Encyclopedia of Industrial Chemistry","author":"Schubert D. M.","year":"2015"},{"issue":"6","key":"e_1_2_15_27_1","doi-asserted-by":"crossref","first-page":"596","DOI":"10.2341\/16-133-C","article-title":"Effectiveness and Impact of the Walking Bleach Technique on Esthetic Self\u2010Perception and Psychosocial Factors: A Randomized Double\u2010Blind Clinical Trial","volume":"42","author":"Bersezio C.","year":"2017","journal-title":"Operative Dentistry"},{"issue":"1","key":"e_1_2_15_28_1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.2341\/17-288-C","article-title":"Color Regression and Maintenance Effect of Intracoronal Whitening on the Quality of Life: RCT\u2010A One\u2010Year Follow\u2010Up Study","volume":"44","author":"Bersezio C.","year":"2019","journal-title":"Operative Dentistry"},{"issue":"4","key":"e_1_2_15_29_1","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.joen.2005.08.018","article-title":"Bleaching Teeth Treated Endodontically: Long\u2010Term Evaluation of a Case Series","volume":"32","author":"Amato M.","year":"2006","journal-title":"Journal of Endodontics"},{"issue":"2","key":"e_1_2_15_30_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1034\/j.1600-9657.2003.00112.x","article-title":"Effect of Internal Bleaching Agents on Dentinal Permeability of Non\u2010Vital Teeth: Quantitative Assessment","volume":"19","author":"Carrasco L. D.","year":"2003","journal-title":"Dental Traumatology"},{"issue":"8","key":"e_1_2_15_31_1","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1111\/j.1365-2842.2004.01298.x","article-title":"Effect of Traditional and Alternative Intracoronal Bleaching Agents on Microhardness of Human Dentine","volume":"31","author":"Chng H. K.","year":"2004","journal-title":"Journal of Oral Rehabilitation"},{"issue":"4","key":"e_1_2_15_32_1","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.joen.2006.08.008","article-title":"Effect of Intracoronal Bleaching Agents on Dentin Microhardness","volume":"33","author":"Oliveira D. P.","year":"2007","journal-title":"Journal of Endodontics"},{"issue":"4","key":"e_1_2_15_33_1","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1002\/jemt.22995","article-title":"Dentin Bond Strength and Nanoleakage of the Adhesive Interface After Intracoronal Bleaching","volume":"81","author":"Cavalli V.","year":"2018","journal-title":"Microscopy Research and Technique"},{"issue":"1","key":"e_1_2_15_34_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/0109-5641(94)90019-1","article-title":"The Effects of Peroxide Bleaching on Composite to Enamel Bond Strength","volume":"10","author":"Dishman M. V.","year":"1994","journal-title":"Dental Materials"},{"issue":"7","key":"e_1_2_15_35_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1177\/154405910208100709","article-title":"Reversal of Compromised Bonding in Bleached Enamel","volume":"81","author":"Lai S. C.","year":"2002","journal-title":"Journal of Dental Research"},{"issue":"5","key":"e_1_2_15_36_1","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1111\/jopr.12303","article-title":"Effect of Delayed Bonding and Antioxidant Application on the Bond Strength to Enamel After Internal Bleaching","volume":"25","author":"K\u0131l\u0131n\u00e7 H. \u0130.","year":"2016","journal-title":"Journal of Prosthodontics"},{"issue":"11","key":"e_1_2_15_37_1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/S0099-2399(79)80091-6","article-title":"External Resorption Associated With Bleaching of Pulpless Teeth","volume":"5","author":"Harrington G. W.","year":"1979","journal-title":"Journal of Endodontics"},{"issue":"9","key":"e_1_2_15_38_1","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/S0099-2399(07)80132-4","article-title":"Histological Characterization of Bleaching\u2010Induced External Root Resorption in Dogs","volume":"17","author":"Rotstein I.","year":"1991","journal-title":"Journal of Endodontics"},{"issue":"6","key":"e_1_2_15_39_1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.2341\/18-023-C","article-title":"Six\u2010Month Follow\u2010Up of the Effect of Nonvital Bleaching on IL\u20101\u03b2 and RANK\u2010L: A Randomized Clinical Trial","volume":"44","author":"Bersezio C.","year":"2019","journal-title":"Operative Dentistry"},{"issue":"9","key":"e_1_2_15_40_1","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1097\/00004770-200109000-00005","article-title":"Cytotoxicity of Intracanal Bleaching Agents on Periodontal Ligament Cells In\u00a0Vitro","volume":"27","author":"Kinomoto Y.","year":"2001","journal-title":"Journal of Endodontics"},{"issue":"2","key":"e_1_2_15_41_1","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/j.1365-2591.2009.01648.x","article-title":"Cytotoxicity and Genotoxicity of Sodium Percarbonate: A Comparison With Bleaching Agents Commonly Used in Discoloured Pulpless Teeth","volume":"43","author":"Fern\u00e1ndez M. R.","year":"2010","journal-title":"International Endodontic Journal"},{"issue":"2","key":"e_1_2_15_42_1","doi-asserted-by":"crossref","first-page":"180","DOI":"10.2341\/24-179-L","article-title":"Effect of Intracoronal Barrier Location on Bleaching Efficacy and Peroxide Diffusion","volume":"51","author":"Rodrigues Pereira M. M.","year":"2026","journal-title":"Operative Dentistry"}],"container-title":["Journal of Esthetic and Restorative Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jerd.70269","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jerd.70269","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jerd.70269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:26:58Z","timestamp":1789025218000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jerd.70269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":41,"alternative-id":["10.1111\/jerd.70269"],"URL":"https:\/\/doi.org\/10.1111\/jerd.70269","archive":["Portico"],"relation":{},"ISSN":["1496-4155","1708-8240"],"issn-type":[{"value":"1496-4155","type":"print"},{"value":"1708-8240","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"assertion":[{"value":"2026-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jerd.70269"}}