title: The use of QLF to quantify in vitro whitening in a product testing model.
abstract: BACKGROUND
  Professional and consumer interest in whitening products continues to increase against a background of both increased oral health awareness and demand for cosmetic procedures. In the current legal climate, few dentists are providing 'in-office' whitening treatments, and thus many patients turn to home-use products. The most common of these are the whitening toothpastes. Researchers are keen to quantify the effectiveness of such products through clinically relevant trials.
  
  
  OBJECTIVE
  Previous studies examining whitening products have employed a variety of stained substrates to monitor stain removal. This study aimed to quantify the removal of stain from human enamel using a new device, quantitative light-induced fluorescence (QLF). The experimental design follows that of a product-testing model.
  
  
  METHODS
  A total of 11 previously extracted molar teeth were coated with transparent nail varnish leaving an exposed window of enamel. The sound, exposed enamel was subject to a staining regime of human saliva, chlorhexidine and tea. Each of the eleven teeth was subjected to serial exposures of a positive control (Bocasan), a negative control (water) and a test product (Yotuel toothpaste). Following each two-minute exposure QLF images of the teeth were taken (a total of 5 applications). Following completion of one test solution, the teeth were cleaned, re-stained and the procedure repeated with the next solution. QLF images were stored on a PC and analysed by a blinded single examiner. The deltaQ value at 5% threshold was reported. ANOVA and paired t-tests were used to analyse the data.
  
  
  RESULTS
  The study confirmed the ability of QLF to longitudinally quantify stain reduction from human enamel. The reliability of the technique in relation to positive and negative test controls was proven. The positive control had a significantly (alpha = 0.05) higher stain removal efficacy than water (p = 0.023) and Yotuel (p = 0.046). Yotuel was more effective than water (p = 0.023).
  
  
  CONCLUSIONS
  The research community, the practicing clinician and the consumer all require sound product evaluation data. The use of human enamel specimens may offer more relevant clinical data. QLF has been designed as an in vivo device. Further development of the technique should permit in vivo clinical whitening trials.
authors.affiliation: The University of Liverpool, Department of Clinical Dental Sciences. ipretty@liv.ac.uk
authors.forename: I A
authors.initials: IA
authors.lastname: Pretty
authors.forename: W M
authors.initials: WM
authors.lastname: Edgar
authors.forename: S M
authors.initials: SM
authors.lastname: Higham
mesh_terms: D000704:Analysis of Variance; D001881:Borates / Q000627:therapeutic use; D003743:Dental Enamel; D005453:Fluorescence; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008422:Materials Testing / Q000379:methods; D008963:Molar; D009067:Mouthwashes / Q000627:therapeutic use; D023861:Photography, Dental; D011358:Product Surveillance, Postmarketing / Q000379:methods*; D015203:Reproducibility of Results; D013644:Tartrates / Q000627:therapeutic use; D014073:Tooth Bleaching / Q000379:methods*; D014075:Tooth Discoloration / Q000628:therapy*; D014100:Toothpastes / Q000627:therapeutic use*
chemical_list: D001881:Borates; D009067:Mouthwashes; D013644:Tartrates; D014100:Toothpastes; C080535:Amosan