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with limited evidence based information in literature about using Strawberry extract for teeth bleaching in patients with extrinsic staining , it is beneficial to evaluate this new material using a randomized controlled clinical trial to test the null hypothesis that this extract will have the same effect as Hydrogen peroxide regarding the bleaching effect and hypersensitivity.
The whitening effect of strawberry is due to the presence of malic acid, which acts as a natural astringent to remove surface discoloration. The ellagic acid content in strawberry is ranging from 0.43 to 4.64 mg/g dry weight. The more amount of ellagic acid will produce more potential OH clusters as a powerful oxidizer thus make the more effective bleaching process. Ellagic acid releases the OH and H radicals which will react with the tooth enamel organic molecules and disrupt the electron conjugation, as well as changing the energy absorption in the tooth enamel organic molecules to form smaller organic molecules with a lighter color. Ellagic acid has an OH cluster, not COOH cluster like any other acids. The electronegativity of the OH group will be easier to break and react with the organic molecules of tooth enamel.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients with extrinsic staining will be treated with strawberry extract. | Experimental |
| |
| patients with extrinsic staining will be treated with Hydrogen peroxide bleaching agent. | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| strawberry extract. | Other | strawberry has a whitening effect due to its content of ellagic and maleic acids. the presence of acidic components namely ascorbic acid may increase the surface energy by removing the surface debris, thereby allowing the citric and maleic acids to penetrate into tooth surface to remove the surface stains. |
| Measure | Description | Time Frame |
|---|---|---|
| Bleaching effect of strawberry extract versus Hydrogen peroxide. | objective assessment for the bleaching effect by spectrophotometer. | immediately , one week and one month after application. |
| Measure | Description | Time Frame |
|---|---|---|
| post operative sensitivity. | Tooth sensitivity is scored according to the VRS verbal Rating scale, where 0=none, 1=mild, 2=moderate, 3=considerable, and 4=severe | immediately after bleaching agent removal , 24 hours after application. |
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Inclusion Criteria:
Participant inclusion criteria:
Tooth inclusion criteria:
yellowing of teeth due to age.
stains due to coffee or tea.
light tetracycline stain.
participant exclusion criteria:
Tooth exclusion criteria:
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