Efficacy of carbamide peroxide with and without additive vegetative enzyme

Background: Considering the adverse effects of peroxide on vital teeth, alternatives include lowering chemical concentrations and adding natural vegetative enzymes. These enzymes, derived from plants, may enhance and accelerate the bleaching effect when combined with traditional agents, and they are anticipated to be less harmful when used on vital teeth. Aim: This study aimed to compare the bleaching efficacy of two different concentrations of carbamide peroxide with and without the addition of bromelain on artificially stained human enamel. Materials and Methods: Thirty-two extracted maxillary anterior teeth were artificially stained and divided into two main groups ( n = 16 each) based on the concentration of carbamide peroxide used: Group I (16%) and Group II (22%). Each group was further divided into two subgroups depending on the use of bromelain: Group IA – 16% carbamide peroxide alone, Group IB – 16% carbamide peroxide with bromelain, Group IIA – 22% carbamide peroxide alone, and Group IIB – 22% carbamide peroxide with bromelain. Each tooth was sectioned into mesiodistal halves; one half was treated with carbamide peroxide alone and the other with a combination of carbamide peroxide and bromelain. Postbleaching, color changes were assessed using a spectrophotometer. Results: The mean ΔE values observed in Group IB (23.88 ± 1.74) and Group IIB (26.43 ± 1.46) were significantly greater compared to Group IA (19.10 ± 1.86) and Group IIA (24.25 ± 1.77), indicating enhanced bleaching efficacy with the addition of bromelain. Conclusion: Bromelain incorporated into carbamide peroxide enhanced the bleaching efficacy on stained human enamel more effectively than carbamide peroxide alone.