Objectives: The effect of 10% carbamide peroxide or 10% hydrogen peroxide on the surface levels of mercury, silver, tin, and copper of amalgam fillings was tested in vitro with scanning electron microscopy and energy dispersive spectrometric microanalysis.
Study design: Samples of amalgam were treated for 14 and 28 days with either 10% carbamide peroxide or 10% hydrogen peroxide solutions and compared with phosphate buffer controls.
Results: A significant increase in mercury levels occurred after treatment with carbamide peroxide for 14 days (p < 0.01) and 28 days (p < 0.001) and after treatment with hydrogen peroxide for 28 days (p < 0.001). A significant increase in silver levels occurred after treatment with carbamide peroxide for 14 days (p < 0.05) and 28 days (p < 0.01) and subsequent to treatment with hydrogen peroxide for 14 days (p < 0.05) and 28 days (p < 0.001). A significant reduction in tin levels occurred after treatment with hydrogen peroxide for 14 days (p < 0.01) and 28 days (p < 0.001), and after treatment with carbamide peroxide for 28 days (p < 0.01). A significant reduction in copper levels was found after treatment with carbamide peroxide for 14 days (p < 0.05).
Conclusions: It appears that prolonged treatment with bleaching agents may cause microstructural changes in amalgam surfaces, possibly increasing exposure of patients to toxic byproducts.