Effects of a reduced in‐office bleaching protocol with 37.5% hydrogen peroxide on effectiveness and tooth sensitivity: A double‐blind randomized clinical trial

Six-month Follow-up of the Effect of Nonvital Bleaching on IL-1β and RANK-L: A Randomized Clinical Trial

Operative Dentistry ◽

10.2341/18-023-c ◽

2019 ◽

Vol 44 (6) ◽

pp. 581-588 ◽

Cited By ~ 1

Author(s):

C Bersezio ◽

J Estay ◽

M Sáez ◽

F Sánchez ◽

R Vernal ◽

...

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Randomized Clinical Trial ◽

Gingival Crevicular Fluid ◽

Color Change ◽

Double Blind ◽

Time Points ◽

Periodontal Tissues ◽

Significant Difference ◽

Spearman Test

SUMMARY Objectives: It has been reported that bleaching generates an increase in the activity of osteoclasts in vitro. We quantified the RANK-L and IL-1β biomarkers in a double-blind, randomized clinical trial evaluating the in vivo effect of hydrogen peroxide (35%) and peroxide carbamide (37%) six months after whitening. Methods and Materials: Fifty volunteers participated, each with color change in a nonvital tooth. Fifty teeth were randomly divided into two groups (n=25), and the teeth were bleached using either 35% hydrogen peroxide (G1) or 37% carbamide peroxide (G2). Intracoronal bleaching was carried out by a technical “walking bleach” over four sessions. Gingival crevicular fluid samples were collected and used to quantify the IL-1β and RANK-L secreted levels. Samples of six periodontal sites (three vestibular and three palatal) were collected for up to six months (at the beginning of the study [baseline] and at one week, one month, and six months posttreatment). The color change was visually monitored using the Vita Bleached Guide (ΔSGU). Results: Comparing each time to baseline assessment, a significant increase in the levels of IL-1β and RANK-L across time points was detected (p<0.05). The color change was 4 in G1 and G2, and a statistically significant difference (p<0.05) was found at the month time point between the groups. Using the Spearman test, a strong correlation (>0.8) between the IL-1β and RANK-L levels in both groups at all time points was detected. Conclusions: Nonvital bleaching using a technical walking bleach induces an increase in the IL-1β and RANKL production in periodontal tissues, which persists for six months after treatment. Both biomarkers were highly correlated in both groups and at all time points.

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Hydrogen peroxide release kinetics into saliva from different whitening products: a double-blind, randomized clinical trial

Clinical Oral Investigations ◽

10.1007/s00784-010-0491-x ◽

2011 ◽

Vol 16 (1) ◽

pp. 155-163 ◽

Cited By ~ 7

Author(s):

Duarte Nuno da Silva Marques ◽

António Duarte Sola Pereira da Mata ◽

João Miguel Lourenço Silveira ◽

Joana Rita Oliveira Faria Marques ◽

João Pedro de Almeida Rato Amaral ◽

...

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Randomized Clinical Trial ◽

Release Kinetics ◽

Double Blind ◽

Hydrogen Peroxide Release

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Effect of acidity of in-office bleaching gels on tooth sensitivity and whitening: a two-center double-blind randomized clinical trial

Clinical Oral Investigations ◽

10.1007/s00784-017-2083-5 ◽

2017 ◽

Vol 21 (9) ◽

pp. 2811-2818 ◽

Cited By ~ 17

Author(s):

A. D. Loguercio ◽

F. Servat ◽

R. Stanislawczuk ◽

A. Mena-Serrano ◽

M. Rezende ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Double Blind ◽

Tooth Sensitivity ◽

Bleaching Gels

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Comparison of Effectiveness and Sensitivity Using Two In-Office Bleaching Protocols for a 6% Hydrogen Peroxide Gel in a Randomized Clinical Trial

Operative Dentistry ◽

10.2341/16-043-c ◽

2017 ◽

Vol 42 (3) ◽

pp. 244-252 ◽

Cited By ~ 12

Author(s):

P Vildósola ◽

F Vera ◽

J Ramírez ◽

J Rencoret ◽

H Pretel ◽

...

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Randomized Clinical Trial ◽

Absolute Risk ◽

Color Variation ◽

Tooth Sensitivity ◽

Tooth Color ◽

Protocol Group ◽

Group A ◽

Group B

SUMMARY Objective: The aim of this blinded and randomized clinical trial was to compare two application protocols (one 36-minute application vs three 12-minute applications). We then assessed the effectiveness of the bleaching and any increase in sensitivity that was induced by bleaching via a split-mouth design. Methods and Materials: Thirty patients were treated. One group had a half arch of teeth treated with a traditional application protocol (group A: 3 × 12 minutes for two sessions). The other received an abbreviated protocol (group B: 1 × 36 minutes over two sessions). Two sessions were appointed with a two-day interval between them. The tooth color was registered at each session, as well as one week and one month after completing the treatment via a spectrophotometer. This measured L*, a*, and b*. This was also evaluated subjectively using the VITA classical A1-D4 guide and VITA Bleachedguide 3D-MASTER. Tooth sensitivity was registered according to the visual analogue scale (VAS) scale. Tooth color variation and sensitivity were compared between groups. Results: Both treatments changed tooth color vs baseline. The ΔE* = 5.71 ± 2.62 in group A, and ΔE* = 4.93 ± 2.09 in group B one month after completing the bleaching (p=0.20). No statistical differences were seen via subjective evaluations. There were no differences in tooth sensitivity between the groups. The absolute risk of sensitivity reported for both groups was 6.25% (p=0.298). The intensity by VAS was mild (p=1.00). Conclusions: We used hydrogen peroxide (6%) that was light activated with a hybrid LED/laser and two different protocols (one 36-minute application vs three 12-minute applications each for two sessions). These approaches were equally effective. There were no differences in absolute risk of sensitivity; both groups reported mild sensitivity.

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Effectiveness of 6% hydrogen peroxide concentration for tooth bleaching—A double-blind, randomized clinical trial

Journal of Dentistry ◽

10.1016/j.jdent.2015.05.011 ◽

2015 ◽

Vol 43 (8) ◽

pp. 965-972 ◽

Cited By ~ 40

Author(s):

J. Martín ◽

P. Vildósola ◽

C. Bersezio ◽

A. Herrera ◽

J. Bortolatto ◽

...

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Randomized Clinical Trial ◽

Tooth Bleaching ◽

Double Blind

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Efficacy of and Effect on Tooth Sensitivity of In-office Bleaching Gel Concentrations: A Randomized Clinical Trial

Operative Dentistry ◽

10.2341/12-140-c ◽

2013 ◽

Vol 38 (4) ◽

pp. 386-393 ◽

Cited By ~ 56

Author(s):

A Reis ◽

S Kossatz ◽

GC Martins ◽

AD Loguercio

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Side Effects ◽

Randomized Clinical Trial ◽

Color Change ◽

Absolute Risk ◽

Tooth Sensitivity ◽

Bleaching Gels ◽

Shade Guide

SUMMARY With the aim of reducing the side effects of in-office bleaching agents, less-concentrated hydrogen peroxide (HP) gels have been released by manufacturers. We evaluated the tooth sensitivity (TS) and bleaching efficacy (BE) of two HP concentrations in this study. Gels containing 35% and 20% HP (HP35 and HP20, respectively) were applied on teeth of 60 caries-free patients. Color was recorded at baseline and one week after the first and second bleaching sessions using the Vita Classical shade guide. TS was recorded on a 0-4 scale. BE at each weekly recall was evaluated by Kruskall-Wallis and Mann-Whitney tests (α=0.05). Absolute risk of TS and its intensity was evaluated by Fisher exact and Mann-Whitney tests, respectively (α=0.05). After two bleaching sessions, color change of approximately eight tabs was obtained with HP35; whereas, with HP20 it was six tabs (p<0.05). Only 26.7% (HP35) and 16.7% (HP20) of the participants reported TS, and no statistical differences were detected among them. Both in-office bleaching gels showed similar TS intensity, but the 35% HP agent produced faster bleaching.

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Evaluation of At-home Bleaching Times on Effectiveness and Sensitivity with 10% Hydrogen Peroxide: A Randomized Controlled Double-blind Clinical Trial

Operative Dentistry ◽

10.2341/20-104-c ◽

2021 ◽

Author(s):

K Chemin ◽

M Rezende ◽

MC Costa ◽

ADY Salgado ◽

JL de Geus ◽

...

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Repeated Measures ◽

Rating Scale ◽

Double Blind ◽

Tooth Sensitivity ◽

Once Daily ◽

Whitney Test ◽

Mann Whitney Test ◽

At Home

SUMMARY Objectives: The aim of this randomized double-blind controlled clinical trial was to evaluate different protocols for at-home use of 10% hydrogen peroxide in whitening effectiveness and tooth sensitivity. Methods: Seventy-two patients were selected according to the inclusion and exclusion criteria, with the upper central incisors having color A2 or darker according to the Vita Classical scale (VITA Zahnfabrik, Bad Säckingen, Germany) and randomized into two groups: 10% hydrogen peroxide applied once daily for 15 minutes (HP 15) or applied once daily for 30 minutes (HP 30). Bleaching was performed for 14 days in both groups. The color was evaluated before bleaching, during bleaching (1st and 2nd weeks), and 1 month after the bleaching treatment using the Vita Classical, Vita Bleachedguide 3D-MASTER, and Vita Easyshade spectrophotometer (VITA Zahnfabrik). Dental sensitivity was recorded by the patients using the numerical rating scale (0–4) and visual analogue scale (0-10 cm). Color data were evaluated by two-way analysis of variance (ANOVA) of repeated measures (group vs. treatment time). The Mann-Whitney test was performed to contrast the means (α=0.05). Tooth sensitivity was assessed by Fisher’s exact test (p=1.00) and intensity of tooth sensitivity was evaluated by the Mann-Whitney test (α=0.05) for both scales. Results: A significant whitening effect was observed after 2 weeks of bleaching for all color measurements (p=0.01), with no difference between HP 15 and HP 30 (p>0.05). Also, the absolute risk and intensity of tooth sensitivity were similar (47%; p>0.05). Conclusions: The effectiveness and tooth sensitivity of at-home bleaching carried out with 10% hydrogen peroxide applied for 15 minutes or 30 minutes are similar.

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Effect of Daily Usage Time of 4% Hydrogen Peroxide on the Efficacy and Bleaching-induced Tooth Sensitivity: A Single-blind Randomized Clinical Trial

Operative Dentistry ◽

10.2341/20-058-c ◽

2021 ◽

Author(s):

RMO Terra ◽

KL da Silva ◽

L Vochikovski ◽

E Sutil ◽

M Rezende ◽

...

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Patient Satisfaction ◽

Randomized Clinical Trial ◽

Color Change ◽

T Test ◽

Tooth Sensitivity ◽

Anterior Teeth ◽

Single Blind ◽

At Home

Clinical Relevance Although color change was slightly lower in a 3-week 30-minutes/day protocol, than in the 120-minute protocol, this could be compensated by an extra week of bleaching. The advantage of the shorter protocol is the reduced daily application, making the procedure more comfortable for the patients. SUMMARY Objective: Compare the risk/intensity of tooth sensitivity (TS) and color change of a 30-minute vs. the recommended 120-minute application time of 4% hydrogen peroxide (HP) for at-home bleaching. Methods: A single-blind, parallel, randomized clinical trial was conducted with 92 adult patients with caries and restoration-free anterior teeth A2 or darker, randomly allocated to two groups. Bleaching trays containing 4% HP were used for three-weeks. A four-week regimen was also offered to the patients for the 30-min group after the end of the 3-week protocol. The color change was assessed with the Vita Classical (VITA Zahnfabrik, Bad Säckingen, Germany) and Vita Bleachedguide shade guides (VITA Zahnfabrik) and the Vita Easyshade spectrophotometer (VITA Zahnfabrik) at baseline, weekly, and 30 days after the bleaching. The absolute risk and the intensity of TS were assessed daily using the 0-10 visual analogue scale (VAS) and 5-point Numerical Rating Scale (NRS) scale, and patient satisfaction was recorded with a Likert 0-7 scale. Risk of TS (Fisher’s test), intensity of TS in NRS scale (Mann-Whitney test), VAS scale (t-test), and a color change (t-test) were compared. Results: The 30-minute group saw color change of around 1 SGU inferior to the 120-minute group in all-time assessments (p<0.05). After an extra week of bleaching, mean color change was similar (p>0.05). Patient satisfaction was high for both groups (p>0.05). Conclusions: A four-week protocol of at-home dental bleaching with 4% HP for 30 minutes/day whitened teeth similarly to the 120 minutes/day protocol, with low intensity of dental sensitivity and high patient satisfaction.

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