In-Office Tooth Bleaching for Adolescents Using Hydrogen Peroxide-Based Gels: Clinical Trial

Abstract The aim of the present study was to evaluate colorimetric changes and tooth sensitivity in adolescents and young patients submitted to tooth bleaching with 20% and 35% hydrogen peroxide. A randomized, controlled, clinical trial was conducted with 53 patients aged 11 to 24 years who were allocated to groups based on the use of the following commercial products: Whiteness HP - FGM® (35% hydrogen peroxide); Whiteness HP Blue Calcium - FGM® (35% hydrogen peroxide); and Whiteness HP Blue Calcium - FGM® (20% hydrogen peroxide). After the bleaching procedure, the visual analog scale was used to measure tooth sensitivity and the Vita Classical Shade guide was used to determine changes in tooth color. Statistical analysis involved the Friedman, Kruskal-Wallis and Student-Newman-Keuls tests, with p≤0.05 considered indicative of statistical significance. The addition of calcium contributed to a reduction in tooth sensitivity, especially when the lower concentration of hydrogen peroxide (20%) was used. Tooth sensitivity occurred in a transitory way and did not influence the tooth bleaching process. Significant differences in color were found after each of the two bleaching sessions. In-office tooth bleaching was considered an effective method for adolescents and young adults. Further studies in this population are necessary in order to fully evaluate the effects of bleaching in young teeth.

Download Full-text

Combination of at-home and in-office bleaching techniques: case series

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720200003620190149 ◽

2021 ◽

Vol 69 ◽

Author(s):

Marcela Alvarez FERRETTI ◽

Matheus KURY ◽

Beatriz Curvello de MENDONÇA ◽

Marcelo GIANNINI ◽

Vanessa CAVALLI ◽

...

Keyword(s):

Hydrogen Peroxide ◽

Case Series ◽

Tooth Bleaching ◽

Central Incisor ◽

Carbamide Peroxide ◽

Tooth Sensitivity ◽

Tooth Color ◽

Shade Guide ◽

At Home

ABSTRACT Tooth bleaching is one of the most conservative aesthetic techniques. At-home and in-office bleaching may be performed, as well as the combination of both techniques. As this combination may be done in different manners, distinct orders of combinations were proposed in this report. A 24 years-old man, whose upper central incisor and canine shades were A2 and A3 respectively, was initially treated by chair-side with 40-min application of 40% hydrogen peroxide (HP) for two sessions. Afterwards, an two-week overnight at-home bleaching was performed with 10% carbamide peroxide (CP). The shade of upper central incisors changed to 1M1 and canine was B1. Conversely, a 30 years-old woman was firstly conducted with at-home bleaching (overnight 4-weeks 10% CP) and, subsequently, with a single appointment of in-office bleaching for 45 minutes (35% HP). The shade of her upper central incisor changed from A1 to 0.5M1 and the upper canine from A3 to B1. The VITA classical (A1-D4) shade guide and VITA Bleached guide 3D-MASTER were used to determine the tooth color during the treatments. In both bleaching treatments, patients reported no significant tooth sensitivity and the final outcomes met their expectation.

Download Full-text

Combination of strontium chloride and photobiomodulation in the control of tooth sensitivity post-bleaching: A split-mouth randomized clinical trial

PLoS ONE ◽

10.1371/journal.pone.0250501 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250501

Author(s):

Danielle da Silva Pompeu ◽

Brennda Lucy Freitas de Paula ◽

Antônia Patricia Oliveira Barros ◽

Samir Costa Nunes ◽

Alexandra Melo Pingarilho Carneiro ◽

...

Keyword(s):

Clinical Trial ◽

Near Infrared ◽

Laser System ◽

Tooth Bleaching ◽

Infrared Light ◽

Controlled Clinical Trial ◽

Strontium Chloride ◽

Tooth Sensitivity ◽

The Individual

Objective This split-mouth randomized controlled clinical trial assessed the effect of 10% strontium chloride in combination with photobiomodulation (PBM) for the control of tooth sensitivity (TS) post-bleaching. Methods The upper/lower, right and left quadrants of fifty volunteers were randomized and allocated to four groups (n = 25): PLACEBO—placebo gel + simulation of PBM; Placebo + PBM; STRONTIUM—10% strontium chloride + simulation of PBM; and PBM + STRONTIUM—10% strontium chloride + PBM. All groups received tooth bleaching treatment with 35% hydrogen peroxide. For the PBM treatment, the laser tip was positioned in the apical and cervical regions of the teeth bleached in the respective hemi-arch. The laser system was operated in continuous mode, using 1.7 J of energy. A dose of 60 J/cm2 was applied to each point for 16 seconds under 808 nm near-infrared light (100mW of power), with a point area of 0.028 cm2. TS was assessed during a 21-day follow-up, using the modified visual analogue scale. Results In the intragroup assessment, the Friedman test indicated that PBM + STRONTIUM promoted the greatest reduction in TS after the second week of treatment (p ≤ 0.05). The Wilcoxon-Mann-Whitney test indicated that the groups Placebo + PBM, STRONTIUM, and STRONTIUM + PBM did not differ statistically (p ≥ 0.05) in the first and third weeks of treatment The group PLACEBO exhibited the greatest TS in the first three days after each bleaching session. Conclusion The combination of 10% strontium chloride with PBM was effective in reducing post-bleaching TS; however, the combination of 10% strontium chloride with PBM was effective in reducing post-bleaching TS; however, it did not differ from the individual use of Placebo + PBM or STRONTIUM groups assessed after 21 days of follow-up.

Download Full-text

Longevity, Esthetic Perception, and Psychosocial Impact of Teeth Bleaching by Low (6%) Hydrogen Peroxide Concentration for In-office Treatment: A Randomized Clinical Trial

Operative Dentistry ◽

10.2341/15-335-c ◽

2017 ◽

Vol 42 (1) ◽

pp. 41-52 ◽

Cited By ~ 22

Author(s):

E Fernández ◽

C Bersezio ◽

J Bottner ◽

F Avalos ◽

I Godoy ◽

...

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Randomized Clinical Trial ◽

Positive Impact ◽

Color Difference ◽

Psychosocial Impact ◽

Bleaching Procedure ◽

Significant Difference ◽

Before And After ◽

Shade Guide

SUMMARY Objective: The aim was to evaluate the color longevity after nine months of in-office bleaching with gel (6% hydrogen peroxide), to compare this to a control concentration of 35% in a split-mouth study model, and to assess the dental confidence and psychosocial impact on patients. Methods and Materials: Twenty-seven patients were assessed at the nine-month recall. The bleaching procedure with 6% or 35% hydrogen peroxide gel was performed randomly in the upper hemi-arch of each patient. The color was measured at baseline and at one week, one month, and nine months after the procedure, using the Vita Easyshade spectrophotometer, the Vita classical shade guide organized by value, and Vita Bleach Guide 3DMaster. Moreover, two surveys, OHIP-Esthetics and PIDAQ, were used to assess the esthetic self-perception and psychosocial impact of the bleaching procedure. During the nine-month recall, the color was assessed before and after dental prophylaxis. Results: Twenty-seven patients participated in the nine-month recall. There was a significant difference in ΔE between the two groups at all times assessed (p<0.011). The ΔL, Δa, and Δb showed a difference between the two groups at all times assessed (p<0.038), except for ΔL from the baseline vs nine-month after prophylaxis value (p>0.20). There was no significant difference in ΔSGU at all times (p>0.05). There was a significant difference in OHIP-Esthetics and PIDAQ sums compared with baseline scores (p<0.03). Conclusion: The two compounds remained effective at nine months, with a slight rebound of color, and maintained their objective color difference but not the subjective color difference. Patients were satisfied with the bleaching procedure, and this had a positive impact on esthetic perception and a positive psychosocial impact at the nine-month recall.

Download Full-text

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.

Download Full-text

INFLUENCE OF DIFFERENT METHODS OF WHITENING ON THE STRUCTURE OF HARD TISSUES OF TEETH

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.19.4.136 ◽

2019 ◽

Vol 19 (4) ◽

pp. 136-140

Author(s):

A.V. Lemeshko ◽

V.V. Kovalenko ◽

Y.Y. Vodoriz ◽

I.M. Tkachenko

Keyword(s):

Hydrogen Peroxide ◽

Negative Impact ◽

Tooth Bleaching ◽

Chemical Components ◽

Chemical Agent ◽

Common Procedure ◽

Tooth Color ◽

Bleaching Procedure ◽

Direct Restoration ◽

Hard Tissues

Nowadays 74% of people believe that an imperfect smile has a negative impact on their careers, and 92% believe that it is one that contributes to success in their personal lives. The desire of patients to have an aesthetically perfect smile has always aroused great interest from dentists and has led to the active development of such a trend in aesthetic dentistry, such as teeth whitening. The color of the crowns of teeth and the inherent color characteristics play an important role in the perception of the appearance of the person, the formation of his image and self-esteem. Therefore, they affect the quality of life of a person due to his dental health. There are 5 main treatments for altered teeth: microabrasion, teeth whitening, direct restoration of composites, veneering, restoration of ceramic and metal-ceramic crowns. In recent years, conservative treatments, which include different types of whitening, have been favored to achieve maximum aesthetic results in the correction of altered teeth. For whitening, a considerable number of different remedies are offered that allow the tooth color to change relatively quickly. Nowadays, the world of dental practice is increasingly paying attention to the development of more cost-effective methods that meet the aesthetic needs of patients. The most common procedure for improving the color of the crowns of teeth today is whitening, which does not affect the reduction of the volume of hard tissues of the tooth. Teeth whitening is a restoration of the natural color of the teeth with the application of a chemical agent that oxidizes the organic pigments of the hard tissues of the tooth. Bleaching process is possible due to the ability of the active chemical components ( carbamide peroxide, hydrogen peroxide) to penetrate into enamel and dentin to all parts of the tooth. These substances break down into oxygen radicals, which destroy the colored pigments, the formation of which leads to discoloration of the teeth. The structure of the tooth does not change. Nowadays, home, professional and combined teeth whitening are widely used. The effect of bleaching is analyzed using a scanning electron microscope. Most studies did not report significant changes in the surface morphology of enamel after bleaching with low concentrations of urea peroxide and hydrogen peroxide. Similarly, studies evaluating the effects of higher concentrations of hydrogen peroxide (35%) and carbamidee peroxide (35%) have also reported no significant changes in the morphology of the enamel surface. In general, it is obvious that tooth sensitivity is a common clinical side effect after a teeth whitening procedure. However, the sensitivity is transient and disappears shortly after the bleaching procedure has been stopped.

Download Full-text

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.

Download Full-text

Comparison of Whitening Dentifrices on the Effectiveness of In-office Tooth Bleaching: A Double-blind Randomized Controlled Clinical Trial

Operative Dentistry ◽

10.2341/17-333-c ◽

2019 ◽

Vol 44 (2) ◽

pp. 138-145 ◽

Cited By ~ 3

Author(s):

N Jiang ◽

C Zhang ◽

C Agingu ◽

T Attin ◽

H Cheng ◽

...

Keyword(s):

Clinical Trial ◽

Tooth Bleaching ◽

Controlled Clinical Trial ◽

Randomized Controlled Clinical Trial ◽

Double Blind ◽

Tooth Color ◽

Color Changes ◽

Randomized Controlled ◽

Anterior Teeth ◽

Repeated Analysis

SUMMARY Objectives: To investigate the effect of whitening dentifrices on the effectiveness of in-office tooth bleaching. Methods and Materials: A double-blind randomized controlled clinical trial was performed. The participants were randomly allocated into three groups according to the different dentifrices used during this clinical trial: regular dentifrice (group C), conventional whitening dentifrice (group CW), and whitening dentifrice containing blue covarine (group CU). All participants received in-office tooth bleaching for the maxillary anterior teeth (two sessions conducted at a one-week interval). Tooth color was measured with a spectrophotometer at baseline (T1), after the first bleaching session (T2), after the second bleaching session (T3); one week after the completion of in-office bleaching (T4); and three weeks after the completion of in-office bleaching (T5). The data were statistically analyzed through repeated analysis of variance and the Tukey test (α=0.05). Results: Sixty participants completed the study (n=20 per group). At T3, group CU exhibited the lowest ΔE values (p=0.008). The ΔE values increased from T4 to T5 in the CW and CU groups, whereas a decrease in ΔE values was observed for group C. Conclusions: The use of a whitening dentifrice containing blue covarine during in-office bleaching reduced color changes. After tooth bleaching, brighter tooth colors were observed in the participants who brushed with whitening dentifrices compared to those who brushed with a regular dentifrice.

Download Full-text

Impact of Microabrasion on the Effectiveness of Tooth Bleaching

Brazilian Dental Journal ◽

10.1590/0103-6440201601494 ◽

2017 ◽

Vol 28 (5) ◽

pp. 612-617 ◽

Cited By ~ 2

Author(s):

Camila Evelyn Perete-de-Freitas ◽

Paula Damasceno Silva ◽

André Luis Faria-e-Silva

Keyword(s):

Hydrogen Peroxide ◽

Color Change ◽

T Test ◽

Tooth Bleaching ◽

Repeated Measure ◽

Tooth Color ◽

Color Changes ◽

Bleaching Procedure ◽

To Receive ◽

Paired T Test

Abstract The aim of the present study was to evaluate the effect of prior microabrasion on the teeth color change and tooth bleaching effectiveness. Eight sound molars were mesio-distally sectioned and the halves were randomly allocated to receive enamel microabrasion or non-abrasion (control) in one of surfaces (buccal or lingual), while the remaining surface received the other treatment. The tooth color on baseline was evaluated by spectrophotometer (CieL*a*b system). After the microabrasion procedure, the tooth color was measured again. Following, the specimens were bleached with 35% hydrogen peroxide for two sessions with one-week interval. The color was re-evaluated 7 days after each section and 30 days after the second session. The effect of enamel microabrasion on color changes was evaluated by paired T-test. Deltas L*, a*, b*, and E were calculated and data submitted to 2-way repeated measure ANOVA followed by Tukey`s test. Paired T-test was also used to assess possible differences on the ultimate color achieved after tooth bleaching. Enamel microabrasion reduced the lightness and increased the redness of specimens. Specimens that received microabrasion presented higher values of ∆L* than control after each bleaching procedure; and higher ∆a* after the 2nd bleaching session. However, the prior enamel microabrasion did not affect the ultimate values of color parameters. Despite enamel microabrasion have modified the tooth color, this procedure did not affect the ultimate results achieved with tooth bleaching using a high-concentrated hydrogen peroxide.

Download Full-text

Clinical Efficacy of Four In-Office Vital Tooth Bleaching Products with Different Concentrations of Hydrogen Peroxide: A Randomized, Quadruple-Blind Clinical Trial

Applied Sciences ◽

10.3390/app10134650 ◽

2020 ◽

Vol 10 (13) ◽

pp. 4650

Author(s):

Marta Peydro-Herrero ◽

José María Montiel-Company ◽

Carlos Labaig-Rueda ◽

María Fernanda Solá-Ruiz ◽

Rubén Agustín-Panadero ◽

...

Keyword(s):

Clinical Trial ◽

Hydrogen Peroxide ◽

Tooth Bleaching ◽

High Concentration ◽

Tooth Color ◽

Color Changes ◽

Group 4 ◽

Anterior Teeth ◽

Group 3 ◽

Group 2

Background: Dental bleaching has become an everyday procedure for treating teeth presenting discoloration, as a therapy on its own or as a part of restorative dentistry. The most widely used bleaching products available for vital teeth are hydrogen peroxide and carbamide peroxide, marketed as a range of products adapted to different treatment modes. The purpose of the study was to evaluate the clinical whitening efficacy of four high-concentration bleaching products for vital teeth applied in single in-office sessions. Methods: This clinical trial included 40 patients divided into four groups according to the concentration of the hydrogen peroxide-based (HP) product used (Group 1: HP 35%; Group 2: HP 37.5%; Group 3: HP 38%; Group 4: HP 40%). Each patient received one in-office whitening treatment of maxillary and mandibular anterior teeth (incisors, canines, and premolars), making a total of 791 teeth. The color changes produced in central incisors and canines were measured. Results: All groups underwent significant color changes from initial to final evaluations for color parameters L*, a*, and b*. No significant differences between the four groups were found for either the L* or a* parameters. Analysis of the b* parameter found significant differences between the HP 38% group and the HP 35% group. No significant differences in ΔE were found between the four groups (ANOVA p = 0.174). HP 38% obtained the highest ΔE (4.63), while HP 40% obtained 4.01. Conclusions: A single in-office whitening session, regardless of the bleaching product used, modifies tooth color effectively. All four products achieved increases in the L* parameter and significant reductions in parameters a* and b*. The ΔE did not show significant differences between the four groups. In-office whitening with high concentration hydrogen-peroxide-based products was found to be an effective treatment for moderate and severe dental discoloration.

Download Full-text

Preemptive Use of Piroxicam on Tooth Sensitivity Caused By In-Office Bleaching: A Randomized Clinical Trial

Brazilian Dental Journal ◽

10.1590/0103-6440201902762 ◽

2019 ◽

Vol 30 (5) ◽

pp. 498-504

Author(s):

Aline de Carvalho Peixoto ◽

Savil Costa Vaez ◽

Karla DaniellyAlves Soares ◽

Lorena Fernandes Ferreira ◽

Alessandro Dourado Loguercio ◽

...

Keyword(s):

Clinical Trial ◽

Single Dose ◽

Tooth Bleaching ◽

Treatment Sequence ◽

Time Data ◽

Double Blind ◽

Tooth Sensitivity ◽

Color Changes ◽

Bleaching Procedure ◽

Assessment Time

Abstract This clinical trial evaluated the effect of preemptive use of the non-steroidal anti-inflammatory drug piroxicam in a single dose 30 min prior to in-office bleaching on the prevention of tooth sensitivity (TS) reported by patients. Fifty patients were submitted to two sessions of in-office tooth bleaching with 35% hydrogen peroxide used for 2 sessions, each consisting of a single 45-min application, with an interval of 7 days between session. Thirty minutes prior to the procedure, the patient randomly received a single dose of piroxicam (200 mg) or placebo in a double-blind, randomized, crossover design. The TS was evaluated using verbal rate (VRS) and visual analog (VAS) scales during the bleaching procedure and at 24 h after each session. The color changes were assessed by the Vita Bleachedguide scale 1 week after each bleaching session. Risk of TS was calculated from the VRS and analyzed by the McNemar test, while the level of TS was analyzed by the Mann-Whitney test. For the VAS, t-tests were used to compare data from the treatments at each assessment time. Data regarding color changes were subjected to Wilcoxon and Mann-Whitney tests (α=0.05). The preemptive administration of piroxicam did not affect the risk and level of TS compared to placebo, irrespective of the assessment time. The treatment sequence did not affect bleaching effectiveness. In conclusion, the administration of a single dose of piroxicam prior to in-office tooth bleaching was unable to significantly reduce the risk and level of TS.

Download Full-text