scholarly journals Combined Bleaching Technique Using Low and High Hydrogen Peroxide In-Office Bleaching Gel

2016 ◽  
Vol 41 (4) ◽  
pp. 388-396 ◽  
Author(s):  
M Rezende ◽  
L Ferri ◽  
S Kossatz ◽  
AD Loguercio ◽  
A Reis
Keyword(s):  
Hydrogen Peroxide ◽  
Repeated Measures ◽  
Color Change ◽  
Absolute Risk ◽  
Color Stability ◽  
Fisher Exact Test ◽  
High Hydrogen ◽  
Significant Difference ◽  
Shade Guide ◽  
At Home

SUMMARY Objectives: The aim of this study was to evaluate the efficacy, color stability, risk, and intensity of tooth sensitivity (TS) of combined bleaching techniques performed with 20% or 35% hydrogen peroxide for an in-office protocol. Methods: Thirty patients were randomly divided into two groups and submitted to a single 45-minute in-office bleaching session with 35% hydrogen peroxide or 20% hydrogen peroxide. At-home bleaching was performed with 10% carbamide peroxide for two hours daily over the course of two weeks. The color was evaluated with the value-oriented shade guide Vita Classical at different periods up to 12 months after bleaching. Patients recorded the intensity of TS using a five-point verbal scale. Color change data were submitted to a two-way repeated-measures analysis of variance and Tukey test (α=0.05). The absolute risk and intensity of TS were compared with the Fisher exact test and Mann-Whitney test, respectively (α=0.05). Results: On average, an effective and similar whitening of three units in shade guide was observed for both groups, which remained stable for 12 months. When both protocols were compared, the one with hydrogen peroxide 35% showed a higher risk (p=0.02) and intensity of TS (p=0.04). In regard to the TS intensity, no significant difference was observed up to 48 hours after in-office bleaching (p=0.09) and during the at-home bleaching phase of the study (p=0.71). Conclusion: The combined bleaching technique using at-home bleaching associated with in-office bleaching was effective and stable over the course of 12 months, regardless of the concentration of the hydrogen peroxide used for in-office bleaching. However, the protocol with 20% hydrogen peroxide produced lower risk and intensity of TS.

Effectiveness of and Dental Sensitivity to At-home Bleaching With 4% and 10% Hydrogen Peroxide: A Randomized, Triple-blind Clinical Trial

2018 ◽  
Vol 43 (3) ◽  
pp. 232-240 ◽  
Author(s):  
K Chemin ◽  
M Rezende ◽  
AD Loguercio ◽  
A Reis ◽  
S Kossatz
Keyword(s):  
Hydrogen Peroxide ◽  
Rating Scale ◽  
Color Change ◽  
Absolute Risk ◽  
Tooth Sensitivity ◽  
Whitney Test ◽  
Mann Whitney Test ◽  
The Absolute ◽  
Shade Guide ◽  
At Home

SUMMARY Objectives: To evaluate the risk for and intensity of tooth sensitivity and color change of at-home dental bleaching with 4% and 10% hydrogen peroxide (HP). Methods: For this study, 78 patients were selected according to the inclusion and exclusion criteria and randomized into two groups: HP 4 (White Class 4%, FGM) and HP 10 (White Class 10%, FGM). In both groups, the at-home bleaching was performed for a period of 30 minutes twice a day for two weeks. The color was assessed by Vita Classical, Vita Bleachedguide 3D-MASTER and spectrophotometer Vita Easyshade (Vita Zahnfabrik) at baseline, during bleaching (first and second weeks) and after bleaching (one month). Patients recorded their tooth sensitivity using a numeric rating scale (0-4) and visual analog scale (0-10). Data from color change (DeltaE data) was submitted to two-way analysis of variance. The color change data in Delta SGU from the two shade guide units were compared with the Mann Whitney test. The risk of tooth sensitivity was evaluated by χ2 test and the intensity of tooth sensitivity from both scales was evaluated by a Mann-Whitney test (α=0.05). Results: The absolute risk and intensity of tooth sensitivity was higher in the group that used HP 10 than the one that used HP 4. Data from change in the number of shade guide units and color variation after one month of bleaching for both groups showed significant whitening, with no difference between groups. Conclusions: At-home bleaching is effective with 4% and 10% HP concentrations, but 10% HP increased the absolute risk and intensity of tooth sensitivity during at-home bleaching.

Sonic Activation of a Desensitizing Gel Prior to In-Office Bleaching

2021 ◽  
Author(s):  
VP Lima ◽  
LM da Silva ◽  
A Nuñez ◽  
A Armas-Vega ◽  
AD Loguercio ◽  
...  
Keyword(s):  
Sodium Fluoride ◽  
Rating Scale ◽  
Color Change ◽  
Absolute Risk ◽  
Potassium Nitrate ◽  
Controlled Clinical Trial ◽  
Significant Difference ◽  
The Absolute ◽  
Sonic Activation ◽  
Shade Guide

SUMMARY This double-blind, randomized, and controlled clinical trial evaluated the effect of sonic activation during the application of a desensitizing agent (DA) containing 5% potassium nitrate and 2% sodium fluoride on the occurrence of tooth sensitivity (TS) associated with in-office dental bleaching. Treatment with or without sonic activation of the DA was randomly assigned to one-half of the maxillary teeth of 34 patients in a split-mouth design. On the side without sonic activation (noSA), the DA was applied and maintained in contact with the teeth for 10 minutes. On the sonic activation side (SA), the DA was activated 30 seconds per tooth. The DA application was followed by application of 35% hydrogen peroxide in two bleaching sessions separated by a one-week interval. The primary outcome was the absolute risk of TS, recorded using a numeric rating scale and a visual analog scale. Color was evaluated with a digital spectrophotometer and a value-oriented shade guide. No significant difference between treatments was observed in the absolute risk of TS, which occurred in 93% (p=1.00) of both noSA and SA groups. The TS intensity was higher in the 24-hour interval after sessions, for both treatments, without differences between them. There was no difference in the color change for the treatments, with the average change in number of shade guide units of the Vita Classical scale of 6.35 for both (p=0.87). Sonic activation of DA containing 5% potassium nitrate and 2% sodium fluoride did not reduce the absolute risk and intensity of TS associated with in-office bleaching.

Preventive Use of a Resin-based Desensitizer Containing Glutaraldehyde on Tooth Sensitivity Caused by In-office Bleaching: A Randomized, Single-blind Clinical Trial

2018 ◽  
Vol 43 (5) ◽  
pp. 472-481 ◽  
Author(s):  
ACS Diniz ◽  
SNL Lima ◽  
RRdJ Tavarez ◽  
AH Borges ◽  
SCS Pinto ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Color Change ◽  
Absolute Risk ◽  
Tooth Whitening ◽  
Tooth Sensitivity ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Numerical Rating ◽  
Shade Guide ◽  
Single Blind

SUMMARY Objective: To evaluate the risk and intensity of bleaching-induced tooth sensitivity (TS) after in-office bleaching following topical application of a resin-based glutaraldehyde desensitizer. Methods: Thirty-three patients were randomly assigned to the experimental (Gluma Desensitizer Liquid, Heraeus Kulzer, Hanau, Germany) and placebo groups. The placebo or Gluma Desensitizer Liquid was applied for one minute prior to application of an in-office bleaching gel. Bleaching was performed with 35% hydrogen peroxide gel (three applications × 15 minutes each) over two sessions, one week apart. The color of the anterior teeth was evaluated before and 21 days after treatment using the VITA Classical shade guide, Bleachedguide 3D, and Easyshade spectrophotometer. TS during and after the bleaching was recorded according to the visual analog (VAS) and numerical rating (NRS) scales. All data were submitted to statistical analysis (α=0.05). Results: There was no significant difference in absolute risk or intensity of TS between the two groups (risk and VAS, p=0.93 and 0.31, respectively; NRS, p≥0.45). At the end of the bleaching protocol, tooth whitening was observed in both groups, as evident from color change in shade guide units (ΔSGU, 4.1-7.1; both guides) and overall color change (ΔE, 7.4-9.3 units); however, there were no significant differences in whitening between the two groups (p>0.11). Conclusion: Gluma Desensitizer Liquid was not able to reduce the risk or intensity of TS. Bleaching efficacy was not affected by application of the desensitizer.

scholarly journals Effectiveness and Impact of the Walking Bleach Technique on Esthetic Self-perception and Psychosocial Factors: A Randomized Double-blind Clinical Trial

2017 ◽  
Vol 42 (6) ◽  
pp. 596-605 ◽  
Author(s):  
C Bersezio ◽  
J Martin ◽  
F Peña ◽  
M Rubio ◽  
J Estay ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Psychosocial Factors ◽  
Color Change ◽  
Carbamide Peroxide ◽  
Self Perception ◽  
Dental Esthetics ◽  
Tooth Discoloration ◽  
Significant Difference ◽  
The Impact ◽  
Shade Guide

SUMMARY Objective: This trial evaluates the impact of psychosocial and esthetic self-perceptions of patients undergoing nonvital tooth bleaching using the walking bleach technique. We also assessed the clinical effectiveness of bleaching tooth discoloration. Methods: Fifty volunteers with nonvital tooth discoloration were enrolled. Teeth were randomized into two groups: 35% hydrogen peroxide (n=25) and 37% carbamide peroxide (n=25). Intracoronal bleaching was performed over four sessions using the walking bleach technique. Tooth color was evaluated at each session to measure total color variation. The shade guide was arranged from highest (B1) to lowest (C4) values to assess the color and calculate the color change in the number of shade guide units. Subjective and objective assessments were compared with the tooth counterpart. Esthetic self-perception and psychosocial factors were assessed before and after treatment. Results: Color change was 15.48<5.17 for hydrogen peroxide and 14.02<4.85 for carbamide peroxide. There was no significant difference at any time point (p>0.05) except at sessions 3 and 4 (p<0.05). Overall, whitened teeth values were similar to those of counterpart teeth (p>0.05). There was a decrease in Oral Health Impact Profile and Psychosocial Impact of Dental Esthetics questionnaire scores after treatment compared with baseline (p<0.05). Conclusion: The walking bleach technique was highly effective on nonvital teeth and had a positive effect on self-esthetic perception and psychological impact for the patients.

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

2013 ◽  
Vol 38 (4) ◽  
pp. 386-393 ◽  
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.

Assessment of Peroxide in Saliva During and After At-home Bleaching With 10% Carbamide and Hydrogen Peroxide Gels: A Clinical Crossover Trial

2020 ◽  
Vol 45 (4) ◽  
pp. 368-376
Author(s):  
MC Mailart ◽  
PA Sakassegawa ◽  
CRG Torres ◽  
RM Palo ◽  
AB Borges
Keyword(s):  
Hydrogen Peroxide ◽  
Repeated Measures ◽  
Pearson Correlation ◽  
Salivary Flow ◽  
Toxic Dose ◽  
Repeated Measures Analysis ◽  
Significant Difference ◽  
Pearson Correlation Test ◽  
Mouth Rinsing ◽  
At Home

Clinical Relevance This study suggests that at-home bleaching systems are safe in relation to toxicity based on peroxide levels in saliva since the amount of peroxide potentially ingested is much lower than the estimated toxic dose. SUMMARY Objectives: This study evaluated the presence of peroxide in saliva using at-home bleaching systems containing hydrogen peroxide (HP) and carbamide peroxide (CP) with a prefilled tray (PT) or conventional tray (CT). Methods and Materials: Participants received bleaching treatments after the sequence randomization (n=10): PT-HP/OpalescenceGo10%; CT-HP/WhiteClass10%; and CT-CP/OpalescencePF10%. Saliva was collected at the following times: baseline; at 1, 5, 15, and 30 minutes after administration; and at 3, 5, and 8 minutes after the tray was removed. Colorimetric analysis using analytic spectrophotometry was performed. The salivary flow (SF) was monitored during use of trays. Data about peroxide concentration (PC) were submitted to repeated-measures analysis of variance and Tukey tests (5%), and toxic dose was calculated based on body weight. The relation between SF and PC was verified with the Pearson correlation test. Results: There was a significant difference for bleaching (p=0.0001) and time (p=0.0003) but not for interaction (p=0.3121). PC was lower for CT-CP in relation to PT-HP and CT-HP. After tray removal, expectoration, of the remaining gel, and mouth rinsing, no peroxide was detected in saliva. Correlation between SF and PC was considered weak (r=0.3379). The overall mean SF was 50.44% during tray use. In general, PC in saliva was 68.72% lower than the estimated toxic dose (0.26 mg/kg/day) considering all the bleaching systems. Conclusions: Higher peroxide levels were detected in saliva with 10% HP gels. Nevertheless, they were below estimated toxic dose and were considered safe in relation to toxicity.

Influence of Staining Solutions on Color Change and Enamel Surface Properties During At-home and In-office Dental Bleaching: An In Situ Study

2019 ◽  
Vol 44 (6) ◽  
pp. 595-608 ◽  
Author(s):  
NR Carlos ◽  
AVD Pinto ◽  
FLB do Amaral ◽  
FMG França ◽  
CP Turssi ◽  
...  
Keyword(s):  
Color Change ◽  
Enamel Surface ◽  
Control Group ◽  
High Hydrogen ◽  
Dental Bleaching ◽  
Staining Solution ◽  
In Situ Study ◽  
Significant Difference ◽  
At Home

SUMMARY The purpose of this in situ study was to evaluate the influence of staining solutions (coffee and cola) on the color change, microhardness, roughness, and micromorphology of the enamel surface during at-home and in-office dental bleaching. One hundred and thirty-five enamel bovine blocks were prepared to perform the evaluations. Fifteen volunteers used an intraoral appliance with nine enamel blocks for 15 days. The enamel blocks were randomly assigned among the different groups according to the three treatments: in-office bleaching with high hydrogen peroxide concentration (Opalescence Boost PF 40%, Ultradent) for 40 minutes in three sessions (first, eighth, and 15th days of treatment), at-home bleaching with low carbamide peroxide concentration (Opalescence PF 10%, Ultradent) for 60 minutes daily for 15 days, and a control group (no bleaching agent applied). The enamel blocks were immersed daily in different staining solutions (coffee or cola) for 30 minutes for 15 days or were not submitted to staining (control) to obtain a factorial scheme (3×3) of the dental bleaching treatment and staining solution (n=15). The microhardness analyses (Knoop), roughness evaluations (Ra), surface micromorphological observations, and color measurements (using the CIELAB system and the VITA Classical scale) were made before and after the bleaching treatments to assess immersion in staining solutions. Mixed model tests showed that there was a decrease in enamel microhardness after exposure to cola compared with coffee and the control group (p<0.0001) for both bleaching techniques. Roughness was higher for the cola groups (p<0.0001), and there was no significant difference between the coffee and the control groups. Generalized linear models showed that when no staining solution was applied, lighter color scores were found for the VITA Classical scale (p<0.0001). Without the staining solutions, there was an increase in luminosity (ΔL) (p=0.0444) for in-office bleaching. Lower values of Δa (p=0.0010) were observed when the staining solutions were not used. The Δb (p=0.3929) did not vary significantly between the bleaching agents, but when cola was applied, the values were significantly higher than for the control (p=0.0293). Higher values of ΔE (p=0.0089) were observed for in-office bleaching without staining solutions, while lower values of ΔE were observed for the in-office associated with coffee immersion. Regardless of whether being submitted to bleaching, the enamel stained with cola showed a decrease in microhardness, an increase in roughness, and changes in the micromorphology. The efficacy of the bleaching agents was greater when no staining solution (cola or coffee) was used, and in-office bleaching showed greater color change than the at-home bleaching technique.

scholarly journals A Single-Blind Randomized Trial About the Effect of Hydrogen Peroxide Concentration on Light-Activated Bleaching

2016 ◽  
Vol 41 (5) ◽  
pp. 455-464 ◽  
Author(s):  
AP Mena-Serrano ◽  
E Garcia ◽  
I Luque-Martinez ◽  
RHM Grande ◽  
AD Loguercio ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Randomized Trial ◽  
Laser Light ◽  
Color Change ◽  
Absolute Risk ◽  
Light Activation ◽  
Anterior Teeth ◽  
Significant Difference ◽  
The Absolute ◽  
Single Blind

SUMMARY Objective: To compare the bleaching efficacy and tooth sensitivity (TS) of two hydrogen peroxide (HP) concentrations (20% and 35%) used for in-office bleaching associated or not with a light-emitting diode (LED)/laser light activation. Method: Seventy-seven patients with a right maxillary canine darker than A3 were selected for this single-blind randomized trial. The participants were distributed in four groups: bleaching with 35% HP, 35% HP + LED/laser, 20% HP, and 20% HP + LED/laser. The anterior teeth were bleached in two sessions, using a 35% or 20% HP gel with a one-week interval. Each session had three applications of 15 minutes. For the light-activated groups, the LED/laser energy (Whitening Laser Light Plus, DMC) was employed according to the manufacturer's instructions. The color change was evaluated by subjective and objective methods. Participants recorded TS with five-point verbal and visual analog scales. Color change in ΔE was evaluated by analysis of variance and Tukey tests (α=0.05) and in ΔSGU with Kruskall-Wallis and Dunn test. The absolute risk of TS and TS intensity were evaluated by Fisher exact test and Kruskall-Wallis test, respectively (α=0.05). Results: All groups achieved the same level of whitening, except for the 20% HP group, which showed the lowest degree of whitening in the subjective analysis. The use of light did not increase the absolute risk or intensity of TS. No significant difference among groups was observed when color changes were assessed with the spectrophotometer. Conclusion: According to the value-oriented shade guide, the use of LED/laser light activation was able to increase the degree of whitening of the 20% HP group, but this association was not useful for the 35% HP gel. The spectrophotometer, however, did not detect significant differences among groups.

Comparison of the Effect of Agitation on Whitening and Tooth Sensitivity of In-Office Bleaching: A Randomized Clinical Trial

2021 ◽  
Author(s):  
RC Kiyuna ◽  
LM Martins ◽  
TA Hanzen ◽  
A Reis ◽  
AD Loguercio ◽  
...  
Keyword(s):  
Color Change ◽  
Absolute Risk ◽  
Wilcoxon Test ◽  
Fisher Exact Test ◽  
Bleaching Agent ◽  
Tooth Sensitivity ◽  
Exact Test ◽  
Color Changes ◽  
Sonic Activation ◽  
Shade Guide

SUMMARY Objective: This single-blind, split-mouth, randomized trial was aimed at evaluating the bleaching efficacy (BE) and tooth sensitivity (TS) of a 20% hydrogen peroxide (HP) bleaching agent used under active or passive application. Methods and Materials: Twenty-two patients with canines darker than C2 were selected. Teeth were bleached in two sessions, with a one-week interval between treatments. The bleaching agent was applied using active (HPactive) or passive (HPpassive) application. Each tooth in the HPactive-allocated hemiarch received bleaching gel with sonic activation after 10 and 30 minutes from the start of treatment, with rounded movements all over the buccal surface. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (VITA Easyshade Spectrophotometer) methods at baseline and 30 days after the second session. TS was recorded up to 48 hours after treatment using a 0–10 visual analog scale. Color change in shade guide units (SGUs) and ΔE was analyzed using a Wilcoxon test (α=0.05). The absolute risk and intensity of TS were evaluated using McNemar test and a Wilcoxon test, respectively (α=0.05). Results: Significant whitening was observed in both groups after 30 days of clinical evaluation. The activation did not significantly influence BE (ΔSGU HPpassive=5.6 and HPActive=5.8; p=0.98; and ΔE HPpassive=10.6 and HPactive=10.3; p=0.83). Absolute risk of TS (HPactive=36.4% and HPpassive=31.8%; p=0.94) was similar for both groups (Fisher exact test). TS intensity (visual analogue scale) was higher during the bleaching sessions and up to 24 hours thereafter for both groups, with no differences between groups (twoway analysis of variance and Tukey). Conclusion: The active application of a 20% HP gel did not improve BE and TS.

Efficacy of a Novel At-home Bleaching Technique With Carbamide Peroxides Modified by CPP-ACP and Its Effect on the Microhardness of Bleached Enamel

2011 ◽  
Vol 36 (5) ◽  
pp. 521-528 ◽  
Author(s):  
BCD Borges ◽  
JS Borges ◽  
CD de Melo ◽  
IVA Pinheiro ◽  
AJS dos Santos ◽  
...  
Keyword(s):  
Vickers Microhardness ◽  
Color Change ◽  
Artificial Saliva ◽  
Carbamide Peroxide ◽  
Peroxide Bleaching ◽  
Significant Difference ◽  
Casein Phosphopeptide ◽  
Shade Guide ◽  
At Home

SUMMARY This study was designed to evaluate in vitro the efficacy of a novel at-home bleaching technique using 10% or 16% carbamide peroxide modified by casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and its influence on the microhardness of bleached enamel. A total of 40 bovine incisors were divided into four groups (n=10) according to the bleaching agent used: 10% carbamide peroxide only; a blend of 10% carbamide peroxide and a CPP-ACP paste; 16% carbamide peroxide only; and a blend of 16% carbamide peroxide and a CPP-ACP paste. During the 14-day bleaching regimen, the samples were stored in artificial saliva. The Vickers microhardness and color of the teeth were assessed at baseline (T0) and immediately after the bleaching regimen (T14) using a microhardness tester and a spectrophotometer, respectively. The degree of color change was determined by the Commission Internationale de l'Eclariage (CIE) L*a*b* system (ΔE, ΔL*, Δa*, and Δb*) and Vita shade guide parameters. The data were analyzed by analysis of variance and the Tukey test (p<0.05). The teeth that were bleached with a blend of peroxide (10% or 16%) and the CPP-ACP paste presented increased microhardness values at T14 compared with T0, whereas the samples that were bleached with peroxide only did not show any differences in their microhardness values. All of the bleaching agents were effective at whitening the teeth and did not show a statistically significant difference using the CIEL*a*b* system (ΔE, ΔL*, Δa*, and Δb*) or the Vita shade guide parameters. The use of a CPP-ACP paste with carbamide peroxide bleaching agents increased the bleached enamel's microhardness and did not have an influence on whitening efficacy.

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