Efficacy of Home-use Bleaching Agents Delivered in Customized or Prefilled Disposable Trays: A Randomized Clinical Trial

2017 ◽  
Vol 42 (1) ◽  
pp. 30-40 ◽  
Author(s):  
NR Carlos ◽  
EC Bridi ◽  
FLB Amaral ◽  
FMG França ◽  
CP Turssi ◽  
...  
Keyword(s):  
Color Change ◽  
The Other ◽  
Bleaching Agent ◽  
Application Time ◽  
Carbamide Peroxide ◽  
Analog Scale ◽  
Tooth Sensitivity ◽  
Whitening Agent ◽  
Time Periods ◽  
Gingival Irritation

SUMMARY The purpose of this study was to evaluate bleaching methods containing hydrogen peroxide (HP) or carbamide peroxide (CP), dispensed in customized or prefilled trays, in terms of color change, tooth sensitivity, gingival irritation, acceptance, and comfort. Seventy-five volunteers were randomly selected and distributed according to the whitening agent (n=25): 10% HP dispensed in prefilled trays (Opalescence Go 10%) and 9.5% HP (Pola Day) and 10% CP both delivered in customized trays (Opalescence PF 10%). HP was applied for 30 min/d for 14 days (d), and CP for 8 h/d for 14 days. Evaluations were performed at baseline and at 7 days and 14 days of treatment. Color change was measured with Commission internationale de l'éclairage color coordinates (L*, a*, b*), Vita Classical, and 3D Master scales. A visual analog scale was used to assess tooth sensitivity, acceptance of the method and degree of comfort of the tray. Gingival irritation was evaluated as present or absent and localized or generalized. Regarding gingival irritation, tray acceptance, and tooth sensitivity, no differences were observed among the groups at any time (p>0.05). As for degree of comfort, 10% HP showed lower scores (comfortable) than 10% CP, with significant differences (p<0.05) from the other groups (comfortable to very comfortable). In terms of ΔL, Δa, and ΔE, no difference was observed among the groups or between the time periods (p>0.05). The Δb average was higher at 14 days (p<0.05), and there was no difference among the groups (p>0.05). Localized gingival irritation was observed in both tray methods. Mild tooth sensitivity was observed with time, regardless of the bleaching agent concentration or the application time. Color change was similar for all the groups at 7 days and 14 days, but there was a greater reduction in the yellow hue at 14 days. All the bleaching methods were highly accepted and effective in promoting whitening. Although prefilled trays are generally comfortable, they proved less comfortable than customized trays.

Comparison of the Effects of In-office Bleaching Times on Whitening and Tooth Sensitivity: A Single Blind, Randomized Clinical Trial

2016 ◽  
Vol 41 (2) ◽  
pp. 138-145 ◽  
Author(s):  
C Kose ◽  
AL Calixto ◽  
JRO Bauer ◽  
A Reis ◽  
AD Loguercio
Keyword(s):  
Color Change ◽  
Absolute Risk ◽  
The Other ◽  
Bleaching Agent ◽  
Tooth Sensitivity ◽  
Anterior Teeth ◽  
Verbal Scale ◽  
The Absolute ◽  
Shade Guide ◽  
Single Blind

SUMMARY Objectives: The objective of the present study was to compare the bleaching efficacy (BE) and tooth sensitivity (TS) of in-office bleaching applied under different time protocols. Methods and Materials: Fifty-three patients were randomly distributed into three groups: the bleaching agent was applied in one (1×15), two (2×15), or three (3×15) 15-minute applications. The labial surfaces of the anterior teeth were bleached using a 35% hydrogen peroxide gel. Two bleaching sessions with a one-week interval between were performed. The shade evaluation was performed with a visual shade guide and spectrophotometer before and 30 days after bleaching. Participants recorded TS with a five-point verbal scale. Color change was analyzed by one-way analysis of variance and Tukey tests. The absolute risk of TS and TS intensity were evaluated by the Fisher exact and Friedman/Kruskal-Wallis tests, respectively (α= 0.05). Results: Significant whitening was observed in all groups, with statistically lower BE for the 1×15 group (p<0.05). The absolute risk of TS (95% confidence interval) was lower for the 1×15 group than for the other groups (p<0.05). The TS intensity of the 3×15 group was statistically higher than that associated with the other protocols (p<0.05). Conclusions: A single 15-minute application produced less TS but reduced BE. The protocol with 2×15 produced a degree of BE similar to that of the 3×15 group, but with reduced overall TS intensity.

Effect of 10% and 15% Carbamide Peroxide on Fracture Toughness of Human Dentin In Situ

2013 ◽  
Vol 38 (2) ◽  
pp. 142-150 ◽  
Author(s):  
LE Tam ◽  
P Bahrami ◽  
O Oguienko ◽  
H Limeback
Keyword(s):  
Fracture Toughness ◽  
Placebo Group ◽  
Color Change ◽  
Carbamide Peroxide ◽  
Tooth Sensitivity ◽  
Custom Made ◽  
Dental Hard Tissues ◽  
Significant Difference

SUMMARY Purpose Although damage to the structural integrity of the tooth is not usually considered a significant problem associated with tooth bleaching, there have been some reported negative effects of bleaching on dental hard tissues in vitro. More studies are needed to determine whether the observed in vitro effects have practical clinical implications regarding tooth structural durability. Objectives This in situ study evaluated the effect of 10% and 15% carbamide peroxide (CP) dental bleach, applied using conventional whitening trays by participants at home, on the fracture toughness of dentin. Methods Ninety-one adult volunteers were recruited (n ≈ 30/group). Compact fracture toughness specimens (approximately 4.5 × 4.6 × 1.7 mm) were prepared from the coronal dentin of recently extracted human molars and gamma-radiated. One specimen was fitted into a prepared slot, adjacent to a maxillary premolar, within a custom-made bleaching tray that was made for each adult participant. The participants were instructed to wear the tray containing the dentin specimen with placebo, 10% CP, or 15% CP treatment gel overnight for 14 nights and to store it in artificial saliva when not in use. Pre-bleach and post-bleach tooth color and tooth sensitivity were also evaluated using ranked shade tab values and visual analogue scales (VASs), respectively. Within 24–48 hours after the last bleach session, the dentin specimens were tested for fracture toughness using tensile loading at 10 mm/min. Analysis of variance, Kruskal-Wallis, χ2, Tukey's, and Mann-Whitney U tests were used for statistical analysis. The level of significance was set at p<0.05 for all tests, except for the Mann-Whitney U tests, which used a Bonferroni correction for post hoc analyses of the nonparametric data (p<0.017). Results The placebo, 10% CP, and 15% CP groups contained 30, 31, and 30 participants, respectively. Mean fracture toughness (+ standard deviation) for the placebo, 10% CP, and 15% CP groups were 2.3 ± 0.9, 2.2 ± 0.7, and 2.0 ± 0.5 MPa*m1/2 respectively. There were no significant differences in mean fracture toughness results among the groups (p=0.241). The tooth sensitivity VAS scores indicated a significantly greater incidence (p=0.000) and degree of tooth sensitivity (p=0.049 for VAS change and p=0.003 for max VAS) in the bleach groups than in the placebo group. The color change results showed generally greater color change in the bleach groups than in the placebo group (p=0.008 for shade guide determination and p=0.000 for colorimeter determination). Conclusions There were no significant differences in in situ dentin fracture toughness results among the groups. The results of this study provide some reassurance that dentin is not overtly weakened by the bleaching protocol used in this study. However, the lack of a statistically significant difference cannot be used to state that there is no effect of bleach on dentin fracture toughness.

Evaluation of the color change and tooth sensitivity in treatments that associate violet LED with carbamide peroxide 10 %: A randomized clinical trial of a split-mouth design

2020 ◽  
Vol 30 ◽  
pp. 101679
Author(s):  
Marjorie de Oliveira Gallinari ◽  
Luciano Tavares Angelo Cintra ◽  
Ana Carolina Souza Barboza ◽  
Lívia Maria Alves Valentim da Silva ◽  
Sibele de Alcantara ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Color Change ◽  
Carbamide Peroxide ◽  
Tooth Sensitivity

Tooth Sensitivity After Dental Bleaching With a Desensitizer-containing and a Desensitizer-free Bleaching Gel: A Systematic Review and Meta-analysis

2019 ◽  
Vol 44 (2) ◽  
pp. E58-E74 ◽  
Author(s):  
M Rezende ◽  
FM Coppla ◽  
K Chemin ◽  
AC Chibinski ◽  
AD Loguercio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Latin American ◽  
Risk Ratio ◽  
Color Change ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Tooth Sensitivity ◽  
Dental Bleaching ◽  
Gingival Irritation

SUMMARY Objectives: A systematic review and meta-analysis were performed to evaluate the risk and intensity of tooth sensitivity (TS) after dental bleaching with a desensitizer-containing and a desensitizer-free bleaching gel in adult patients. Color change and risk of gingival sensitivity was also evaluated. Methods: A comprehensive search was performed MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), EMBASE and Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions to identify randomized clinical trials. Abstracts from the annual conference of the International Association for Dental Research (1990–2016), unpublished and ongoing trials registries, dissertations, and theses were also searched. The quality of the evidence was rated using the Grading of Recommendations: Assessment, Development and Evaluation (GRADE) approach. Data: After duplicates were removed, 1352 articles were identified. After title and abstract screening, only 47 studies remained for qualitative evaluation. Most of the studies had unclear risk of bias. No difference between groups were observed for the risk ratio of TS (risk ratio = 0.99; 95% confidence interval [CI] = 0.74–1.33); intensity of TS (standardized difference in means [SMD] = 0.04; 95% CI = 0.79–0.70); color change in shade guide units (SMD – 0.04; 95% CI = 0.50–0.42); color change in ΔE* (SMD = 0.41 (95% CI = 0.07–0.89); and risk ratio of gingival irritation (SMD = 1.05; 95% CI = 0.81–1.36). Except for the risk of TS, graded as moderate quality of evidence, all other outcomes were rated as low and very low quality. Conclusions: Incorporating desensitizers in the bleaching gel did not reduce the risk of TS, and the quality of this evidence was considered moderate. On the other hand, the intensity of TS, color change, and risk of gingival irritation was similar between groups, but the quality of the evidence for these outcomes was graded as low or very low, thus reducing the level of confidence in these outcomes.

Effectiveness of LED/Laser Irradiation on In-Office Dental Bleaching after Three Years

2018 ◽  
Vol 43 (1) ◽  
pp. 31-37 ◽  
Author(s):  
RFL Mondelli ◽  
FAP Rizzante ◽  
ER Rosa ◽  
AFS Borges ◽  
AY Furuse ◽  
...  
Keyword(s):  
Color Change ◽  
Color Stability ◽  
The Other ◽  
Lower Sensitivity ◽  
Activation Time ◽  
Tooth Sensitivity ◽  
Dental Bleaching ◽  
Lower Activation

SUMMARY The present in vivo randomized, triple-blinded, and split-mouth clinical study evaluated the effectiveness of a hybrid light (HL) source on the color change, stability, and tooth sensitivity in patients submitted to different in-office bleaching techniques. Twenty volunteers were divided into two groups and four subgroups. A split-mouth design was conducted to compare two in-office bleaching techniques (with and without light activation): 35% Lase Peroxide Sensy (LPS) + HL: 35% hydrogen peroxide (HP) + HL; 35% LPS: 35% HP; 25% LPS + HL: 25% HP + HL; and 35% Whiteness HP (WHP): 35% HP. For the groups activated with HL, the HP was applied on the enamel surface three consecutive times using a 3 × 2-minute protocol (three HL activations for two minutes each, with a 30-second interval for a total of seven minutes and 30 seconds) for each gel application, totaling 22 minutes and 30 seconds. For the other groups, HP was applied 3 × 15 minutes, totaling 45 minutes. A spectrophotometer was used to measure the color change (ΔE) before the treatment and 24 hours, one week, and one, 12, and 36 months after. A visual analog scale was used to evaluate the tooth sensitivity before the treatment, immediately following treatment, 24 hours, and one week after. Analysis of variance, Tukey's, Kruskall-Wallis, and Wilcoxon tests, all with α = 0.05 were performed. Statistical analysis did not reveal any significant differences (ΔE) between the in-office bleaching techniques with or without HL in the periods evaluated; the activation with HL required 50% less time to achieve such results. The groups without HL presented statistical differences for ΔE when comparing 24 hours with the other follow-up times (intergroup) and an increase in tooth sensitivity in the initial periods. All techniques and bleaching agents were effective on bleaching during a 36-month evaluation of color stability. The groups activated with HL presented lower sensitivity and required a lower activation time.

scholarly journals Clinical and Spectrophotometric Evaluation of LED and Laser Activated Teeth Bleaching

2016 ◽  
Vol 10 (1) ◽  
pp. 242-250 ◽  
Author(s):  
R. Lo Giudice ◽  
G. Pantaleo ◽  
A. Lizio ◽  
U. Romeo ◽  
G. Castiello ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Mean Value ◽  
Ease Of Use ◽  
Bleaching Agent ◽  
Carbamide Peroxide ◽  
Power Sources ◽  
Chromatic Scale ◽  
Whitening Agent ◽  
Auxiliary Power ◽  
Before And After

Background: Auxiliary power sources (LED and laser) are used in in-office teeth bleaching techniques to accelerate the redox reaction of the whitening gel to increase ease of use, to improve comfort and safety, and to decrease the procedure time. Objective: The aim this study is to evaluate the efficiency of the teeth whitening procedures performed with hydrogen peroxide and carbamide peroxide, LED or Laser activated. Method: 18 patients, affected by exogenous dyschromia, were treated with a bleaching agent composed by 35% hydrogen peroxide and 10% carbamide peroxide. They were divided into two groups: in the first group the bleaching agent was activated by a LED lamp; in the second group it was activated by a Laser diode lamp. Both groups were subjected to 3 bleaching cycle of 15’ each. The chromatic evaluations were performed before and after one week from the treatment, using a chromatic scale and a spectrophotometer. The mean value of pre, post bleaching and follow-up were analyzed using a T-test, with results statistically significant for P<0,05. Results: Results showed that the variations in brightness, chroma and hue are significantly influenced by the interaction between the whitening agent and the original colour of the teeth. Laser-activation has marginally improved the bleaching effectiveness. All patients treated with laser activation complained an increase in dental sensitivity. Conclusion: The use of laser-activating systems did not improve the efficacy of bleaching.

Clinical Comparative Study of the Effectiveness of and Tooth Sensitivity to 10% and 20% Carbamide Peroxide Home-use and 35% and 38% Hydrogen Peroxide In-office Bleaching Materials Containing Desensitizing Agents

2012 ◽  
Vol 37 (5) ◽  
pp. 464-473 ◽  
Author(s):  
RT Basting ◽  
FLB Amaral ◽  
FMG França ◽  
FM Flório
Keyword(s):  
Hydrogen Peroxide ◽  
Potassium Nitrate ◽  
Wilcoxon Test ◽  
Bleaching Agent ◽  
Carbamide Peroxide ◽  
Fluoride Ions ◽  
Tooth Sensitivity ◽  
Desensitizing Agents ◽  
Low Prevalence ◽  
Bleaching Treatment

SUMMARY The aim of this study was to compare the effectiveness of and tooth sensitivity to 10% and 20% carbamide peroxide (CP) home-use bleaching agents and 35% and 38% hydrogen peroxide (HP) in-office bleaching agents, all of which contain desensitizing agents, in a clinical trial. Four agents were evaluated: 10% CP and 20% CP (Opalescence PF 10% and Opalescence PF 20%, Ultradent, both with 0.5% potassium nitrate and 0.11% fluoride ions), 38% HP (Opalescence Boost PF, Ultradent, with 3% potassium nitrate and 1.1% fluoride ions), and 35% HP (Pola Office, SDI, with potassium nitrate). The initial screening procedure included 100 volunteers, aged 18 to 42, with no previous sensitivity or bleaching treatment and with any tooth shade. Volunteers were randomly assigned among the technique/bleaching agent groups. A run-in period was performed 1 week before the beginning of the bleaching treatment. For the home-use bleaching technique, each volunteer was instructed to dispense gel (10% CP or 20% CP) into the trays and then insert them into his or her mouth for at least two hours per night for three weeks. For the in-office bleaching technique, the bleaching agents (38% HP or 35% HP) were prepared and used following the manufacturer's instructions, with three applications performed in each session. Three sessions were carried out with an interval of seven days between each session. The participants were evaluated before, at one week, two weeks, and three weeks after the beginning of the bleaching treatment, and again one and two weeks after the bleaching treatment ended. A shade guide (Vita Classical, Vita) was used by a blinded examiner to perform shade evaluations before bleaching and two weeks after the end of bleaching. At the time of the shade evaluations, tooth sensitivity was also recorded by asking the volunteers to classify the sensitivity during bleaching treatment as absent, mild, moderate, or severe. The present study found that 13.8% of the volunteers withdrew from the study due to tooth sensitivity, and 43.2% of the participants experienced some type of sensitivity during bleaching treatment. The χ2 test showed that there was a significant prevalence of tooth sensitivity during bleaching treatment using the home-use 20% CP agent, with 71.4% of volunteers reporting any level of tooth sensitivity (p=0.0032). A low prevalence of tooth sensitivity was observed for volunteers who used the in-office 38% HP agent (15.0%). The Wilcoxon test (p&lt;0.05) showed that all of the bleaching treatments were effective in bleaching teeth and that there were no differences between the final color shade results among the treatments (Kruskal-Wallis, p&lt;0.05). This study showed that 43.2% of all the volunteers experienced mild or moderate tooth sensitivity during the treatment with bleaching agents. A higher prevalence of tooth sensitivity was observed for 71.4% of the volunteers who used the 20% CP home-use bleaching agent, which may be ascribed to the peroxide concentration and/or the time/length the agent was in contact with the dental structures.

Effectiveness of In-office Hydrogen Peroxide With Two Different Protocols: A Two-center Randomized Clinical Trial

2018 ◽  
Vol 43 (4) ◽  
pp. 353-361 ◽  
Author(s):  
IEB Martins ◽  
S Onofre ◽  
N Franco ◽  
LM Martins ◽  
A Montenegro ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Color Change ◽  
Absolute Risk ◽  
Rank Test ◽  
Bleaching Agent ◽  
Tooth Sensitivity ◽  
Peroxide Bleaching ◽  
Color Changes ◽  
Ph Values ◽  
The Absolute

SUMMARY Objectives: The aim of this study was to compare the bleaching efficacy and tooth sensitivity (TS) of a 38% hydrogen peroxide bleaching agent used for in-office bleaching, applied under different time protocols: a 40-minute application or two 20-minute applications. Methods and Materials: Forty-four patients from Brazil and Colombia, with right superior canines darker than C2, were selected for this multicenter, single-blind, randomized trial. The teeth were bleached in two sessions, with a one-week interval between them, in a split-mouth design. The bleaching agent was applied in two 20-minute (2×20) applications or one 40-minute (1×40) application in each session according to the manufacturer's instructions. The color changes were evaluated by using subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Spectrophotometer) methods at baseline and 30 days after the second session. Tooth sensitivity was recorded up to 48 hours with a 0-10 visual analog scale. Also, the pH values during the application of bleaching were recorded. Color change in shade guide units and ΔE were analyzed by using the Student t-test (α=0.05). The absolute risk and intensity of TS were evaluated with the McNemar test, the Wilcoxon signed-rank test, and the Friedman test, respectively (α= 0.05). Results: Significant whitening was observed in both groups after 30 days of clinical evaluation. The use of a 40-minute application did not significantly influence the absolute risk of TS (68%, 95% confidence interval [CI] = 53-80) as well as the intensity of TS compared with the acid bleaching gel (absolute risk of 82%, 95% CI = 68-91). The pH values did not differ significantly between groups and at the different assessment periods (p=0.42). Conclusion: The use of a 40-minute in-office bleaching agent gel application produced the same whitening degree and TS that the two 20-minute bleaching agent applications did. The former preferably should be applied because one 40-minute application does not require gel refreshing.

scholarly journals CLINICAL OBSERVATION OF DISCOLORING TREATMENT OF NON-VITAL TEETH BY BLEACHING

2018 ◽  
pp. 83-87
Author(s):  
O.A. Pysarenko ◽  
Yu.I. Silenko ◽  
M.V. Khrebor
Keyword(s):  
Hydrogen Peroxide ◽  
Clinical Observation ◽  
Color Change ◽  
Sodium Perborate ◽  
Tooth Crown ◽  
Carbamide Peroxide ◽  
Whitening Agent ◽  
Use Of Technology ◽  
Success Of Treatment ◽  
Methods Of Treatment

A dental cosmetic is actual for everyone. Whitening of teeth can be the method of lab treatmen. Whitening facilities which are used with this goal often contain peroxide, hydrogen, carbamide peroxide, and combinations of peroxides hydrogen with sodium perborate. The treatment of 3 patients with discoloration of non-vital teeth was done. In two cases the reason of color change was the use of paste containing resorcinol-formalin. Discoloring of root of the tooth was caused by necrotic damage of the pulp. Clinically satisfactory results were received after 1-4 visits in 1-2 days. Use of the bleaching method with further aesthetic restoration of tooth crowns allows avoiding significant weakening of the tooth crown in comparison with prosthetic methods of treatment. The main whitening agent was 30-40% hydrogen peroxide in combination with sodium perborate. The positive cosmetic results were achieved in short terms. Clear compliance with of manufacturer’s recommendations and the use of technology allow achieving success of treatment.

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.

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