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.

Administration of Ascorbic Acid to Prevent Bleaching-induced Tooth Sensitivity: A Randomized Triple-blind Clinical Trial

2014 ◽  
Vol 39 (2) ◽  
pp. 128-135 ◽  
Author(s):  
EA de Paula ◽  
S Kossatz ◽  
D Fernandes ◽  
AD Loguercio ◽  
A Reis
Keyword(s):  
Clinical Trial ◽  
Hydrogen Peroxide ◽  
Ascorbic Acid ◽  
Color Change ◽  
Absolute Risk ◽  
Tooth Sensitivity ◽  
Parallel Design ◽  
Color Changes ◽  
The Absolute ◽  
Similar Risk

SUMMARY This study evaluated the effect of ascorbic acid, 500 mg every eight hours, on bleaching-induced tooth sensitivity. A triple-blind, parallel design, and placebo-controlled randomized clinical trial was conducted on 39 adults. The pills (placebo or ascorbic acid) were administered three times per day for 48 hours; the first dose was given one hour prior to each bleaching session. Two bleaching sessions with 35% hydrogen peroxide gel were performed with a one-week interval. Tooth sensitivity was recorded up to 48 hours after bleaching. The color evaluation was performed before and 30 days after bleaching. The absolute risk and intensity of tooth sensitivity were evaluated by Fisher exact and Mann-Whitney U-tests, respectively. Color changes were evaluated by unpaired t-test (α=0.05). There were no significant differences in the absolute risk and intensity of tooth sensitivity and color change between the groups. Both groups showed a similar risk of tooth sensitivity (p>0.05). The perioperative use of an antioxidant, such as ascorbic acid (500 mg, three times daily) perorally, was not able to prevent bleaching-induced tooth sensitivity or reduce its intensity.

Clinical Effects of Desensitizing Prefilled Disposable Trays in In-office Bleaching: A Randomized Single-blind Clinical Trial

2020 ◽  
Vol 45 (1) ◽  
pp. E1-E10
Author(s):  
LM Martins ◽  
LA Lima e Souza ◽  
E Sutil ◽  
LM da Silva ◽  
JOS Silva ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Color Change ◽  
Absolute Risk ◽  
Potassium Nitrate ◽  
Clinical Effects ◽  
Bleaching Agent ◽  
Chi Square ◽  
Peroxide Bleaching ◽  
The Absolute ◽  
Single Blind

SUMMARY Objectives: This study aimed to evaluate the desensitizing effect of a prefilled disposable tray containing potassium nitrate and fluoride on the self-reported tooth sensitivity (TS) and the bleaching efficacy of 40% hydrogen peroxide bleaching agent used for in-office bleaching in comparison with potassium nitrate and fluoride gel applied in a conventional-delivered tray system in an equivalence clinical trial. Methods and Materials: Seventy-eight patients, with a right maxillary canine darker than A3, were selected for this single-blind (evaluators), randomized clinical trial. Teeth were bleached in two sessions with a one-week interval in between. Before in-office bleaching, the prefilled disposable tray or conventional tray containing potassium nitrate and fluoride was used for 15 minutes. Subsequently, the bleaching agent was applied in two 20-minute applications (per the manufacturer's directions) in each session. The color change was evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Advance Spectrophotometer) methods at baseline and 30 days after the first bleaching session. TS was recorded for up to 48 hours using a 0-10 visual analog scale. The absolute risk was evaluated by chi-square test, while the intensity of TS was evaluated by McNemar test (α=0.05). Color change in shade guide units and ΔE was analyzed by Student t-test for independent samples (α=0.05). Results: Significant whitening was observed in both groups after 30 days of clinical evaluation. The use of different methods of desensitizer in a tray did not influence the absolute risk and intensity of TS (p>0.05), although a tendency of lower risk of TS with the prefilled disposable tray containing potassium nitrate and fluoride was observed. Conclusion: The use of a prefilled disposable tray containing potassium nitrate and fluoride before the application of the in-office bleaching product did not affect the whitening degree and decreased self-reported TS when compared with a conventional-delivered tray system.

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.

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.

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.

Influence of Hydrogen Peroxide Bleaching Gels on Color, Opacity, and Fluorescence of Composite Resins

2012 ◽  
Vol 37 (5) ◽  
pp. 526-531 ◽  
Author(s):  
CRG Torres ◽  
CF Ribeiro ◽  
E Bresciani ◽  
AB Borges
Keyword(s):  
Hydrogen Peroxide ◽  
Composite Resin ◽  
Color Change ◽  
Composite Resins ◽  
Control Group ◽  
Peroxide Bleaching ◽  
Color Changes ◽  
Tukey Test ◽  
Bleaching Gels ◽  
Bleaching Treatment

SUMMARY The aim of the present study was to evaluate the effect of 20% and 35% hydrogen peroxide bleaching gels on the color, opacity, and fluorescence of composite resins. Seven composite resin brands were tested and 30 specimens, 3-mm in diameter and 2-mm thick, of each material were fabricated, for a total of 210 specimens. The specimens of each tested material were divided into three subgroups (n=10) according to the bleaching therapy tested: 20% hydrogen peroxide gel, 35% hydroxide peroxide gel, and the control group. The baseline color, opacity, and fluorescence were assessed by spectrophotometry. Four 30-minute bleaching gel applications, two hours in total, were performed. The control group did not receive bleaching treatment and was stored in deionized water. Final assessments were performed, and data were analyzed by two-way analysis of variance and Tukey tests (p<0.05). Color changes were significant for different tested bleaching therapies (p<0.0001), with the greatest color change observed for 35% hydrogen peroxide gel. No difference in opacity was detected for all analyzed parameters. Fluorescence changes were influenced by composite resin brand (p<0.0001) and bleaching therapy (p=0.0016) used. No significant differences in fluorescence between different bleaching gel concentrations were detected by Tukey test. The greatest fluorescence alteration was detected on the brand Z350. It was concluded that 35% hydrogen peroxide bleaching gel generated the greatest color change among all evaluated materials. No statistical opacity changes were detected for all tested variables, and significant fluorescence changes were dependent on the material and bleaching therapy, regardless of the gel concentration.

Effects of pH Values of Hydrogen Peroxide Bleaching Agents on Enamel Surface Properties

2011 ◽  
Vol 36 (5) ◽  
pp. 554-562 ◽  
Author(s):  
B Xu ◽  
Q Li ◽  
Y Wang
Keyword(s):  
Hydrogen Peroxide ◽  
Chemical Composition ◽  
Ph Value ◽  
Negative Control ◽  
Enamel Surface ◽  
Control Group ◽  
Solution Ph ◽  
Peroxide Bleaching ◽  
Color Changes ◽  
Ph Values

SUMMARY This study investigated the influence of pH values of bleaching agents on the properties of the enamel surface. Sixty freshly extracted premolars were embedded in epoxy resin and mesiodistally sectioned through the buccal aspect into two parts. The sectioned slabs were distributed among six groups (n=10) and treated using different solutions. Group HCl was treated with HCl solution (pH=3.0) and served as a positive control. Group DW, stored in distilled water (pH=7.0), served as a negative control. Four treatment groups were treated using 30% hydrogen peroxide solutions with different pH values: group HP3 (pH=3.0), group HP5 (pH=5.0), group HP7 (pH=7.0), and group HP8 (pH=8.0). The buccal slabs were subjected to spectrophotometric evaluations. Scanning electron microscopy investigation and Micro-Raman spectroscopy were used to evaluate enamel surface morphological and chemical composition alterations. pH value has a significant influence on the color changes after bleaching (p<0.001). Tukey's multiple comparisons revealed that the order of color changes was HP8, HP7>HP5, HP3>HCl>DW. No obvious morphological alterations were detected on the enamel surface in groups DW, HP7, and HP8. The enamel surface of groups HCl and HP3 showed significant alterations with an erosion appearance. No obvious chemical composition changes were detected with respect to Micro-Raman analysis. Within the limitations of this study, it was concluded that no obvious morphological or chemical composition alterations of enamel surface were detected in the neutral or alkaline bleaching solutions. Bleaching solutions with lower pH values could result in more significant erosion of enamel, which represented a slight whitening effect.

Influence of pH on the Effectiveness of Hydrogen Peroxide Whitening

2014 ◽  
Vol 39 (6) ◽  
pp. E261-E268 ◽  
Author(s):  
CRG Torres ◽  
E Crastechini ◽  
FA Feitosa ◽  
CR Pucci ◽  
AB Borges
Keyword(s):  
Hydrogen Peroxide ◽  
Red Wine ◽  
Alcoholic Solution ◽  
Bleaching Effect ◽  
Significance Level ◽  
Peroxide Bleaching ◽  
Color Changes ◽  
Ph Values ◽  
Naoh Solution ◽  
Influence Of Ph

SUMMARY Objective To evaluate the influence of pH on the bleaching effect of hydrogen peroxide on chromogen agents. Method Hydrogen peroxide 50% was mixed with red wine or with an alcoholic solution of tobacco in glass cuvettes, resulting in final peroxide concentrations of 16.97% and 21.12%, respectively. The pH of this mixture was measured and adjusted with 3.3 M HCl solution or 2.5 M NaOH solution to obtain the final pH values of 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, and 9.0. After mixing, the color of these solutions was evaluated in a reflectance spectrophotometer; readings were repeated after 10 minutes for the wine solution and 20 minutes for the tobacco solution. Ten samples were prepared for each solution at each pH. Color changes (Delta E) were calculated. The data were statistically analyzed using analysis of variance one-way and Tukey tests, with a significance level of 5%. Results There were significant differences among the different pH values for the wine and tobacco solutions (p=0.0001). The Tukey test showed that for both solutions, pH 9.0 resulted in a significantly greater bleaching effect than the other values tested. Conclusion The efficacy of hydrogen peroxide bleaching is directly proportional to the increase in its pH.

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.

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.

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