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

2021 ◽  
Author(s):  
RMO Terra ◽  
KL da Silva ◽  
L Vochikovski ◽  
E Sutil ◽  
M Rezende ◽  
...  

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

2013 ◽  
Vol 07 (04) ◽  
pp. 405-411 ◽  
Author(s):  
Fatemeh Velayati Moghadam ◽  
Sara Majidinia ◽  
Joseph Chasteen ◽  
Marjaneh Ghavamnasiri

ABSTRACT Aim: The purpose of the present randomized clinical trial was to evaluate the color change, rebound effect and sensitivity of at-home bleaching with 15% carbamide peroxide and power bleaching using 38% hydrogen peroxide. Materials and Methods: For bleaching techniques, 20 subjects were randomized in a split mouth design (at-home and power bleaching): In maxillary and mandibular anterior teeth (n = 20). Color was recorded before bleaching, immediately after bleaching, at 2 weeks, 1, 3 and 6 month intervals. Tooth sensitivity was recorded using the visual analog scale. The Mann-Whitney test was used to compare both groups regarding bleaching effectiveness (∆E 1 ), rebound effect (∆E 2 ) and color difference between the rebounded tooth color and unbleached teeth (∆E 3) while the Wilcoxon compared ∆E within each group. Distribution of sensitivity was evaluated using the Chi-square test (α =0.05). Results: There was no significant difference between groups regarding ∆E 1 and ∆E 3 (P > 0.05). Even though, ∆E 2 showed no significant difference between groups after bleaching as well as at 2 week, 1 month and 3 month follow-up periods (P > 0.05). Although, significant difference was found in ∆E 2 (P < 0.05 Mann-Whitney) between two methods after 6 months and a high degree of rebound effect was obtained with power bleaching. Within each group, there was no significant difference between ∆E 1 and ∆E 3 (P < 0.05 Wilcoxon). The distribution of sensitivity was identical with both techniques (P > 0.05).Conclusion: Bleaching techniques resulted in identical tooth whitening and post-operative sensitivity using both techniques, but faster color regression was found with power bleaching even though color regression to the baseline of the teeth in both groups was the same after 6 months.


2018 ◽  
Vol 43 (5) ◽  
pp. 472-481 ◽  
Author(s):  
ACS Diniz ◽  
SNL Lima ◽  
RRdJ Tavarez ◽  
AH Borges ◽  
SCS Pinto ◽  
...  

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&gt;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.


2013 ◽  
Vol 38 (4) ◽  
pp. 386-393 ◽  
Author(s):  
A Reis ◽  
S Kossatz ◽  
GC Martins ◽  
AD Loguercio

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&lt;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.


2018 ◽  
Vol 23 (5) ◽  
pp. 2199-2206 ◽  
Author(s):  
Marcílio Jorge Fernandes Monteiro ◽  
Jéssica Bruna Corrêa Lindoso ◽  
Nikeila Chacon de Oliveira Conde ◽  
Luciana Mendonça da Silva ◽  
Alessandro D. Loguercio ◽  
...  

2019 ◽  
Vol 44 (6) ◽  
pp. 581-588 ◽  
Author(s):  
C Bersezio ◽  
J Estay ◽  
M Sáez ◽  
F Sánchez ◽  
R Vernal ◽  
...  

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


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 ◽  
...  

2014 ◽  
Vol 39 (2) ◽  
pp. 128-135 ◽  
Author(s):  
EA de Paula ◽  
S Kossatz ◽  
D Fernandes ◽  
AD Loguercio ◽  
A Reis

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&gt;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.


2021 ◽  
Vol 17 (1) ◽  
pp. 60
Author(s):  
Diga Albrian Setiadi

Furosemid continuous infusion merupakan obat pilihan pertama dalam mengatasi kondisi Fluid overload syndrome disertai hipoalbumin pada pasien Penyakit Ginjal Kronik (PGK). Namun pada kondisi tersebut, dosis furosemid yang digunakan oleh para klinisi yakni antara 10 dan 20 mg/jam. Belum ada penelitian yang membandingkan efektivitas dan keamanan furosemid dosis yang berbeda. Penelitian ini bertujuan mengevaluasi efektivitas dan keamanan furosemid dosis 10 dan 20 mg/jam yang diberikan secara continuous infusion pada pasien PGK dengan kondisi fluid overload syndrome disertai hipoalbumin. Metode penelitian Single blind, Randomized Clinical Trial yang dilakukan selama periode bulan Februari-April 2017 di ruang rawat inap RSUD Abdul Wahab Sjahranie. Pengolahan data dilakukan dengan uji analisis statistik yaitu uji parametrik Two Independent T Test untuk data yang terdistribusi normal dan yang tidak saling berkolerasi, sedangkan untuk data yang terdistribusi tidak normal dan yang tidak saling berkolerasi maka digunakan uji non-parametrik Mann Whitney dan Kruskal Willis. Outcome yang diteliti adalah volume urin tampung 24 jam, sesak napas, lama pemakaian oksigen, ronkhi dan keamanan terapi yang dilihat dari efek samping obat (hipotensi, hiperuricemia, hiperglikemia, hiponatremia, hipokalemia). Hasil penelitian, sebanyak 34 pasien PGK dengan kondisi fluid overload syndrome disertai hipoalbumin (2,5-3,0 g/dL) telah didaftarkan. Pada efektivitas terapi, tidak ada perbedaan secara signifikan pada volume urin tampung 24 jam (P=0,324; P>0,05; 95% CI=714,6-1017,8 ml kelompok 1; CI=818,0-1113,2 ml kelompok 2), sesak napas (P=0,781; P>0,05; 95% CI=0,68-1,32 kelompok 1; CI=0,72-1,40 kelompok 2), lama pemakaian oksigen (P=0,363; P>0,05; 95% CI=1,34-2,66 hari kelompok 1; CI=1,72-3,10 hari kelompok 2), ronkhi (P=0,692; P>0,05) dan tidak adanya kejadian efek samping obat (P=1,000; P>0,05) antara dua kelompok tersebut. Kesimpulan, furosemid dosis 10 dan 20 mg/jam memiliki efektivitas terapi yang sama dan furosemid memiliki kemanan terapi yang baik pada pasien PGK dengan kondisi fluid overload syndrome disertai hipoalbuminemia.


2017 ◽  
Vol 42 (3) ◽  
pp. 244-252 ◽  
Author(s):  
P Vildósola ◽  
F Vera ◽  
J Ramírez ◽  
J Rencoret ◽  
H Pretel ◽  
...  

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


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