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Aidos M, Marto CM, Amaro I, Cernera M, Francisco I, Vale F, Marques-Ferreira M, Oliveiros B, Spagnuolo G, Carrilho E, Coelho A, Baptista Paula A. Comparison of in-office and at-home bleaching techniques: An umbrella review of efficacy and post-operative sensitivity. Heliyon 2024; 10:e25833. [PMID: 38371984 PMCID: PMC10873745 DOI: 10.1016/j.heliyon.2024.e25833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 02/20/2024] Open
Abstract
Objectives The objective of this umbrella review is to evaluate the efficacy and adverse effects of different teeth whitening techniques in-office (IO) and at-home (AH), regarding chromatic changes and teeth sensitivity. Materials and methods The search was carried out from several databases. The included studies were all systematic reviews with or without meta-analysis of RCT or quasi-RCT. The participants were patients that underwent external dental bleaching in permanent vital teeth. The interventions were in-office (IO) bleaching techniques and at-home (AT) bleaching techniques with different bleaching agents and concentrations. Results The search resulted in a total of 257 articles, and 28 SR were included in the qualitative analysis and nine in the quantitative analysis. There is no difference between in-office and at-home techniques in terms of color change (p = 0.95) and post-treatment sensitivity (p = 0.85). There is similarity risk and intensity of teeth sensitivity between AH and IO bleaching. IO bleaching with light-activated systems with low concentrations of bleaching agent showed similar results to IO bleaching techniques with high concentrated bleaching gels. With the application of the criteria of the AMSTAR 2 tool, the reviews were considered critically low to high. Conclusions There are no significant differences in terms of color change between the different bleaching techniques compared. Teeth sensitivity is always present regardless of the technique used. The use of light activation systems did not increase the intensity and risk of post-operative sensitivity.
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Affiliation(s)
- Maria Aidos
- Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal
| | - Carlos Miguel Marto
- Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Institute of Experimental Pathology, Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Inês Amaro
- Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Mariangela Cernera
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples, “Federico II”, 80131, Naples, Italy
| | - Inês Francisco
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Univ Coimbra, Institute of Orthodontics, Faculty of Medicine, Coimbra, Portugal
| | - Francisco Vale
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Univ Coimbra, Institute of Orthodontics, Faculty of Medicine, Coimbra, Portugal
| | - Manuel Marques-Ferreira
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Univ Coimbra, Institute of Endodontics, Faculty of Medicine, Coimbra, Portugal
| | - Bárbara Oliveiros
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Univ Coimbra, Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, Coimbra, Portugal
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples, “Federico II”, 80131, Naples, Italy
| | - Eunice Carrilho
- Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Ana Coelho
- Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Anabela Baptista Paula
- Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal
- Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal
- Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal
- Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
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Daneshpooy M, Azar FP, Nouri F, Safaralizadeh R. Investigating the Effect of Internal Bleaching With 10% Carbamide Peroxide on the Color Change of Three Types of Common Endodontic Sealers. Cureus 2024; 16:e53116. [PMID: 38420069 PMCID: PMC10899006 DOI: 10.7759/cureus.53116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
Background and purpose Color change caused by materials used for endodontic treatment is an important clinical issue. The current research examined the impact of internal bleaching with 10% carbamide peroxide on discolored teeth resulting from various types of sealers. Materials and methods In this study, 36 anterior teeth were cut from 1 mm beneath the cementoenamel junction (CEJ), and the samples were divided into three groups of 12. Then, AH26 (Tulsa Dental, Tulsa, OK), Endofill (Herpo Produtos Dentários Ltda, Petrópolis, Brazil), and AH Plus (Dentsply DeTrey, Konstanz, Germany) color change potential sealers were placed inside the pulp chamber. The cervical access cavity was covered with a thin layer of glass ionomer. After one month, the material was removed, and bleaching was done with 10% carbamide peroxide. The color of the samples was measured by a spectrophotometer before bleaching, one week after bleaching, and one week after bleaching again. The data were subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS) software version 16 (IBM SPSS Statistics, Armonk, NY), with a significance level set at P<0.05. Results The results showed that the factor of time and material used and the opposing effect of these two on the amount of L and ΔE were statistically significant (P<0.05). After one to two weeks of internal bleaching, all groups showed some degree of reduction in sealer-induced discoloration. In addition, in all groups, the largest difference in L was related to the difference in L0 and L2 (before bleaching and one week after bleaching again), and the lowest difference was related to the difference in L0 and L1. Also, the highest ΔE(T0,T1) belonged to the Endofill group, and this significantly differed from the AH26 group. AH26 showed the lowest value of ΔE(T0,T1), and after two weeks, the ΔE of all groups was higher than the clinically observable limit. The highest ΔE(T2,T0) among the groups belonged to the Endofill group. The ΔE(T2,T0) of AH26 and Endofill was significantly higher than AH Plus. Among all ΔE values, the AH Plus group had the lowest values. Conclusion Color change caused by Endofill and AH26 sealers showed a better response to internal bleaching than the AH Plus sealer.
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Affiliation(s)
- M Daneshpooy
- Department of Operative Dentistry, Dental Faculty, Tabriz University of Medical Sciences, Tabriz, IRN
| | - F Pournaqi Azar
- Department of Operative Dentistry, Dental Faculty, Tabriz University of Medical Sciences, Tabriz, IRN
- Dental and Periodontal Research Center, Dental Faculty, Tabriz University of Medical Sciences, Tabriz, IRN
| | - F Nouri
- Department of Operative Dentistry, Dental Faculty, Tabriz University of Medical Sciences, Tabriz, IRN
| | - Reza Safaralizadeh
- Dental and Periodontal Research Center, Dental Faculty, Tabriz University of Medical Sciences, Tabriz, IRN
- Department of Operative Dentistry, Dental Faculty, Tabriz University of Medical Sciences, Tabriz, IRN
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Yezdani S, Khatri M, Vidhya S, Mahalaxmi S. Effect of strontium fluorophosphate bioactive glass on color, microhardness and surface roughness of bleached enamel. Technol Health Care 2024; 32:285-292. [PMID: 37270825 DOI: 10.3233/thc-230074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Undesirable effects of tooth bleaching can alter the biomechanical properties of enamel. OBJECTIVE To determine the influence of strontium fluorophosphate bioactive glass (Sr-FPG) on color, microhardness and surface roughness of enamel bleached with 35% hydrogen peroxide. METHODS The labial enamel of 36 extracted intact human anterior teeth were divided into 3 groups (n= 12), group 1 (HP): bleaching with 35% hydrogen peroxide only, group 2 (Sr-HP): bleaching with Sr-FPG incorporated 35% hydrogen peroxide and group 3 (HP-SrFPG): bleaching with 35% hydrogen peroxide followed by remineralization with Sr-FPG. Four consecutive eight-minute applications of the bleaching gel were done twice in all the groups. Color change (ΔE), microhardness and surface roughness were evaluated at baseline, post-bleaching and post-remineralization using spectrophotometer, Vickers hardness tester and profilometric analysis respectively. RESULTS The mean ΔE among the groups was statistically similar (p> 0.05). Bleaching with HP significantly reduced microhardness (p< 0.05), whereas bleaching with Sr-HP and HP-SrFPG did not (p> 0.05). Post-bleaching microhardness in Sr-HP was significantly higher than HP-SrFPG (p< 0.05). An increased surface roughness was seen in Sr-HP bleached samples (p< 0.05). CONCLUSION The addition of Sr-FPG to hydrogen peroxide significantly improved enamel microhardness than its use post-bleaching. An increase in surface roughness was seen post-bleaching with HP and Sr-HP.
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Modern concepts of teeth whitening – a narrative review. EUREKA: HEALTH SCIENCES 2022. [DOI: 10.21303/2504-5679.2022.002690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Whitening has been known since Biblical times. Nowadays, in the developed world, patients are placing a stronger interest in the aesthetic appearance of their teeth. As a result, public demand for aesthetic dentistry, including tooth whitening, has recently increased. Aesthetics of the teeth is of great importance to many patients.
The aim is to summarise and discuss the teeth whitening procedure, tools, materials, and methods, as well as its efficacy and safety. In addition, the paper aims to provide full and comprehensive information for dentists and their patients about the merits and perils of whitening.
Methods. Relevant literature from Scopus published in English was selected using the following search criteria "tooth OR teeth AND whitening OR bleaching" by 2022. In total, there were found 3840 papers. Then, we applied the inclusion and exclusion criteria to the selected scientific papers to choose the relevant ones.
Results. A comprehensive study of the available information related to means and products for teeth whitening was carried out. Whitening may be accomplished by the physical removal of the stain or a chemical reaction to lighten the tooth colour. The indications for appropriate use of tooth-whitening methods and products depend on the correct diagnosis of the discolouration. When used appropriately, tooth-whitening methods are safe and effective.
Conclusions. Tooth whitening is a form of dental treatment and should be completed as part of a comprehensive treatment plan developed by a dentist after an oral examination.
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Barros Júnior EDS, Ribeiro MES, Lima RR, Souza Júnior MHDSE, Loretto SC. Excessive Dental Bleaching with 22% Carbamide Peroxide Combined with Erosive and Abrasive Challenges: New Insights into the Morphology and Surface Properties of Enamel. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7496. [PMID: 36363088 PMCID: PMC9655651 DOI: 10.3390/ma15217496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to evaluate the effects of 22% carbamide peroxide combined with an erosive challenge and simulated brushing on enamel. Bovine incisor teeth were divided into G1, tooth bleaching; G2, tooth bleaching + erosive challenge; and G3, tooth bleaching + erosive challenge + simulated brushing, and evaluated at T0, before any intervention; T1, 14 days after the proposed treatments; and T2, 28 days after the proposed treatments. Tooth bleaching was performed daily for 1 h for 28 days. The microhardness, surface roughness, mass variation, and ultrastructure were analyzed at T0, T1, and T2. Two-way analysis of variance for repeated measures was performed and Tukey's post hoc test (α = 5%) was used. The surface roughness increased in groups G2 and G3 as a function of time, whereas microhardness and mass measurements demonstrated a significant reduction for groups associated with challenges. Ultrastructural evaluation indicated a loss of the aprismatic layer and exposure of the enamel prisms in all groups after 14 days of bleaching, with more pronounced results in G2 and G3 after 28 days. In conclusion, abrasive and erosive challenges potentiated the deleterious effects of tooth whitening on microhardness, ultramorphology, and mass, without affecting the roughness of dental enamel.
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Affiliation(s)
- Edson de Sousa Barros Júnior
- Biomaterials Laboratory of the Postgraduate Program in Dentistry, Institute of Health Sciences, UFPA, Belém 66075-110, Pará, Brazil
| | - Mara Eliane Soares Ribeiro
- Biomaterials Laboratory of the Postgraduate Program in Dentistry, Institute of Health Sciences, UFPA, Belém 66075-110, Pará, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, UFPA, Belém 66075-110, Pará, Brazil
| | | | - Sandro Cordeiro Loretto
- Biomaterials Laboratory of the Postgraduate Program in Dentistry, Institute of Health Sciences, UFPA, Belém 66075-110, Pará, Brazil
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Klär V, Palarie V, Burkovski A, Karl M, Grobecker-Karl T. Pilot study on the applicability of boron-doped diamond electrodes for tooth whitening. Clin Exp Dent Res 2022; 8:757-762. [PMID: 35543493 PMCID: PMC9209806 DOI: 10.1002/cre2.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives While various approaches are available for tooth whitening, the basic concept employs the use of peroxides in the form of gels, which are applied to tooth surfaces. Previous studies have shown that reactive oxygen species acting as potent disinfectants can be produced using boron‐doped diamond (BDD) electrodes for the electrolysis of water. With these electrodes being applicable, for example, for endodontic treatment, it was the goal of this pilot study to use such electrodes for tooth whitening. Material and Methods Two groups (n = 10) of intact clinical crowns were obtained by horizontally cutting off roots of extracted human teeth. The crowns were either bleached by applying a commercially available agent based on 40% hydrogen peroxide or were immersed in saline undergoing electrolysis with BDD electrodes. Whitening of specimens was judged on standardized photographs by examiners with three different levels of experience. Statistical analysis was based on Gwet's AC2 coefficient with quadratic weights, Shapiro–Wilk tests, and two‐way analysis of variance of aligned rank transformed data (level of significance set at α = .05). Results Levels of reliability ranging from fair to substantial were recorded for single persons while the level of reliability ranged between fair and moderate for groups of raters. The level of experience had no significant effect on the ratings (p = .2500). The bleaching method had a significant effect on ratings (p = .0005) with BDD electrodes showing less effect. Conclusions Bleaching by applying BDD electrodes was possible, but was not as effective as the use of commercially available in‐office whitening gel. A potential explanation may be seen in different concentrations of reactive oxygen species.
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Affiliation(s)
- Virgilia Klär
- Department of Prosthodontics, Saarland University, Homburg/Saar, Germany
| | - Victor Palarie
- Laboratory of Tissue Engineering and Cellular Cultures, State University of Medicine and Pharmacy "N. Testemitanu", Chisinau, Moldova
| | - Andreas Burkovski
- Microbiology Division, Department of Biology, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Karl
- Department of Prosthodontics, Saarland University, Homburg/Saar, Germany
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Manso AP, De Morais DC, Yamamoto K, Owen G, de Carvalho RM, Palma-Dibb RG. Effects of prolonged use of over-the-counter bleaching agents on enamel: An in vitro study. Microsc Res Tech 2021; 85:1016-1027. [PMID: 34693595 DOI: 10.1002/jemt.23970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/29/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022]
Abstract
This study evaluated the effects of four over-the-counter (OTC) bleaching products on the properties of enamel. Extracted human molars were randomly assigned into four groups (n = 5): PD: Poladay (SDI), WG: White Teeth Global (White Teeth Global), CW: Crest3DWhite (Procter & Gamble), and HS: HiSmile (HiSmile). The hydrogen peroxide (H2 O2 ) content in each product was analyzed via titration. Twenty teeth were sectioned into quarters, embedded in epoxy resin, and polished. Each quarter-tooth surface was treated with one of the four beaching times: T0: control/no-bleaching, T14: 14 days, T28: 28 days, and T56: 56 days. Materials were applied to enamel surfaces as recommended. Enamel surfaces were examined for ultramicrohardness (UMH), elastic modulus (EM), superficial roughness (Sa), and scanning electron microscopy (SEM). Ten additional teeth were used to evaluate color and degree of demineralization (DD) (n = 5). Data were statistically tested by two-way ANOVA and Tukey's tests (α = 5%). Enamel surfaces treated with PD and WG presented UMH values significantly lower than the controls (p < .05). Elastic modulus (E) was significantly reduced at T14 and T28 for PD, and at T14 for HS (p < .05). A significant increase in Sa was observed for CW at T14 (p < .05). Color changes were observed in the PD and WG groups. Additionally, DD analysis showed significant demineralization at T56 for CW. Overall, more evident morphological alterations were observed for bleaching products with higher concentrations of H2 O2 (p < .05), PD, and WG. Over-the-counter bleaching products containing H2 O2 can significantly alter enamel properties, especially when application time is extended.
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Affiliation(s)
- Adriana P Manso
- Division of Restorative Dentistry, Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Dayana C De Morais
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kayoko Yamamoto
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Gethin Owen
- Centre for High-Throughput Phenogenomics, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ricardo Marins de Carvalho
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Regina G Palma-Dibb
- Department of Restorative Dentistry, Faculty of Dentistry, The University of Sao Paulo at Ribeirao Preto, Ribeirao Preto, Brazil
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Chemin K, Rezende M, Costa MC, Salgado A, de Geus JL, Loguercio AD, Reis A, Kossatz S. Evaluation of At-home Bleaching Times on Effectiveness and Sensitivity with 10% Hydrogen Peroxide: A Randomized Controlled Double-blind Clinical Trial. Oper Dent 2021; 46:385-394. [PMID: 34370025 DOI: 10.2341/20-104-c] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this randomized double-blind controlled clinical trial was to evaluate different protocols for at-home use of 10% hydrogen peroxide in whitening effectiveness and tooth sensitivity. METHODS Seventy-two patients were selected according to the inclusion and exclusion criteria, with the upper central incisors having color A2 or darker according to the Vita Classical scale (VITA Zahnfabrik, Bad Säckingen, Germany) and randomized into two groups: 10% hydrogen peroxide applied once daily for 15 minutes (HP 15) or applied once daily for 30 minutes (HP 30). Bleaching was performed for 14 days in both groups. The color was evaluated before bleaching, during bleaching (1st and 2nd weeks), and 1 month after the bleaching treatment using the Vita Classical, Vita Bleachedguide 3D-MASTER, and Vita Easyshade spectrophotometer (VITA Zahnfabrik). Dental sensitivity was recorded by the patients using the numerical rating scale (0-4) and visual analogue scale (0-10 cm). Color data were evaluated by two-way analysis of variance (ANOVA) of repeated measures (group vs. treatment time). The Mann-Whitney test was performed to contrast the means (α=0.05). Tooth sensitivity was assessed by Fisher's exact test (p=1.00) and intensity of tooth sensitivity was evaluated by the Mann-Whitney test (α=0.05) for both scales. RESULTS A significant whitening effect was observed after 2 weeks of bleaching for all color measurements (p=0.01), with no difference between HP 15 and HP 30 (p>0.05). Also, the absolute risk and intensity of tooth sensitivity were similar (47%; p>0.05). CONCLUSIONS The effectiveness and tooth sensitivity of at-home bleaching carried out with 10% hydrogen peroxide applied for 15 minutes or 30 minutes are similar.
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de Freitas MR, de Carvalho MM, Liporoni PCS, Fort ACB, Moura RDME, Zanatta RF. Effectiveness and Adverse Effects of Over-the-Counter Whitening Products on Dental Tissues. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The role of bleaching agents (e.g., hydrogen peroxide) in tooth bleaching is quite well-described in a few literature studies and considered as the option choice for those desiring brighter teeth, but alternative methods have emerged to fulfill the desire of patients in a faster, easier, and cheaper way. In this context, whitening over-the-counter (OTC) products are available in several vehicles, such as toothpaste, rinses, gums, paint-on varnishes, and strips, but their effectiveness in terms of bleaching is questioned. This review aimed to describe their mode of action, whitening effectiveness, and harmful effects associated with the indiscriminate use of these products. Dentifrices usually present a combination of abrasives that can induce damage to the tooth surface without evidence of promoting real bleaching. The same was found for rinses, which might present a low pH, with an erosive potential. Charcoal has been included in the composition of these products to improve their whitening effect but there is no evidence supporting it. Regarding strips, they present hydrogen peroxide in a variety of concentrations and are the only OTC products able to promote bleaching. Despite the vehicle, an indication for the use of these products should be made after a careful individual diagnosis of the etiology of the dental staining, considering that most of them seem to be effective only in removing extrinsic stains or preventing their formation over enamel. Also, their indiscriminate use might induce damage and deleterious effects over tooth tissues or gingival tissues. The dentist should be aware of the composition and mode of action of each individual product as they change according to the composition and the vehicle used to recommend the best mode of usage. Still, there is no sound evidence that any of the described OTC products promote a better bleaching effect than the products indicated for a professional.
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