Abstract
This controlled randomized clinical trial evaluated the effect of associating at-home and in-office bleaching procedures on tooth sensitivity (TS) and bleaching effectiveness. Forty patients subjected to on session of in-office bleaching with 38% peroxide hydrogen. Subsequently, the patients were randomly allocated to receive a second session of in-office bleaching or to use a tray containing 10% carbamide peroxide delivered during 7 consecutive days. The worst TS score reported during or after each bleaching procedure was recorded using a verbal rating scale and TS risk (score different from 0) was calculated. Color changes were measured 7 days after each in-office session (for patients receiving in-office procedures only) or after the end of at-home bleaching (for the combined protocol), and 6 months after the last procedure for both bleaching protocols. Color was assessed by a spectrophotometer and by color match with the Vita Classical and Bleach guide scales. Statistical analyses were carried out to assess possible differences between the protocols regarding the outcomes and to analyze the effect of time of assessment on color changes. The bleaching protocol did not affect the risk for and the maximum level of TS reported, irrespective of the time of assessment. In the color evaluation, the bleaching protocol also did not affect the ultimate tooth color. In conclusion, after one in-office bleaching session, there was no difference in bleaching effectiveness and TS between performing a second in-office session and associating it with 1-week at-home bleaching.
Highlights
Bleaching is a usual conservative clinical procedure carried out by clinicians to solve esthetic problems associated with tooth discoloration
Irrespective of the tool used to measure color changes, no differences between the evaluated protocols were observed at any time of assessment
In-office tooth bleaching has a high incidence of tooth sensitivity (TS) and usually requires two or three around 1-hour sessions for a satisfactory bleaching effect [2,3]
Summary
Bleaching is a usual conservative clinical procedure carried out by clinicians to solve esthetic problems associated with tooth discoloration This esthetic procedure can be performed either by clinicians in the office using high concentrations of hydrogen peroxide or by patients at home using customized trays that deliver peroxide (usually carbamide peroxide) at low concentrations [1,2]. The fact that clinicians do not have to rely on patient collaboration and have increased control over the procedure provides additional advantages to in-office bleaching. Another important aspect is the time of treatment required to obtain the tooth color desired by the patient
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