Abstract
Tooth bleaching has become the first clinical option in reversing chromatic changes. This study evaluated the efficiency of four different approaches for home-based chemically induced tooth whitening. 32 patients were randomly distributed into four groups (n=8), according to the bleaching technique performed: G1: control group – at-home dental bleaching with 10% carbamide peroxide (Whiteness Perfect/FGM) delivered in a customized tray, G2: teeth whitening pen containing hydrogen peroxide (Walgreens), G3: night-time whitening gel (CVS) containing hydrogen peroxide and G4: whitening strips (3D White Oral B) containing 10% hydrogen peroxide. Chromatic changes (ΔE) were collected at baseline and at the middle and end of the treatment, using a digital spectrophotometer (EasyShade – Vita). Tooth sensitivity, gingival irritation, and degree of satisfaction were also recorded. The comparison between the average ΔE means, considering the final and initial values, revealed a statistically significant difference between the results obtained by G1 (ΔE2=11.65) and the other groups (ΔE2 of G2=4.38, G3=4.83 and G4 = 8.32). No significant difference was observed in the occurrence of tooth sensitivity and gingival irritation. The patients from G1 and G4 were more satisfied with the treatment outcome.
Highlights
Disharmony in the shape and color of the teeth directly interferes with the attractiveness of the smile, which may have consequences for the individual's personal life, psychological profile, and even professional attitude, which can cause significant negative effects on health and well-being (Afroz et al, 2016).Tooth bleaching has become the first option in reversing chromatic changes in teeth and can have a positive effect depending on the etiology and intensity of tooth darkening
Regarding the value of L *, significant variations were observed in Group 1 (G1) and Group 4 (G4), an increase in this value was observed at after the bleaching treatment, there was, for Group 2 (G2) and Group 3 (G3), a decrease in the value of L *, presenting a negative average between the final and initial evaluation (Table 1)
Posttreatment tooth shades were darker in G2 and G3 (Table 2)
Summary
Tooth bleaching has become the first option in reversing chromatic changes in teeth and can have a positive effect depending on the etiology and intensity of tooth darkening. The bleaching agents act mainly through the oxidation of organic compounds. These agents are highly unstable and, when in contact with the tissue, release free radicals (mainly nascent oxygen) that oxidize the pigments. The released oxygen penetrates the dentinal tubules and acts on compounds with carbon rings that are highly pigmented, converting them into lighter compounds (Carey, 2014). The success of whitening will depend directly on the concentration of the agent, its ability to penetrate to reach the chromophoric molecules, and the duration and number of times that it remains in contact with these molecules (Wang et al, 2020)
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