Abstract
Tooth whitening represents perhaps the most common aesthetic procedure in dentistry worldwide. The efficacy of bleaching depends on three aspects: bleaching agent, bleaching method, and tooth color.Objective:This in vivo study aimed to examine whitening effects on frontal teeth of the upper and lower jaws using an over-the-counter (OTC) non-hydrogen peroxide bleaching agent in comparison to a placebo after one single use.Material and methods:Forty subjects (25 female; 15 male) participated in this double-blind randomized placebo-controlled trial. The subjects were randomly allocated to two groups (n=20). The test group received the OTC product (iWhite Instant) and the placebo group received an identically composed product except for the active agents. Each subject was treated with a prefilled tray containing iWhite Instant or the placebo for 20 minutes. The tooth shade of the front teeth (upper and lower jaws) was assessed before (E_0), immediately after (E_1) and 24 h after treatment (E_2), using a shade guide (VITA classical). Statistical testing was accomplished using the Mann-Whitney U test (p<0.001). The dropout rate was 0%.Results:There were no significant differences at E_0 between placebo and test groups regarding the tooth color. Differences in tooth color changes immediately after (ΔE1_0) and 24 h after treatment (ΔE2_0) were calculated for both groups. The mean values (standard deviations) of tooth color changes for ΔE1_0 were 2.26 (0.92) in the test group and 0.01 (0.21) in the placebo group. The color changes for ΔE2_0 showed mean values of 2.15 (1.10) in the test group and 0.07 (0.35) in the placebo group. For ΔE1_0 and ΔE2_0 significant differences were found between the groups.Conclusion:In this short-term study, the results showed that a non-hydrogen peroxide bleaching agent has significant whitening effects immediately and 24 h after a single-use treatment.
Highlights
According to representative data from the United Kingdom and from a study with Chinese urban population, the prevalence of tooth discoloration in 1365 year-olds is approximately 50%3,27
The (XURSHDQ6FLHQWL¿F&RPPLWWHHRQ&RQVXPHU3URGXFWV (SCCP)4 reported that the use of tooth whitening products containing >0.1 to 6.0% hydrogen peroxide or equivalent hydrogen peroxide-releasing substances is safe after consultation with a dentist
The mean (±standard deviation, and 95% FRQ¿GHQFHOHYHO&, tooth color shade E_0 was 9.84 (±1.93, 95% CI=8.94-10.74) unit for the test group and 9.21 (±1.11, 95% CI=8.69-9.73) unit for VITA color scale mean
Summary
According to representative data from the United Kingdom and from a study with Chinese urban population, the prevalence of tooth discoloration in 1365 year-olds is approximately 50%3,27. Tooth whitening is perhaps the most frequently applied aesthetic procedure in dentistry. The etiology of tooth discolorations is multi-causal and can result from individual behavior, diseases, injury and other exposures along with various physiological processes. Professional cleaning of discolored teeth is a common procedure to remove the majority of extrinsic strains. Most bleaching products use hydrogen peroxide as active agent. Bleaching treatments with peroxide may cause local adverse effects such as oral mucosa irritation, pulpal sensitivity, pulpitis or alteration of the enamel surface. On the other hand, bleaching is a relatively safe procedure that predominantly causes severe adverse effects only at high hydrogen peroxide concentrations on hard tissue, soft tissue and restorative materials. The (XURSHDQ6FLHQWL¿F&RPPLWWHHRQ&RQVXPHU3URGXFWV (SCCP) reported that the use of tooth whitening products containing >0.1 to 6.0% hydrogen peroxide or equivalent hydrogen peroxide-releasing substances is safe after consultation with a dentist
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