Abstract
Background: The clinical evidence relate the effect of associating the in-office and at home vital tooth whitening, describing positive effects on tooth color change and reduction of dental sensitivity. Objective: The purpose of this randomized double-blind clinical trial was to evaluate the effect on the shortened application of in-office vital tooth whitening combined with different concentrations of at-home peroxides in the final tooth color change and dental sensitivity. Methods: Randomized double-blind clinical trial with 120 participants between 18-65 years, allocated in four tooth whitening treatment groups: G1= Carbamide Peroxide 10% + Hydrogen Peroxide 40%, G2= Carbamide Peroxide 15% + Hydrogen Peroxide 40%, G3= Carbamide Peroxide 20% + Hydrogen Peroxide 40%, G4= Hydrogen Peroxide 10% + Hydrogen Peroxide 40% was conducted. Tooth color was measured at baseline and dental sensitivity and tooth color change during and after treatment. Results: No statistical significant differences were found in tooth color change (superior arch p= 0.183 / inferior arch p= 0.374), and in dental sensitivity (p=0.268). Conclusion: Reducing the application time of in-office whitening, combined with in-home products was effective in improving the color. All groups resulted in identical final color change and dental sensitivity. Clinicaltrials.gov: NCT02682329 Available from: https://clinicaltrials.gov/ct2/show/NCT02682329?term=hydrogen+peroxide.
Highlights
Vital Tooth Whitening (VTW) is a widely documented non-invasive technique that improves the aesthetic for discolored teeth [1 - 10]
All groups resulted in identical final color change and dental sensitivity
Analysis of variance (ANOVA) and HSD Tukey test detected that there was no statistical significance for the color change in the superior/ inferior arc for de 4 experimental groups (p= 0.183/ p=0.374)
Summary
Vital Tooth Whitening (VTW) is a widely documented non-invasive technique that improves the aesthetic for discolored teeth [1 - 10]. Vaez et al [19], concluded that the combined technique reduced the time necessary to obtain satisfactory tooth color compared with at-home bleaching, but increased the risk and level of DS. To decrease DS in at-office protocols, it has been suggested that a single application of the VTW gel is applied, since the amount of product that reaches the pulp might be reduced, Reis et al [18], showed that one 45 minutes application reduces the whitening speed and increases the DS intensity, compared to 315 minutes protocol. In order to decrease the interaction with high Hydrogen Peroxide concentration, Rodriguez et al [4], evaluated the combined technique with two in-office sessions, showing that both protocols result in acceptable color and same DS, in this order Kose et al [10], found that a single 15 minutes session produced less DS but reduced the whitening effect. The clinical evidence relate the effect of associating the in-office and at home vital tooth whitening, describing positive effects on tooth color change and reduction of dental sensitivity
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