Evaluation of reservoirs in bleaching trays for at-home bleaching: a split-mouth single-blind randomized controlled equivalence trial.

Fabiana Madalozzo COPPLA,Alessandro Dourado LOGUERCIO,Michael Willian FAVORETO,Eveline Claudia MARTINI,Alessandra REIS

doi:10.1590/1678-7757-2020-0332

Fabiana Madalozzo COPPLA, Alessandro Dourado LOGUERCIO + Show 3 more

Open Access

https://doi.org/10.1590/1678-7757-2020-0332

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Abstract

ObjectivesThis randomized, split-mouth, single-blinded trial assessed whether the use of reservoirs in at-home bleaching trays is equivalent to non-reservoir trays. Our choice of an equivalence trial was based on the expectation that a non-reservoir tray is sufficient to produce a color change. Secondary outcomes such as tooth sensitivity (TS) and gingival irritation (GI) were also assessed.MethodologyForty-six patients were selected with canines shade A2 or darker. In half of the patient’s arch, bleaching trays were made with reservoirs and the other half, without reservoirs. At-home bleaching was performed with carbamide peroxide (CP) 10% (3 h daily; 21 days). Color change was evaluated with a digital spectrophotometer (ΔE, ΔE00, and Whiteness Index) and shade guide units (ΔSGU) at baseline, during and one-month post-bleaching. TS and GI were assessed with a numeric scale (NRS) and a visual analog scale (VAS).ResultsAfter one month, the equivalence of reservoir and non-reservoir groups were observed in all color instruments (p>0.05). Fifteen and sixteen patients presented pain (absolute risk: 33% and 35%, 95%, confidence interval (CI) 21-46% and 23-49%) in the reservoir and non-reservoir side, respectively. The odds ratio for pain was 0.8 (95%CI 0.2-3.0) and the p-value was non-significant (p=1.0). TS intensity was similar between both groups in any of the pain scales (p>0.05). No difference in the GI was observed (p>0.05).ConclusionsThe protocol with reservoirs is equivalent in color change to the non-reservoir, although no superiority of the latter was observed in terms of reduced TS and GI with at-home 10% carbamide peroxide bleaching.Clinical RelevanceThe presence of reservoirs in a bleaching tray did not improve color change or affect tooth sensitivity and gingival irritation.

Highlights

Dental bleaching is widely used to make teeth whiter and brighter, a common desire among patients.1-3 The dentist-supervised dental bleaching technique can be performed using high-concentrate materials or by dispensing low concentrate-material in a custom bleaching tray.Among these available protocols, clinicians consider at-home bleaching safer as it employs low concentrate products2 and reduces the risk and intensity of tooth sensitivity.4,5 it is an easy protocol, requires reduced chair-time, and it is cheaper than the in-office protocol.Since the introduction of at-home bleaching, several modifications of the protocol and materials occurred in the past years
The protocol with reservoirs is equivalent in color change to the non-reservoir, no superiority of the latter was observed in terms of reduced tooth sensitivity (TS) and gingival irritation (GI) with at-home 10% carbamide peroxide bleaching
Clinicians consider at-home bleaching safer as it employs low concentrate products2 and reduces the risk and intensity of tooth sensitivity

Summary

Introduction

Dental bleaching is widely used to make teeth whiter and brighter, a common desire among patients. The dentist-supervised dental bleaching technique can be performed using high-concentrate materials (in-office protocol) or by dispensing low concentrate-material in a custom bleaching tray (at-home use).Among these available protocols, clinicians consider at-home bleaching safer as it employs low concentrate products and reduces the risk and intensity of tooth sensitivity. it is an easy protocol, requires reduced chair-time, and it is cheaper than the in-office protocol.Since the introduction of at-home bleaching, several modifications of the protocol and materials occurred in the past years. The dentist-supervised dental bleaching technique can be performed using high-concentrate materials (in-office protocol) or by dispensing low concentrate-material in a custom bleaching tray (at-home use). Among these available protocols, clinicians consider at-home bleaching safer as it employs low concentrate products and reduces the risk and intensity of tooth sensitivity.. Clinicians consider at-home bleaching safer as it employs low concentrate products and reduces the risk and intensity of tooth sensitivity.4,5 It is an easy protocol, requires reduced chair-time, and it is cheaper than the in-office protocol. The daily usage time of the bleaching tray was reduced and modifications in the manufacture of the bleaching trays were proposed with the presence of reservoirs. Carbamide peroxide or hydrogen peroxide with varied concentrations can be employed. The daily usage time of the bleaching tray was reduced and modifications in the manufacture of the bleaching trays were proposed with the presence of reservoirs.

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