Minimally invasive approach for improving aesthetic in a patient with tetracycline-stained teeth by bleaching: A clinical evaluation

Abstract

ObjectiveTo compare 16% carbamide peroxide (CP) with a higher concentration of hydrogen peroxide (HP) for bleaching teeth in office or at-home to erase tetracycline stains on teeth. Materials and methodsIn a randomized, self-controlled clinical trial, we assigned eligible subjects to group A with 40% HP compared with 16% CP or group B with 45% CP compared with 16% CP on the split maxillary arch and followed the manufacturers’ instructions. Tooth color changes were measured with vita 3D-bleached guide and colorimeter at baseline and three-time assessment. Tooth sensitive intensity was evaluated using numeric rating scales, and oral soft and hard tissue examination was recorded. Patient satisfaction survey was conducted at the last tooth color evaluation. ResultsThere were 20 subjects enrolled. The color changes by the end of the study were A1 (40% HP) = 8.22, A2 (16% CP) = 8.20, B1 (45% CP) = 11.27, B2 (16% CP) = 8.26 respectively. All groups experienced significant shade reductions by bleaching, the 45% CP group had significantly greatest color changes compared with the other groups (p = 0.03). For tooth sensitivity evaluation, significant differences were observed in 40% HP group (p = 0.01), but with mild level. None patients suffered oral soft or hard tissue abnormalities before and after treatment. Patients were more in favor of using 45% CP according to the questionnaire results. ConclusionThe 3 whitening agents were effective and safe for the whitening of tetracycline-stained teeth, the 45% CP agent had quicker whitening efficacy with low tooth sensitivity and positive feedback. Clinical significance45% of high-concentration CP whitener by at-home using, brought faster and superior efficacy to bleaching tetracycline-stained teeth while had the equal intensity of tooth sensitivity.