Abstract
Objective Our study aims to compare the efficacy and tooth sensitivity following in-office (35% hydrogen peroxide) or at-home (10% carbamide peroxide) bleaching treatments both preceded by 2% potassium nitrate (2%KF) desensitizing gel.Methodology 130 volunteers were randomly allocated to a) in-office bleaching and a placebo at-home protocol; or b) in-office placebo and at-home bleaching treatment. 2% KF was applied for 10 min before both treatments.Objective color evaluation was performed (spectrophotometer CIEL*a*b* system and CIEDE2000) to calculate the color change (ΔE00). Subjective evaluation was performed using the VITA classical shade guide followed by shade variation (ΔSGU) at the beginning and end of bleaching treatment and 2 weeks post-bleaching. Tooth sensitivity was daily recorded using a Likert scale varying from 1 (no sensitivity) to 5 (severe sensitivity). Analysis was carried out using non-parametric tests.Results Regarding the color change, at-home bleaching resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.003) and Δa* (p=0.014). Two weeks post-bleaching, the at-home treatment resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.037) and ΔE00 (p=0.033). No differences were observed in either ΔSGU parameters. Concerning sensitivity, patients treated with in-office bleaching reported more tooth sensitivity than the at-home group only on the first day after bleaching started, without significant differences in the other periods evaluated (p>0.05).Conclusions At-home and in-office bleaching, preceded by a desensitizing agent, were effective for vital teeth bleaching and 10% carbamide peroxide produced a higher whitening effect than 35% hydrogen peroxide in the short time evaluation. Tooth sensitivity rates were similar for the two techniques tested.
Highlights
Tooth bleaching is the most common esthetic treatment requested by individuals.[1,2] Many techniques and products are available for tooth bleaching, but at-home bleaching using low concentration gel (10% carbamide peroxide - CP) in a custom tray is still considered the gold-standard treatment for tooth discoloration in vital teeth.[3,4] This treatment has been effective in producing whiter teeth – lasting up to 2 years without color reversal6 – with none or mild transient tooth sensitivity and it is well accepted by patients.[4,5] Some patients, present difficulties in adaptation to at-home protocol, since they prefer not to use a bleaching tray or are not willing to wait 2-3 weeks to see the results, wanting a faster bleaching effect
Our study aims to compare the efficacy and tooth sensitivity following in-office (35% hydrogen peroxide) or at-home (10% carbamide peroxide) bleaching treatments both preceded by 2% potassium nitrate (2%KF) desensitizing gel
130 volunteers were randomly allocated to a) in-office bleaching and a placebo at-home protocol; or b) in-office placebo and at-home bleaching treatment. 2% KF was applied for 10 min before both treatments
Summary
Tooth bleaching is the most common esthetic treatment requested by individuals.[1,2] Many techniques and products are available for tooth bleaching, but at-home bleaching using low concentration gel (10% carbamide peroxide - CP) in a custom tray is still considered the gold-standard treatment for tooth discoloration in vital teeth.[3,4] This treatment has been effective in producing whiter teeth – lasting up to 2 years without color reversal6 – with none or mild transient tooth sensitivity and it is well accepted by patients.[4,5] Some patients, present difficulties in adaptation to at-home protocol, since they prefer not to use a bleaching tray or are not willing to wait 2-3 weeks to see the results, wanting a faster bleaching effect. Tooth bleaching is the most common esthetic treatment requested by individuals.[1,2] Many techniques and products are available for tooth bleaching, but at-home bleaching using low concentration gel (10% carbamide peroxide - CP) in a custom tray is still considered the gold-standard treatment for tooth discoloration in vital teeth.[3,4] This treatment has been effective in producing whiter teeth – lasting up to 2 years without color reversal6 – with none or mild transient tooth sensitivity and it is well accepted by patients.[4,5]. Present difficulties in adaptation to at-home protocol, since they prefer not to use a bleaching tray or are not willing to wait 2-3 weeks to see the results, wanting a faster bleaching effect In these cases, in-office bleaching could be an alternative.[7]. A meta-analysis has reported that both potassium nitrate and sodium fluoride were effective in reducing tooth sensitivity,[13] despite the contradictory results observed in recent studies.[12,14,15]
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