Carbamide Peroxide Bleaching Research Articles

Effectiveness of desensitizing toothpastes in reducing tooth sensitivity after tooth bleaching: a systematic review.

To evaluate the effectiveness of desensitizing toothpastes in reducing post-bleaching tooth sensitivity. A systematic review of randomized clinical trials was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Electronic searches were conducted in the PubMed/MEDLINE, Scopus, Web of Science, The Cochrane Library and Embase databases, using the following terms: (dentifrices OR toothpaste) AND (sensitive OR sensitivity OR dental sensitivity) AND (dental bleaching OR tooth bleaching OR dental whitening OR tooth whitening). Five studies involving 387 individuals undergoing in-office or at-home teeth bleaching were reviewed. Desensitizing toothpastes reduced sensitivity effectively after home bleaching with 22% carbamide peroxide and single-session in-office bleaching with 35% hydrogen peroxide. However, they were ineffective for home bleaching with 16% carbamide peroxide and in-office bleaching across two sessions with 35% or 38% hydrogen peroxide. Desensitizing toothpastes are effective for home bleaching with high concentration carbamide peroxide and single-session in-office bleaching with highly concentrated hydrogen peroxide, but ineffective for home bleaching with low concentration carbamide peroxide and two-session in-office bleaching with concentrated hydrogen peroxide.

Effect of Various Vital Bleaching Systems on Clinical Outcomes and Patient Satisfaction.

Objective To evaluate the clinical behavior of different bleaching products - the hydrogen peroxide (H2O2), carbamide peroxide (CP), and titanium dioxide bleaching systems. Methods Three bleaching systems with different concentrations (H2O2 15%, 38%, CP 15%, 35%, and titanium dioxide 20% H2O2) were used. Sixty participants with discolored teeth were enrolled and equally divided into six groups. Each group was rendered the assigned bleaching protocol against the control group, which received plain dentifrice polishing.Each case was evaluated immediately, two weeks, three months, six months, and one year after the bleaching treatment. The clinical evaluation was made for color change by (shade guide and digital images with L*a*b* parameters), tooth sensitivity, gingival irritation, and participants' satisfaction. Results All bleaching systems showed color improvement after bleaching regimens with significant effect showed by in-office titanium dioxide 20% H2O2 followed by 38% H2O2 with Δ=10.26 and Δ=6.52, respectively, when compared to other bleaching techniques. Higher sensitivity was recorded in group III with 50% of the participants reporting postoperative sensitivity. Higher gingival irritation was recorded in group IV (15% CP) where 60% of the patients reported gingival irritation. Thirty-five of the 60 participants (58.5%) recorded that the treatment whitened their teeth "moderately" and "a lot" while seven participants recorded "a slight" difference. There was a highly significant difference in participants' satisfaction between all bleaching groups (p < 0.05). Conclusion It is evident that there is a development of dental sensitivity and gingival irritation irrespective of the bleaching system used. The color assessment showed that the desired result can be achieved with variable levels of patientsatisfaction with excellent overall results with the titanium dioxide system.

The Effect of Carbamide Peroxide Bleaching Gel with and without Remineralizing Agents on Microtensile Bond Strength of Resin Composites to Enamel

Introduction: Carbamide peroxide bleaching gel, along with remineralizing agents, can induce changes in the structure and mineral content of enamel, potentially leading to a decrease in the bond strength of resin composite to the enamel. Therefore, this laboratory study aimed to determine the effect of carbamide peroxide bleaching gel with and without remineralizing agents on the microtensile bond strength (µTBS) of resin composites with microhybrid and nanofill structures to enamel. Materials and Methods: Thirty extracted third molar teeth were randomly divided into five groups, each group subdivided into two equal subgroups: Group 1: Control group, Group 2: Bleaching gel without fluoride, Group 3: Bleaching gel containing fluoride, Group 4: Bleaching gel containing CPP-ACP, and Group 5: Bleaching gel containing fluoride and CPP-ACP. In the first subgroups, nanofilled resin composite Filtek Z350, while in the second subgroups, microhybrid resin composite Filtek Z250 were bonded to enamel surface. After specimen preparation, µTBS was measured using a universal testing machine. Data were analyzed using parametric tests (P value&lt;0.05). Results: The highest µTBS of resin composite to enamel was observed in the control group, while the lowest bond strength was seen in the fluoride-containing bleaching group. Comparisons of µTBS between the study groups pairwise, except for the comparison between the control group and the bleaching group, the bleaching group with (CPP-ACP+Fluoride), and the (CPP-ACP) group with the fluoride group, showed significant differences in bond strength. Although, the mean µTBS of the Filtek Z250 composite was higher than the Filtek Z350 composite in all groups, but this difference was not statistically significant. Conclusion: The use of carbamide peroxide bleaching gel with remineralizing agents leads to a decrease in µTBS of the resin composite to the enamel.

Effect of Bleaching Agents on Healthy Enamel, White Spots, and Carious Lesions: A Systematic Review and Meta-Analysis.

This systematic review examines studies focusing on tooth bleaching and its effects on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Clinical studies, in vitro studies, and observational studies that compared at least two groups were included. A search strategy was used to select studies from the MEDLINE via Pubmed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. From 968 initial records, 28 studies were selected for a full-text evaluation. Of these, 7 studies were classified as cluster 1 (bacterial adherence on teeth), 12 studies as cluster 2 (no bacteria involved), 4 studies as cluster 3 (no teeth deployment), and 5 clinical studies were cluster 4. Of the selected studies, 6 (21.4%) supported increased bacterial attachment capacity and cariogenic dynamics, 4 (14.3%) decreased adhesion and cariogenic activity, 7 (25%) showed no difference, and 11 (39.3%) followed a different methodological approach and could not be categorized. The risk of bias appeared to be high, mainly because of the different methodologies in the studies, so we cannot reach a confident conclusion. Nevertheless, as far as carbamide peroxide bleaching is concerned, there does not seem to be a clinically significant alteration, neither in microorganism counts nor in enamel microstructure.

The Effect of Home Bleaching on Color Match with Anterior Single Shade Composite Restoration

Background: Aim of this study is to assess the color matching in class III restorations made with single-shade resin composite after bleaching with different carbamide peroxide concentrations. Methods: In this study, 20 human incisors that were free of caries or enamel abnormalities and freshly extracted for periodontal or orthodontic reasons were cleaned of blood, debris, and calculus. Mesial and distal surfaces were restored with single-shade composite (Omnichroma, Tokuyama, Japan). All samples were randomly divided into two groups, all of the mesial surfaces were isolated, and distal surfaces were coated with %10 and %15 carbamide peroxide (Opalescence PF; Ultradent Products, Inc, USA). Polishing discs (Zenit Flex, President Dental, Germany) were used the composite restoration. Color matching was evaluated on photographs with a digital colorimeter. SPSS software program was used to perform statistical analysis (IBM Corp., Armonk, NY, USA). Results: Statistically significant difference was found between the color matching of the restorations after the 5th treatment with 15% carbamide peroxide (p = 0.004), and at the end of 10th treatment with 10% carbamide peroxide (p = 0.028). Depending on the carbamide peroxide concentration, after the 5th treatment a statistically significant difference was found between 15% and 10% carbamide peroxide (p = 0.000), but no statistically significant difference after the 10th treatment (p &amp;gt; 0.05). Conclusions: After carbamide peroxide bleaching, hard tissue color became lighter. Since there is no color pigment in single-shade composites, color might be lighter after bleaching. Therefore, these composites may be considered safer in bleaching. Keywords: Bleaching, Color Match, Composite

In vitro evaluation of the effect of addition of biomaterials to carbamide peroxide on the bleaching efficacy and microhardness of enamel.

Teeth bleaching, although considered safe and conservative, cause microscopic changes in the tooth structure. The aim of this study is to evaluate the bleaching efficacy of carbamide peroxide (CP) bleaching gel when modified with the incorporation of bioactive glass (BG) and hydroxyapatite (HA) and its effect on enamel microhardness. Forty-five maxillary incisors were decoronated, artificially stained and mounted in acrylic. The samples were divided into three groups of 15 each and subjected to the following bleaching protocol for 8 h/day at 37°C for 2 weeks: Group 1 - 16% CP, Group 2 - CP modified with BG, and Group 3 - CP modified with hydroxyapatite (HA). Spectrophotometric color assessment using CIE L*a*b* system and Vickers microhardness were assessed before and after bleaching. Data were analyzed using Student's paired t-test and one-way ANOVA followed by Tukey's post hoc analysis. There was a significant change in color (L*a*b*) in all the three groups when compared to the baseline values. However, no significant difference in the total color change (ΔE) was observed between the three groups. Enamel microhardness reduced significantly in the CP group, whereas it increased in the BG and HA group after bleaching. Scanning electron microscopy images of BG and HA groups showed crystalline deposits suggesting mineral deposition. Addition of biomaterials can be a beneficial alternative to bleaching with CP alone, considering the increase in microhardness without hindering the bleaching action.

Effect of the β-tricalcium phosphate particle on dental enamel associated with 10% carbamide peroxide bleaching.

Since bleaching gels can cause adverse effects on tooth enamel, it is important to evaluate new remineralizing agents on the market and their effects. Seventy-five bovine enamel/dentin blocks (4x4x3mm) were randomly divided into six groups (n=10): Negative Control (NC) with no bleaching treatment or brushing; 10 CP (Carbamide Peroxide) (no brushing - Whiteness Perfect FGM); CT12 + 10 CP (Colgate Total® 12); ES + 10 CP (Elmex® Sensitive); BPC + 10 CP (Bianco® ProClinical); CMP + 10 CP (Colgate® Máxima Proteção Anticáries). The color was evaluated by reflectance spectrophotometry (∆E*ab, ∆E00, and ∆WID) at times T1 (baseline), T2 (24 hours after brushing), and T3 (24 hours after bleaching). Knoop microhardness (KHN) analysis were performed at T3. The enamel surface was qualitatively analyzed by Scanning Electron Microscopy (SEM). The data were analyzed using generalized linear models through descriptive and exploratory analyses, and a significance level of 5% was considered. Significant differences were observed when the bleached groups were compared to the NC group for ∆E*ab, ∆E00, and ∆WID at time T3 (p= <0.0001). However, the bleached groups presented no significant differences regarding studied times (p> 0.05). KHN did not differ significantly among the six groups (p=0.7585). Toothpastes with tricalcium phosphate (β-TCP) do not intervene with the efficacy of bleaching treatment with 10% carbamide peroxide. Although a slight mineral deposition on enamel surface can be observed on SEM images, KHN was not significantly altered, and the polishing of the samples were maintained. Key words:Dental Bleaching, Carbamide Peroxide, Hydrogen Peroxide, Dental Enamel, Tricalcium Phosphate.

The Effect of Carbamide Peroxide Bleaching Gel Containing Remineralization Agents on the Bond Strength of Universal Adhesives to Enamel

The Effect of Carbamide Peroxide Bleaching Gel Containing Remineralization Agents on the Bond Strength of Universal Adhesives to Enamel

Effect of Tooth Bleach on Dentin Fatigue Resistance in Situ.

Negative effects of bleaching on dentin have previously been reported in vitro. The purpose of this study was to determine the effect of carbamide peroxide bleaching on dentin fatigue resistance using a clinically relevant in situ model. Following research ethics board approval, 60 human teeth requiring extraction were collected. Sterilized human dentin specimens were cut (1.2×1.2×10 mm) and secured into customized bleaching trays to be used by study participants. Participants were randomly assigned to either bleach (10% carbamide peroxide, n=23) or control (gel without bleach, n=26) treatment groups. Treatment was applied to the bleaching trays and worn overnight by participants for 14 days. After treatment completion, dentin specimens were removed from the bleaching trays and subjected to fatigue testing (10 N, 3 mm/s, 2×105 cycles) while submerged in artificial saliva. Kaplan-Meier survival analysis was conducted to compare the number of cycles to failure during fatigue testing in both groups. A log rank test was run to determine if there were differences in the survival distribution between the two groups (α<0.05). The median number of cycles to failure was 352 ± 202 and 760 ± 644 for the bleach and control groups, respectively. The survival distributions for the two groups were significantly different (p=0.020). Dentin fatigue resistance was significantly lower in the bleach group compared to the control. Direct bleaching of human dentin using an at-home tray bleaching protocol in situ reduced dentin fatigue resistance. This has implications for tooth fracture risk and longevity.

Dental aesthetic perception of patients submitted to activated charcoal-based bleaching agents: A randomized clinical trial

ObjectiveTo evaluate the effects of activated charcoal-based products used in two presentation forms (powder or toothpaste), compared to 10 % carbamide peroxide and conventional toothpaste on aesthetic perception and psychosocial impact before and after treatment. MethodsFifty-six participants were divided into 4 experimental groups (n = 14). Activated charcoal-based powder (PW); Activated charcoal-based dentifrice (AC); Conventional fluoride toothpaste (CD) and 10 % carbamide peroxide (CP). All products were used for 14 days. Psychosocial impact on dental esthetics (PIDAQ), oral health impact profile (OHIP- Esthetics) and orofacial esthetics scale (OES) questionnaires were applied before and after treatment. Descriptive and exploratory data analyses were performed and analyzed using linear mixed models for repeated measures over time considering significance level of α = 0.05. ResultsFor PIDAQ, the CP group showed significant decrease in psychological impact, aesthetic perception domains and overall score, while in the PW group, there was only a significant decrease in the psychological impact domain. Decrease in OHIP was observed for the functional limitation domain scores for treatments with CP and PW, in the psychological discomfort domain, decrease was observed for all groups, while for the OES questionnaire, significant increase in the color domain was observed for the CP group. ConclusionActivated charcoal-based products showed lower scores in all questionnaires when compared with carbamide peroxide; thus, charcoal-based products promoted lower impact on quality of life and aesthetic perception. Clinical relevanceIn this randomized clinical trial, charcoal-based OTC products had inferior quality of life and aesthetic perception results compared to conventional carbamide peroxide bleaching.

Ozone gas therapy for tooth bleaching preserves enamel microhardness, roughness and surface micromor.

Bovine enamel blocks were planed and distributed among the following three bleaching treatment groups (n=10): CP - 1 hour per day/14 days (Opalescence PF 10%/ Ultradent); O - 1 hour per day every 3 days/3 sessions (Medplus V Philozon, 60 mcg/mL and oxygen flow rate of 1 L/min); and OCP - CP with O, 1 hour per day every 3 days/3 sessions. Enamel surface microhardness (Knoop), roughness (Ra), and micromorphology by scanning electron microscopy (5,000x magnification) were determined before and after the treatments. ANOVA and Tukey-Kramer’s test showed that enamel microhardness remained unchanged by treatment with O and OCP (p=0.0087), but decreased by treatment with CP. Treatment with O promoted higher enamel microhardness than the other groups (p=0.0169). Generalized linear mixed models for repeated measures over time indicated treatment with CP increased enamel roughness more than OCP or O (p=0.0003). CP produced slight irregularities in enamel micromorphology after the whitening treatment. O, with or without CP, maintained the mechanical and physical properties of microhardness and enamel surface micromorphology, and either maintained or reduced surface roughness, compared to the conventional tray-delivered CP bleaching treatment. Treatment with 10% carbamide peroxide in trays promoted greater changes in enamel surface properties than treatments with ozone and with 10% ozonized carbamide peroxide in the office.

Influence of violet LED and fluoride-containing carbamide peroxide bleaching gels on early-stage eroded/abraded teeth

PurposeThis study evaluated enamel with early-stage erosion/abrasion following bleaching with 20% and 45% carbamide peroxide (CP) gels containing fluoride (F) and irradiated with violet LED (LED). MethodsEnamel blocks were immersed in 1% citric acid (5 min) and artificial saliva (120 min) three times to produce early-stage enamel erosion. Simulated toothbrushing was performed only after the first saliva immersion, to provoke enamel abrasion. The erosive/abraded enamel samples were submitted to (n=10): LED/CP20, CP20, LED/CP20_F, CP20_F, LED/CP45, CP45, LED/CP45_F, CP45_F, LED, and control (without treatment). The pH of the gels was assessed, and color (ΔE00) and whiteness index (ΔWID) changes were calculated after cycling (T1), and 7 days from bleaching (T2). Enamel surface roughness average (Ra) and Knoop microhardness (kg/mm2, %SHR) were evaluated at baseline (T0) at T1 and T2. Scanning electron microscopy evaluated the enamel surface morphology at T2. ResultsThe gels’ pH was neutral and CP20 and CP45 exhibited no differences in ΔE00 and ΔWID (p>0.05) but LED increased these parameters for CP20_F and CP45. Erosion/abrasion significantly decreased mean kg/mm2, and the LED group was the only one not increasing microhardness after bleaching (p>0.05). None of the groups fully recovered the initial microhardness. All groups exhibited %SHR similar to the control (p>0.05) and the increase in Ra was detected only after erosion/abrasion. CP20_F groups exhibited a more preserved enamel morphology. ConclusionLight irradiation combined with low-concentrated CP gel promoted a bleaching effect comparable to the high-concentrated CP. The bleaching protocols did not adversely impact the surface of early-stage eroded/abraded enamel.

Efficacy and safety of carbamide peroxide tooth-whitening gels

Carbamide and hydrogen peroxide are the most frequently utilized compounds for various whitening techniques, that differ as per peroxide level, method of administration, and exposure period, when it comes to the active solutions accessible for important tooth whitening. The 10±1% carbamide peroxide dosage was the only level to date to acquire the American Dental Association's stamp of approval, ensuring its safety and effectiveness for at-home tooth whitening with customized trays. There has been a noticeable growth in the range of in-office tooth whitening compounds commercially available, which typically use elevated carbamide peroxide levels (30 to 37%) with or without an additional illumination. Even though tooth sensitivity appears to be the most frequent side effect of carbamide peroxide bleaching, discomfort goes away when the plan of care is finished. Sensitivity is typically linked to a background of sensitive teeth, greater administration rate, or use of greater carbamide peroxide levels. Additionally, studies have showed that using 10% carbamide peroxide at home to lighten teeth had comparable effectiveness to other methods (over the counter or in-office whitening). Patients generally prefer home vital bleaching with 10% carbamide peroxide to office procedures with 35% hydrogen peroxide. When comparing the safety utilizing 16% carbamide peroxide for nightguard vital bleaching to a placebo or 10% carbamide peroxide, patients receiving 16% reported higher gingival soreness than those administered a 10% carbamide peroxide or a placebo.

Chemical behavior of 20%-22% carbamide peroxide gels in at-home bleaching: Randomized crossover in situ trial.

To evaluate if distinct 20%-22% carbamide peroxide bleaching gels present similar decomposition pattern and pH during the clinical use in both arches, as well as gels viscosity. Participants randomly received treatments with carbamide peroxide gels (n=10): OPF (OpalescencePF-20%); PNT (Polanight-22%); and WPC (Whiteness Perfect-22%) in three different days, with 2-day washout. Decomposition pattern was assessed by peroxide concentration. Both PC and pH of bleaching gels were measured in different time points in upper and lower trays during a total of 120 min of clinical use. Viscosity of bleaching gels was measured in triplicate. ANOVA and Tukey's test were applied (α=0.05). Regarding decomposition pattern, no significant differences were observed for the interaction between gel, time, and tray position factors. The peroxide concentration progressively reduced until 120 min of trays use (p < 0.001), being overall more notable in lower trays (p < 0.001). Regarding pH, the lowest values were verified in WPC within time. At 120 min, an increase of pH was observed for both WPC and OPF (p < 0.001) compared to baseline means. PNT exhibited constant pH values over time. The values of viscosity were: OPF (1.682.000 ± 19 cP)a, WPC (1.388.667 ± 172.63 cP)ab, PNT (579.567 ± 0.98 cP)b. The bleaching gels presented overall decomposition pattern clinically equivalent, being more notable in lower trays over time. Nevertheless, distinct pH and viscosities were observed among the products. Although the manufacturers recommend different times of use for bleaching gels with similar peroxide concentrations, the commercial products tested did not exhibit clinically relevant difference in the decomposition pattern during the 120 min of clinical procedure.

At-home Bleaching with a Novel Carbamide Peroxide Polymeric Nanoparticle Gel: A Multicenter Randomized Controlled Trial.

To compare the risk and intensity of tooth sensitivity (TS) as well the effectiveness of at-home bleaching using two carbamide peroxide bleaching gels, specifically a novel polymeric nanoparticle gel (experimental) and a commercial gel (Opalescence PF, Ultradent, South Jordan, Utah, USA), applied at two application times. This multicenter, triple-blind, and split-mouth randomized controlled trial was conducted on 80 healthy adults with canine teeth that were shade A2 or darker. The participants all used the experimental and the control gels on one side of a tray, depending on the group to which they were allocated, for 30 or 60 minutes per day over four weeks. The absolute risk and intensity of TS were assessed daily using the five-point Numeric Rating Scale and the 0-10 Visual Analogue Scale. Color change was evaluated with shade guide units (ΔSGU) and a digital spectrophotometer (ΔEab, ΔE00, and ΔWid) at baseline and 30 days postbleaching. The risk and intensity of TS was evaluated by the McNemar and the Wilcoxon signed-rank tests, respectively. Color change (ΔSGU, ΔEab, ΔE00, and ΔWid) was evaluated by Mann-Whitney and paired t-tests (α=0.05). No differences in the risk and intensity of TS were observed based on the bleaching gels used and the times of application (p>0.05). Thirty days after bleaching, there was no significant difference in color change, in terms of the bleaching gels used or the application times (p>0.05). The novel carbamide peroxide polymeric nanoparticles gel, when applied for 30 or 60 minutes, produced effective color change and a low rate of tooth sensitivity, as compared to the control group.

Evaluation of Concentration and pH Stability of 10% Carbamide Peroxide Bleaching Agents

Evaluation of Concentration and pH Stability of 10% Carbamide Peroxide Bleaching Agents

Color change after tooth bleaching with ozone and 10% ozonized carbamide peroxide for in-office use.

There is a constant search for bleaching treatments that can offer greater safety with fewer adverse effects, especially in the techniques performed in the office, which usually employ hydrogen peroxide in high concentrations (35% to 40%) that are not recommended by some international control agencies. This in vitro study evaluated the color change after tooth bleaching with the use of ozone and a 10% ozonized carbamide peroxide bleaching treatment for in-office use. Thirty molars were allocated (n = 10): three applications of ozone (1 hour every 3 days); three applications of 10% ozonized carbamide peroxide (1 hour every 3 days); 10% carbamide peroxide agent (8 hours a day for 7 days). The teeth were mounted on a plaster model to simulate the dental arch, and trays made of silicone were used for the application of the bleaching agents and to allow ozone to enter through. The ozone concentration used was 60 μg/mL, with an oxygen flow of 0.25 L/min. The values of color change showed no significant differences among treatments. The variations in the parameters over time, as well as the values of ΔEab, ΔE00, and WID, showed that there was no significant difference among the three treatments. The use of ozone and 10% ozonized carbamide peroxide for in-office use was effective for tooth bleaching with clinically perceptible and acceptable color alterations. The study was approved on September 10, 2019 by the São Leopoldo Mandic Ethics Research Committee (CAAE No. 17711719.4.0000.5374).

The Evaluation of the Effect of Coffee Staining and 16% Carbamide Peroxide Bleaching on the Color Change of Chairside CAD/CAM Ceramics

Introduction: The aim of this study was to evaluate the effect of coffee staining and home bleaching agent on the color stability of stained CAD/CAM ceramics.Methods: Forty specimens were prepared from feldspathic ceramic (CEREC Blocs) and hybrid nano-ceramic (Cerasmart) CAD/CAM blocks (N=40). The polished specimens were ultrasonically cleaned in distilled water and then, immersed in coffee for seven days. The stained specimens were divided into four subgroups (n=10) according to their type of ceramic and bleaching treatment; CEREC control, CEREC bleaching, Cerasmart control and, Cerasmart bleaching. The home bleaching agent (Opalescence PF 16%) was applied to specimens of bleaching groups for seven days. Control groups did not take any bleaching procedure and were placed in distilled water during this period. Then the specimens were immersed in coffee for seven days again for staining susceptibility. CIELAB parameters were recorded at four times; initial color, 1-week coffee staining, after bleaching, and coffee staining after bleaching with a dental spectrophotometer (VITA Easyshade). Color changes between each step were calculated as ΔE values. The data were statistically analyzed with t-test and Kruskal Wallis test. Results: After 1-week coffee staining the highest ΔE values were obtained from Cerasmart (p<0.001). The bleached Cerasmart group showed significantly higher color change values compared to Cerasmart control and both CEREC groups (P<0.05). No significant differences were found between control and bleached groups in both Cerasmart and CEREC groups after coffee immersion.Conclusion: Coffee staining and 16% carbamide peroxide bleaching significantly influenced the color of resin ceramic CAD/CAM materials.

Clinical Evaluation of the Efficacy of 10% Carbamide Peroxide Bleaching Agent Used During Night-Time and Day-Time

This split-arch clinical study was performed to compare the effects of using 10% carbamide peroxide bleaching agent for one hour twice a day with its use for 8 hours/night on tooth color change, color stability and sensitivity. Method: Bleaching trays, with reservoirs for the six maxillary anterior teeth, were fabricated for 12 volunteers. The trays were cut into two halves between the left and right central incisors (day-side vs. night-side) to be used with 10% carbamide peroxide for two weeks. The day-side tray was applied for one hour twice a day, while the night-side was applied for 8 hours overnight. Objective color measurements, using a colorimeter, were adopted to measure the color of the teeth of the two sides at the baseline appointment and at 1, 2, 3, 6 and 12 weeks. Total color difference (ΔE*) between two color measurements was calculated for all periods. Teeth and soft-tissue sensitivity were self-recorded for both sides during the bleaching weeks and the following week. Both Student's t-test and Tukey's test were used to compare ΔE* between the two sides and with time at p

Triple-blinded randomized clinical trial comparing efficacy and tooth sensitivity of in-office and at-home bleaching techniques.

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.