In-office Whitening Research Articles

Influence of in-office whitening on the color matching and surface characteristics of single-shade resin composites.

The color matching of single-shade resin composites after in-office whitening was investigated. Four single-shade resin composites were used. A total of 35% hydrogen peroxide was used as the whitening agent. The resin composite was placed in a cavity of an artificially discolored bovine tooth. The color differences between the restoration and surrounding enamel before and after whitening were determined based on ΔE*ab, ΔE00, and ΔWID. The color stability, surface roughness (Sa), and surface gloss (GU) of the resin composite alone were also evaluated. Statistical analyses were performed using repeated-measures analysis of variance with the Tukey-Kramer test. Based on the 50:50% of perceptibility and acceptability thresholds of ΔE*ab and ΔE00, none of the resin composite restorations were clinically acceptable before or after whitening. Regarding ΔWID, although all resin composites showed "acceptable match" in the baseline, they showed "mismatch" after the third session of whitening. Most of the resin composites alone were stable in color against whitening. Although the single-shade resin composites failed to achieve the expected color matching on discolored teeth either before or after the whitening, the impact of the whitening on the color of the resin composite alone may be negligible.

Major clinical approaches to tooth whitening techniques and differences in terms of sensitivity and protection: a systematic review

Introduction: Tooth whitening is an initial step in the analysis and reproduction of the aesthetics of the smile, so the dentist must know how to diagnose the causes of color changes, and recommend whitening before proposing the appropriate dental procedure. With technological advances, tooth whitening techniques have emerged to facilitate their use improve comfort and safety, and reduce time spent performing the technique. The conventional means of external tooth whitening is with carbamide peroxides or light-activated hydrogen or not. However, both at-home and in-office whitening procedures cause tooth sensitivity. There is a new whitening proposal on the market without the use of whitening gels, thus reducing post-treatment sensitivity. This proposal highlights ultraviolet light as a whitening agent. Objective: It was to carry out a concise systematic review of the main clinical approaches to tooth whitening techniques, to point out the differences between them in terms of sensitivity and tooth protection. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from January to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 178 articles were found, 40 articles were evaluated in full and 20 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 31 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=67.4%>50%. It was concluded that tooth whitening can be indicated in practically all situations in which tooth darkening occurs, such as pulp tissue decomposition, internal hemorrhage, trauma, use of medications, restorative materials, and systemic conditions such as fluorosis, jaundice, and fetal erythroblastosis, among others. others. Contraindications for tooth whitening treatment occur in children under 10 years of age. Whitening using the home technique uses products with lower concentrations, between 10% and 22% carbamide peroxide. In-office, 16% carbamide peroxide was effective. In office-based tooth whitening, higher concentrations of whitening substances are used and laser, LED, ultraviolet, and halogen light can be used to intensify the whitening process. Patients undergoing vital teeth whitening report sensitivity or discomfort during treatment. Oxidative stress generated by bleaching agents can cause apoptosis and damage to periodontium DNA (genotoxicity) and cellular cytotoxicity. A new generation of whitening agents with low concentrations of hydrogen peroxide (3.5% and 15%) was introduced on the market for in-office teeth whitening, aiming to achieve greater safety and efficiency in tooth whitening.

Effect of Sodium Ascorbate, Grape Seed Extract, and Aloe Vera Application after In-Office Bleaching on the Bond Strength of Enamel: A 3-Year Evaluation

Introduction. Dental bleaching is the first choice to improve smile esthetics, but, in some cases, it needs to be associated with resin composite restoration to obtain a satisfactory result. Unfortunately, the bonding of resin-based materials can be impaired due to residual oxygen molecules, which can decrease the durability of the restoration. Objectives. To evaluate the effect of the antioxidant application on the bond strength of bleached enamel after 24 hr and 3 years of water storage. Methods. In total, 84 bovine teeth were used in this study. Of these, 77 were bleached with 35% hydrogen peroxide in a single session for three cycles of 15 min. Then, the specimens were divided into groups (n = 7 each): control (without bleaching), without antioxidant (WA) use; application of 10% sodium ascorbate (SA) gel, grape seed (GS) extract, and aloe vera (AV). The restorative procedure was performed immediately after bleaching, 7 and 14 days after bleaching. Specimens were sectioned and evaluated using microtensile bond strength (μTBS). Half of the resin-enamel sticks were tested after 24 hr, and the remaining half after 3 years of water storage. µTBS data were analyzed using a three-way analysis of variance, Tukey’s test, and Dunnett’s test. Results. The lowest µTBS values were observed when the restoration was performed immediately after bleaching in the AV, GS, and WA groups when compared with the SA group ( p < 0.005 ). However, no significant differences were observed among all groups after 3 years of water storage ( p < 0.001 ). Conclusions. SA at 10% was the most effective antioxidant agent for improving the immediate bond strength. However, independent of the antioxidant agent used, the bond strength values were maintained or recovered after 3 years of water storage. SA at 10% could be used to avoid delayed bonding procedures after in-office whitening without compromising bond strength over time. Clinical Significance. The use of antioxidants after dental bleaching can be effective in improving the bonding durability of the adhesive restorations.

Hydrogen Peroxide Diffusion through Dental Tissues-In Vitro Study.

Whitening products commonly utilize hydrogen peroxide (HP) as an active principle, which can penetrate dental tissues with potential side effects due to its low molecular weight. This study aimed to evaluate the HP diffusion of two in-office whitening products, namely 6% VivaStyle Paint On Plus (VS) and Opalescence Boost 40% (OP), in different tooth types. Additionally, the influence of the area of exposure, dental tissue thickness and pulp chamber volume was assessed. Each group consisted of eighteen intact anterior (A), premolar (PM) and molar (M) human teeth, and a positive pulpal pressure model was employed. The samples were analyzed using spectrophotometry, and results were expressed as the mean and 95% confidence interval. Statistical tests and linear regression models were appropriately applied at α = 5%. The total HP (µg) retrieved was as follows: VS-A, 1.333 [1.214, 1.452]; OP-A, 1.538 [1.457, 1.620]; VS-PM, 1.208 [1.123, 1.291]; OP-PM, 3.628 [3.401, 3.855]; VS-M, 2.560 [2.297, 2.823]; and OP-M, 4.197 [3.997, 4.396], with statistically significant differences in diffusion kinetics between whitening products for PM and M. Several HP concentrations attained a minimum cytotoxicity value of 2.22 µg/mL. The regression model shows that OP exposed the pulp chamber to 1.421 µg of HP more than that of VS. Different whitening products can cause cytotoxic HP concentrations in the pulp chamber, with a higher risk observed in molars.

Effect of Different Desensitizing Protocols on Pulp Inflammatory Responses in Whitened Teeth: A Randomized Clinical Trial

Purpose: This randomized controlled, blind clinical trial evaluated the efficacy of different desensitizing protocols in preventing pulp inflammation after whitening treatment with hydrogen peroxide (HP) at 35% (Whiteness HP 35%). Materials and Methods: Thirty healthy third human molars extracted by orthodontic indication were randomized and allocated into five groups (n=5): NC (negative control): without intervention; PC (positive control): HP; PBM: HP + photobiomodulation with a Watts LASER; CPP: HP + casein phosphopeptide amorphous calcium phosphopeptide (CPP-ACP); and NANO: HP + nano-hydroxyapatite. The in-office whitening was performed in two sessions with a single 45 minutes application at an interval of 48 hours. Pulp tissues were extirpated for immunohistochemical analysis. Immunoreaction for activated caspase-3 was observed, and images were acquired using an Axio Scope A1 microscope. The Kruskal-Wallis test was used to evaluate the immunoexpression of caspase-3. Results: Comparisons between the PC and NC groups revealed a statistically significant difference (p<0.05) for the analysis of caspase-3 immunoexpression. A statistically significant difference (p<0.05) was also observed for the CPP and PBM groups in relation to the PC. Conclusion: Photobiomodulation and CPP-ACP are promising alternatives to minimize pulpal inflammation induced by tooth whitening. Clinical Trial Registration Number: NCT04548674.

Use of Raman spectroscopy for assessment of changes in enamel and dentin composition after in-office whitening

Use of Raman spectroscopy for assessment of changes in enamel and dentin composition after in-office whitening

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.

Pro-inflammatory mediators expression by pulp cells following tooth whitening on restored enamel surface.

This paper aimed to assess the influence of adhesive restoration interface on the diffusion of hydrogen peroxide (H2O2), indirect toxicity, and pro-inflammatory mediators expression by odontoblast-like cells, after in-office tooth whitening. Dental cavities prepared in bovine enamel/dentin discs were adhesively restored and subjected or not to hydrolytic degradation (HD). A whitening gel with 35% H2O2 (WG) was applied for 45 min onto restored and non-restored specimens adapted to artificial pulp chambers giving rise to the groups: SD- intact discs (control); SD/HP- whitened intact discs; RT/HP- restored and whitened discs; and RT/HD/HP- restored and whitened discs subjected to HD. The extracts (culture medium + WG components diffused through enamel/dentin/restoration interface) were collected and applied to odontoblast-like MDPC-23 cells. The study evaluated the amount of H2O2 in the extracts, as well as the cell viability (CV), cell morphology (CM), and gene expression of inflammatory mediators (TNF-α and COX-2) by the pulp cells exposed to the extracts (ANOVA and Tukey tests; 5% significance). All whitened groups presented lower CV than SD (control; p<0.05). The highest CV reduction and gene expression of TNF-α and COX-2 was observed in the RT/HD/HP group in comparison with SD/HP and RT/HP (control; p<0.05). CM alterations occurred in all whitened groups. The intensity of these cell side effects was directly related with the amount of H2O2 in the extracts. We concluded that adhesive restoration of dental cavity increases the H2O2 diffusion after in-office whitening, enhancing the indirect toxicity of this therapy and trigger pro-inflammatory overexpression by MDPC-23 cells.

Characterization and effectiveness of a violet LED light for in-office whitening.

This study characterized a violet LED light (V-LED; bright max whitening) tooth whitening device and evaluated its efficacy on stained enamel compared to hydrogen peroxide (HP). Characterization of the V-LED beam profile was performed using a laser beam-profiler. The irradiance was measured throughout an exposure cycle at 0- and 8-mm distances using an integrating sphere and a spectral radiometer. Bovine enamel/dentin blocks stained with black tea (BT), cigarette smoke (CS), or without staining (CONT) were subjected to V-LED or 40% HP (n = 10/group). Color parameters (ΔL, Δa, Δb, and ΔE00) were measured using a digital spectrophotometer. Light transmission was estimated through 1-mm-thick bovine enamel slices (n = 5). ΔL, Δb, ΔE00, and irradiance were analyzed by two-way ANOVAs and Tukey's tests, Δa by Kruskal-Wallis and Mann-Whitney tests, and light transmission by t-test (α = 5%). Heterogeneous beam distribution was observed for the emitting V-LED chips. After 20 sequential exposures, irradiance levels were reduced 25-50%, regardless of the distance from V-LED. Localized irradiance values were statistically different between beam locations and different distances from the target. V-LED produced lower ΔE00, ΔL, Δa, and Δb values than HP for CONT and BT, with no differences for CS. Light transmittance decreased approximately 98% through 1-mm thick enamel. V-LED irradiance was heterogeneous and decreased throughout the exposure cycles and was also greatly reduced with increasing tip distance. V-LED produced a significantly lower whitening effect on BT and control teeth. This study contributes to the knowledge of V-LED and its clinical use.

The raman spectroscopy method for evaluation of structural changes in hard tissues of teeth after in-office whitening

Start The experiments in evaluation of hard tissues using the Raman spectroscopy method have been made. Spectral differences between the tooth enamel and dentin before and after the in-office whitening procedure were found as a result of the work. It was shown with the use of the Raman spectroscopy method that the whitening process causes changes of tooth enamel and dentin related to the changes of organic and mineral components.

Patients' Assessments of Tooth Sensitivity Increase One Day Following Different Whitening Treatments.

ObjectivesThe aim of this clinical study was to compare tooth sensitivity scores and color change values before and 1 day following whitening treatments using different concentrations of whitening agents for in-office and at-home procedures.Materials and methodsA total of 60 participants divided into 3 groups were included in this study. A whitening procedure was carried out in groups using 40% hydrogen peroxide (HP) in in-office treatment, 16% and 10% carbamide peroxide (CP), respectively. Participants rated their tooth sensitivity at the baseline and 1 day following the treatment. The CIElab values were recorded and color differences were calculated.ResultsWithin each of the whitening treatments, the tooth sensitivity scores significantly increased following the procedure (p<0.05). The largest significant increase in scores was noted in 40% HP in-office whitening treatment, while the lowest increase was noted in 10% CP at-home whitening treatments (p<0.05). The highest color change 1 day following the procedure was found in the 40% HP in-office whitening treatment group (3.3) and it significantly differed from both 16% CP and 10% CP at-home whitening treatments whose color difference was both 2.0, respectively (p<0.05).Conclusion1 day following the procedure, a low concentrate CP agent for at-home whitening causes the least tooth sensitivity compared to higher concentrate CP for at-home and HP for in-office agents, with the same color change efficacy as higher concentrate CP agent. In case with slight tooth sensitivity reported at the baseline, a 10% CP whitening treatment should be recommended.

Retrospective Evaluation of Different Shade Selection Methods in the Context of the Vital Bleaching Technique

Objective: This retrospective study was performed to evaluate the correspondence between digital image analysis and spectrophotometry tooth shade results.Methods: The study population consisted of 10 patients. Office bleaching was performed using an in-office whitening. Tooth shade was analysed by spectrophotometry and image analysis of digital photographs at baseline, and at 1-week and 3-month follow-up visits. The correspondence between the two methods was evaluated based on the total color change (ΔE), calculated using lightness, chroma, and hue (LCH) values for spectrophotometry and lightness, red-green, blue-yellow (LAB) values for digital image analysis. The Mann–Whitney U, Wilcoxon signed rank and Kruskal–Wallis tests were used for the statistical analyses (p&amp;lt;0.05). The correspondence between digital image analysis and spectrophotometry results was determined using the intraclass correlation coefficient (ICC).Results: At the 3-month follow-up, there were no significant differences in tooth shade results between the spectrophotometry and digital image analysis methods (p=0.855), which showed strong agreement (ICC=0.983).Conclusion: Digital image analysis may be a useful alternative to spectrophotometry for tooth shade selection.

Assessment of hygienic and periodontal status of patients after in-office tooth whitening

Nowadays, an increasing number of dentists support non-invasive methods of treatment of dental discoloration, one of which is the in-office teeth whitening procedure. When treating teeth discoloration and taking into account the aesthetic wishes of the patient, correction of the hygienic state of the oral cavity is important. The study involved 123 people aged 18 to 35 years with sanitized oral cavity and no somatic pathologies. The patients were divided into 3 groups depending on the type of the used whitening system. To assess the hygienic state of the oral cavity, the OHI-S index (GreenVermillion) was used. The presence of the inflammatory process in the periodontal tissues and its intensity was checked using the gingival sulcus bleeding SBI index (MuhlemanSon). The indices were assessed 2 weeks before the office teeth whitening procedure, immediately before it, and 2 weeks, 6 and 12 months after the procedure. Teeth in-office whitening has a positive effect on oral hygiene. Good oral hygiene is noted both in the immediate and long-term follow-up, which is due to the high level of patient motivation. The study of the dynamics of the gingival bleeding index indicates the absence of the adverse effect of in-office teeth whitening on the condition of the periodontal soft tissues.

Clinical Evaluation of 6-Month Efficacy of 40% in-Office Whitening Treatment

Objective: To assess the 6-month efficacy of natural tooth color change in in-office bleaching treatment in terms of time by using a spectrophotometer. Material and Methods: A total of 20 participants were chairside treated with 40% hydrogen peroxide (HP), three applications each 20 minutes, in one appointment. Instrumental color measurement was performed on six anterior maxillary teeth before bleaching (baseline-t0), immediately after in-office bleaching and rehydration of the teeth (t1), 3 months (t2), and 6 months after bleaching treatment (t3). The spectrophotometer measured the tooth shades based on the CIE L*a*b* color notation system and Bleach index during the period of observation. CIE L*a*b* (ΔEab) color differences were calculated. Results: The color change at t1 was ΔEab = 3.2, at t2 was ΔEab = 1.8, at t3 was ΔEab = 1.2 and overall color change of in-office method was ΔEab = 3.6 (p<0.05). A significant effect for the mean CIEL*a*b* values was detected as within time b* values decreased significantly (p<0.05). Bleach index values significantly decreased during the time of observation, too (p<0.05). Conclusion: The in-office bleaching treatment using 40% hydrogen peroxide was effective, and the results showed a statistically significant decrease in color change during the period of 6-month observation.

Clinical Efficacy of Four In-Office Vital Tooth Bleaching Products with Different Concentrations of Hydrogen Peroxide: A Randomized, Quadruple-Blind Clinical Trial

Background: Dental bleaching has become an everyday procedure for treating teeth presenting discoloration, as a therapy on its own or as a part of restorative dentistry. The most widely used bleaching products available for vital teeth are hydrogen peroxide and carbamide peroxide, marketed as a range of products adapted to different treatment modes. The purpose of the study was to evaluate the clinical whitening efficacy of four high-concentration bleaching products for vital teeth applied in single in-office sessions. Methods: This clinical trial included 40 patients divided into four groups according to the concentration of the hydrogen peroxide-based (HP) product used (Group 1: HP 35%; Group 2: HP 37.5%; Group 3: HP 38%; Group 4: HP 40%). Each patient received one in-office whitening treatment of maxillary and mandibular anterior teeth (incisors, canines, and premolars), making a total of 791 teeth. The color changes produced in central incisors and canines were measured. Results: All groups underwent significant color changes from initial to final evaluations for color parameters L*, a*, and b*. No significant differences between the four groups were found for either the L* or a* parameters. Analysis of the b* parameter found significant differences between the HP 38% group and the HP 35% group. No significant differences in ΔE were found between the four groups (ANOVA p = 0.174). HP 38% obtained the highest ΔE (4.63), while HP 40% obtained 4.01. Conclusions: A single in-office whitening session, regardless of the bleaching product used, modifies tooth color effectively. All four products achieved increases in the L* parameter and significant reductions in parameters a* and b*. The ΔE did not show significant differences between the four groups. In-office whitening with high concentration hydrogen-peroxide-based products was found to be an effective treatment for moderate and severe dental discoloration.

Combined Vital Tooth Whitening: Effect of Number of In-Office Sessions on the Duration of Home Whitening. A Randomized Clinical Trial

Background: In cases of moderate to severe dental discoloration, vital tooth whitening usually requires a prolonged treatment time if it is to obtain satisfactory outcomes. Variations in the clinical efficacy of whitening products in terms of their concentration and application time mean that we need to be aware of the real bleaching capacity of each whitening method and each product. This randomized clinical trial aimed to analyze with a spectrophotometer the effect of the number of in-office vital tooth whitening sessions (one or two) on the number of weeks of ensuing home whitening until color stability was obtained. Methods: Twenty patients with moderate/severe discoloration were treated with combined vital tooth whitening. Ten patients were treated with a single in-office session consisting of two applications of a product containing 40% hydrogen peroxide, followed by home treatment with individualized splints and a 16% carbamide peroxide gel (Group 1S). The other ten patients (Group 2S) were treated in two in-office sessions with two applications of the same product as Group 1S, followed in the same way by home treatment. Results: Comparing the two groups (1S and 2S), no significant differences in Euclidean distance (ΔE) were found after in-office whitening, or when color stabilization was obtained and home whitening ceased. Significant differences in the number of weeks of home whitening until color stabilization reached the same outcomes were found between 1S and 2S; 1S required a mean of 11.6 weeks home whitening, while 2S required 8.2 weeks. Conclusions: Combined tooth whitening with two in-office sessions significantly reduces the number of weeks (by three to four weeks) of subsequent home tooth whitening needed to reach color stabilization.

Laser Influence on Dental Sensitivity Compared to Other Light Sources Used During In-office Dental Bleaching: Systematic Review and Meta-analysis.

The use of laser light during bleaching will not reduce the incidence or severity of sensitivity and will not increase the degree of color change compared with nonlaser light sources. Objective: To evaluate whether the use of laser during in-office bleaching promotes a reduction in dental sensitivity after bleaching compared with other light sources.Methods: The present review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and is registered with PROSPERO (CDR42018096591). Searches were conducted in the PubMed/Medline, Web of Science, and Cochrane Library databases for relevant articles published up to August 2018. Only randomized clinical trials among adults that compared the use of laser during in-office whitening and other light sources were considered eligible.Results: After analysis of the texts retrieved during the database search, six articles met the eligibility criteria and were selected for the present review. For the outcome dental sensitivity, no significant difference was found favoring any type of light either for intensity (mean difference [MD]: -1.60; confidence interval [CI]: -3.42 to 0.22; p=0.09) or incidence (MD: 1.00; CI: 0.755 to 1.33; p=1.00). Regarding change in tooth color, no significant differences were found between the use of the laser and other light sources (MD: -2.22; CI: -6.36 to 1.93; p=0.29).Conclusions: Within the limitations of the present study, laser exerts no influence on tooth sensitivity compared with other light sources when used during in-office bleaching. The included studies demonstrated that laser use during in-office bleaching may have no influence on tooth color change.

Dental Whitening at-home, in-office and Combined Techniques: Case Report and Literature Review

Smile esthetics and the quest for whiter teeth has become a main concern among patients. As a response, dental whitening techniques and materials have been developed, allowing dentist to offer a safe treatment that responds to patient´s demands. However, there is no standard consensus regarding the indicated protocol for each patient. The purpose of this article is to present the case of a patient treated with a combination of in-office and at-home whitening techniques and to clinically evaluate the color change in the patient´s teeth.

Evaluation of In-office Vital Tooth Whitening Combined with Different Concentrations of At-home Peroxides: A Randomized Double-blind Clinical Trial

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.

A clinical study assessing the short-term efficacy of combined in-office/at-home whitening treatment.

The purpose of this randomized clinical trial was to assess the efficacy of color change in combined in-office/at-home whitening. Thirty participants were randomly divided into two groups: 15 received combined treatment in-office whitening (6% hydrogen peroxide + 2 weeks at-home whitening with 16% carbamide peroxide [CP]); 15 were assigned to control group. Instrumental color measurements were obtained before whitening (t0 ), immediately after in-office whitening (tin-office ), after 1 week of active treatments (t1 ), and at the completion of the whitening treatment (t2 ). CIE L*a*b* values were recorded and CIE L*a*b* and CIEDE2000 color differences were calculated. The color change at tin-office was ΔEab = 4.7 and ΔE00 = 3.2 and overall color change of combined method at t2 was ΔEab = 8.2 and ΔE00 = 5.3 (P < 0.05). A statistically significant effect for the mean CIE L*a*b* and CIEDE2000 values was detected within time with the mean a*, b* and C' values decreasing and mean h' values increasing significantly (P < 0.05). Combined in-office/at-home whitening was effective. Whitening efficacy increased upon application of 16% CP in combined in-office/at-home treatment (P < 0.05). The statistically significant increase in color change recommends clinical application of combined in-office/at-home whitening treatment.