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SUMMARY Objective: This study investigated whether it is possible to achieve equally satisfactory results between 37.5% hydrogen peroxide (HP) gel and 6% HP gel. We also assessed the psychosocial impact and self-perception of esthetics generated by extracoronal tooth whitening. Methods and Materials: A prospective, double-blind, randomized clinical trial was carried out. A total of 33 patients were selected from the clinic of the Faculty of Dentistry at the University of Chile. The patients included men and women over 18 years old without prior tooth whitening treatments, tooth decay, or restorations of the maxillary anterior teeth. The patients had tooth colors of A3 or less according to the Vita Classical scale, which was determined with a Vita Easy Shade spectrophotometer. The study was carried out with a “split-mouth” design. One side of each mouth was randomly treated with 37.5% HP, and the other side was bleached with 6% HP. Each group received 3 to 12 minutes of treatment with the respective gel applications. Two sessions of bleaching were carried out each week. A spectrophotometer was used to measure the total variation of color (ΔE), and a subjective evaluation was made with Vita Classical scale (ΔSGU) between the baseline (session 1) and different measurement times. We compared ΔE and ΔSGU for both agents using the Mann-Whitney test (α=0.05). Results: In both groups, there was variation among the initial color and the color in the different measurement times. In the month after the treatment was completed, ΔE was 9.06 in the 37.5% HP group and 5.69 in the 6% HP group. The difference between the two groups was statistically significant starting in the second session (p=0.000). Conclusion: There was a significant difference between the effectiveness of the bleaching gel concentrations of 37.5% and 6% HP according to spectrophotometer measurements and subjective evaluations. There was also a positive effect on psychosocial impact and esthetic self-perception among patients.

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Since color matching is considered a subjective procedure, accurate shade choice is often the most challenging stage of recreating the natural appearance of teeth. Furthermore, accurate determination of tooth color is imperative for the final outcome of dental restorations. The purpose of this research is to assess the accuracy of color match between diverse shade selection methods throughout a systematic review and meta-analysis. Two independent investigators (L.H. and R.B.) screened the literature in five electronic databases. Randomized controlled trials or in vitro papers studying the effect of using either digital shade selection or visual shade selection on the accuracy of color match were included. A total of 13 manuscripts comprised the meta-analysis. Color difference (ΔE) between restorations where the shade matching was performed by the conventional method was greater than those where the shade matching was performed by computerized methods (p = 0.007). According to the subgroup analysis, only the use of digital photographs for shade matching showed a reduction in the (ΔE) (p < 0.0001), while the use of a spectrophotometer has no advantages over the use of visual shade guide tabs (p = 0.57). On the other hand, global analysis showed that incorrect shade matching was higher when the conventional method using shade guide tabs was used (p < 0.001), irrespective of whether a spectrophotometer or a digital camera was used (p < 0.001). This study concluded that the use of digital photography and spectrophotometric measurements led to fewer color differences and less incorrect shade matching than conventional methods using color shade tabs.