Clinical Relevance
Although color change was slightly lower in a 3-week 30-minutes/day protocol, than in the 120-minute protocol, this could be compensated by an extra week of bleaching. The advantage of the shorter protocol is the reduced daily application, making the procedure more comfortable for the patients.
SUMMARY
Objective: Compare the risk/intensity of tooth sensitivity (TS) and color change of a 30-minute vs. the recommended 120-minute application time of 4% hydrogen peroxide (HP) for at-home bleaching.
Methods: A single-blind, parallel, randomized clinical trial was conducted with 92 adult patients with caries and restoration-free anterior teeth A2 or darker, randomly allocated to two groups. Bleaching trays containing 4% HP were used for three-weeks. A four-week regimen was also offered to the patients for the 30-min group after the end of the 3-week protocol. The color change was assessed with the Vita Classical (VITA Zahnfabrik, Bad Säckingen, Germany) and Vita Bleachedguide shade guides (VITA Zahnfabrik) and the Vita Easyshade spectrophotometer (VITA Zahnfabrik) at baseline, weekly, and 30 days after the bleaching. The absolute risk and the intensity of TS were assessed daily using the 0-10 visual analogue scale (VAS) and 5-point Numerical Rating Scale (NRS) scale, and patient satisfaction was recorded with a Likert 0-7 scale. Risk of TS (Fisher’s test), intensity of TS in NRS scale (Mann-Whitney test), VAS scale (t-test), and a color change (t-test) were compared.
Results: The 30-minute group saw color change of around 1 SGU inferior to the 120-minute group in all-time assessments (p<0.05). After an extra week of bleaching, mean color change was similar (p>0.05). Patient satisfaction was high for both groups (p>0.05).
Conclusions: A four-week protocol of at-home dental bleaching with 4% HP for 30 minutes/day whitened teeth similarly to the 120 minutes/day protocol, with low intensity of dental sensitivity and high patient satisfaction.
Purpose
The aim of this trial was to evaluate bleaching effectiveness, tooth sensitivity and gingival irritation of whitening patients with 10% versus 37% carbamide peroxide (CP).
Methods
Eighty patients were selected by inclusion and exclusion criteria and randomly allocated into two groups (n = 40): 37% CP and 10% CP. In both groups, patients performed whitening for 3 weeks, 4 h/day for 10% group and 30 min/day for 37% group. Color was evaluated with Vita Classical, Vita Bleachedguide 3D Master and Spectrophotometer Easyshade, at baseline, weekly and 30 days after treatment. Absolute risk and intensity of tooth sensitivity (TS) and gingival irritation (GI) were assessed with numeric rating scale (NRS) and a visual analog scale (VAS). Color changes were compared with t‐test for independent samples. TS and GI were evaluated with Fisher's exact tests. Mann–Whitney test was used for NRS, and t‐tests for VAS (α = 0.05).
Results
The 37% CP group showed faster whitening than 10% group at 1–3 weeks. However, 1 month after conclusion, both groups showed equivalent bleaching (p = 0.06). Regarding sensitivity and gingival irritation, 10% and 37% groups met no significant differences (p > 0.05).
Conclusion
The use of 37% CP 30 min/day showed equivalent results to 10% 4 h/day.
Clinical significance
The use of 37% carbamide peroxide 30 min/day may decrease the time of tray use in at‐home protocol for whitening because it presents equivalent results to 10% carbamide peroxide 4 h/day.
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