Evaluation of several clinical parameters after bleaching with hydrogen peroxide at different concentrations: A randomized clinical trial

Lima, Suellen Nogueira Linares; Ribeiro, Izabella Santos; Grisotto, Marcos Augusto Grigolin; Fernandes, Elizabeth S.; Hass, Viviane; Tavarez, Rudys Rodolfo de Jesus; Pinto, Shelon Cristina Souza; Lima, Darlon Martins; Loguércio, Alessandro Dourado; Bandéca, Matheus Coêlho

doi:10.1016/j.jdent.2017.11.008

Cited by 54 publications

(69 citation statements)

References 29 publications

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“…Therefore, by inhibiting local damage to the tissues by NAC, we may be able to prevent subsequent insults to the pulp region. The levels and type of cell death induced by bleaching agents, namely apoptotic versus necrotic, should also contribute to the degree of hypersensitivity and inflammation [43,44].…”

Section: Discussionmentioning

confidence: 99%

N-acetyl cysteine prevents pain and hypersensitivity of bleaching agents without affecting their aesthetic appeal; evidence from in vitro to animal studies and to human clinical trials

Wang¹,

Kaur²,

Lee³

et al. 2019

transl med commun

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Background: Tooth hypersensitivity and pain are undesirable side effects of bleaching agents in humans. The aim of this study is to implement strategies to counter such side effects, and to demonstrate the efficacy and mechanisms of action of N-acetyl cysteine (NAC) in countering the side effects of clinically used bleaching agents. Methods: In a series of in vitro experiments, animal model studies, and human clinical trials, we demonstrate that NAC protects oral mucosa and teeth from damage induced by bleaching agents. Results: The addition of NAC along with clinically used bleaching agents to dental pulp stromal/stem cells (DPSCs), stem-cells of apical papillae (SCAP) and oral epithelial cells, inhibited cell death mediated by bleaching agents in several in vitro assays. In addition, rat teeth, when treated with chair-side or over-the-counter bleaching agents, exerted adverse side effects to pulpal and gingival tissues as evidenced by the white lesions of gingivae as well as decreased survival and function of DPSCs. These side effects of bleaching agents were greatly mitigated by the application of NAC to the surfaces of the teeth and to the oral mucosa. NAC protected the surface topography and the appearance of the tissues after bleaching using scanning electron microscopic (SEM) analysis. Finally, application of NAC prior to the bleaching demonstrated significant translational benefit for the patients since it ameliorated pain and hypersensitivity and protected gingivae from bleaching induced white lesions and improved inflammatory index in the oral mucosa in human clinical trials. Conclusions: Therefore, application of NAC to the surfaces of the teeth and oral mucosa prior to the use of bleaching materials is beneficial for countering adverse side effects of bleaching in patients and decreases pain, sensitivity, and potential damage to the dentition and oral mucosa associated with bleaching. Trial registration: NCT03534115 (NAC Prevents Side-Effects of Teeth Bleaching). Registration 4 December 2014.

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Section: Discussionmentioning

confidence: 99%

N-acetyl cysteine prevents pain and hypersensitivity of bleaching agents without affecting their aesthetic appeal; evidence from in vitro to animal studies and to human clinical trials

Wang¹,

Kaur²,

Lee³

et al. 2019

transl med commun

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“…The instrument was calibrated prior to shade measurements. By measuring the CIE L*a*b* values, the overall colour difference before and after exposure (ΔE) was calculated per the following expression (de l'Eclairage 1978;Lima et al 2018) For the spectroshade measurement, each treatment group (5%CP/2hrs; 5%CP/4hrs; 10%CP/2hrs and 10%CP/4hrs) was assessed pre and post-treatment. The pretreatment assessment acted as a control measurement to evaluate the change of colour.…”

mentioning

confidence: 99%

Impact of Carbamide Peroxide Whitening Agent on Dentinal Collagen

et al. 2019

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Carbamide peroxide (CP) is widely used as a tooth whitening agent in selfadministered tooth bleaching products. In this study, the effects of 5% and 10% CP on dentinal collagen structure and chemical properties were evaluated in-vitro. Thirtyfive (35) intact teeth were exposed to two whitening protocols (2 or 4 hours daily) with either 5% or 10% CP gel for 1-week. Shade changes before and after the whitening protocol were captured colourimetrically using a spectroshade. Collagen scaffold

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“…Tooth bleaching treatment with 35% hydrogen peroxide is more effective than 15% hydrogen peroxide, but generates a greater risk and intensity of tooth sensitivity [6]. However, in-office bleaching could be considered an effective method for adolescents and young adults [7].…”

Section: Discussionmentioning

confidence: 99%

Combination of the custom trays bleaching technique with the in-office bleaching and considerations for result maintenance

Monteiro

Vieira

Magalhães

et al. 2020

RGO, Rev. Gaúch. Odontol.

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This study goal is to present a case report of tooth bleaching treatment with the combination of the custom tray and in-office techniques, and to discuss about the considerations for result maintenance. A treatment approach was planned involving exogenous bleaching with custom trays with 7.5% hydrogen peroxide, and in-office bleaching with 35% hydrogen peroxide. The in-office bleaching agent was applied in two 15-minute applications, without led light. The patient was instructed to use the custom trays only a day after, with one drop of the bleaching agent for each tooth space. After the application of the bleaching agent, the patient used the trays for 1 hour per day, continuously for 30 days, 15 days for each arch. Considering the executed treatment approach, we may conclude that when correctly indicated, tooth bleaching with the combination of the in-office and custom trays techniques can be an acceptable choice of treatment, capable of enhancing the smile esthetics with a simple technique that preserves the sound dental structure. The patient should be instructed for the maximum color preservation and esthetic result maintenance, and should be advised that retreatments may become necessary depending on the oral hygiene and frequence of coloured food and drinks intake.

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Evaluation of several clinical parameters after bleaching with hydrogen peroxide at different concentrations: A randomized clinical trial

Abstract: Hydrogen peroxide at a lower concentration (e.g., 15%) should be considered a good treatment alternative for in-office bleaching because the higher concentration for in-office bleaching generates a greater risk and intensity of TS for patients.

Cited by 54 publications

References 29 publications

N-acetyl cysteine prevents pain and hypersensitivity of bleaching agents without affecting their aesthetic appeal; evidence from in vitro to animal studies and to human clinical trials

N-acetyl cysteine prevents pain and hypersensitivity of bleaching agents without affecting their aesthetic appeal; evidence from in vitro to animal studies and to human clinical trials

Impact of Carbamide Peroxide Whitening Agent on Dentinal Collagen

Combination of the custom trays bleaching technique with the in-office bleaching and considerations for result maintenance

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