The degree of color change, rebound effect and sensitivity of bleached teeth associated with at-home and power bleaching techniques: A randomized clinical trial

Abstract

Aim:The purpose of the present randomized clinical trial was to evaluate the color change, rebound effect and sensitivity of at-home bleaching with 15% carbamide peroxide and power bleaching using 38% hydrogen peroxide.Materials and Methods:For bleaching techniques, 20 subjects were randomized in a split mouth design (at-home and power bleaching): In maxillary and mandibular anterior teeth (n = 20). Color was recorded before bleaching, immediately after bleaching, at 2 weeks, 1, 3 and 6 month intervals. Tooth sensitivity was recorded using the visual analog scale. The Mann-Whitney test was used to compare both groups regarding bleaching effectiveness (ΔE1), rebound effect (ΔE2) and color difference between the rebounded tooth color and unbleached teeth (ΔE3) while the Wilcoxon compared ΔE within each group. Distribution of sensitivity was evaluated using the Chi-square test (α =0.05).Results:There was no significant difference between groups regarding ΔE1 and ΔE3 (P > 0.05). Even though, ΔE2 showed no significant difference between groups after bleaching as well as at 2 week, 1 month and 3 month follow-up periods (P > 0.05). Although, significant difference was found in ΔE2 (P < 0.05 Mann-Whitney) between two methods after 6 months and a high degree of rebound effect was obtained with power bleaching. Within each group, there was no significant difference between ΔE1 and ΔE3 (P < 0.05 Wilcoxon). The distribution of sensitivity was identical with both techniques (P > 0.05).Conclusion:Bleaching techniques resulted in identical tooth whitening and post-operative sensitivity using both techniques, but faster color regression was found with power bleaching even though color regression to the baseline of the teeth in both groups was the same after 6 months.

Effects of a bleaching agent with calcium on bovine enamel

“…[1,2] Bleaching agents containing peroxide have been widely used for the whitening of stained and discolored teeth, both home treatment and in office bleaching and both techniques appear to be effective in treating of the dark teeth. [3,4] Bleaching occurs through an oxidation reaction that results in the between bleaching agents and dental tissues can cause adverse effects to the tissue. [6,7] For example, bleaching treatments have been reported to cause a loss of tissue components, [4,8] leading to surface changes associated with decreased calcium and fluoride content in the enamel.…”

Efficacy of natural, peroxide‐free tooth‐bleaching agents: A systematic review, meta‐analysis, and technological prospecting

“…Tooth bleaching is one of the most common aesthetic procedures in dentistry. It is a more conservative option for vital teeth whitening when compared with other treatment modalities such as crowns or ceramic laminates (Meireles et al, ; Moghadam, Majidinia, Chasteen, & Ghavamnasiri, ). It is a well‐established technique, and it provides a high level of satisfaction and effectiveness.…”

“…Despite being a fairly well‐tolerated method, some patients still report sensitivity during and after the bleaching procedures (Guedes, ). The percentage of patients experiencing sensitivity varies from approximately 43% to 80% (He, Shao, Tan, Xu, & Li, ; Kossatz, Dalanhol, Cunha, Loguercio, & Reis, ; Leonard, Haywood, & Phillips, ; Martini et al, ; Moghadam et al, ).…”

“…These molecules diffuse through enamel and dentin, producing oxidation of tooth pigments; this chemical reaction is what provides the bleaching effect (Hortkoff, Bittencourt, Nadal, & Rezende, ). The by‐products of this reaction can reach the pulp chamber (Shackelford, Kaufmann, & Paules, ; Young, Fairley, Mohan, & Jumeaux, ) and cause serious damage to pulp tissue, especially to odontoblasts underlying dentin (Li & Greenwall, ; Moghadam et al, ; Tredwin, Naik, Lewis, & Scully, ); this may affect the regenerative potential of pulp cells, once it induces pro‐inflammatory cytokine release (Attin, Vollmer, Wiegand, Attin, & Betke, ; Soares et al, ).…”

In-Office Tooth Bleaching for Adolescents Using Hydrogen Peroxide-Based Gels: Clinical Trial

“…Bleaching is the most conservative treatment for darkened teeth, as it does not involve the loss of tissue (8)(9)(10)(11). At-home bleaching with a gel and mouth guard supervised by a dentist is the most widely used modalty (12).…”