Treatment Durations and Whitening Outcomes of Different Tooth Whitening Systems

Abstract

Background and Objectives: Tooth whitening is a relatively conservative and effective option to treat discolored teeth. However, questions remain whether in-office or at-home tooth whitening products with short treatment durations are as effective and stable as products with longer treatment durations. Materials and Methods: Forty human third molars with intact enamel surfaces were divided into four groups of ten each, subjected to discoloration challenges with coffee for 60 h, and they were treated with four professional tooth whitening systems: two for take-home use—6% hydrogen peroxide for 30 min/d for a total of 7 h in 14 days (HP6), 10% carbamide peroxide for 10 h/d for 140 h in 14 days (CP10), as well as two for in-office use—35% HP for 10 min × 3 (HP35) for a total of 30 min and 40% HP for 20 min × 3 (HP40) for a total of 60 min. Teeth colors were assessed in the CIE L*a*b* color space with a spectrophotometer immediately and six months after whitening treatments. Surface roughness (Sa) for the treated and untreated enamel surfaces of the teeth in all groups were evaluated with a three-dimensional laser scanning microscope after six months. Results: No significant differences were found between HP6 and CP10 groups immediately after whitening (∆E 10.6 ± 1.6 vs. 11.4 ± 1.7, p > 0.05) and at six months after treatments (∆E 9.0 ± 1.9 vs. 9.2 ± 2.5, p > 0.05), or between HP35 and HP40 groups immediately after whitening (∆E 5.9 ± 1.2 vs. 5.3 ± 1.7, p > 0.05) and at six months after treatments (∆E 7.2 ± 1.6 vs. 7.7 ± 1.3, p > 0.05). The two at-home whitening systems achieved significantly better whitening outcomes than the two in-office products immediately after whitening (p < 0.05). However, at six months after treatments, the differences between at-home and in-office treatments had narrowed significantly (p > 0.05). There were no statistically significant differences with respect to the Sa values between the treated and untreated surfaces (p > 0.05). Conclusions: Tooth whitening products in the same product category have similar whitening efficacies, despite significant differences in treatment durations (7 vs. 140 h, and 30 min vs. 60 min, respectively). Take-home products achieved better whitening outcomes than in-office products, but they needed 14 to 280 times longer treatment durations.

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

“…In this way, several methods have been developed to enhance chemical reactions, such as chemical catalysis by Fenton reactions, thermocatalyzation with heat units, lasers, and high-intensity lamps (plasma arc, xenon, and halogen), photothermal conversion (lowintensity lights -LED and LED/Laser) and ultraviolet light [1,7].…”

“…This is the principle of action of homemade whitening gels and some in-office whitening products that do not depend on irradiation for the whitening process to occur. However, the whitening gel can receive an energy source to accelerate its process [7,19].…”

“…MedNEXT Journal of Medical and Health Sciences peroxide, even in low concentrations, can easily penetrate the enamel and diffuse deep into the dentin reaching the pulp, especially in regions where the dentin meets -if exposed, in areas of gingival recession, abrasions, erosions, wear, defects in the enamel, defects in the dental-enamel junction, or marginal areas between the tooth and the restoration. Oxidative stress, generated by bleaching agents, causes apoptosis and damage to periodontium DNA (genotoxicity) and cellular cytotoxicity [1,5,7].…”

“…Low-intensity laser therapies for desensitization have also been reported in the literature [1,3,7]. Tooth sensitivity continues to be a major concern, although many studies and techniques combine desensitizing approaches and whitening substances, it is important to explore alternative desensitization regimens that are capable of reducing or eliminating sensitivity and discomfort [1].…”

Clareamento dental: Desvendando mitos e abordando uma visão contemporânea dos mecanismos de ação, eficácia e segurança

“…No mercado há uma variedade de agentes clareadores que são classificados com base no próprio mecanismo de ação, as duas categorias principais são o clareamento no consultório odontológico e o clareamento caseiro (Zhao, 2023). Esses dois tipos de clareamento possuem o mesmo ingrediente ativo, o peroxido de hidrogênio, contudo a diferença será no tempo de ação, na concentração do gel e o método de administração (Ibidem, 2023).…”