This study evaluated the degree of color change of teeth, the rebound effect and the sensitivities of teeth and gingiva associated with the use of an in-office bleaching agent followed by an at-home bleaching agent to lighten stained teeth in an in vivo study. Thirty-seven subjects who met the Inclusion/Exclusion criteria were divided into two cells. Twenty-five subjects received three 15-minute in-office bleaching treatments in succession with 36% hydrogen peroxide (HP) on the maxillary anterior teeth, followed by at-home overnight bleaching with 15% carbamide peroxide (CP) for seven days on one side of the dental arch. Twelve other subjects received a 40-minute in-office bleaching treatment on their maxillary anterior teeth, followed by at-home overnight bleaching for seven days on one side of the dental arch with the same product. The cells of teeth on the other side of the dental arch received the same in-office treatment but were not bleached overnight for seven days. Color was subjectively evaluated using the Vitapan Classical Shade Guide and was objectively evaluated using the Chroma Meter at the baseline appointment, immediately after in-office bleaching and at 4, 7 and 14 days and 3 months after the in-office treatment. For two weeks, the subjects completed sensitivity evaluations of gingival tissues and hard tooth tissues. The cells that did not receive the at-home bleaching had significantly less color change than the cells that received at-home bleaching. The cell that was bleached for 40 minutes and received the at-home treatment had significantly less overall change (deltaE) at 14 days and 3 months than the cell that received three 15-minute treatments with the at-home treatment. Throughout the study, the subjects in the three 15-minute treatment cells had less gingival and tooth sensitivity than the other cells.
Clinical RelevanceRapid bleaching is the main advantage of in-office bleaching; however, there is also a rapid reversal that occurs with most in-office products after bleaching. SUMMARYThis in vivo pilot study evaluated eight products with hydrogen peroxide (HP) concentrations ranging from 15% to 35%. The treatment contact time varied from 15 minutes to 60 minutes. Patients were evaluated for color at baseline, immediately after treatment and at one, two, four and six weeks after treatment using a colorimeter, shade guide and photos.All eight products were effective in bleaching teeth. Colorimeter data for ΔE immediately after treatment was 6.77. At one and six weeks after bleaching, there were 51% and 65% reductions in ΔE, respectively.
©Operative Dentistry, 2009, 34-2, 230-235 BA Matis • MA Cochran • G Eckert Clinical RelevanceTooth whitening is observable with all methods of bleaching. Dentist-prescribed overnight bleaching was shown to be the most effective method of bleaching. SUMMARYThis review compares nine published studies conducted at the Indiana University School of Dentistry. Twenty-five products in four different systems were evaluated using the Trubyte Bioform Color Ordered Shade Guide and a Chroma Meter. The dentist-prescribed overnight bleaching delta mean shade guide value (DSGV) 10 weeks post-bleaching was 13.2 and delta E value (DEV) 4.7; dentist-prescribed daytime bleaching DSGV 10 weeks post-bleaching was 10.5 and DEV 3.4; in-office bleaching DSGV 10 weeks post-bleaching was 6.7 and DEV was 2.1; over-the-counter bleaching DSGV two weeks post-bleaching was 7.2 and DEV was 4.1. A color difference of Delta E 2.6 is perceivable. Tooth whitening is observable with all methods of bleaching. Dentist-prescribed overnight bleaching was shown to be the most effective method of bleaching.
This study evaluated tooth whitening and sensitivity that occurred during and after 14 days of overnight bleaching with 15% carbamide peroxide gel with potassium nitrate and fluoride (Opalescence 15% PF, OP) and 16% carbamide peroxide with amorphous calcium phosphate (Nite White 16%, NW). Thirty-two subjects bleached their teeth using custom trays. The subjects had a baseline evaluation and returned after 7, 14, 21, 35 and 90 days for subjective and objective color evaluations. The subjects also recorded daily tooth and gingival sensitivity. The treatments were compared for differences in mean L*, a*, b* and shade guide rank order at baseline and each appointment thereafter, using repeated measures analysis of variance (ANOVA). OP and NW showed significant tooth whitening. Subjects using OP were significantly lighter in b* and E* than those using NW, while exhibiting no difference in tooth or gingival sensitivity overall or during any evaluation.
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