Objective: To compare at-home systems with reduced daily time of use (10% hydrogen peroxide [HP] gel with prefilled (PT) or customized trays (CT), and 10% carbamide peroxide [CP] gel), with the conventional nightguard vital bleaching (10% CP).Bleaching efficacy, adverse effects, and patient's satisfaction were evaluated. Methods: Sixty participants were randomly divided into treatments (14 days): Opalescence GO (OGO)-10%HP PT-30 min, White Class-10%HP CT-30 min, Opalescence PF-10%CP CT-2 h, and Opalescence PF-10%CP CT-8 h. Color difference (visual and spectrophotometer), tooth sensitivity (visual analogue scale), gingival condition (Löe index), enamel mineralization (laser fluorescence), and patients' satisfaction (questionnaire) were assessed. Statistical tests were applied (5%).Results: After 1 year, color difference was similar for the groups (p > 0.05). All groups showed similar sensitivity risk (p > 0.05). The intensity of sensitivity and gingival irritation was mild for all gels, but higher for OGO. Fluorescence after bleaching remained similar to those of sound enamel. All participants were satisfied with treatments.Conclusions: All systems produced similar bleaching efficacy, which was maintained after 1 year. Patients were satisfied with bleaching outcomes. Tooth sensitivity occurred in all groups, but with overall mild intensity. No relevant gingival irritation and enamel demineralization was observed.Clinical significance: Bleaching with 10% HP gels in prefilled and CTs represent efficacious alternative for tooth color change, with patients' acceptance similar to conventional 10% CP. Patients must be warned about the mild sensitivity and gingival irritation potential, mainly with PTs.
Objective: To evaluate if distinct 20%-22% carbamide peroxide bleaching gels present similar decomposition pattern and pH during the clinical use in both arches, as well as gels viscosity. Methods: Participants randomly received treatments with carbamide peroxide gels (n = 10): OPF (OpalescencePF-20%); PNT (Polanight-22%); and WPC (Whiteness Perfect-22%) in three different days, with 2-day washout. Decomposition pattern was assessed by peroxide concentration. Both PC and pH of bleaching gels were measured in different time points in upper and lower trays during a total of 120 min of clinical use. Viscosity of bleaching gels was measured in triplicate. ANOVA and Tukey's test were applied (α = 0.05). Results: Regarding decomposition pattern, no significant differences were observed for the interaction between gel, time, and tray position factors. The peroxide concentration progressively reduced until 120 min of trays use (p < 0.001), being overall more notable in lower trays (p < 0.001). Regarding pH, the lowest values were verified in WPC within time. At 120 min, an increase of pH was observed for both WPC and OPF (p < 0.001) compared to baseline means. PNT exhibited constant pH values over time. The values of viscosity were: OPF (1.682.000 ± 19 cP)a, WPC (1.388.667 ± 172.63 cP)ab, PNT (579.567 ± 0.98 cP)b. Conclusions: The bleaching gels presented overall decomposition pattern clinically equivalent, being more notable in lower trays over time. Nevertheless, distinct pH and viscosities were observed among the products. Clinical Significance: Although the manufacturers recommend different times of use for bleaching gels with similar peroxide concentrations, the commercial products tested did not exhibit clinically relevant difference in the decomposition pattern during the 120 min of clinical procedure.
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