Efficacy and tooth sensitivity of at-home bleaching in patients with esthetic restorations: a randomized clinical trial

Abstract

Objectives: This study aims to evaluate the color change and tooth sensitivity (TS) caused by at-home bleaching in patients with sound and with restored teeth.

Methods: Forty patients were selected according to the inclusion and exclusion criteria and divided into two groups: So (patients with six caries-free maxillary anterior teeth) and Re (patients with at least one restoration in the six maxillary anterior teeth). Both groups were bleached with 10% carbamide peroxide (CP) at-home bleaching. The color change (CIELab [ΔE*_ab], CIEDE00 [ΔE₀₀], and whiteness index [∆WI_D]) were assessed using a spectrophotometer at baseline, 2 weeks, and 1 and 3 months after bleaching. Patients recorded their TS using a numeric rating scale (0-4). Data of color change were submitted to Student's T-test. The absolute risk and intensity of TS were compared using Fisher's and the Mann-Whitney tests, respectively (α = 0.05).

Results: Higher ΔE*_ab, ΔE₀₀, and ∆WI_D values were observed for So in relation to Re after all recall rate (p < 0.0001). No significant differences were observed regarding of bleaching-induced TS (p > 0.9).

Conclusions: At-home dental bleaching with 10% CP generated the same pattern of TS in patients with or without restorations. However, in patients with restored teeth, it produced a lower color change after 2 weeks of bleaching.

Clinical significance: After 2 weeks of at-home bleaching, a lower whitening effect was observed in patients with anterior restorations when compared with patients with sound teeth.

Trial registration: ClinicalTrials.gov identifier RBR-52j6gmg.

Keywords: Carbamide peroxide; Dental esthetics; Tooth bleaching; Tooth sensitivity.