The Efficacy of At-home, In-office, and Combined Bleaching Regimens: A Randomized Controlled Clinical Trial

B-J Zhong; S Yang; D-W Hong; Y-L Cheng; T Attin; H Yu

doi:10.2341/22-099-C

The Efficacy of At-home, In-office, and Combined Bleaching Regimens: A Randomized Controlled Clinical Trial

Oper Dent. 2023 May 1;48(3):E71-E80. doi: 10.2341/22-099-C.

Authors

B-J Zhong¹, S Yang², D-W Hong³, Y-L Cheng⁴, T Attin⁵, H Yu⁶

Affiliations

¹ †Bing-jie Zhong, DDS, PhD candidate, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
² †Song Yang, DDS, MS, PhD candidate, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
³ Deng-wei Hong, DDS, MS, dentist, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
⁴ Yi-ling Cheng, DDS, PhD candidate, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
⁵ Thomas Attin, Dr Med Dent, professor, Clinic of Conservative and Preventive Dentistry, Center for Dental Medicine, University of Zurich, Switzerland.
⁶ *Hao Yu, DDS, PhD, Dr Med Dent, associate professor and associate dean, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China; adjunct professor, Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.

PMID: 37079917
DOI: 10.2341/22-099-C

Abstract

Objective: The aim of this study was to compare the clinical efficacy of at-home, in-office, and combined bleaching regimens.

Methods: Forty-eight participants were recruited and randomly divided into four groups based on the bleaching regimen (n=12) as follows: 1) at-home bleaching using 10% carbamide peroxide (Opalescence PF 10%, Ultradent) for 14 days (HB); 2) two sessions of in-office bleaching using 40% hydrogen peroxide (Opalescence BOOST PF 40%, Ultradent) with a one-week interval (OB); 3) one session of in-office bleaching followed by at-home bleaching for seven days (OHB); and 4) at-home bleaching for seven days followed by one session of in-office bleaching (HOB). Tooth color was measured using a spectrophotometer (Easyshade, Vita ZahnFabrik) at baseline (T0), day 8 (T1), day 15 (T2), and day 43 (T3, four weeks after the end of the bleaching treatment). The color data were calculated using the CIEDE2000 (ΔE00) and whiteness index for dentistry (WID) formulas. Tooth sensitivity (TS) was recorded using a visual analogue scale (VAS) for 16 days. Data were analyzed by one-way analysis of variance (ANOVA) and the Wilcoxon signed-rank test (α=0.05).

Results: All bleaching regimens resulted in a significant increase in WID values (all p<0.05), while no significant differences in WID and ΔWID values were found among the different groups at each time point (all p>0.05). Significant differences in ΔE00 values were observed between T1 and T3 for all groups (all p<0.05), while no significant differences in ΔE00 values were found among the different groups at any time point (all p>0.05). Significantly lower TS values were observed in the HB group than in the OB and HOB groups (p=0.006 and p=0.001, respectively).

Conclusions: All bleaching regimens resulted in great color improvement, and different regimens led to similar color changes at any of the evaluation time points. The sequence of treatments applying in-office bleaching or at-home bleaching did not affect the bleaching efficacy. The in-office bleaching and combined bleaching regimens yielded a higher intensity of TS than did at-home bleaching.

Publication types

Randomized Controlled Trial

MeSH terms

Carbamide Peroxide / therapeutic use
Color
Dentin Sensitivity*
Humans
Hydrogen Peroxide / therapeutic use
Tooth Bleaching Agents* / therapeutic use
Tooth Bleaching* / methods
Treatment Outcome

Substances

Hydrogen Peroxide
Carbamide Peroxide
Tooth Bleaching Agents