Skip to main content

Advertisement

Log in

Longevity, effectiveness, safety, and impact on quality of life of low-concentration hydrogen peroxides in-office bleaching: a randomized clinical trial

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

The study evaluated the longevity, effectiveness, safety, and impact on the oral health-related quality of life of in-office dental bleaching using low-concentration hydrogen peroxides.

Materials and methods

Randomized, parallel, and double-blinded clinical trial was performed with 54 participants using 6% or 15% hydrogen peroxide (HP) in-office bleaching activated via hybrid LED/laser light. Tooth color was evaluated at baseline (T1), 1 week of bleaching (T2), 2 weeks of bleaching (T3) and 1 week (T4) and 6 months (T5) after finishing the bleaching using the Classical Vita™ scale and spectrophotometer. Tooth sensitivity and gingival irritation were measured with Visual Numeric Scale and Modified Gingival Index. The impact on quality of life was evaluated using the Oral Impact on Daily Performance. The data were analyzed using the Friedman, Mann-Whitney, and McNemar tests (p < 0.05).

Results

The group HP15% presented significant color change (ΔE) from T1 to T4 (p = 0.002) and T1 to T5 (p < 0.001). Parameters L, a*, and b* differed significantly at T3, T4, and T5 compared T1 for both groups. At 6-month follow-up, 57.1% of HP6 and 43.7% of HP15% participants migrated from B1 to a darker color. No significant differences were observed between the groups in tooth sensitivity, gingival irritation, or impact on quality of life.

Conclusions

Both agents showed bleaching effectiveness, but HP15% presented greater color stability than HP6%, at 6-month follow-up. The agents showed low levels of tooth sensitivity, gingival irritation, and did not affect the oral health-related quality of life of the participants.

Clinical relevance

Despite the greater presence of sensitivity during treatment compared with 6% hydrogen peroxide, 15% hydrogen peroxide demonstrated better bleaching effectiveness, and greater color stability at the end of bleaching and at 6-month follow-up. The use of 15% hydrogen peroxide presents more suitable results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. ADA (2006) Dentist dispensed home-use tooth bleaching products. In: Am. Dent. Assoc. http://www.ada.org/ada/seal/standards/guide_home_

  2. Joiner A (2006) The bleaching of teeth: a review of the literature. J Dent 34:412–419. https://doi.org/10.1016/j.jdent.2006.02.002

    Article  PubMed  Google Scholar 

  3. Bruzell EM, Pallesen U, Thoresen NR, Wallman C, Dahl JE (2013) Side effects of external tooth bleaching: a multi-centre practice-based prospective study. Br Dent J 215:E17. https://doi.org/10.1038/sj.bdj.2013.1047

    Article  PubMed  Google Scholar 

  4. SCCP The Scientific Committee on Consumer Products (2005) Public consultation on a preliminary opinion on hydrogen peroxide in tooth whitening products. http://ec.europa.eu/health/ph_risk/committees/04_sccp/docs/sccp_cons_01_en.pdf

  5. Haywood VB, Caughman WF, Frazier KB, Myers ML (2001) Tray delivery of potassium nitrate-fluoride to reduce bleaching sensitivity. Quintessence Int 32:105–109

    PubMed  Google Scholar 

  6. Kossatz S, Dalanhol AP, Cunha T, Loguercio A, Reis A (2011) Effect of light activation on tooth sensitivity after in-office bleaching. Oper Dent 36:251–257. https://doi.org/10.2341/10-289-C

    Article  PubMed  Google Scholar 

  7. Martin J, Fernandez E, Bahamondes V et al (2013) Dentin hypersensitivity after teeth bleaching with in-office systems. Randomized clinical trial. Am J Dent 26:10–14

    PubMed  Google Scholar 

  8. de Souza Costa CA, Riehl H, Kina JF, Sacono NT, Hebling J (2010) Human pulp responses to in-office tooth bleaching. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:e59–e64. https://doi.org/10.1016/j.tripleo.2009.12.002

    Article  Google Scholar 

  9. Munro IC, Williams GM, Heymann HO, Kroes R (2006) Use of hydrogen peroxide-based tooth whitening products and its relationship to oral cancer. J Esthet Restor Dent 18:119–125. https://doi.org/10.1111/j.1708-8240.2006.00006.x

    Article  PubMed  Google Scholar 

  10. Munro IC, Williams GM, Heymann HO, Kroes R (2006) Tooth whitening products and the risk of oral cancer. Food Chem Toxicol 44:301–315. https://doi.org/10.1016/j.fct.2005.07.012

    Article  PubMed  Google Scholar 

  11. Goldberg M, Grootveld M, Lynch E (2010) Undesirable and adverse effects of tooth-whitening products: a review. Clin Oral Investig 14:1–10. https://doi.org/10.1007/s00784-009-0302-4

    Article  PubMed  Google Scholar 

  12. Gerlach RW, Zhou X (2002) Comparative clinical efficacy of two professional bleaching systems. Compend Contin Educ Dent 23:35–41

    PubMed  Google Scholar 

  13. Reis A, Kossatz S, Martins GC, Loguercio AD (2013) Efficacy of and effect on tooth sensitivity of in-office bleaching gel concentrations: a randomized clinical trial. Oper Dent 38:386–393. https://doi.org/10.2341/12-140-C

    Article  PubMed  Google Scholar 

  14. Bortolatto JF, Trevisan TC, Sadalla P et al (2016) A novel approach for in-office tooth bleaching with 6% H2O2/TiO_N and LED/laser system—a controlled , triple-blinded , randomized clinical trial. Lasers Med Sci 31:437–444. https://doi.org/10.1007/s10103-016-1866-2

    Article  PubMed  Google Scholar 

  15. Bortolatto JF, Pretel H, Floros MC, Luizzi ACC, Dantas AAR, Fernandez E, Moncada G, de Oliveira OB Jr (2014) Low concentration H(2)O(2)/TiO_N in office bleaching: a randomized clinical trial. J Dent Res 93:66S–71S. https://doi.org/10.1177/0022034514537466

    Article  PubMed  PubMed Central  Google Scholar 

  16. Martín J, Vildósola P, Bersezio C, Herrera A, Bortolatto J, Saad JRC, Oliveira OB Jr, Fernández E (2015) Effectiveness of 6% hydrogen peroxide concentration for tooth bleaching—a double-blind, randomized clinical trial. J Dent 43:6–13. https://doi.org/10.1016/j.jdent.2015.05.011

    Article  Google Scholar 

  17. Vildósola P, Bottner J, Avalos F, Godoy I, Martín J, Fernández E (2017) Teeth bleaching with low concentrations of hydrogen peroxide (6%) and catalyzed by LED blue (450 ± 10 nm) and laser infrared (808 ± 10 nm) light for in-office treatment: randomized clinical trial 1-year follow-up. J Esthet Restor Dent 29:339–345. https://doi.org/10.1111/jerd.12318

    Article  PubMed  Google Scholar 

  18. Fernández E, Bersezio C, Bottner J, Avalos F, Godoy I, Inda D, Vildósola P, Saad JRC, Oliveira OB Jr, Martín J (2017) Longevity, esthetic perception, and psychosocial impact of teeth bleaching by low (6%) hydrogen peroxide concentration for in-office treatment: a randomized clinical trial. Oper Dent 42:41–52. https://doi.org/10.2341/15-335-C

    Article  PubMed  Google Scholar 

  19. Angel P, Bersezio C, Estay J et al (2018) Color stability, psychosocial impact, and effect on self-perception of esthetics of tooth whitening using low-concentration (6%) hydrogen peroxide. Quintessence Int 49:557–566. https://doi.org/10.3290/j.qi.a40468

    Article  PubMed  Google Scholar 

  20. Bersezio C, Martín J, Angel P, Bottner J, Godoy I, Avalos F, Fernández E (2018) Teeth whitening with 6% hydrogen peroxide and its impact on quality of life: 2 years of follow-up. Odontology. https://doi.org/10.1007/s10266-018-0372-3

  21. Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS Med 7:1–7. https://doi.org/10.1371/journal.pmed.1000251

    Article  Google Scholar 

  22. Meireles SS, Goettems ML, Dantas RVF, Bona ÁD, Santos IS, Demarco FF (2014) Changes in oral health related quality of life after dental bleaching in a double-blind randomized clinical trial. J Dent 42:114–121. https://doi.org/10.1016/j.jdent.2013.11.022

    Article  PubMed  Google Scholar 

  23. Tavares M, Stultz J, Newman M et al (2003) Light augments tooth whitening with peroxide. J Am Dent Assoc 134:167–175

    Article  PubMed  Google Scholar 

  24. Lobene RR, Weatherford T, Ross NM et al (1986) A modified gingival index for use in clinical trials. Clin Prev Dent 8:3–6

    PubMed  Google Scholar 

  25. Abegg C, Fontanive VN, Tsakos G, Davoglio RS, de Oliveira MMC (2015) Adapting and testing the oral impacts on daily performances among adults and elderly in Brazil. Gerodontology 32:46–52. https://doi.org/10.1111/ger.12051

    Article  PubMed  Google Scholar 

  26. Commission Internationale de L’Eclairage (1978) Recommendations on uniform colour spaces, colour terms. Bureau Central de la CIE, Paris

    Google Scholar 

  27. Bizhang M, Chun Y-HP, Damerau K, Singh P, Raab WHM, Zimmer S (2009) Comparative clinical study of the effectiveness of three different bleaching methods. Oper Dent 34:635–641. https://doi.org/10.2341/08-069-C

    Article  PubMed  Google Scholar 

  28. Matis BA, Cochran MA, Eckert G (2009) Review of the effectiveness of various tooth whitening systems. Oper Dent 34:230–235. https://doi.org/10.2341/08-74

    Article  PubMed  Google Scholar 

  29. Gerlach RW, Zhou X (2001) Vital bleaching with whitening strips: summary of clinical research on effectiveness and tolerability. J Contemp Dent Pract 2:1–16

    Article  PubMed  Google Scholar 

  30. Martín J, Ovies N, Cisternas P, Fernández E, Oliveira Junior OB, de Andrade MF, Moncada G, Vildósola P (2015) Can an LED-laser hybrid light help to decrease hydrogen peroxide concentration while maintaining effectiveness in teeth bleaching? Laser Phys 25:1–5. https://doi.org/10.1088/1054-660X/25/2/025608

    Article  Google Scholar 

  31. Suyama Y, Otsuki M, Ogisu S et al (2009) Effects of light sources and visible light-activated titanium dioxide photocatalyst on bleaching. Dent Mater J 28:693–699

    Article  PubMed  Google Scholar 

  32. Sulieman M, Addy M, Rees JS (2003) Development and evaluation of a method in vitro to study the effectiveness of tooth bleaching. J Dent 31:415–422

    Article  PubMed  Google Scholar 

  33. Vano M, Derchi G, Barone A, Genovesi A, Covani U (2015) Tooth bleaching with hydrogen peroxide and nano-hydroxyapatite: a 9-month follow-up randomized clinical trial. Int J Dent Hyg 13:301–307. https://doi.org/10.1111/idh.12123

    Article  PubMed  Google Scholar 

  34. Soares DG, Ribeiro APD, da Silveira Vargas F, Hebling J, de Souza Costa CA (2013) Efficacy and cytotoxicity of a bleaching gel after short application times on dental enamel. Clin Oral Investig 17:1901–1909. https://doi.org/10.1007/s00784-012-0883-1

    Article  PubMed  Google Scholar 

  35. Sulieman M, Addy M, MacDonald E, Rees JS (2004) The effect of hydrogen peroxide concentration on the outcome of tooth whitening: an in vitro study. J Dent 32:295–299. https://doi.org/10.1016/j.jdent.2004.01.003

    Article  PubMed  Google Scholar 

  36. Matis BA, Cochran MA, Franco M, al-Ammar W, Eckert GJ, Stropes M (2007) Eight in-office tooth whitening systems evaluated in vivo: a pilot study. Oper Dent 32:322–327. https://doi.org/10.2341/06-135

    Article  PubMed  Google Scholar 

  37. Sulieman MA (2008) An overview of tooth-bleaching techniques: chemistry, safety and efficacy. Periodontol 2000(48):148–169. https://doi.org/10.1111/j.1600-0757.2008.00258.x

    Article  Google Scholar 

  38. Moncada G, Sepúlveda D, Elphick K, Contente M, Estay J, Bahamondes V, Fernandez E, Oliveira OB, Martin J (2013) Effects of light activation, agent concentration, and tooth thickness on dental sensitivity after bleaching. Oper Dent 38:467–476. https://doi.org/10.2341/12-335-C

    Article  PubMed  Google Scholar 

  39. Buck D, Newton JT (2001) Non-clinical outcome measures in dentistry: publishing trends 1988-98. Community Dent Oral Epidemiol 29:2–8

    Article  PubMed  Google Scholar 

  40. Preciado A, Del RJ, Lynch CD, Oyagüe RC (2013) A new, short, specific questionnaire (QoLIP-10) for evaluating the oral health-related quality of life of implant-retained overdenture and hybrid prosthesis wearers. J Dent 41:753–763. https://doi.org/10.1016/j.jdent.2013.06.014

    Article  PubMed  Google Scholar 

  41. Adulyanon S, Vourapukjaru J, Sheiham A (1996) Oral impacts affecting daily performance in a low dental disease Thai population. Community Dent Oral Epidemiol 24:385–389

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful to CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) for providing the scholarship to Nayara Kelly Lyrio Ferraz and to the Postgraduate Collegiate (Faculty of Dentistry, Universidade Federal de Minas Gerais). We thank Prof. Dr. Osmir Batista de Oliveira Júnior, FOAR-UNESP for loaning the LED/laser equipment Whitening Laser II DMC.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Claudia Silami Magalhães.

Ethics declarations

Conflict of interest

The author Nayara Kelly Lyrio Ferraz declares no conflicts of interest.

The author Lilian Capanema Nogueira declares no conflicts of interest.

The author Isabela Moreira Neiva declares no conflicts of interest.

The author Raquel Conceição Ferreira declares no conflicts of interest.

The author Allyson Nogueira Moreira declares no conflicts of interest.

The author Claudia Silami Magalhães declares no conflicts of interest.

Ethical approval

This study followed the ethical principles established in the Helsinki Declaration of 1964, and was approved by the University Ethics Committee (Process no. 1.269.466). The study was registered as a clinical trial (NCT02816593-https://clinicaltrials.gov/ct2/results?term=NCT02816593&Search=Pesquisa) and reported in accordance with the CONSORT Statement (Consolidated Standards of Reporting Trials).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ferraz, N.K.L., Nogueira, L.C., Neiva, I.M. et al. Longevity, effectiveness, safety, and impact on quality of life of low-concentration hydrogen peroxides in-office bleaching: a randomized clinical trial. Clin Oral Invest 23, 2061–2070 (2019). https://doi.org/10.1007/s00784-018-2607-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-018-2607-7

Keywords

Navigation