21 March 2022

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Short-time home whitening systems compared to traditional systems

Lara Figini

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Originally home whitening techniques used a low concentration 10% carbamide peroxide (CP) gel in custom masks (CT) worn overnight (6-8 h). Subsequently, the manufacturing companies have developed more "attractive" products allowing you to whiten your teeth in a short time for daily use. The gel composition has been reformulated and modified and usage protocols have been suggested, based on gel concentrations (usually 4% –15% HP hydrogen peroxide or 10% –22% carbamide peroxide PC) and usage time (from 15 min to 8 h).

Materials and methods
In a randomized clinical trial, published in the Journal of Esthetic Restorative Dentistry in December 2021, the authors compared home whitening systems with shortened daily wearing time (10% hydrogen peroxide [HP] gel with pre-filled (PT) aligners) or custom (CT) and 10% carbamide peroxide [CP] gel), compared to conventional overnight whitening (6-8 hours) (10% CP). The efficacy of whitening, adverse effects and patient satisfaction were assessed. Sixty participants were randomly divided into the various 14-day treatment groups:

- Opalescence GO (OGO): 10% HP hydrogen peroxide with PT pre-filled masks kept daily for 30 min,

- White Class: 10% HP hydrogen peroxide with customized CT masks kept daily for 30 min,

- Opalescence PF: 10% carbamide peroxide CP with customized CT masks kept daily for 2 h and

- Opalescence PF: 10% carbamide peroxide CP with customized CT masks kept daily for 8 h.

Color difference (visual and by spectrophotometer), tooth sensitivity (by visual analog scale), gingival condition (by Löe index), enamel mineralization (by laser fluorescence) and patient satisfaction (by a questionnaire) were evaluated. Statistical tests were applied (5%).

Results
After 1 year, the color difference was similar for all groups. All groups showed increased dentinal sensitivity. The intensity of gingival sensitivity and irritation was mild for all gels investigated in the study, but greater for OGO. Fluorescence after bleaching gave similar results to healthy enamel. All participants were satisfied with the treatments.

Conclusions
From the data of this study, which must be confirmed in other similar studies, it can be concluded that the whitening efficacy of the home systems investigated in this study, even those kept for a short daily time, is maintained until after 1 year, finding satisfaction on the part of patients with the results obtained. The increased dental sensitivity occurred in all groups, but with an overall mild intensity. These home whitening systems do not cause significant gingival irritation or demineralization of the enamel.

Clinical implications
Home whitening with 10% HP gel with pre-filled and customized short-time (30 minutes) trays is an effective alternative to teeth whitening, with a similar acceptance by patients to that of conventional 10 CP whiteners. %. Patients should be warned of mild sensitivity and potential gingival irritation, mainly with PT pre-filled aligners.

For additional information: One-year follow-up comparing at-home bleaching systems outcomes and the impact on patient's satisfaction: Randomized clinical trial