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Nightguard vital bleaching: side effects and patient satisfaction 10 to 17 years post-treatment
Lee W Boushell1, André V Ritter, Glenn E Garland
1Department of Operative Dentistry, University of North Carolina School of Dentistry, Chapel Hill, NC, USA. boushell@dentistry.unc.edu
Statement Of The Problem:
The long-term patient satisfaction and safety of nightguard vital bleaching (NGVB) requires further evaluation.
Purpose Of The Study:
The purpose of this study was to evaluate patients' satisfaction and identify side effects of NGVB up to 17 years post-treatment.
Materials And Methods:
Thirty-one participants who had completed previous NGVB studies using 10% carbamide peroxide were contacted at least 10 years post-treatment (range 10-17 years, average 12.3 years). Participants reported shade satisfaction (very satisfied [VS], partially satisfied [PS], or not satisfied [NS]) as well as potential complications. Participants had teeth # 6 to 11 examined for tooth vitality, gingival inflammation (Löe's Gingival Index [GI]), and radiographically for external cervical resorption (ECR).
Results:
All of the participants had successful lightening of their teeth. Sixty-one percent (19) had not retreated their teeth. Of those who had not retreated their teeth and who responded to the question of whitening satisfaction, 31% (4/13) were VS, 54% (7/13) were PS, and 15% (2/13) were NS with their current shade. Of those who had retreated their teeth, all were VS or PS. Ninety-one percent of the examined teeth had GI = 0 (normal), 7% had GI = 1 (mild inflammation), and 2% had GI = 2 (moderate inflammation). Sixty-nine percent of teeth tested responded to a cold stimulus. Radiographs did not detect ECR or apical lesions. No participant reported having a gingival biopsy post-treatment, and 87% would whiten again.
Conclusions:
Patient satisfaction with NGVB may last as long as 12.3 years in average (range 10-17 years) post-treatment. GI and ECR findings were considered within the normal expectations for the sample studied, suggesting minimal clinical post-NGVB side effects up to 17 years.
Clinical Significance:
Nightguard vital bleaching provides patient satisfaction with minimal side effects up to 17 years post-treatment.
