Clinical evaluation of different desensitizing agents in home-bleaching gels

The influence of different compositions of desensitizing agents in whitening gels should be evaluated.

The purpose of this clinical trial was to compare the effectiveness of 4 carbamide peroxide (CP)-based bleaching gels containing desensitizing agents regarding the degree of bleaching, tooth sensitivity, degree of participant satisfaction, and gingival irritation.

The maxillary arch of the 50 participants was bleached using a split mouth, home-bleaching technique. The participants were divided into 2 groups: G1, 10% CP (Opalescence PF; Ultradent Products, Inc) (right) and 10% CP (Power Bleaching 10%; BM4) (left); and G2, 15% CP (Opalescence PF) (right) and 16% CP (Power Bleaching 16%) (left). Each gel was used in a 2-hour daily regimen for 45 days. The shade of the 6 maxillary anterior teeth was recorded with a shade guide and spectrophotometer at baseline, and after 15, 30, 45, and 180 days of treatment. Statistical differences were analyzed with ANOVA for repeated measures followed by the Bonferroni and Student t tests (α=.05). Tooth sensitivity was evaluated with a visual analog scale (rated on a 0 to 10 scale). Participant satisfaction was evaluated by using participant reports of their personal satisfaction or dissatisfaction with the shade. Gingival irritation was evaluated using the Löe index scores.

Color change was found to be statistically significant for all treatment periods evaluated, both by the objective and the subjective analyses, regardless of the composition and the concentration of the bleaching agent (P<.001). After 45 days, all participants were satisfied with the shade obtained. No clinically diagnosed gingival irritation was noted. Neither of the 10% CP products caused sensitivity during treatment, and 16% CP containing 3% potassium oxalate showed lower sensitivity than 15% CP containing potassium nitrate.

The association of 3% potassium oxalate with fluoride was effective in reducing tooth sensitivity during and after bleaching, particularly with the 16% CP product, and did not compromise the effectiveness of treatment.