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Systematic review of in vitro studies evaluating tooth bleaching efficacy
So Ran Kwon1, Elisa Cortez2, Min Wang3
1Center for Dental Research, Loma Linda University School of Dentistry, Loma Linda, CA, USA, sorankwon@llu.edu.
American Journal of Dentistry
|February 15, 2020
Summary
In vitro tooth bleaching studies show that negative controls (NC) significantly exceed the perceptibility threshold for color change. This highlights the importance of establishing appropriate in vitro cut-off values for reliable bleaching efficacy assessment.
Area of Science:
- Dental Materials Science
- Biomaterials Research
- Cosmetic Dentistry
Background:
- In vitro studies are crucial for initial screening of tooth bleaching agents.
- Standardized methodologies are needed to ensure the reliability of in vitro tooth bleaching efficacy evaluations.
- Previous research has varied in its use of negative controls, tooth substrates, storage media, and color assessment methods.
Purpose of the Study:
- To systematically review and assess in vitro studies on tooth bleaching efficacy.
- To analyze the impact of negative controls, tooth substrate type, storage medium, color evaluation methods, and time points on bleaching outcomes.
Main Methods:
- A comprehensive literature search was conducted in PubMed (MEDLINE) and Web of Science databases.
- Search terms included MeSH and free text keywords related to in vitro tooth bleaching and control parameters.
- Eleven studies were included for qualitative and quantitative analysis after applying specific search limits (English, 1989-2017).
Main Results:
- A meta-analysis of nine studies reporting overall CIELAB color change (ΔE*ab) values was performed.
- The negative control (NC) group statistically exceeded the perceptibility threshold (PT) of 1.2 (P<0.05).
- The estimated ΔE*ab for the NC was 2.872 (95% CI: 1.955–3.790).
Conclusions:
- While randomized controlled trials are the gold standard for clinical evaluation, in vitro studies provide valuable preliminary screening for bleaching efficacy.
- Establishing appropriate cut-off values for in vitro bleaching efficacy is vital for determining clinical relevance.
- Standardized in vitro methodologies, particularly concerning negative controls, are essential for accurate assessment.
