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Combined Bleaching Technique Versus At-home Bleaching-A Single-blind Randomized Controlled Trial.

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Combined bleaching offers slightly better color change than at-home bleaching, but at-home bleaching has a lower risk of tooth sensitivity (TS). Both methods achieve similar bleaching results.

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Area of Science:

  • Dentistry
  • Cosmetic Dentistry
  • Dental Materials

Background:

  • Tooth discoloration is a common aesthetic concern.
  • Professional and at-home bleaching are popular treatment options.
  • Combined bleaching protocols aim to enhance efficacy but may increase adverse effects.

Purpose of the Study:

  • To compare the efficacy, color stability, and tooth sensitivity (TS) of a combined bleaching protocol versus at-home bleaching.
  • To evaluate a modified protocol involving in-office and at-home bleaching.
  • To assess the risk and intensity of tooth sensitivity associated with different bleaching approaches.

Main Methods:

  • Eighty participants were randomized into a combined group (in-office + at-home bleaching) and an at-home group.
  • The combined group received a desensitizing gel prior to in-office bleaching (35% hydrogen peroxide) and subsequent at-home bleaching (4% hydrogen peroxide).
  • Color change was measured using VITA Classical, Bleachedguide, and Easyshade spectrophotometer; tooth sensitivity was recorded daily via VAS and NRS.

Main Results:

  • The at-home group showed a 40% lower risk of tooth sensitivity.
  • The combined group exhibited higher color change and tooth sensitivity intensity during the first week.
  • No significant difference in overall bleaching degree was found between the groups post-treatment.

Conclusions:

  • Combined bleaching yields a slightly greater color change compared to at-home bleaching alone.
  • However, combined bleaching is associated with a higher risk and intensity of tooth sensitivity.
  • At-home bleaching presents a favorable risk-benefit profile regarding tooth sensitivity.