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

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.