02 01 11 - Tooth Whitening

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    home bleaching

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    in-office bleaching

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    in-office bleaching

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    o-t-c bleaching

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    Dr. Fabiano Marson

    Dr. Luis Sensi

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    What bleaching techniqueis the best ???

    In-Office or At-Home ???

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    Carbamide peroxide

    10% 2h/dayHydrogen peroxide

    35% 3 sessions

    (each session 3X15)

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    After 7 days10% Carbamide peroxide 2h/day

    After 1 session35% Hydrogen peroxide

    (each session 3X15)

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    After 21 days10% Carbamide peroxide 2h/day

    After 3 sessions35% Hydrogen peroxide

    3 sessions (each session 3X15)

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    6 months follow-up10% Carbamide peroxide 2h/day

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    6 months follow-up 35%Hydrogen peroxide3 sessions (each session 3X15)

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    3 months follow-up 35%

    Hydrogen peroxide3 sessions (each session 3X15)

    3 months follow-up10% Carbamide peroxide 2h/day

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    Conclusions

    Home-bleaching provided

    better long-term outcomes andproduced less tooth sensitivity

    than the in-office technique.Auschill TM, Hellwig E, Schmidale S et al.; Oper Dent. 2005;30(2):156-63.Zekonis R, Matis BA, Cochran MA et al.; Oper. Dent., 2003;28(2):114-21.

    i ffi bl hi

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    in-office bleaching

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    in office bleaching

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    in-office bleaching

    in office bleaching

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    in-office bleaching

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    Do we need to use a light

    source ???

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    LIGHT NO light

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    3 months follow-up3 Sessions (3X15each) + light

    3 months follow-up3 Sessions (3X15each) - NO light

    Concl sions

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    a- do not improve the bleaching outcome;

    b- they do have the potential to cause more

    sensitivity due to heat generation

    c- they should be considered nothing but a

    questionable marketing tool.Kugel G, Papathanasiou A, Williams AJ 3rd et al.; Compend Contin Educ Dent. 2006;27(1):54-62.

    Hein DK, Ploeger BJ, Hartup JK et al.; Compend Contin Educ Dent. 2003;24(4A):340-52.

    Eldeniz AU, Usumez A, Usumez S, et al.; J Biomed Mater Res B Appl Biomater. 2005;72(2):254-59.

    Baik JW, Rueggeberg FA, Liewehr FR. J Esthet Restor Dent. 2001;13(6):370-8.

    Papathanasiou A, Kastali S, Perry RD, Kugel G. Compend Contin Educ Dent. 2002;23(4):335-48.

    Conclusions

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    % and Application time for

    At-Home Bleaching ???

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    - 10 / 16% both effectiveregardless of 2/8hs;

    - 2hs results in less

    sensitivity than 8hs;

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    Application time for

    In-Office Bleaching???

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    We questioned the manufacturers instructions for

    the bleaching gel to be re-applied and replenished

    every 15 minutes during an in-office session andhypothesized if a single 45 minutes long

    application would result in the same amount of

    bleaching with the same safety and longevity.

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    !

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    Clinical Evaluation ofIn-Office Bleaching

    Gel Application Times3x15 vs 1x45

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    35% Hydrogen peroxide

    3 X 1535% Hydrogen peroxide

    1 X 45

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    1 week2 Sessions (3X15each)

    1 week2 Sessions (1X45each)

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    3 months follow-up2 Sessions (3X15each)

    3 months follow-up2 Sessions (1X45each)

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    1 year follow-up2 Sessions (3X15each)

    1 year follow-up2 Sessions (1X45each)

    Conclusions

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    - no statistically significant differences in efficacy andcolor stability, comfort, sensitivity or patientsatisfaction were observed between the two bleaching

    protocols.

    - no differences could be observed between the right

    and left side for any of the patients in all periods ofevaluation.

    Conclusions

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    Ad f h d h i i l d

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    - a faster and simpler procedure, since only oneapplication is required and there is no time wasted bysuctioning or replenishing the gel;

    - the final cost for both the dentist and patients isreduced, since a considerably less amount of gel is usedand overall less time is needed;

    - similar results as the traditional application techniqueregarding amount of color change, sensitivity and safety.

    Advantages of the proposed technique include:

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