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8/6/2019 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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