Clinical evaluation of shade improvement after in-office vital bleaching

Abstract

Tooth discoloration has increased the demand by patients to pursue aesthetic treatment options. Bleaching is considered a conservative approach in performing an aesthetic treatment for discolored teeth; however colour rebound and post-operative sensitivity are among the adverse effects associated with vital bleaching. In-office bleaching systems employ the use of high hydrogen peroxide concentrations. The effects of in-office bleaching agents on the degree of colour change and the gender differences in relation to bleaching outcomes are questionable. Post-operative sensitivity can be considered a bleaching side effect and the number of patients that experience it is unknown. Aim: The aim of this study was to assess the outcome of an in-office vital bleaching technique. Objectives: The objectives of this study were to evaluate the degree of colour change after vital tooth bleaching using a 35% hydrogen peroxide gel (Yotuel® Special, Biocosmetics Laboratories, Spain), using a spectrophotometer (CM-2600d Konica, Minolta) to measure the colour change at each intervention during the bleaching process, to assess the post operative sensitivity during the first week of the intervention, to evaluate the patients' perception of the colour change and to compare it to the colour change (~E) expressed in numeric values and to investigate whether gender differences exist in relation to the outcome of the bleaching procedure. Materials and Methods: The maxillary anterior teeth of 22 patients comprising of 11 males and 11 females were. bleached with a 35% hydrogen peroxide gel (Yotuel® Special, Biocosmetics Laboratories, Spain). Pre-treatment readings of the two maxillary central incisors using a spectrophotometer (CM-2600d Konica, Minolta) were obtained. Subsequent readings were obtained after scaling and polishing, before bleaching (which was used as a baseline reading), immediately after bleaching, one week and one month postoperatively. Patients were requested to complete a form regarding postoperative tooth sensitivity and their colour perception toward the bleaching treatment. Results: The quantitative effect of the bleaching material on tooth colour showed an increase in L * values and a decrease in a* and b* values, the changes were significant (p values- 0.05) except for the mean value of b* one month after bleaching which was only significant between five and ten percent.