SpringerLink
Log in

Effect of acidity of in-office bleaching gels on tooth sensitivity and whitening: a two-center double-blind randomized clinical trial

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

The study aimed to compare the tooth sensitivity (TS) and bleaching efficacy of two hydrogen peroxide gels with different pHs (acid pH [Pola Office, SDI] and the neutral pH [Pola Office+, SDI]) used for in-office bleaching.

Materials and methods

Fifty-four patients from Brazil and Chile, with right superior incisor darker than A2, were selected for this double-blind, split-mouth randomized trial. Teeth were bleached in two sessions, with 1-week interval. Each session had three applications of 8 min each, according to the manufacturer’s instructions. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easy shade spectrophotometer) methods. Participants recorded TS with 0–10 visual analog scale. Color change in shade guide units (SGU) and ΔE was analyzed by Student’s t test (α = 0.05). The absolute risk and intensity of TS were evaluated by McNemar’s test and Wilcoxon-paired test, respectively (α = 0.05).

Results

All groups achieved the same level of whitening after 30 days of clinical evaluation. The use of a neutral in-office bleaching gel significantly decreases the absolute risk of TS (28%, 95% CI 18–41) and intensity of TS when compared to the acid bleaching gel (absolute risk of 50%, 95% CI 37–63).

Conclusion

The use of a neutral in-office bleaching agent gel produced the same whitening degree than an acid bleaching gel but with reduced risk and intensity of tooth sensitivity.

Clinical significance

Clinicians should opt to use in-office bleaching with a neutral gel than an acid product because the former causes a significant lower risk and intensity of tooth sensitivity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Matis BA, Cochran MA, Eckert G (2009) Review of the effectiveness of various tooth whitening systems. Oper Dent 34:230–235. doi:10.2341/08-74

    Article  PubMed  Google Scholar 

  2. Kwon SR, Wertz PW (2015) Review of the mechanism of tooth whitening. J Esthet Restor Dent 27:240–257. doi:10.1111/jerd.12152

    Article  PubMed  Google Scholar 

  3. Tay LY, Kose C, Herrera DR, Reis A, Loguercio AD (2012) Long-term efficacy of in-office and at-home bleaching: a 2-year double-blind randomized clinical trial. Am J Dent 25:199–204

    PubMed  Google Scholar 

  4. Giachetti L, Bertini F, Bambi C, Nieri M, Scaminaci Russo D (2010) A randomized clinical trial comparing at-home and in-office tooth whitening techniques: a nine-month follow-up. J Am Dent Assoc 141:1357–1364

    Article  PubMed  Google Scholar 

  5. Auschill TM, Schneider-Del Savio T, Hellwig E, Arweiler NB (2012) Randomized clinical trial of the efficacy, tolerability, and long-term color stability of two bleaching techniques: 18-month follow-up. Quintessence Int 43:683–694

    PubMed  Google Scholar 

  6. Ferrari M, Cagidiaco MC, Monticelli F, Kugel G, Barker ML, Gerlach RW (2007) Daytime use of a custom bleaching tray or whitening strips: initial and sustained color improvement. Am J Dent 20 Spec No A:19A–22A

    PubMed  Google Scholar 

  7. Majeed A, Grobler SR, Moola MH (2011) The pH of various tooth-whitening products on the South African market. South Afr Dent J 66:278–281

    Google Scholar 

  8. Price RB, Sedarous M, Hiltz GS (2000) The pH of tooth-whitening products. J Can Dent Assoc 66:421–426

    PubMed  Google Scholar 

  9. Freire A, Archegas LR, de Souza EM, Vieira S (2009) Effect of storage temperature on pH of in-office and at-home dental bleaching agents. Acta Odontol Latinoam 22:27–31

    PubMed  Google Scholar 

  10. Chen JH, Xu JW, Shing CX (1993) Decomposition rate of hydrogen peroxide bleaching agents under various chemical and physical conditions. J Prosth Dent 69:46–48

    Article  Google Scholar 

  11. Attin T, Schmidlin PR, Wegehaupt F, Wiegand A (2009) Influence of study design on the impact of bleaching agents on dental enamel microhardness: a review. Dent Mater 25:143–157. doi:10.1016/j.dental.2008.05.010

    Article  PubMed  Google Scholar 

  12. Sa Y, Sun L, Wang Z, Ma X, Liang S, **ng W, Jiang T, Wang Y (2013) Effects of two in-office bleaching agents with different pH on the structure of human enamel: an in situ and in vitro study. Oper Dent 38:100–110. doi:10.2341/11-173-L

    Article  PubMed  Google Scholar 

  13. Xu B, Li Q, Wang Y (2011) Effects of pH values of hydrogen peroxide bleaching agents on enamel surface properties. Oper Dent 36:554–562. doi:10.2341/11-045-1

    Article  PubMed  Google Scholar 

  14. Azrak B, Callaway A, Kurth P, Willershausen B (2010) Influence of bleaching agents on surface roughness of sound or eroded dental enamel specimens. J Esthet Restor Dent 22:391–399. doi:10.1111/j.1708-8240.2010.00372.x

    Article  PubMed  Google Scholar 

  15. Jadad EBRM, Arana G, Palo RM, Gomes OMM, Arana-Gordillo LA (2014) In vitro evaluation of pH values of whitening agents in relationship to time. Revista APCD de Estética 2:520–526

    Google Scholar 

  16. Torres CR, Crastechini E, Feitosa FA, Pucci CR, Borges AB (2014) Influence of pH on the effectiveness of hydrogen peroxide whitening. Oper Dent 39:E261–E268. doi:10.2341/13-214-L

    Article  PubMed  Google Scholar 

  17. Frysh H, Bowles WH, Baker F, Rivera-Hidalgo F, Guillen G (1995) Effect of pH on hydrogen peroxide bleaching agents. J Esthet Dent 7:130–133

    Article  PubMed  Google Scholar 

  18. Basting RT, Amaral FL, Franca FM, Florio FM (2012) Clinical comparative study of the effectiveness of and tooth sensitivity to 10% and 20% carbamide peroxide home-use and 35% and 38% hydrogen peroxide in-office bleaching materials containing desensitizing agents. Oper Dent 37:464–473. doi:10.2341/11-337-C

    Article  PubMed  Google Scholar 

  19. Reis A, Kossatz S, Martins GC, Loguercio AD (2013) Efficacy of and effect on tooth sensitivity of in-office bleaching gel concentrations: a randomized clinical trial. Oper Dent 38:386–393. doi:10.2341/12-140-C

    Article  PubMed  Google Scholar 

  20. Kossatz S, Martins G, Loguercio AD, Reis A (2012) Tooth sensitivity and bleaching effectiveness associated with use of a calcium-containing in-office bleaching gel. J Am Dent Assoc 143:e81–e87

    Article  PubMed  Google Scholar 

  21. Schulz KF, Altman DG, Moher D, Group C (2011) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg 9:672–677. doi:10.1016/j.ijsu.2011.09.004

    Article  PubMed  Google Scholar 

  22. Rezende M, Loguercio AD, Reis A, Kossatz S (2013) Clinical effects of exposure to coffee during at-home vital bleaching. Oper Dent 38:E229–E236. doi:10.2341/12-188-C

    Article  PubMed  Google Scholar 

  23. Bonafe E, Loguercio AD, Reis A, Kossatz S (2014) Effectiveness of a desensitizing agent before in-office tooth bleaching in restored teeth. Clin Oral Investig 18:839–845. doi:10.1007/s00784-013-1055-7

    Article  PubMed  Google Scholar 

  24. Bonafe E, Bacovis CL, Iensen S, Loguercio AD, Reis A, Kossatz S (2013) Tooth sensitivity and efficacy of in-office bleaching in restored teeth. J Dent 41:363–369. doi:10.1016/j.jdent.2013.01.007

    Article  PubMed  Google Scholar 

  25. de Geus JL, Bersezio C, Urrutia J, Yamada T, Fernandez E, Loguercio AD, Reis A, Kossatz S (2015a) Effectiveness of and tooth sensitivity with at-home bleaching in smokers: a multicenter clinical trial. J Am Dent Assoc 146:233–240. doi:10.1016/j.adaj.2014.12.014

    Article  PubMed  Google Scholar 

  26. de Geus JL, Rezende M, Margraf LS, Bortoluzzi MC, Fernandez E, Loguercio AD, Reis A, Kossatz S (2015b) Evaluation of genotoxicity and efficacy of at-home bleaching in smokers: a single-blind controlled clinical trial. Oper Dent 40:E47–E55. doi:10.2341/14-121-C

    Article  PubMed  Google Scholar 

  27. Rezende M, Ferri L, Kossatz S, Loguercio AD, Reis A (2016a) Combined bleaching technique using low and high hydrogen peroxide in-office bleaching gel. Oper Dent 41:388–396. doi:10.2341/15-266-C

    Article  PubMed  Google Scholar 

  28. Rezende M, Loguercio AD, Kossatz S, Reis A (2016b) Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: a multi regression and logistic analysis. J Dent 45:1–6. doi:10.1016/j.jdent.2015.11.003

    Article  PubMed  Google Scholar 

  29. Ontiveros JC, Eldiwany MS, Paravina R (2012) Clinical effectiveness and sensitivity with overnight use of 22% carbamide peroxide gel. J Dent 40(Suppl 2):e17–e24. doi:10.1016/j.jdent.2012.08.009

    Article  PubMed  Google Scholar 

  30. Kossatz S, Dalanhol AP, Cunha T, Loguercio A, Reis A (2011) Effect of light activation on tooth sensitivity after in-office bleaching. Oper Dent 36:251–257. doi:10.2341/10-289-C

    Article  PubMed  Google Scholar 

  31. Bernardon JK, Sartori N, Ballarin A, Perdigao J, Lopes GC, Baratieri LN (2010) Clinical performance of vital bleaching techniques. Oper Dent 35:3–10. doi:10.2341/09-008CR

    Article  PubMed  Google Scholar 

  32. Kose C, Calixto AL, Bauer J, Reis A, Loguercio AD (2016) Comparison of the effects of in-office bleaching times on whitening and tooth sensitivity: a single blind, randomized clinical trial. Oper Dent 41:138–145. doi:10.2341/15-085-C

    Article  PubMed  Google Scholar 

  33. Abdel-Halim ES, Al-Deyab SS (2013) One-step bleaching process for cotton fabrics using activated hydrogen peroxide. Carbohydr Polym 92:1844–1849. doi:10.1016/j.carbpol.2012.11.045

    Article  PubMed  Google Scholar 

  34. Mena-Serrano AP, Parreiras SO, do Nascimento EM, Borges CP, Berger SB, Loguercio AD, Reis A (2015) Effects of the concentration and composition of in-office bleaching gels on hydrogen peroxide penetration into the pulp chamber. Oper Dent 40:E76–E82. doi:10.2341/13-352-L

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil

    A. D. Loguercio, M. Rezende & A. Reis

  2. Department of Restorative Dentistry, School of Dentistry, Faculdade de Odontologia, Universidade Estadual de Ponta Grossa, Rua Carlos Cavalcanti, 4748, São Paulo, CEP 84030-900, Brazil

    A. D. Loguercio

  3. School of Dentistry, Department of Restorative Dentistry, Center of Higher Education of Campos Gerais, Ponta Grossa, Brazil

    F. Servat & R. Stanislawczuk

  4. School of Dentistry, Department of Restorative Dentistry, Universidad de las Americas, Quito, Ecuador

    A. Mena-Serrano

  5. Department of Restorative Dentistry, School of Dentistry, School of Dentistry of Santiago, Universidad de Chile, Santiago, Chile

    M. V. Prieto, V. Cereño, M. F. Rojas, K. Ortega & E. Fernandez

  6. Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile

    E. Fernandez

Authors
  1. A. D. Loguercio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Servat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Stanislawczuk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Mena-Serrano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Rezende
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. V. Prieto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. V. Cereño
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. F. Rojas
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. K. Ortega
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. E. Fernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. A. Reis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. D. Loguercio.

Ethics declarations

Conflict of interest

A. Loguercio declares that he has no conflict of interest, F. Servat declares that he has no conflict of interest, R. Stanislawczuk declares that he had no conflict of interest, A. Mena-Serrano declares that she has no conflict of interest, M. Rezende declares that she has no conflict of interest, M. V. Prieto declares that she has no conflict of interest, V. Cereño declares that she has no conflict of interest, M. F. Rojas declares that she has no conflict of interest, K. Ortega declares that she has no conflict of interest, E. Fernández declares that he has no conflict of interest, and A. Reis declares that she has no conflict of interest.

Funding

The work was partially supported by National Council for Scientific and Technological Development under grants 304105/2013-9 and 305588/2014-1.

Ethical approval

This clinical study was approved by the Ethics Committee of The Center of Higher Education of Campos Gerais (CESCAGE, protocol 390.941) and the University of Chile (protocol 2013/41) and was conducted according to the Consolidated Standards of Reporting Trials Statement and Helsinki Declaration of 1975 revised in 2000.

Informed consent

All persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study were omitted.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Loguercio, A.D., Servat, F., Stanislawczuk, R. et al. Effect of acidity of in-office bleaching gels on tooth sensitivity and whitening: a two-center double-blind randomized clinical trial. Clin Oral Invest 21, 2811–2818 (2017). https://doi.org/10.1007/s00784-017-2083-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-017-2083-5

Keywords

Search

Navigation