![]() ![]() Finally, future studies could use other questionnaires to measure whether there are improvements in the quality of life of a patient after undergoing tooth whitening. ![]() This would shed more light on whether the positive changes are due to bleaching and not other factors. The esthetic self-perception and psychosocial impact could also be compared among patients undergoing tooth whitening vs untreated patients. It would also be desirable to compare the psychosocial changes of patients in relation to the different techniques of extracoronal bleaching (in-office vs at home) and with different concentrations. It would be useful in future research to include comparative studies contrasting color changes after extracoronal tooth whitening (either through spectrophotometer or shadeguides) versus the changes in psychosocial aspects of cosmetic dentistry patients in the medium and long term. ![]() The gel used in this study comes with the alkaline components separated in two compartments that are self-mixed at the time of application, reducing the possibility of inactivation of the HP, perhaps representing an advantage in the effectiveness of the product compared with other forms of presentation. However, this effectiveness is similar to low concentration gels assisted by a LED/laser light. 10, 26, 27 In our study we obtained color changes around six units of ΔE with a low concentrated gel. 24, 25 In contrast, low concentrated agents traditionally have been less effective, with ΔE of around five units. Highly concentrated groups traditionally show a high effectiveness, with more than eight units of ΔE in color change, in treatments of around 100 minutes of segmented contact in different sessions using different protocols. Related to the objective effectiveness, dental in-office whitening systems can be categorized into groups of high or low concentration of HP (>35% or <20%, respectively). At the one-month control, the evaluation was done after dental prophylaxis and after waiting 15 minutes for rehydration of the teeth before color assessment. 19 The color difference was calculated as the number of shade guide units that the tooth changed toward the lighter end of the shade guide (ΔSGU). 18 The color was registered over the middle third of the labial surface as established by the American Dental Association (ADA) guidelines. The perceptibility threshold considered was 2.7 ΔE units. 17 Two calibrated evaluators with a κ value of 0.85 recorded the shades of both central incisors at baseline, at each session, one week after treatment, and one month after. Although the Vita Classical scale is not linear in the truest sense, we treated the changes as continuous with a linear ranking as in previous clinical trials of dental bleaching. We compared ΔE and ΔSGU for both agents using the Mann-Whitney test ( α=0.05).įor the subjective evaluation, we used the Vita Classical shade guide (Vita Classic, Vita Zahnfabrik), which ranges from lightest (B1) to darkest (C4) according to the color. A spectrophotometer was used to measure the total variation of color (ΔE), and a subjective evaluation was made with Vita Classical scale (ΔSGU) between the baseline (session 1) and different measurement times. Two sessions of bleaching were carried out each week. Each group received 3 to 12 minutes of treatment with the respective gel applications. One side of each mouth was randomly treated with 37.5% HP, and the other side was bleached with 6% HP. The study was carried out with a “split-mouth” design. The patients had tooth colors of A3 or less according to the Vita Classical scale, which was determined with a Vita Easy Shade spectrophotometer. The patients included men and women over 18 years old without prior tooth whitening treatments, tooth decay, or restorations of the maxillary anterior teeth. A total of 33 patients were selected from the clinic of the Faculty of Dentistry at the University of Chile. ![]() A prospective, double-blind, randomized clinical trial was carried out. ![]()
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