Elnawawy Mohamed Samir A, Gharote Harshkant, Pullishery Fawaz, Al Wakeb Rehab, Abuzenada Basem
Clinical Sciences Department, General Dentistry Program, Batterjee Medical College, Jeddah, SAU.
Conservative Dentistry, Mansoura University, Mansoura, EGY.
Cureus. 2024 Jul 29;16(7):e65648. doi: 10.7759/cureus.65648. eCollection 2024 Jul.
Objective To evaluate the clinical behavior of different bleaching products - the hydrogen peroxide (HO), carbamide peroxide (CP), and titanium dioxide bleaching systems. Methods Three bleaching systems with different concentrations (HO 15%, 38%, CP 15%, 35%, and titanium dioxide 20% HO) were used. Sixty participants with discolored teeth were enrolled and equally divided into six groups. Each group was rendered the assigned bleaching protocol against the control group, which received plain dentifrice polishing. Each case was evaluated immediately, two weeks, three months, six months, and one year after the bleaching treatment. The clinical evaluation was made for color change by (shade guide and digital images with Lab* parameters), tooth sensitivity, gingival irritation, and participants' satisfaction. Results All bleaching systems showed color improvement after bleaching regimens with significant effect showed by in-office titanium dioxide 20% HO followed by 38% HO with Δ=10.26 and Δ=6.52, respectively, when compared to other bleaching techniques. Higher sensitivity was recorded in group III with 50% of the participants reporting postoperative sensitivity. Higher gingival irritation was recorded in group IV (15% CP) where 60% of the patients reported gingival irritation. Thirty-five of the 60 participants (58.5%) recorded that the treatment whitened their teeth "moderately" and "a lot" while seven participants recorded "a slight" difference. There was a highly significant difference in participants' satisfaction between all bleaching groups (p < 0.05). Conclusion It is evident that there is a development of dental sensitivity and gingival irritation irrespective of the bleaching system used. The color assessment showed that the desired result can be achieved with variable levels of patient satisfaction with excellent overall results with the titanium dioxide system.
目的 评估不同漂白产品——过氧化氢（HO）、过氧化脲（CP）和二氧化钛漂白系统的临床效果。方法 使用三种不同浓度的漂白系统（HO 15%、38%，CP 15%、35%，以及含20% HO的二氧化钛）。招募60名牙齿变色的参与者并将其平均分为六组。每组按照指定的漂白方案进行处理，对照组使用普通牙膏进行抛光。在漂白治疗后即刻、两周、三个月、六个月和一年对每个病例进行评估。通过（比色板和具有Lab*参数的数字图像）评估颜色变化、牙齿敏感性、牙龈刺激情况以及参与者的满意度。结果 所有漂白系统在漂白方案实施后均显示出颜色改善，其中诊室使用的含20% HO的二氧化钛系统效果显著，其次是38% HO的系统，与其他漂白技术相比，其Δ值分别为10.26和6.52。第三组记录到较高的敏感性，50%的参与者报告术后有敏感症状。第四组（15% CP）记录到较高的牙龈刺激，60%的患者报告有牙龈刺激。60名参与者中有35名（58.5%）记录到治疗使他们的牙齿“中度”和“显著”变白，而7名参与者记录到“轻微”变化。所有漂白组之间参与者的满意度存在高度显著差异（p < 0.05）。结论 显然，无论使用何种漂白系统，都会出现牙齿敏感性和牙龈刺激的情况。颜色评估表明，使用二氧化钛系统可以在不同程度的患者满意度下实现预期效果，总体效果良好。
