Extended at-home bleaching of tetracycline-stained teeth with different concentrations of carbamide peroxide.
OBJECTIVE
The degree of color change and the dental sensitivity associated with the use of different concentrations (10%, 15%, and 20%) of carbamide peroxide every night for 6 months was evaluated in tetracycline-stained teeth.


METHODS
Fifty-nine subjects were shown how to place two different concentrations of carbamide peroxide in the custom trays with reservoirs. For a period of 6 months, the patients were to insert the tray every evening before retiring. Patients returned in 1 and 2 weeks and at 1, 2, 3, 4, 5, 6, 7, 8, and 9 months for evaluation of the degree of color change by subjective shade matching and by photographic means. Sensitivity of hard or soft tissues was self-reported.


RESULTS
Fifty-two subjects attended more than 90% of the recalls. A colorimeter was used to convert shade guide tabs to Commission Internationale de l'Eclairage color spaces (CIELAB). The most rapid whitening occurred in the first month. At 3 and 9 months, 91% and 85% of the subjects, respectively, were at least "a little pleased" with the results of the bleaching. In the professional evaluation, 90% of the teeth were deemed to have an excellent or satisfactory esthetic result. The higher the concentration of carbamide peroxide, the more rapidly the lightness value and color difference changed. There was no difference among the three concentrations in resulting gingival sensitivity. Patients experienced less tooth sensitivity with 10% gel than they did with 15% and 20% gels.


CONCLUSIONS
Bleaching with 10%, 15%, and 20% carbamide peroxide is effective for removing tooth staining caused by tetracycline. The 10% concentration has the most advantages and the fewest disadvantages.
Matis
Bruce A
BA
Department of Restorative Dentistry, Indiana University, School of Dentistry, Indianapolis, Indiana 46202, USA. bmatis@iupui.edu
Wang
Yining
Y
Jiang
Tao
T
Eckert
George J
GJ
D000328:Adult; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000077463:Carbamide Peroxide; D003124:Colorimetry; D003742:Dental Devices, Home Care; D003807:Dentin Sensitivity / Q000139:chemically induced; D004338:Drug Combinations; D005882:Gingival Diseases / Q000139:chemically induced; D006801:Humans; D016877:Oxidants / Q000008:administration & dosage* / Q000009:adverse effects; D017060:Patient Satisfaction; D010545:Peroxides / Q000008:administration & dosage* / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013752:Tetracycline / Q000009:adverse effects; D014073:Tooth Bleaching / Q000295:instrumentation* / Q000379:methods*; D014075:Tooth Discoloration / Q000139:chemically induced / Q000188:drug therapy*; D014508:Urea / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D016877:Oxidants; D010545:Peroxides; D000077463:Carbamide Peroxide; D014508:Urea; D013752:Tetracycline