title: Clinical evaluation of a combined in-office and take-home bleaching system.
abstract: BACKGROUND
  Tooth whitening is one of the fastest growing areas in cosmetic and restorative dentistry. An increasing number of patients are demanding faster ways to bleach their teeth. Therefore, clinicians are being pushed to seek quicker and easier means to bleach their patients' teeth, while maintaining safety in bleaching procedures.
  
  
  METHODS
  The authors included in the clinical trial 10 subjects 18 years of age or older, each of whom had six caries-free maxillary anterior teeth without restorations on the labial surfaces and no tooth sensitivity. For each subject, one-half of the maxillary arch received a 35 percent hydrogen peroxide (Group 1) gel application for 30 minutes, and the other one-half of the maxillary arch received a 38 percent hydrogen peroxide (Group 2) gel application for 30 minutes. The in-office bleaching treatment was maintained and reinforced using a 10 percent carbamide peroxide at-home bleaching agent for 60 minutes. Subjects repeated both the in-office and take-home bleaching treatments for three consecutive days.
  
  
  RESULTS
  The shade change was 8.5 for Group 1 and 9 for Group 2. There was no statistically significant difference between the two groups (P = .3434). An average shade rebound of two shades was recorded at seven days for both treatment systems. No sensitivity was reported during or after the bleaching treatment.
  
  
  CONCLUSIONS
  When combined with 10 percent carbamide peroxide at-home applications, use of the Group 1 and Group 2 bleaching materials resulted in significant tooth lightening.
  
  
  CONCLUSIONS
  By using the clinical technique presented, clinicians can reduce the time required to complete tooth-whitening treatment. Using the correct tray design and improved chemical formulations of tooth whiteners may reduce gingival and tooth sensitivity, thus increasing safety.
authors.affiliation: Department of Prosthodontic and Operative Dentistry, Tufts University School of Dental Medicine, Boston, Mass 02111, USA. simone.deliperi@tufts.edu
authors.forename: Simone
authors.initials: S
authors.lastname: Deliperi
authors.forename: David N
authors.initials: DN
authors.lastname: Bardwell
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Papathanasiou
mesh_terms: D000293:Adolescent; D000328:Adult; D000077463:Carbamide Peroxide; D004338:Drug Combinations; D005260:Female; D005881:Gingiva / Q000187:drug effects; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage; D008297:Male; D016877:Oxidants / Q000008:administration & dosage; D010545:Peroxides / Q000008:administration & dosage; D010865:Pilot Projects; D016037:Single-Blind Method; D014073:Tooth Bleaching / Q000009:adverse effects / Q000379:methods*; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D004338:Drug Combinations; D016877:Oxidants; D010545:Peroxides; D000077463:Carbamide Peroxide; D014508:Urea; D006861:Hydrogen Peroxide