Effect of reservoirs on gingival inflammation after home dental bleaching.
OBJECTIVE
To evaluate the influence of reservoirs on the gingival mucosa of patients submitted to at-home bleaching with 16% carbamide peroxide.


METHODS
Nineteen nonsmoking male patients, 18 to 25 years of age, were submitted to home bleaching with a 16% carbamide peroxide gel for 2 consecutive hours for 21 days. The custom-made mouth trays were made with a reservoir on only the left side and cut anatomically 1 mm beyond the gingival margin. Smears of the gingival mucosa were obtained by the exfoliation cytology in liquid media technique before (control), immediately after, and 30 and 45 days after treatment. The samples were processed in the laboratory and evaluated according to Papanicolaou's criteria of malignity. Statistical analysis was carried out by McNemar test, 2 proportions test, and Wilcoxon test with a level of significance of 1%.


RESULTS
The presence of a reservoir in the custom tray resulted in an increase of inflammation only immediately after the bleaching procedure. After 30 and 45 days, the difference between inflammation on the sides with and without a reservoir was not statistically significant. Significant differences were found in the degree of inflammation, classified as predominantly mild on the nonreservoir side and moderate on the reservoir side (P < .01).


CONCLUSIONS
A 16% carbamide peroxide bleaching gel caused gingival inflammation immediately after the procedure and persisted until 45 days after the bleaching treatment. The use of a reservoir in the custom tray for home bleaching resulted in higher rates and higher intensity of gingival inflammation.
School of Dentistry, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.
Giovanna A
GA
Kirsten
Andrea
A
Freire
Antonio Adilson S
AA
de Lima
Sergio Aparecido
SA
Ignácio
Evelise M
EM
Souza
D000293:Adolescent; D000328:Adult; D000077463:Carbamide Peroxide; D003581:Cytodiagnosis / Q000379:methods; D003742:Dental Devices, Home Care / Q000009:adverse effects*; D004338:Drug Combinations; D005891:Gingivitis / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000187:drug effects; D016877:Oxidants / Q000009:adverse effects; D010545:Peroxides / Q000009:adverse effects; D014073:Tooth Bleaching / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D014508:Urea / Q000009:adverse effects / Q000031:analogs & derivatives; D055815:Young Adult
D004338:Drug Combinations; D016877:Oxidants; D010545:Peroxides; D000077463:Carbamide Peroxide; D014508:Urea