title: Hydrogen peroxide release kinetics into saliva from different whitening products: a double-blind, randomized clinical trial.
abstract: The objective of this study is to compare salivary hydrogen peroxide (HP) release kinetics and potential toxicity of systemic exposure of four different whitening products. A double-blind, randomized controlled trial was conducted in a Portuguese dental faculty clinic. Two hundred forty volunteers were randomized to eight intervention groups. Participants were randomly assigned to receive active or placebo applications of one of four different products: Opalescence 10% PF™ (OPL), Vivastyle® 10%™ (VS10%), Vivadent Paint On Plus™ (PO+), and Trés White Supreme™ (TWS). Saliva collection was obtained by established methods at different times. The HP salivary content was determined by a photometric method. Salivary HP variations, total amount of salivary HP, and counts of subjects above the safe daily HP dose were the main outcome measures. All whitening systems significantly released HP to the saliva when compared to placebo, and all showed different release kinetics. The adaptable tray system (TWS) presented a risk increase of 37% [20-54%, 95% confidence interval] when compared to the other systems. The use of an adaptable tray whitening system with higher concentration of HP increases the toxicity potential.
authors.affiliation: Oral Biology and Biochemistry Group, Biomedical and Oral Sciences Research Unit (FCT Unit 4062), University of Lisbon School of Dental Medicine, Campus Universitário, 1649-003, Lisbon, Portugal. duartemd@yahoo.co.uk
authors.forename: Duarte Nuno da Silva
authors.initials: DN
authors.lastname: Marques
authors.forename: António Duarte Sola Pereira
authors.initials: AD
authors.lastname: da Mata
authors.forename: João Miguel Lourenço
authors.initials: JM
authors.lastname: Silveira
authors.forename: Joana Rita Oliveira Faria
authors.initials: JR
authors.lastname: Marques
authors.forename: João Pedro de Almeida Rato
authors.initials: JP
authors.lastname: Amaral
authors.forename: Nuno Filipe Rito Parada Marques
authors.initials: NF
authors.lastname: Guilherme
mesh_terms: D000077463:Carbamide Peroxide; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006861:Hydrogen Peroxide / Q000493:pharmacokinetics*; D008297:Male; D010545:Peroxides / Q000493:pharmacokinetics; D010783:Photometry; D010919:Placebos; D011145:Polyvinyls / Q000493:pharmacokinetics; D012449:Safety; D012463:Saliva / Q000378:metabolism*; D013997:Time Factors; D014073:Tooth Bleaching / Q000295:instrumentation / Q000379:methods; D058205:Tooth Bleaching Agents / Q000493:pharmacokinetics*; D014508:Urea / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D010545:Peroxides; D010919:Placebos; D011145:Polyvinyls; D058205:Tooth Bleaching Agents; C500417:Vivastyle; C093177:tooth-bleaching agent, Opalescence; D000077463:Carbamide Peroxide; D014508:Urea; D006861:Hydrogen Peroxide