Clinical evaluation of 4% hydrogen peroxide bleaching in mandibular teeth

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Introduction: Bleaching agents have been constantly introduced into market; however, the efficacy of new hydrogen peroxides still needs to be evaluated. Objective: The aim of this study was to evaluate in vivo the effectiveness of 4% hydrogen peroxide bleaching agent in color change, bleaching maintenance, tooth sensitivity, and patients’ satisfaction. Material and methods: Forty subjects were selected, lower bleaching trays were constructed, and the patients were instructed to apply 4% hydrogen peroxide bleaching agent at home. Shade measurements of the mandibular anterior teeth were carried out with a spectrophotometer and Vita Classical shade guide (VITA) at the following moments: baseline, 14 days, after patients’ satisfaction, and after 90 days. In addition, tooth sensitivity was evaluated using a visual analogue scale (VAS) at the first 14 days. Shade measurements were submitted to repeated measures ANOVA with Bonferroni adjustment and level of significance set at 5%. Results: Statistically significant differences were found for mandibular tooth shade after at-home bleaching (p < 0.001). After 14 days of bleaching, 90% of the subjects were not pleased with the achieved bleaching; however, after 27 days most of the patients reported to be satisfied. Tooth sensitivity was reported to range from 1.01 in a scale from 0-10. Conclusion: At-home bleaching using 4% hydrogen peroxide is effective in lower teeth with reduced tooth sensitivity.