Lasers in medical science, vol.25, no.6, pp.817-22, 2010 (SCI-Expanded)
The aim of this clinical study was to evaluate the efficiency of in-office bleaching systems with different light sources for color change and possible side effects such as tooth sensitivity and gingival irritations. Forty healthy volunteers aged 18 years and older (average age 27.3 years), having all their natural healthy teeth in shade A3 or darker on the Vita shade guide, with no restorations on the buccal surfaces and no tooth sensitivity, participated in this study. Participants were randomly assigned to four groups of ten volunteers. Group 1 received bleaching without light activation (Opalescence Xtra Boost, Ultradent); group 2 received bleaching (Laser White 10, Biolase) with a diode laser (810 nm, 10 W/ Laser Smile, Biolase) activation; group 3 received bleaching treatment (Remewhite, Remedent) with a plasma arc lamp (400-490 nm, 2800 mV/cm(2), Remecure CL15), and group 4 received bleaching with a light emitting diode (LED) lamp (By White accelerator, Ensodent) according to the manufacturers' recommendations. The shade was assessed with a classical Vita shade guide (Vita Zahnfabrik) and a digital spectrophotometer (Vita Easy Shade, Vident). The color of teeth was scored at baseline and 1 week after bleaching. Any side effects on teeth or gingiva was recorded by visual analog scale. Results were analyzed statistically, by one-way analysis of variance (ANOVA), Kruskal-Wallis, and Mann-Whitney U tests with Bonferroni correction. All the bleaching techniques resulted in shade change. No significant differences were found in the color change among the four groups with shade guide assessment (P > 0.05), but spectrophotometer readings exhibited significant differences among the groups (P < 0.05). The overall shade change values expressed as Delta L, Delta a, Delta b, Delta E for group 2 was significantly higher than those for the other groups (P < 0.05). Group 2 also showed lower tooth and gingival sensitivity scores than those of the other groups (P < 0.05). All techniques resulted in shade change. Although the shade guide evaluation did not exhibit any differences among the bleaching treatment groups, spectrophotometer readings showed different findings. The results obtained by the two methods of evaluation of shade change used in this study were different from each other. Bleaching with diode laser resulted in less tooth and gingival sensitivity than the other bleaching systems. Clinical relevance: in-office bleaching systems used with or without light, lead to a shade change. As bleaching with diode laser resulted in less tooth and gingival sensitivity, it might be preferred among in-office bleaching systems.