Efficacy of a buccal and lingual at-home bleaching protocol—A randomized, split-mouth, single-blind controlled trial

Objective

To compare the color change, the risk and intensity of tooth sensitivity (TS), and gingival irritation (GI) of at-home bleaching applied on the buccal surface only or the buccal and lingual surfaces.

Materials and Methods

Sixty patients with canines A₂ or darker were selected and their superior arches were randomized in two groups: at-home bleaching on the buccal-only or on the buccal and lingual surfaces, with 7.5% hydrogen peroxide, for 1 h daily/2 weeks. The color change was evaluated at baseline, 7, 14 days, and 1 month after bleaching using shade guides scales (ΔSGU) and a spectrophotometer (ΔE_AB, ΔE₀₀, and ΔWI_D). Risk and intensity of TS and GI were recorded daily using visual analogic scale (0–10). Patient satisfaction was evaluated with the orofacial esthetics. Paired t-test, McNemar's, and Wilcoxon signed-rank test were used for data analysis (α = 5%).

Results

Neither the color change nor the risk/intensity of TS was statistically different between groups (p > 0.05). Patient satisfaction increased after bleaching for both groups (p < 0.05).

Conclusion

The addition of one contact surface does not result in an increased whitening degree compared to bleaching applied solely on the buccal surface.

Clinical Significance

Understanding the influence of surfaces interacting with the bleaching agent is crucial for comprehending the bleaching mechanism and avoiding unnecessary material expenses. Notably, employing the buccal-only technique is sufficient to achieve the desired efficacy.