Chemical behavior of 20%-22% carbamide peroxide gels in at-home bleaching: Randomized crossover in situ trial

Objective To evaluate if distinct 20%-22% carbamide peroxide bleaching gels present similar decomposition pattern and pH during the clinical use in both arches, as well as gels viscosity. Methods Participants randomly received treatments with carbamide peroxide gels (n = 10): OPF (OpalescencePF-20%); PNT (Polanight-22%); and WPC (Whiteness Perfect-22%) in three different days, with 2-day washout. Decomposition pattern was assessed by peroxide concentration. Both PC and pH of bleaching gels were measured in different time points in upper and lower trays during a total of 120 min of clinical use. Viscosity of bleaching gels was measured in triplicate. ANOVA and Tukey's test were applied (alpha = 0.05). Results Regarding decomposition pattern, no significant differences were observed for the interaction between gel, time, and tray position factors. The peroxide concentration progressively reduced until 120 min of trays use (p < 0.001), being overall more notable in lower trays (p < 0.001). Regarding pH, the lowest values were verified in WPC within time. At 120 min, an increase of pH was observed for both WPC and OPF (p < 0.001) compared to baseline means. PNT exhibited constant pH values over time. The values of viscosity were: OPF (1.682.000 +/- 19 cP)a, WPC (1.388.667 +/- 172.63 cP)ab, PNT (579.567 +/- 0.98 cP)b. Conclusions The bleaching gels presented overall decomposition pattern clinically equivalent, being more notable in lower trays over time. Nevertheless, distinct pH and viscosities were observed among the products. Clinical Significance Although the manufacturers recommend different times of use for bleaching gels with similar peroxide concentrations, the commercial products tested did not exhibit clinically relevant difference in the decomposition pattern during the 120 min of clinical procedure.