Combined Vital Tooth Whitening: Effect of Number of In-Office Sessions on the Duration of Home Whitening. A Randomized Clinical Trial

Featured Application A second session in office with a high concentration product reduces three weeks of home treatment with splints with a low concentration product. Background: In cases of moderate to severe dental discoloration, vital tooth whitening usually requires a prolonged treatment time if it is to obtain satisfactory outcomes. Variations in the clinical efficacy of whitening products in terms of their concentration and application time mean that we need to be aware of the real bleaching capacity of each whitening method and each product. This randomized clinical trial aimed to analyze with a spectrophotometer the effect of the number of in-office vital tooth whitening sessions (one or two) on the number of weeks of ensuing home whitening until color stability was obtained. Methods: Twenty patients with moderate/severe discoloration were treated with combined vital tooth whitening. Ten patients were treated with a single in-office session consisting of two applications of a product containing 40% hydrogen peroxide, followed by home treatment with individualized splints and a 16% carbamide peroxide gel (Group 1S). The other ten patients (Group 2S) were treated in two in-office sessions with two applications of the same product as Group 1S, followed in the same way by home treatment. Results: Comparing the two groups (1S and 2S), no significant differences in Euclidean distance (Delta E) were found after in-office whitening, or when color stabilization was obtained and home whitening ceased. Significant differences in the number of weeks of home whitening until color stabilization reached the same outcomes were found between 1S and 2S; 1S required a mean of 11.6 weeks home whitening, while 2S required 8.2 weeks. Conclusions: Combined tooth whitening with two in-office sessions significantly reduces the number of weeks (by three to four weeks) of subsequent home tooth whitening needed to reach color stabilization.