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Title |
No Conclusive Evidence That Light-Activated Bleaching Results In Greater Whitening Than Tray/Non-Light Activated Bleaching |
Clinical Question |
In adult patients over the age of 18, does light activated or heat activated bleaching result in greater whitening or increased patient satisfaction compared to tray or strip delivered bleaching agents? |
Clinical Bottom Line |
There is no conclusive evidence that light-activated bleaching results in greater whitening or patient satisfaction than tray/non-light activated bleaching. This is supported by two randomized controlled trials (40 and 90 patients). |
Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
#1) 18335728 | Marson/2008 | 40 patients within age 18-28, caries free anterior teeth without restorations, good oral hygiene, periodontal disease and gingival irritation free, non smokers, and free of cervical lesions and any painful symptoms. | Randomized Controlled Trial | Key results | 4 groups - Group 1–35% Hydrogen Peroxide (HP); Group 2–35% HP plus Halogen Curing Light XL 3000; Group 3–35% HP plus Demetron LED and Group 4–35% HP plus LED/LASER were tested to evaluate whiteness with a spectrophotometer, visually and patient satisfaction. Maxillary anterior teeth were tested. All 4 groups showed equality between the ΔE (differences in color before and after treatment) with p=0.999993. Similarly, all groups expressed equality in whitening during visual/shade evaluation with a p=1.00000. Patient satisfaction was about equal for all 4 groups (92.5% noted that the treatments whitened their teeth moderately – a lot. There was no statistically significant differences with or without the use of curing light after treatment and the use of light-activated sources for increased whitening was not conclusive clinically. | #2) 20166405 | Bernardon/2010 | 90 subjects with their anterior teeth (A2 or darker, Vita Classic shade guide) | Randomized Controlled Trial | Key results | 3 treatment groups with split mouth study design - Group I: HB (at-home bleaching with 10% carbamide peroxide for two weeks) vs OBL (in-office bleaching with 35% hydrogen peroxide, two sessions, two-week intervals, with light irradiation); Group II: OB (in-office bleaching without light irradiation) vs OBL; Group III: HB vs combination (one session plus HB). With a p<0.05 after two weeks, at-home bleaching resulted in similar color changes as in-office bleaching with light irradiation. Light-activated bleaching did not improve the whiteness/bleaching efficacy. | |
Evidence Search |
"Tooth Bleaching"[Mesh] AND "spectrophotometry"[Mesh] AND Randomized Controlled Trial[ptyp] |
Comments on
The Evidence |
Marson 2008 is a randomized controlled trial with groups similar at the start, > 80% completion rate, groups treated same, adequate compliance and no competing interests. It is not known if there was a double-blind or recall bias. Bernardon 2010 is a randomized controlled trial with groups similar at the start, groups treated the same, adequate compliance and no competing interests. It is not known if there was a >80% completion or double blind or recall bias. |
Applicability |
Subjects are representative of general dentistry/cosmetic dentistry patients including patients over the age of 18. Treatment is feasible in the clinic setting. Patients can benefit from lower costs (not spending more for light-activated whitening), less chair time, and more knowledge on teeth whitening. Patients may be harmed from realization that light-activated whitening isn’t as efficient as what many companies claim it to be. |
Specialty/Discipline |
(Public Health) (General Dentistry) (Restorative Dentistry) (Dental Hygiene) |
Keywords |
Light, light-activated, phototherapy, tooth bleaching, teeth bleaching, bleaching
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ID# |
2279 |
Date of submission: |
04/11/2012 |
E-mail |
nguyenad@livemail.uthscsa.edu |
Author |
Alvin D. Nguyen |
Co-author(s) |
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Co-author(s) e-mail |
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Faculty mentor/Co-author |
David Cox, DDS |
Faculty mentor/Co-author e-mail |
CoxD@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
None available | |
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