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International Arab Journal of Dentistry

Tarek Hanbali, Esthetic and Prosthetic Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon; Saint- Joseph University of Beirut, Beirut, LBNFollow
Rim Bourgi, Department of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut 1107 2180, Lebanon, Saint-Joseph University of Beirut, Beirut, LBN. . Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France, University of Strasbourg, Strasbourg, FRA. Department of Restorative Sciences, Faculty of Dentistry, Beirut Arab University, 115020 Beirut, Lebanon, Beirut Arab University, Beirut, LBNFollow
Carlos Enrique Cuevas-Suárez, Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca 42160, Mexico, Autonomous University of Hidalgo State, Hidalgo State, MEX
Monika Lukomska-Szymanska, Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland, Medical University of Lodz, poland, POL
Walter Devoto, Independent Researcher, 16030 Sestri Levante, Italy, Sestri Levante, ITA
Nicolas Nassar Sr., Department of Orthodontics, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon, Saint-Joseph University of Beirut, beirut, LBN. Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon, Saint-Joseph University of Beirut, beirut, LBN. Department of Digital Dentistry, AI, and Evolving Technologies, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon, Saint-Joseph University of Beirut, beirut, LBN
Naji Kharouf, Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, 67000 Strasbourg, France, University of Strasbourg, Strasbourg, FRA . Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000 Strasbourg, France, University of Strasbourg, Strasbourg, FRA
Louis Hardan, Department of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut 1107 2180, Lebanon, Saint-Joseph University of Beirut, Beirut, LBN- Department of Digital Dentistry, AI, and Evolving Technologies, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon, Saint-Joseph University of Beirut, Beirut, LBNFollow

Abstract

Background:

Dental at-home bleaching is a widely recognized and effective treatment for improving the shade of anterior teeth. However, the impact of varying application times of carbamide peroxide (CP) concentrations on whitening efficacy and tooth sensitivity (TS) remains unclear.

Methods:

In this split-mouth, randomized clinical trial, 80 participants were divided into two groups (n = 40 each) to receive either 10% or 16% CP gel for home bleaching. Different application times were tested. Tooth color was measured using the Optishade colorimeter (Smile Line; St-Imier, Switzerland), and TS was evaluated via a five-point analog numerical rating scale. The Friedman test with post hoc Tukey test analyzed color changes over time within application times. The Mann-Whitney test compared application times at each follow-up. Significance was set at p < 0.05.

Results:

Participants using 16% CP gel for 2 hours daily demonstrated the greatest tooth color improvement at 1 and 2 weeks. A similar effect was observed with 10% CP gel applied for 4 hours daily. Shorter application times (1 hour daily for 16% CP or 2 hours daily for 10%CP) resulted in less whitening regardless of gel concentration (p < 0.01). The highest TS was reported with 16% CP for 2 hours, particularly in the first days. The 10% CP for 4 hours caused moderate sensitivity, while the lowest sensitivity was found in participants applying gels for shorter application times (1 hour daily for 16% CP or 2 hours daily for 10%CP), especially in the 10% CP group (p < 0.03).

Conclusion:

At-home bleaching using 16% CP for 2 hours or 10% CP for 4 hours daily yields optimal whitening but increases tooth sensitivity. Shorter application times reduce sensitivity but may compromise bleaching efficacy. These findings support tailoring bleaching protocols to patient sensitivity and whitening goals.

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