Carbamide Peroxide

This study represents the first network meta-analysis (NMA) comparing the efficacy and safety of different concentrations of carbamide peroxide (CP) for at-home bleaching in permanent dentition. A comprehensive search was conducted across PubMed, Cochrane Central, LILACS/BBO, SCOPUS, Web of Science, EMBASE, and gray literature. Randomized controlled trials (RCTs) comparing at least two CP concentrations were included. Color change (ΔE, ΔSGU), risk and intensity of tooth sensitivity TS was assessed Cochrane RoB 2.0 and GRADE were used to evaluate the risk of bias (RoB) and certainty of evidence. Thirteen RCTs were included, most with high RoB. CP5 % and 37 % appeared in a single trial each. For ΔSGU, no significant differences were detected between concentrations. For ΔE, all concentrations were superior to CP 5 %, with the largest difference observed for CP 37 %; intermediate concentrations showed minimal variations. Regarding TS, CP10 % was associated with a 67 % lower risk compared to CP 20-22 % (RR 1.67; 95 % CrI: 1.15-2.57), and CP 20-22 % also caused significantly higher TS intensity on the NRS scale. Conclusion: Lower concentrations of CP reduced the risk of TS while achieving bleaching efficacy comparable to higher concentrations, suggesting that less concentrated gels is safer and effective for at-home bleaching.

To evaluate the effects of different whitening toothpastes on bovine tooth enamel during at-home bleaching with 10% carbamide peroxide.

Enamel-dentin specimens were randomly assigned to five groups based on the toothpaste used: distilled water (DW), regular toothpaste (RT), whitening toothpaste with abrasive agents (WT), whitening toothpaste with abrasive and chemical agents (PT), and whitening toothpaste with abrasive, chemical, and bleaching agents (HP). All specimens underwent brushing and bleaching procedures for 14 days. Surface microhardness (SMH), surface roughness (Ra), and color parameters (ΔL*, Δa*, Δb*, ΔE*ab, and ΔE*₀₀) were analyzed. Data were statistically evaluated using two-way ANOVA followed by Tukey's post-hoc test (α= 0.05).

All groups showed a significant reduction in SMH and an increase in Ra between the initial and final timepoints (P< 0.05). At the final evaluation, PT showed intermediate values, while HP presented the highest SMH, differing significantly from all other groups. For surface roughness, the WT group exhibited the highest Ra, while RT had the lowest values among the toothpaste groups. No significant differences were observed for ΔE*ab and ΔE*₀₀ between groups (P> 0.05). Whitening toothpastes used concomitantly with at-home dental bleaching do not enhance the whitening effectiveness; however, they may cause changes to the enamel surface.

Whitening toothpastes used concomitantly with at-home bleaching do not enhance whitening effectiveness but may negatively affect enamel surface properties by increasing roughness and reducing microhardness.