Does the Use of Reservoirs Have Any Impact on the Efficacy of At-Home Bleaching? A Systematic Review

Abstract To answer the following focused question through a systematic review: “Are the risk and intensity of tooth sensitivity (TS) and bleaching efficacy different between adult patients who undergo at-home bleaching using trays with reservoirs and those who use trays without reservoirs?”. A comprehensive search was performed in the MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and grey literature without restrictions. Abstracts from conferences; unpublished and ongoing trial registries, dissertations and theses (ProQuest Dissertations and Periódicos Capes Theses databases) were searched. Only randomized clinical trials (RCTs) were included. We used the Risk of Bias tool (RoB) from the Cochrane Collaboration for quality assessment. After the removal of duplicates, title and abstract screening and full-text examination, nine RCTs remained for qualitative analyses. The great majority of the studies did not report the method of randomization, allocation concealment, and examiner blinding during color assessment. From the nine studies, eight were at unclear risk of bias. In regard to color change, four studies reported no change and two reported improved color change with reservoirs. Only four studies recorded tooth sensitivity and they reported no significant differences. Only one study reported greater gingival irritation with reservoirs. Lack of data reporting prevented us from running a meta-analysis. Further well-designed RCT should be conducted to answer this research question. So far there is not evidence to support that reservoirs in bleaching trays improve color change. PROSPERO - CRD42016037628

Effect of the Purple Corn Beverage "Chicha Morada" in Composite Resin during Dental Bleaching

During dental bleaching the staining potential of the surface would increase. This study aims to evaluate the staining susceptibility of one bleached composite resin after the exposure to three different beverages: Peruvian purple corn based beverage (chicha morada), green tea, and distilled water. Thirty disk-shaped specimens of one nanofill composite resin were prepared. The specimens were then divided into six groups (n = 5): purple corn (P), purple corn + bleaching (PB), green tea (T), green tea + bleaching (TB), distilled water (W), and distilled water + bleaching (WB). In groups that received bleaching, two sessions of bleaching with 35% hydrogen peroxide were done. Following bleaching, specimens were exposed to each liquid thirty minutes daily. Color was measured with a digital spectrophotometer. For statistical analysis, color measurement differences between the obtained results were used: during bleaching, after bleaching, and during + after bleaching. Two-way ANOVA was used to compare the color changes in the resins of all groups (p < 0.05). We conclude that all the evaluated beverages produced changes of color in the composite resin regardless of the bleaching procedure. However, purple corn was the only beverage that caused a perceptible color change (ΔE > 3.3).