The Journal of the American Dental Association
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J Am Dent Assoc, Vol 140, No 9, 1109-1117.
© 2009 American Dental Association
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CLINICAL PRACTICE

JADA Continuing Education

A Double-Blind Randomized Controlled Clinical Trial of 10 Percent Versus 16 Percent Carbamide Peroxide Tooth-Bleaching Agents

One-Year Follow-up



Sônia Saeger Meireles, DDS, PhD, Iná da Silva dos Santos, MD, PhD, Álvaro Della Bona, DDS, PhD and Flávio Fernando Demarco, DDS, PhD

Background. The use of high-concentration tooth-bleaching agents has been associated with increased longevity of the whitening effect. The authors conducted a randomized controlled clinical trial to evaluate the longevity of the whitening effect at one year of two at-home tooth-bleaching agents.

Methods. The authors randomly assigned 92 participants with a mean shade of C1 or darker for six maxillary anterior teeth into two equal-sized groups according to carbamide peroxide concentration: 10 percent (CP10) or 16 percent (CP16). Treatment involved the use of a whitening agent in a tray for two hours daily for three weeks. The authors evaluated tooth shade with a shade guide and a spectrophotometer at baseline and one week, six months and one year after bleaching. Participants in both groups answered questions about their dietary and oral hygiene behaviors.

Results. At the one-year recall appointment, the teeth in both groups remained significantly lighter than at baseline. At this time, participants from the CP10 and CP16 groups consumed staining beverages and foods at a level as high as at the six-month recall appointment, and this consumption level was not statistically significant between groups (P > .5).

Conclusions. One year after bleaching, both treatment groups had the same median tooth shade, which remained lighter than at baseline.

Clinical Implications. Higher carbamide peroxide concentration does not increase the longevity of the whitening effect of at-home tooth-bleaching agents.

Key Words: Carbamide peroxide; tooth bleaching; randomized controlled clinical trials

Abbreviations: ADA: American Dental Association • CP10: 10 percent carbamide peroxide concentration • CP16: 16 percent carbamide peroxide concentration • {Delta}a*: Measure of redness or greenness • {Delta}b*: Measure of yellowness or blueness • {Delta}E*: Total color difference or distance between two colors • {Delta}L*: Measure of lightness or darkness






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