Clinical evaluation of 16% and 35% carbamide peroxide as in-office vital tooth whitening agents

Background: Tooth bleaching (whitening) is a conservative and cost effective treatment of discoloured teeth.Objectives: The purpose of this study was to evaluate the clinical efficacy and safety of 16% and 35% carbamide peroxide as in-office bleaching agents.Methods: Thirty adult subjects who desired to whiten their discoloured teeth were enrolled in the study. Carbamide bleaching agents, in concentrations of 16% and 35%, were used to whiten their teeth employing the spilt-arch technique / half-mouth design using vacuum formed halfarch matrix seated over the maxillary teeth for a one-hour session per week for two weeks. Outcome was monitored with Vita shade guide and photographs.Results: Twenty females and ten males, ages 18 - 43 years, with mean age 27.83 years, participated in the study. Tooth whitening was obtained in all subjects. Shade tab movement of 2-4 shades and 4-6 shades was recorded at first sessions then 3-5 and 5-9 shades at second sessions for 16% and 35% concentrations of carbamide peroxide respectively. The bleaching outcome was significantly better with the 35% concentration of carbamide peroxide while transient tooth sensitivity was observed in both concentrations of the bleaching agents.Conclusion: Carbamide peroxide in 16% and 35% concentration are effective and safe for bleaching discoloured vital teeth, however, 35% concentration gave significantly more lightening effect without additional side effects compared to 16% concentration.Keywords: Carbamide peroxide, tooth whitening, colour change, tooth sensitivit