Combination of at-home and in-office bleaching techniques: case series

Tooth bleaching is one of the most conservative aesthetic techniques. At-home and in-office bleaching may be performed, as well as the combination of both techniques. As this combination may be done in different manners, distinct orders of combinations were proposed in this report. A 24 years-old man, whose upper central incisor and canine shades were A2 and A3 respectively, was initially treated by chair-side with 40-min application of 40% hydrogen peroxide (HP) for two sessions. Afterwards, an two-week overnight at-home bleaching was performed with 10% carbamide peroxide (CP). The shade of upper central incisors changed to 1M1 and canine was B1. Conversely, a 30 years-old woman was firstly conducted with at-home bleaching (overnight 4-weeks 10% CP) and, subsequently, with a single appointment of in-office bleaching for 45 minutes (35% HP). The shade of her upper central incisor changed from A1 to 0.5M1 and the upper canine from A3 to B1. The VITA classical (A1-D4) shade guide and VITA Bleached guide 3D-MASTER were used to determine the tooth color during the treatments. In both bleaching treatments, patients reported no significant tooth sensitivity and the final outcomes met their expectation.

Indexing terms
Carbamide peroxide; Hydrogen peroxide; Tooth bleaching

Authorship

Marcela Alvarez FERRETTI Correspondence to: MA FERRETTI. E-mail: marcela.a.ferretti@gmail.com.

Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora. Av. Limeira, 901, Areião, 13414-903, Piracicaba, SP, Brasil.Universidade Estadual de CampinasBrasilPiracicaba, SP, BrasilUniversidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora. Av. Limeira, 901, Areião, 13414-903, Piracicaba, SP, Brasil.

http://orcid.org/0000-0003-3443-5021

Matheus KURY

http://orcid.org/0000-0002-9971-0568

Beatriz Curvello de MENDONÇA

http://orcid.org/0000-0001-7987-0102

Marcelo GIANNINI

http://orcid.org/0000-0002-7260-5231

Vanessa CAVALLI

http://orcid.org/0000-0002-9459-1926

Vanessa CAVALLI

http://orcid.org/0000-0002-9459-1926

Flávio Henrique Baggio AGUIAR

http://orcid.org/0000-0002-9412-4041

Collaborators

MA FERRETTI, responsible for the bleaching treatment and patient follow-up performed in the first clinical report; described and discussed the first clinical report. M KURY, responsible for the bleaching treatment and patient follow-up performed in the second clinical report; described and discussed the second clinical report. BC MENDONÇA, responsible for the photographic documentation of both clinical cases and prepared the figures for paper. M GIANNINI, responsible for correcting full article and paper formatting for publication. V CAVALLI, clinical supervisor responsible for treatment and follow-up the second case report. FHB AGUIAR, clinical supervisor responsible for treatment and follow-up the first case report.

Correspondence to: MA FERRETTI. E-mail: marcela.a.ferretti@gmail.com.

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (6)

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Figure 1
Treatment starting by in-office technique followed by at-home bleaching. A - Initial color aspect, in which upper central incisor showed shade A2; B - The upper canine showed shade A3; C - Following the in-office bleaching procedures, upper central incisor shade changed to A1; D - Upper canine showed shade A2 after in-office bleaching; E - At the end of the combined bleaching, central incisor showed shade 1M1; F - The canine showed shade B1 following the combined technique.

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Figure 2
Bleaching procedures performed during the first case. A - Application of the in-office bleaching gel with an adequate gingival barrier; B - Individual acetate tray made for at-home bleaching technique.

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Figure 3
Clinical picture of the first patient before and after combined bleaching started by in-office technique. A - Initial color aspect of the patient showing good oral health, but teeth with yellow appearance. B - Final clinical aspect, in which the health of the patient was maintained and whiter teeth, was detected.

Thumbnail

Figure 4
Clinical evaluation of the second patient at the first phase of the bleaching treatment (at-home technique). A - Initial upper central incisor showing shade A1; B - Initially, upper canine showed shade A3; C - Shade A1 was shown for upper central incisor after 1 week; D - Upper canine showed shade A2 after 1 week; E - After 2 weeks, central incisor showed shade 1M1; F - The canine showing shade B1.

Thumbnail

Figure 5
The second phase of the bleaching therapy applied in the second patient (in-office technique). A - Upper central incisor showing shade 1M1 after 2-week at-home bleaching; B - Shade B1 was shown for upper canine; C - Lower central incisors showed shade A1 after at-home bleaching during 2 weeks; D - In-office bleaching technique only on upper Canines and lower teeth; E - Following the in-office bleaching, central incisor reduced to 0.5M1; F - Final upper canine was maintained in B1; G - Lower incisors showed shade B1 after the in-office bleaching appointment.

Thumbnail

Figure 6
Clinical picture of the second patient before and after combined bleaching started by at-home technique. A - Starting aspect of the patient presenting acceptable oral health and yellow appearance of the teeth. The colors of upper and lower arches were unpaired. B - Clinical aspect after the bleaching therapy with whiter teeth and improved color harmony among the arches.

Figure 1 Treatment starting by in-office technique followed by at-home bleaching. A - Initial color aspect, in which upper central incisor showed shade A2; B - The upper canine showed shade A3; C - Following the in-office bleaching procedures, upper central incisor shade changed to A1; D - Upper canine showed shade A2 after in-office bleaching; E - At the end of the combined bleaching, central incisor showed shade 1M1; F - The canine showed shade B1 following the combined technique.

Figure 2 Bleaching procedures performed during the first case. A - Application of the in-office bleaching gel with an adequate gingival barrier; B - Individual acetate tray made for at-home bleaching technique.

Figure 3 Clinical picture of the first patient before and after combined bleaching started by in-office technique. A - Initial color aspect of the patient showing good oral health, but teeth with yellow appearance. B - Final clinical aspect, in which the health of the patient was maintained and whiter teeth, was detected.

Figure 4 Clinical evaluation of the second patient at the first phase of the bleaching treatment (at-home technique). A - Initial upper central incisor showing shade A1; B - Initially, upper canine showed shade A3; C - Shade A1 was shown for upper central incisor after 1 week; D - Upper canine showed shade A2 after 1 week; E - After 2 weeks, central incisor showed shade 1M1; F - The canine showing shade B1.

Figure 5 The second phase of the bleaching therapy applied in the second patient (in-office technique). A - Upper central incisor showing shade 1M1 after 2-week at-home bleaching; B - Shade B1 was shown for upper canine; C - Lower central incisors showed shade A1 after at-home bleaching during 2 weeks; D - In-office bleaching technique only on upper Canines and lower teeth; E - Following the in-office bleaching, central incisor reduced to 0.5M1; F - Final upper canine was maintained in B1; G - Lower incisors showed shade B1 after the in-office bleaching appointment.

Figure 6 Clinical picture of the second patient before and after combined bleaching started by at-home technique. A - Starting aspect of the patient presenting acceptable oral health and yellow appearance of the teeth. The colors of upper and lower arches were unpaired. B - Clinical aspect after the bleaching therapy with whiter teeth and improved color harmony among the arches.

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Combination of at-home and in-office bleaching techniques: case series

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[1] Collaborators

MA FERRETTI, responsible for the bleaching treatment and patient follow-up performed in the first clinical report; described and discussed the first clinical report. M KURY, responsible for the bleaching treatment and patient follow-up performed in the second clinical report; described and discussed the second clinical report. BC MENDONÇA, responsible for the photographic documentation of both clinical cases and prepared the figures for paper. M GIANNINI, responsible for correcting full article and paper formatting for publication. V CAVALLI, clinical supervisor responsible for treatment and follow-up the second case report. FHB AGUIAR, clinical supervisor responsible for treatment and follow-up the first case report.