Comparison of the bleaching efficacy of different agents used for internal bleaching – a systematic review and meta-analysis
2021-11-08 | journal article; research paper. A publication with affiliation to the University of Göttingen.
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Comparison of the bleaching efficacy of different agents used for internal bleaching – a systematic review and meta-analysis
Frank, A. C.; Kanzow, P. ; Rödig, T. & Wiegand, A. (2021)
Journal of Endodontics, 48(2) pp. 171-178. DOI: https://doi.org/10.1016/j.joen.2021.10.011
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- Authors
- Frank, Ariadne Charis; Kanzow, Philipp ; Rödig, Tina; Wiegand, Annette
- Abstract
- Introduction: The aim of this study was to analyze and compare the efficacy of different bleaching agents typically used for internal bleaching of endodontically treated discolored teeth. Methods: Electronic databases (PubMed, Web of Science, and Cochrane Library) were searched by 2 reviewers for clinical trials in which the color of endodontically treated discolored teeth before and after internal bleaching was examined using shade guide units (ΔSGU) or a spectrophotometer/colorimeter (ΔE). The efficacies of the bleaching agents were compared using subgroup analyses. Statistical heterogeneity was assessed with the Cochran Q test and I2 statistic. Publication bias was evaluated using funnel plots. Results: Eight studies were included in the systematic review, 6 of which could be included in the meta-analyses. Internal bleaching led to a significant change in tooth shade (ΔSGU: 6.27 [95% confidence interval, 5.36-7.17], ΔE: 12.83 [95% confidence interval, 9.46-16.20]). With regard to ΔSGU, the use of carbamide peroxide (35% or 37%), hydrogen peroxide (35%), and the combination of sodium perborate and hydrogen peroxide (3% or 30%) led to a better bleaching effect than sodium perborate (adjusted P value ≤ .026). Regarding ΔE, there were no significant differences between carbamide peroxide (37%), hydrogen peroxide (35%), and sodium perborate mixed with hydrogen peroxide (P = .051). The risk of bias of the included studies was classified as moderate to high. Conclusions: Carbamide peroxide, hydrogen peroxide, and sodium perborate have a significant bleaching effect on discolored, root canal-treated teeth. For a valid assessment of shade stability and a comparison of bleaching agents and their concentrations, further studies with long-term recalls are necessary.
- Issue Date
- 8-November-2021
- Journal
- Journal of Endodontics
- Organization
- Poliklinik für Präventive Zahnmedizin, Parodontologie und Kariologie
- ISSN
- 0099-2399
- Language
- English
- Subject(s)
- bleaching; color change; discoloration; nonvital teeth; walking bleach technique