Comparison of in-office and at-home bleaching techniques: An umbrella review of efficacy and post-operative sensitivity
Maria Aidos,
Carlos Miguel Marto,
Inês Amaro,
Mariangela Cernera,
Inês Francisco,
Francisco Vale,
Manuel Marques-Ferreira,
Bárbara Oliveiros,
Gianrico Spagnuolo,
Eunice Carrilho,
Ana Coelho,
Anabela Baptista Paula
Affiliations
Maria Aidos
Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal
Carlos Miguel Marto
Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal; Univ Coimbra, Institute of Experimental Pathology, Faculty of Medicine, Coimbra, Portugal; Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal; Corresponding author. Faculty of Medicine, Pólo III, Azinhaga de Santa Comba, Celas, 3000-548, Coimbra, Portugal.
Inês Amaro
Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal; Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
Mariangela Cernera
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples, “Federico II”, 80131, Naples, Italy
Inês Francisco
Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal; Univ Coimbra, Institute of Orthodontics, Faculty of Medicine, Coimbra, Portugal
Francisco Vale
Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal; Univ Coimbra, Institute of Orthodontics, Faculty of Medicine, Coimbra, Portugal
Manuel Marques-Ferreira
Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal; Univ Coimbra, Institute of Endodontics, Faculty of Medicine, Coimbra, Portugal
Bárbara Oliveiros
Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal; Univ Coimbra, Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, Coimbra, Portugal
Gianrico Spagnuolo
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples, “Federico II”, 80131, Naples, Italy
Eunice Carrilho
Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal; Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
Ana Coelho
Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal; Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
Anabela Baptista Paula
Univ Coimbra, Institute of Integrated Clinical Practice, Faculty of Medicine, Coimbra, Portugal; Univ Coimbra, Laboratory for Evidence-Based Sciences and Precision Dentistry, Coimbra, Portugal; Univ Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra, Portugal; Univ Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
Objectives: The objective of this umbrella review is to evaluate the efficacy and adverse effects of different teeth whitening techniques in-office (IO) and at-home (AH), regarding chromatic changes and teeth sensitivity. Materials and methods: The search was carried out from several databases. The included studies were all systematic reviews with or without meta-analysis of RCT or quasi-RCT. The participants were patients that underwent external dental bleaching in permanent vital teeth. The interventions were in-office (IO) bleaching techniques and at-home (AT) bleaching techniques with different bleaching agents and concentrations. Results: The search resulted in a total of 257 articles, and 28 SR were included in the qualitative analysis and nine in the quantitative analysis. There is no difference between in-office and at-home techniques in terms of color change (p = 0.95) and post-treatment sensitivity (p = 0.85). There is similarity risk and intensity of teeth sensitivity between AH and IO bleaching. IO bleaching with light-activated systems with low concentrations of bleaching agent showed similar results to IO bleaching techniques with high concentrated bleaching gels. With the application of the criteria of the AMSTAR 2 tool, the reviews were considered critically low to high. Conclusions: There are no significant differences in terms of color change between the different bleaching techniques compared. Teeth sensitivity is always present regardless of the technique used. The use of light activation systems did not increase the intensity and risk of post-operative sensitivity.
