Does simultaneous versus individual-arch at-home dental bleaching regimen influence patient satisfaction? A randomized clinical trial

Objective Our randomized, parallel and single-blinded clinical trial evaluated patient level of discomfort during at-home bleaching testing the equivalence between two different protocols for the use of bleaching trays (simultaneous vs. single arch), as well as tooth sensitivity (TS), gingival irritation, (GI) and bleaching efficacy (BE). Materials and Methods We randomized 100 patients into: simultaneous (n = 50) and single arch (n = 50). At-home bleaching was performed with 10% hydrogen peroxide (HP) for 2 weeks for simultaneous group and 4 weeks for single arch group. We assessed patient level of discomfort using 9-item questionnaire. The TS and GI, as well as BE using spectrophotometer and color guide were assessed using the visual analog scale (0-10). Data from level of discomfort and BE were evaluated by Student's t test. The TS and GI were compared using the relative risk and confidence interval (alpha = 0.05). Results Only tray adaptation showed a significant effect after the second week (p < 0.002). There was equivalence between groups for level of discomfort (p < 0.01). We found no significant intergroup differences for the risk of TS or GI, nor for intensity. We observed no significant differences between them regarding bleaching efficacy (p > 0.21). Conclusions A simultaneous-use protocol for customized at-home dental bleaching trays proved to be equivalent to using single arch for patient level of discomfort and bleaching efficacy, with no significant increase in adverse effects. Clinical Significance Clinicians may decide whether to use a simultaneous or single arch protocol for tray usage; however, bleaching was achieved more quickly when the trays were worn simultaneously.