Evidence map›Paper›PMID 40257513›Full record

Trial reportClinical oral investigations2025

Impact of the in-office bleaching gels pH on tooth sensitivity in combined bleaching techniques: a randomized clinical trial.

Thiago Costa Verde, Gloria Maria Linhares Bandeira de Melo Ferreira, Michael Willian Favoreto, Taynara de Souza Carneiro, Rosyara Silva Corrêa Muniz, Alessandra Reis, Andres Felipe Millan Cardenas, Alessandro Dourado Loguercio, Fabiana Suelen Figuerêdo de Siqueira

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical oral investigations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. One-Year Color Stability of a Reduced 37.5% Hydrogen Peroxide In-Office Bleaching Protocol: A Randomized Clinical Trial.Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] · 2026
    Trial
  4. Trial
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Thiago Costa VerdeDepartment of Restorative Dentistry, Ceuma University, São Luís, Maranhão, Brazil.
Gloria Maria Linhares Bandeira de Melo FerreiraDepartment of Restorative Dentistry, Ceuma University, São Luís, Maranhão, Brazil.
Michael Willian FavoretoDepartment of Restorative Dentistry, School of Dentistry, Tuiuti University of Paraná, Curitiba, Paraná, Brazil.
Taynara de Souza CarneiroDepartment of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M, Sala 64A- Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil.
Rosyara Silva Corrêa MunizDepartment of Restorative Dentistry, School of Dentistry, Federal University of Maranhão (UFMA), São Luis, Maranhão, Brazil.
Alessandra ReisDepartment of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M, Sala 64A- Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil.
Andres Felipe Millan CardenasDepartment of Restorative Dentistry, School of Dentistry, Federal University of Maranhão (UFMA), São Luis, Maranhão, Brazil.
Alessandro Dourado LoguercioDepartment of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M, Sala 64A- Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil. aloguercio@hotmail.com.
Fabiana Suelen Figuerêdo de SiqueiraDepartment of Restorative Dentistry, Ceuma University, São Luís, Maranhão, Brazil.

Funding

Conselho Nacional de Desenvolvimento Científico e Tecnológico 304817/2021-0Conselho Nacional de Desenvolvimento Científico e Tecnológico 308286/2019-7Coordenação de Aperfeiçoamento de Pessoal de Nível Superior 001Fundação de Amparo à Pesquisa e ao Desenvolvimento Científico e Tecnológico do Maranhão 03628/23
6 · The paper itself

Abstract

objectivesThis randomized, parallel, single-blind clinical trial evaluated tooth sensitivity (TS), efficacy, gingival irritation (GI), aesthetic self-perception, and psychosocial impact of combined bleaching using in-office bleaching agents with different pHs. MATERIALS AND

methods160 participants were randomized into two groups (n = 80) with 35% hydrogen peroxide in-office bleaching gels: Whiteness HP Maxx (acidic, unstable pH) and Whiteness HP Automixx Plus (neutral, stable pH). In-office bleaching was performed in one session: HP Maxx (3 applications of 15 min) and HP Automixx Plus (1 application of 50 min). Both groups then received at-home bleaching with 10% carbamide peroxide for 4 h daily for two weeks. TS and GI were assessed using Visual Analogue Scales. Color change was measured with a spectrophotometer and color guides. Aesthetic self-perception and psychosocial impact were evaluated using three scales: Orofacial Aesthetics Scale, Oral Health Impact Profile, and Psychosocial Impact Questionnaire of Dental Aesthetics.

resultsThe risk and intensity of TS significantly favored the neutral and stable pH gel for both in-office (p < 0.001) and combined treatments (p < 0.004). Both groups achieved significant whitening (p > 0.37). No difference in GI risk or intensity was found (p > 0.11). All aesthetic and psychosocial scales showed significant improvement post-treatment (p < 0.05).

conclusionUsing a gel with neutral and stable pH during in-office bleaching reduces the risk and intensity of TS without compromising whitening efficacy. CLINICAL RELEVANCE: Combining at-home and in-office bleaching with a neutral, stable gel reduces TS risk and intensity while ensuring optimal whitening results and patient comfort.

Indexed as

Dentin SensitivityHydrogen PeroxideTooth BleachingTooth Bleaching AgentsAdultCarbamide PeroxideEsthetics, DentalFemaleGelsHumansHydrogen-Ion ConcentrationMaleMiddle AgedPeroxidesSingle-Blind MethodTreatment OutcomeCarbamide PeroxideGelsHydrogen PeroxidePeroxidesTooth Bleaching AgentsClinical trialsHydrogen peroxideTooth bleachingTooth sensitivity

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.