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Open AccessReview

Non-Vital Tooth Bleaching Techniques: A Systematic Review

by Ana Sofia Coelho 1,2,3,4,5,*, Lara Garrido 1, Mariana Mota 1, Carlos Miguel Marto 1,2,3,4,5,6, Inês Amaro 1, Eunice Carrilho 1,2,3,4,5 and Anabela Paula 1,2,3,4,5
1
Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
2
Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
3
Center for Innovative Biomedicine and Biotechnology, University of Coimbra, 3000 Coimbra, Portugal
4
CIMAGO—Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
5
CNC.IBILI, University of Coimbra, 3000 Coimbra, Portugal
6
Experimental Pathology Institute, Faculty of Medicine, University of Coimbra, 3000 Coimbra, Portugal
*
Author to whom correspondence should be addressed.
Coatings 2020, 10(1), 61; https://doi.org/10.3390/coatings10010061
Received: 12 December 2019 / Revised: 1 January 2020 / Accepted: 7 January 2020 / Published: 9 January 2020
This systematic review aimed to describe and characterize internal tooth bleaching techniques, conventional (walking-bleach) and combined (inside–outside), referring to their efficacy. The research was conducted on the main databases: PubMed, Cochrane Library, EMBASE, and Web of Science. Only randomized controlled trials and cohort studies were considered, on humans of 18 years old or older. A Population, Intervention, Comparison, Outcome (PICO) question was designed to evaluate the scientific evidence. The quality of each randomized controlled trial and cohort study was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions and the Methodological Index for Non-Randomized Studies (ROBINS-I), respectively. The walking-bleach and the combined techniques were both effective at the end of the treatment, obtaining similar aesthetic results. Regardless of the technique used, internal tooth bleaching is an effective procedure, with good aesthetic results, in the treatment of non-vital teeth. The cervical barrier is a standard of care in internal bleaching techniques and should be used. Considering the similarity in the esthetic results obtained in both techniques, the concentrations used for both, and since the biocompatibility of the bleaching agent is more important than its efficiency or speed in obtaining results, the combined technique should be considered the method of choice rather than the walking-bleach technique.
Keywords: tooth bleaching; tooth discoloration; non-vital tooth tooth bleaching; tooth discoloration; non-vital tooth
MDPI and ACS Style

Coelho, A.S.; Garrido, L.; Mota, M.; Marto, C.M.; Amaro, I.; Carrilho, E.; Paula, A. Non-Vital Tooth Bleaching Techniques: A Systematic Review. Coatings 2020, 10, 61.

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