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This randomized, double-blind, split-mouth clinical trial evaluates the effectiveness of at-home dental bleaching using customized nightguards fabricated by digital (3D-printed CAD-CAM) and conventional methods, with and without reservoirs. Adult participants with good general and oral health and a baseline tooth shade of A2 or darker undergo bleaching with 10% carbamide peroxide. Outcomes include tooth color change (subjective and spectrophotometric measures), tooth sensitivity, gingival irritation, patient comfort, and patient satisfaction over time.
This study compares the effectiveness of at-home dental bleaching using customized conventional vacuum-formed trays and digitally fabricated (3D-printed CAD-CAM) trays. It also compares tray designs with and without reservoirs using a randomized split-mouth design.
Each participant receives both tray fabrication approaches and both reservoir conditions, distributed according to randomized allocation. Bleaching is performed with 10% carbamide peroxide. Participants are followed during and after treatment to assess tooth color change, tooth sensitivity, gingival irritation, comfort, and satisfaction.
Tooth color is assessed using both visual and spectrophotometric methods. A customized positioner is used to standardize the measurement location throughout the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Digital tray with reservoir | Experimental | Customized digital (3D-printed CAD-CAM) bleaching tray with reservoir design for at-home bleaching with 10% carbamide peroxide. |
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| Digital tray without reservoir | Experimental | Customized digital (3D-printed CAD-CAM) bleaching tray without reservoir design for at-home bleaching with 10% carbamide peroxide. |
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| Conventional tray with reservoir | Experimental | Customized conventional vacuum-formed bleaching tray with reservoir design for at-home bleaching with 10% carbamide peroxide. |
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| Conventional tray without reservoir | Experimental | Customized conventional vacuum-formed bleaching tray without reservoir design for at-home bleaching with 10% carbamide peroxide. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Customized bleaching tray fabrication | Procedure | Customized bleaching trays were fabricated using either a conventional vacuum-forming technique or a digital CAD-CAM 3D-printing technique, according to randomized allocation within a split-mouth design. |
| Measure | Description | Time Frame |
|---|---|---|
| Tooth color change (spectrophotometer; ΔE*ab) | Tooth color measured with a spectrophotometer (VITA Easyshade) using CIE L*, a*, b* values. Color change will be calculated as ΔE*ab relative to baseline (T0). Measurements are standardized using a customized positioner. Bleaching was performed from T0 through T5. No bleaching gel was applied between T5 and T6; T6 assessed post-treatment stability and adverse effects. | T0 (baseline, Day 0); T1 (Week 1); T2 (Week 2); T3 (Week 3); T4 (Week 4); T5 (Week 6, end of bleaching); T6 (Week 8, 2 weeks post-bleaching). |
| Tooth shade change (VITA Bleachedguide 3D-MASTER; shade guide units) | Tooth shade assessed visually using the VITA Bleachedguide 3D-MASTER. Shade guide scores will be converted to numeric values and reported as change from baseline (T0) at each time point. Bleaching was performed from T0 through T5. No bleaching gel was applied between T5 and T6; T6 assessed post-treatment stability and adverse effects. | T0 (baseline, Day 0); T1 (Week 1); T2 (Week 2); T3 (Week 3); T4 (Week 4); T5 (Week 6, end of bleaching); T6 (Week 8, 2 weeks post-bleaching). |
| Measure | Description | Time Frame |
|---|---|---|
| Tooth sensitivity (Numeric Rating Scale, 0-4) | Tooth sensitivity assessed using a 5-point Numeric Rating Scale (NRS): 0 = none, 1 = slight, 2 = moderate, 3 = considerable, 4 = severe. For each visit, the worst (highest) NRS value reported at that assessment point will be used for analysis. Bleaching was performed from T0 through T5. No bleaching gel was applied between T5 and T6; T6 assessed post-treatment stability and adverse effects. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| MARTA VALLES, DDS, PhD | Contact | +34619747903 | mvalles@uic.es | |
| LISSETHE PEÑATE, DDS, PhD | Contact | +34 679 81 52 13 | lissethe@uic.es |
| Name | Affiliation | Role |
|---|---|---|
| MARTA VALLES, DDS, PhD | Universitat Internacional de Catalunya | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clínica Universitària d'Odontologia UIC Barcelona | Recruiting | Sant Cugat del Vallès | BARCELONA | 08195 | Spain |
Individual participant data (IPD) will not be shared because the dataset contains potentially identifiable clinical information from a small sample treated at a single center, and no data-sharing plan was included in the original participant consent.
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This is a randomized split-mouth clinical trial. Each participant receives both tray fabrication methods (conventional vacuum-formed and digital 3D-printed CAD-CAM) in different arches, and both tray designs (with and without reservoirs) distributed across hemiarches according to randomized allocation. Therefore, within-participant comparisons are performed for tray fabrication method and reservoir presence.
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Participants and clinical outcome evaluators were unaware of group assignments. Data analysis was performed by a separate researcher who was not involved in treatment administration or outcome assessment. Due to the nature of tray fabrication and delivery, personnel involved in tray preparation may not have been blinded.
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| Reservoir tray design | Procedure | Tray designs were prepared either with a reservoir or without a reservoir, according to randomized allocation across hemiarches within the split-mouth design. |
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| Carbamide peroxide 10% | Drug | At-home bleaching gel containing 10% carbamide peroxide applied in customized trays according to the study protocol |
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| T0 (baseline, Day 0); T1 (Week 1); T2 (Week 2); T3 (Week 3); T4 (Week 4); T5 (Week 6, end of bleaching); T6 (Week 8, 2 weeks post-bleaching). |
| Tooth sensitivity (Visual Analog Scale, 0-10) | Tooth sensitivity assessed using a 10-cm Visual Analog Scale (VAS) from 0 (no sensitivity) to 10 (severe sensitivity). For each visit, the highest VAS value reported at that assessment point will be used for analysis. Bleaching was performed from T0 through T5. No bleaching gel was applied between T5 and T6; T6 assessed post-treatment stability and adverse effects. | T0 (baseline, Day 0); T1 (Week 1); T2 (Week 2); T3 (Week 3); T4 (Week 4); T5 (Week 6, end of bleaching); T6 (Week 8, 2 weeks post-bleaching). |
| Gingival irritation presence (NRS, 0-2) | Gingival irritation presence assessed using a Numeric Rating Scale: 0 = absent, 1 = localized, 2 = generalized. | T0 (baseline, Day 0); T1 (Week 1); T2 (Week 2); T3 (Week 3); T4 (Week 4); T5 (Week 6, end of bleaching); T6 (Week 8, 2 weeks post-bleaching). |
| Gingival irritation severity (NRS, 0-2) | Gingival irritation severity assessed using a Numeric Rating Scale: 0 = no irritation, 1 = gingival burning, 2 = erosion. | T0 (baseline, Day 0); T1 (Week 1); T2 (Week 2); T3 (Week 3); T4 (Week 4); T5 (Week 6, end of bleaching); T6 (Week 8, 2 weeks post-bleaching). |
| Patient comfort (VAS, 0-10) | Patient comfort assessed using a Visual Analog Scale (VAS): 0 = no comfort, 10 = high comfort. | T0 (baseline, Day 0); T1 (Week 1); T2 (Week 2); T3 (Week 3); T4 (Week 4); T5 (Week 6, end of bleaching); T6 (Week 8, 2 weeks post-bleaching). |
| Patient satisfaction with tooth color change (VAS, 0-10) | Patient satisfaction (acceptance) with tooth color changes assessed using a Visual Analog Scale (VAS): 0 = least satisfaction, 10 = most satisfaction. | T0 (baseline, Day 0); T1 (Week 1); T2 (Week 2); T3 (Week 3); T4 (Week 4); T5 (Week 6, end of bleaching); T6 (Week 8, 2 weeks post-bleaching). |
| ID | Term |
|---|---|
| D014075 | Tooth Discoloration |
| D003807 | Dentin Sensitivity |
| ID | Term |
|---|---|
| D014076 | Tooth Diseases |
| D009057 | Stomatognathic Diseases |
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