Bleaching with biocatalysts and violet LED: a randomized clinical trial using a hybrid design with parallel-group and split-mouth approaches

Abstract

Objective: To compare conventional 35% hydrogen peroxide whitening for 45 min with test therapies lasting 15 min using a polymeric scaffold, peroxidase, and violet LED.Materials and methodsSixty patients were randomized into three groups (n = 20): TC45 (35% HP for 45’), T15 (35% HP for 15’), and TT (polycaprolactone scaffold + 35% HP with peroxidase for 15’). One hemiarch was irradiated with violet LED (L) (8 cycles of 1 min, with 30-second intervals). ΔE00 and ΔWID were evaluated using a portable spectrophotometer. Spontaneous sensitivity (questionnaire) and provoked sensitivity (thermal test) were assessed at T1, T2, T3, and after 7, 14, and 90 days (three-way repeated measures ANOVA). pH and hydrogen peroxide (HP) consumption were assessed during the first session (one-way ANOVA). Results: The TT group showed ΔE00 efficacy similar to TC45 and superior to T15. With LED, the TTL group was equivalent to TCL45 and superior to TL15. Regarding ΔWID, TT was also comparable to TC45 and superior to T15, while TCL45 showed the best results with LED. LED irradiation significantly affected only the T15 groups. TC45 and TCL45 showed higher sensitivity, whereas TT and TTL exhibited lower pH drop and greater hydrogen peroxide degradation. Conclusion: Therapies using scaffold and peroxidase, with or without LED, were effective, safe, and less sensitive, representing promising alternatives to conventional whitening, even with a two-third reduction in application time.Clinical RelevanceWhitening therapies using polymeric scaffold and peroxidase, with or without violet LED, are effective, safe, and cause less sensitivity, representing promising alternatives to conventional whitening.