Clinical effects of reservoirs on gingival health using two different concentrations of home dental bleaching agents on fluorosed teeth: A comparative study

Objectives: To evaluate the effect of concentration and influence of reservoirs on the gingival mucosa of patients submitted to at-home bleaching with 10% and 35% carbamide peroxide (cp). Materials and Methods: A total of 20 patients were submitted to home bleaching with a 10% cp gel for 2 h/day for 3 weeks and 35% cp gel for 30 min/day for 3 weeks (n = 10). The custom-made mouth trays were made with a reservoir on only the left side and cut anatomically 1 mm beyond the gingival margin. Smears of the gingival mucosa were obtained by the exfoliation cytology in liquid media technique before (control), immediately after, and 30 and 45 days after the treatment. The samples were processed in the laboratory and evaluated for inflammation. Statistical analysis was carried out by McNemar test, two proportions test, independent paired t-test, and Wilcoxon test with a level of significance of 1%. Results: The presence of a reservoir in the custom tray resulted in an increase of inflammation immediately after the bleaching procedure. No significant differences were found in the degree of inflammation between the two groups at different period of observations. (P > 0.01). Conclusion: Ten percent and 35% cp bleaching gel caused gingival inflammation immediately after the procedure and persisted until 45 days after the bleaching treatment. The use of a reservoir in the custom tray for home bleaching resulted in higher rates and higher intensity of gingival inflammation