Maintenance of dental bleaching: A systematic review

Abstract

After bleaching procedure, color pigments can adhere to the rough dental surface and can trigger more discoloration. In this sense, no standard post-bleaching maintenance technique exists. The purpose of this study was to evaluate the maintenance of enamel color after bleaching procedure through a systematic review.
The research question was defined as follows: Is the tooth whitening maintenance necessary after a bleaching treatment? Two reviewers conducted the literature search in PubMed (MEDLINE), Web of Science, Scopus, EMBASE, and SciELO. Both in vitro and clinical trials reporting the color change of bleached enamel after the use of a tooth whitening agent were included in the review. The risk of bias in the included manuscripts was evaluated using the RoBDEMAT tool.
A total of 11 articles were included in the qualitative analysis. Due to the lack of groups for comparison, a meta-analysis could not be conducted. The whitening maintenance procedures identified were remineralizing agents, antioxidants, over-the-counter agents, toothpaste containing Blue Covarine, casein phosphopeptide-amorphous calcium phosphate fluoride paste, 0.05% sodium fluoride mouthwash, arginine, nano-hydroxyapatite, nano-carbonate apatite, and CO2 laser.
In conclusion, tooth whitening maintenance could be achieved by using some agents. The association of these agents might be beneficial for maintaining the color of the enamel throughout 12 months following bleaching procedure.