Clinical Evaluation of Genotoxicity of In-office Bleaching

Objective: The aim of this study was to evaluate the genotoxicity of in-office bleaching with 35% hydrogen peroxide in epithelial cells from the gingival and lip tissues. Methods and Materials: Thirty volunteers with central incisors shade A1 or darker were selected for this study. The gingival tissue of the teeth to be bleached was isolated with a light-polymerized resin dam, and the 35% hydrogen peroxide gel was administered during three 15-minute applications over the course of the 45-minute application period. Two bleaching sessions with a one-week interval in between were performed. Exfoliated oral mucosa gingival epithelial cells and upper lip lining were collected at baseline and one month after the in-office dental bleaching. The scraped cells were placed on clean glass slides and smears were prepared. After staining with Giemsa solution, two blinded examiners performed cell and micronuclei counts under a 1003 optical microscope. Tooth sensitivity was evaluated using the Visual Analogue Scale (VAS). Shade evaluation was recorded before and one month after the bleaching treatment with the value-oriented shade guide Vita Bleachedguide 3D-MASTER and the spectrophotometer Vita Easyshade. Data from the shade guide units and the micronuclei (MN) frequency were subjected to a Mann-Whitney test (alpha=0.05). The overall difference between before and one month after the bleaching treatment (Delta E and Delta SGU), absolute risk, and intensity of tooth sensitivity (TS) were calculated, as was the 95% confidence interval (CI). Results: The frequency of MN was not increased after bleaching with 35% hydrogen peroxide in both study groups (p>0.05). The absolute risk of TS of the participants was 93% (95% CI, 79%-98%), with a mean VAS intensity of 5.7 +/- 2.9 (95% CI, 4.6-6.8). Meaningful whitening was observed after bleaching. The change in shade guide units in the Bleached-guide 3D-MASTER was 2.3 +/- 1.4. In terms of DE, the change in color was 7.7 +/- 3.5. Conclusions: The in-office bleaching did not induce DNA damage to the gingival and lip tissue during the bleaching period. Although effective whitening was observed, most of the participants experienced TS.