JRSSEM 2022, Vol. 01, No. 11, 1890 – 1898

E-ISSN: 2807 - 6311, P-ISSN: 2807 - 6494

DOI : 10.36418/jrssem.v1i11.188 https://jrssem.publikasiindonesia.id/index.php/jrssem/index

EFFECTIVENESS OF ADDING HOME BLEACHING TIME

WITH 10% CARBAMIDE PEROXIDE: LITERATURE REVIEW

Ryan Mahardiansyah

Etny Dyah Harniati

Ismaya Aria Sari

Universitas Muhammadiyah Semarang, Jawa Tengah, Indonesia

e-mail: ryan.mahardiansyah@unimus.ac.id

, etnydyah@gmail.com

, ismaya.as@gmail.com

*Correspondence: ryan.mahardiansyah@unimus.ac.id

Submitted: 25 May 2022, Revised: 04 June 2022, Accepted: 15 June 2022

Abstract. Changes in the color of teeth to become darker are a lot of complaints by the public.

Bleaching is a whitening treatment for teeth that have changed color. Home bleaching is a

bleaching that can be done at home under the supervision of a dentist using 10% carbamide

peroxide for a period of more than 2 weeks. The purpose of this study was to determine the

effectiveness of 10% carbamide peroxide as a home bleaching agent with an extended period of

time against tooth discoloration. This type of research is Literature Review using Google Scholar,

Web of Science, and Pubmed using keywords that have been carried out, obtaining 9 articles that

match the research criteria. The results showed that 10% carbamide peroxide with an application

of more than 2 weeks gave effective and stable results, but the effect was also greater. The use of

10% carbamide peroxide as a home bleaching agent with an additional effective time for

discoloration was seen based on a literature review.

Keywords: home bleaching; 10% carbamide peroxide; increased bleaching time; tooth

discoloration.

Ryan Mahardiansyah, Etny Dyah Harniati, Ismaya Aria Sari                                                  | 1891
 
 
DOI : 10.36418/jrssem.v1i11.188   https://jrssem.publikasiindonesia.id/index.php/jrssem/index 
INTRODUCTION 
 
Tooth  discoloration  is  a  common 
complaint  by  the  public.  The 
discoloration  makes  a  person 
uncomfortable,  therefore  it  is  necessary 
to  have  a  whiter  teeth  whitening 
treatment that is whiter than before with 
aesthetic  goals
 
(Luque-Martinez  et  al., 
2016). Teeth  whitening or  bleaching has 
now  become  a  trend.namely  in  office 
bleaching  and  at  home  bleaching 
(Abusteit et al., 2022). Materials that are 
often  used  are  hydrogen  peroxide  and 
carbamide peroxide
 
(Llena et al., 2020). 
Carbamide  peroxide  has  the 
advantage of being able to give a greater 
white  color  effect  on  the  teeth,  and  a 
lower  risk  of  sensitivity  and  gingival 
irritation  (Rezende  et  al.,  2019). 
Carbamide  peroxide  can  be  used  at  a 
concentration of 10%-37%  (L Darriba  et 
al.,  2019).  A  safe  and  effective 
concentration  used  according  to  the 
American  Dental  Association  (ADA)  is  a 
concentration  of  10%.  These 
concentrations  can  be  used  in  at-home 
bleaching  (Rea  et  al.,  2019).  Carbamide 
peroxide  10%  can  be  used  as  home 
bleaching with a usage time of 2-8 hours 
per day for 2 weeks. The 2 weeks is the 
time  according  to  the  manufacturer's 
instructions for using home bleaching
 
(De 
Almeida et al., 2012); (Kossatz et al., 2012).  
The  results  bleaching  with  10% 
carbamide  peroxide  as  home  bleaching 
gave better color results than before, no 
pain and no other complaints (Serraglio 
et  al.,  2016);  (Markowitz,  2010). 
Carbamide peroxide 10% can be used as 
home  bleaching  within  2-3  weeks  by 
producing a better and more stable color. 
The longer the treatment duration from 
home bleaching, the better the results
 
(Oh 
et al., 2017);
 
(He et al., 2012).  
Based  on  the  above  background, 
researchers are interested in studying and 
reviewing  the  use  of  10%  carbamide 
peroxide  as  home  bleaching  with 
additional time for tooth discoloration in 
a  literature  review.  This  study  aims  to 
determine the effectiveness of using 10% 
carbamide  peroxide  as  home  bleaching 
with  the  addition  of  time  to  tooth 
discoloration. 
 
METHODS 
 
The  study  was  in  the  form  of  a 
literature review by collecting data on the 
use of 10% carbamide peroxide as home 
bleaching  against  tooth  discoloration 
with an extended period of time. The data 
presented  in  this  article  were  obtained 
from  previous  research  using  the 
keywords  carbamide  peroxide  10%  ”OR 
“carbamide  peroxide  10%”  AND  “home 
whitening”  OR  “home  bleaching”  AND 
“Additional  bleaching  time”  OR  “long 
treatment  duration  bleaching”  AND 
“tooth  discoloration”  OR  “bleaching”. 
Then  a  literature  search  of  journals  and 
scientific articles was carried out for the 
last  10  years  (2011-2021)  through  the 
Pubmed,  and  Web  of  Science,  then 
screening  research  articles  to  eliminate 
duplication  or  article  the  same  the 
database used, the research article was in 
accordance  with  the  inclusion  criteria 
(Indonesian and English articles, full text), 
assessing the quality and feasibility of the 
articles  obtained,  and  determining  the 

1892 | Effectiveness of Adding Home Bleaching Time with 10% Carbamide Peroxide: Literature

Review

research article to get a solution to the

research problem then concluded.

RESULTS AND DISCUSSION

Based on the results of the literature

search that has been carried out, I

obtained 7 articles related to the use of

10% carbamide peroxide as home

bleaching with an extension of time. The

data are presented in Table 1.

Table 1. Results of literature review

Materials

Procedural

Research

Results

Reference

Carbamide

peroxide 10%

Using 10% carbamide

peroxide applied using

a custom tray for 2

hours a day. Consists of

50 respondents with

group A (2 weeks) and

group B (3 weeks).

Daily application

for 3 weeks

produces a better

effect than 2 weeks.

This effect is seen

as soon as 1 to 6

months later. The

results of the

treatment look

better and more

stable.

[Darriba]

Carbamide

peroxide 10%

and 20%

100 participants aged

18-42 years were

studied using bleaching

with application using a

custom tray for 2 hours

every night for 3 weeks.

While measurements in

the participant's clinic

were carried out by the

application of 35% or

38% hydrogen peroxide

according to the

manufacturer's

instructions for use.

Then evaluated before,

1 week of treatment, 2

weeks of treatment, 3

weeks of treatment and

2 weeks of post-

treatment.

The use of 10% and

20% carbamide

peroxide which is

done at home and

35% and 38% of

hydrogen peroxide

which is done in the

clinic has the same

effectiveness in

teeth whitening

[Basting]

• -

Carbamid

e peroxide 10%

• - Hydrogen

techniques bleaching.

technique Home

bleaching : the patient is

made a custom tray

The results

obtained were

bleaching on the

same bleaching

[Moghadam]

Ryan Mahardiansyah, Etny Dyah Harniati, Ismaya Aria Sari | 1893

Materials

Procedural

Research

Results

Reference

Peroxide 38%

with carbamide

peroxide gel applied

every 4 hours a day for

2 weeks.

technique In office

hydrogen peroxide is

applied according to

the manufacturer's

regulations. Then

measured sensitivity,

color change and color

stability 2 weeks during

treatment, 1, 3 and 6

weeks after treatment.

technique and

tooth sensitivity

was obtained after

the application

bleaching on both

but the white color

returned faster in

the power

bleaching

technique, and the

color returned to its

original color in

both techniques

after 6 months of

application.

1. -

Carbamid

e peroxide 10%

31 participants who

have used carbamide

peroxide using a night

guard that is used at

home using 10%

carbamide peroxide

applied for 6-8 hours

for 2-6 weeks. Then an

evaluation was carried

out after 6 weeks.

The use of 10%

carbamide

peroxide in

nightguard vital

bleaching had low

side effects such as

gingival

inflammation, pulp

inflammation,

external root

resorption and no

evidence of

malignancy and no

soft tissue

pathological signs

were found, and

the patient was

satisfied with the

treatment after 17

years. .

[Boushell]

• -

Carbamid

e peroxide 10%

• - Hydrogen

Peroxide 10%

and 16%

50 participants who

were bleached using

the split mouth

technique in the home

bleaching, participants

were divided into 2

groups using

carbamide peroxide

and 2 other groups

using hydrogen

There is a

statistically

significant degree

of color change.

After 45 days of

treatment the

patient was

satisfied with the

results, there was

no gingival

[Bernardon]

1894 | Effectiveness of Adding Home Bleaching Time with 10% Carbamide Peroxide: Literature

Review

Materials

Procedural

Research

Results

Reference

peroxide 10% and 16%

application of this

material every 2 hours a

day for 3 weeks, then

measured 15, 30, 45

and 180 post-

treatment.

irritation,

carbamide

peroxide 10% can

cause sensitivity

compared to

carbamide

peroxide 16% and

15%. Because 16%

carbamide

peroxide contains

potassium nitrate.

Carbamide

peroxide 10%

60 smokers and 60

smokers were

measured for color

change with the

condition that the

teeth were A2 or

darker. Then bleaching

with 10% carbamide

peroxide for 3 hours a

day for 3 weeks.

Then the color

evaluation was carried

out using a shade

guide and a

spectrophotometer.

Evaluations were

carried out before,

during, after (1 week to

6 months) and then

sensitivity

measurements were

made using a sensitivity

analog scale.

Smokers and non-

smokers showed a

significant color

change since one

week after the

application of

10% carbamide

peroxide with an

application time

of 3 hours a day

for 3 weeks

statistically

measured using a

spectrophotomet

er.

The side effect of

this whitening is

that the teeth

become sensitive.

[De Geus]

Carbamide

peroxide 10%

and 15%

Smokers and non-

smokers showed a

significant color

change since one week

after the application of

10% carbamide

peroxide with

application time of 3

hours a day for 3

weeks statistically

measured using a

There was no

difference in color

change in the four

teeth whitening

ingredients,

namely hydrogen

peroxide (7.5% and

9.5%) and

carbamide

peroxide (10% and

15%). However,

[De la Pena]

Ryan Mahardiansyah, Etny Dyah Harniati, Ismaya Aria Sari | 1895

Materials

Procedural

Research

Results

Reference

spectrophotometer.

The side effect of this

whitening is that the

teeth become

sensitive.

there are

differences in the

increase in

brightness (L*) and

hue (h*) after

application as well

as a decrease in

chromaticity (C*).

Research shows that the presence of

10% carbamide peroxide can make teeth

whiter with an extended period of time. The

color of the teeth in each individual varies

from white to brownish yellow and becomes

darker with age (Riani et al., 2015). Tooth

discoloration or tooth discoloration can be

caused by several factors, including intrinsic

and extrinsic factors. Intrinsic factors include

systemic causes, metabolism, genetics, while

extrinsic factors include food, drink and

drugs 13.

Bleaching is a procedure for whitening

teeth to be whiter than before using

chemicals for aesthetic purposes

(Cvikl et al.,

2016). Chemicals that can be used as

bleaching hydrogen peroxide 16.and

techniques Bleaching are divided into two,

namely in office bleaching and at home

bleaching

(Syafriadi & Risa, 2011).

Carbamide peroxide has a safe and

effective concentration as a home bleaching

with a concentration of 10%. Bleaching done

at home has the advantages of being safe,

relatively easy to do, affordable prices, and a

high percentage of success. Haywood and

Heyman used home bleaching for the first

time with the application of 10% carbamide

peroxide gel on a night guard for 7 hours

within 14 days giving effective. Longer

treatment can provide better bleaching and

also improve color stability.

The effectiveness of 10% carbamide

peroxide as home bleaching has been

carried out by Darriba with the results of

bleaching at week 3 with application 4 hours

a day carried out at home giving better

results and the white effect produced is

much more stable than at week 2. The use of

10% carbamide peroxide for 1.5 months at

home used for 2 hours every day provides

effective results with success rates of 82% for

3 years, and 42% for 10 years.

Side effects caused by increasing

treatment time vary. These side effects can

affect the hard tissues of the teeth and soft

tissues. Side effects on hard tissue,

decreased calcium, phosphate, phosphorus

contained in enamel minerals, degradation

of enamel, demineralization of teeth which

can affect the structure of the hardness and

roughness of the enamel surface which can

cause caries, and easy fracture of teeth

(Anwar & Tjokro, 2018). Other side effects

such as tooth sensitivity caused by the

penetration of peroxide through the enamel

and dentin tubules to the pulp. To reduce

this sensitivity, a desensitizing agent can be

applied to the bleaching material before or

during the bleaching treatment 11.

Side effects on soft tissues such as

gingival irritation and mucosal irritation. This

1896 | Effectiveness of Adding Home Bleaching Time with 10% Carbamide Peroxide: Literature

Review

is due to an error in the use of the costume

tray (custom tray chemicals bleaching). To

reduce these side effects, it is necessary to

adjust the individual tray so as not to press

the soft tissue.

CONCLUSIONS

The use of 10% carbamide peroxide as

a home bleaching agent with increasing

effective time against tooth discoloration.

The results bleaching with 10% carbamide

peroxide as home bleaching gave better

color results than before, no pain and no

other complaints. Carbamide peroxide has

a safe and effective concentration as a

home bleaching with a concentration of

10%. Longer treatment can provide better

bleaching and also improve color stability.

bleaching at week 3 with application 4

hours a day carried out at home giving

better results and the white effect

produced is much more stable than at week

2 statistically measured using a

spectrophotometer. The use of 10%

carbamide peroxide for 1.5 months at

home used for 2 hours every day provides

effective results with success rates of 82%

for 3 years, and 42% for 10 years.

However, with increasing time, the

resulting effect is getting bigger. Side

effects on hard tissue, decreased calcium,

phosphate, phosphorus contained in

enamel minerals, degradation of enamel,

demineralization of teeth which can affect

the structure of the hardness and

roughness of the enamel surface which can

cause caries, and easy fracture of teeth.

Other effect sensitivity caused by the

penetration of peroxide through the

enamel and dentin tubules to the pulp.

gingival irritation and mucosal irritation is

also effect for soft tissue. To reduce these

side effects, it is necessary to adjust the

individual tray so as not to press the soft

tissue, to reduce this sensitivity, a

desensitizing agent can be applied to the

bleaching material before or during the

bleaching treatment.

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