Bleaching techniques in primary teeth: a systematic review

Objective: Discolouration of primary teeth, often attributed to trauma and pulpal infection, is a prevalent concern that can significantly impact the esthetics and self-esteem of children. To address this issue, bleaching techniques have emerged as a viable treatment option. This systematic review aims to provide a comprehensive summary of the effectiveness of bleaching agents in managing discoloured primary teeth. Methods: Two reviewers independently conducted an electronic database search using PubMed, EMBASE, LILACS, CINAHL via EBSCO, Scopus, and Web of Science until September 26,2023. In vitro studies and case reports that assessed the quantifiable success were included. The present review utilized Distiller SR software for data extraction. The protocol of this study was registered in PROSPERO (International Prospective Register of Systematic Reviews) (CRD42022329831). The quality of studies was analysed with Cochrane tool and the JBI checklist. Results: The search retrieved 1845 references of which 14 studies were included for qualitative analysis. There were 8 in vitro studies and 6 case reports included in this systematic review. There were 299 teeth samples in the in vitro studies and 18 teeth were assessed in the case reports. All the 18 teeth (6 case reports) showed considerable shade improvement within 7–14 days. However, only 3 teeth were followed up for a period of 12–24 months. Substantial shade improvement was also observed in samples in the in vitro studies. Conclusion: This systematic review has comprehensively examined the various bleaching agents and methods for the management of discoloured primary teeth. However, it is crucial to recognize that the available evidence is from case reports and is insufficient to make a clinical recommendation.