Patient satisfaction with at-home dental bleaching using Vivera or Essix retainers: a randomised clinical trial

Smile esthetics have increased the demand for orthodontic treatment and at-home bleaching, yet evidence regarding the performance and patient experience of Vivera ® and Essix retainers as bleaching trays remains limited. This study aimed to compare patient satisfaction during at-home bleaching with 10% carbamide peroxide using Vivera ® and Essix retainers, and to evaluate bleaching efficacy (BE), as well as the risk and intensity of tooth sensitivity (TS) and gingival irritation (GI). A randomised, split-mouth, single-blind equivalence clinical trial was conducted with 40 volunteers. Each hemiarch was randomly assigned to either a Vivera ® or Essix retainer. Bleaching was performed for 2 h, three alternate days per week, completing 12 applications over 4 weeks. Satisfaction was measured via a 9-item visual analog scale (VAS, 0–10). BE was assessed using a spectrophotometer (ΔEab, ΔE00, WID) and shade guides (ΔSGU). TS and GI were evaluated using VAS. Statistical analysis included paired Student’s t-test and TOST-P (± 0.09) for satisfaction; paired Student’s t-test for BE; McNemar’s test for TS and GI risk; and paired t-tests for TS/GI intensity (α = 0.05). After 2 weeks, adaptation, comfort, and overall satisfaction significantly favored Vivera ® ( p < 0.01). At 4 weeks, only comfort remained significantly higher for Vivera ® ( p = 0.04). BE and GI were similar between retainers ( p > 0.05). Although TS risk did not differ significantly ( p > 0.05), Vivera ® was associated with lower TS intensity ( p = 0.03). Vivera ® retainers provided greater patient satisfaction, especially in comfort, and were associated with lower TS intensity during at-home bleaching compared to Essix. However, both retainers showed bleaching efficacy. The study was approved by the University Ethics Committee (protocol code 1601202303323) and registered at ClinicalTrials.gov (Identifier: NCT05835453; date of registration: 04/18/2023). The trial results have not been publicly disclosed in the trial registry, nor disseminated in the form of a preprint or published articles.