Objective: To evaluate clinical efficacy of Rembrandt Intense Stain Removal (RISR), Crest Whitestrips (CWS), Simply White (SW) and QuiK White (QW). Methods: Subjects (120) were randomly assigned to four groups. Demographics and medical history were collected, and subjects were examined for oral tissues, tooth shade of six maxillary anterior teeth using Bioform Color Ordered and Vitapan Classical shade guides, and tooth sensitivity and gingival irritation. The application of whiteners followed manufacturers' instructions for 14 days. SW (Colgate-Palmolive, New York, NY) was applied twice daily. The RISR (Den-Mat, Santa Maria, CA) was used twice daily, each for 15-minute, and CWS (P&G, Cincinnati, OH) and QW (Den-Mat) were applied for 30-minute each time, twice daily. Clinical examinations were conducted at the baseline and 14-day. The shade data were converted to numerical values and analyzed using the One-Way ANOVA and Student-Newman-Keuls methods. Results: The demographical compositions and the average baseline Bioform shade values (14.98, 13.46 13.69, and 14.98 for the RISR, CWS, SW and QW, respectively) were comparable among the four groups. The shade reductions after 14-day treatments were 8.86, 5.35, 4.19 and 6.36 for the RISR, CWS, SW and QW, respectively. The differences between the RISR and other three groups were significant (p<0.001). The trend of the shade reduction for Vitapan Classical at 14-day was similar to that of the Bioform data: 6.26, 4.10, 3.32 and 4.34 for the RISR, CWS, SW and QW, respectively. The ratio between the Bioform and Vitapan Classical ranged from 1.34 to 1.63. No significant clinical evidence of other adverse effects on oral tissues was detected in any of the four groups. Conclusion: All four at-home whitening systems evaluated are effective in whitening teeth, with Rembrandt Intense Stain Removal being the most effective. Support by Den-Mat Corporation.

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