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Cabral AEA, Lourenço MAG, de Medeiros Santos BS, Carvalho MG, Pazinatto RB, Leite FPP, de Melo LA. Effectiveness of desensitizing toothpastes in reducing tooth sensitivity after tooth bleaching: a systematic review. Clin Oral Investig 2024; 28:457. [PMID: 39078468 DOI: 10.1007/s00784-024-05857-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 07/23/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVE To evaluate the effectiveness of desensitizing toothpastes in reducing post-bleaching tooth sensitivity. MATERIALS AND METHODS A systematic review of randomized clinical trials was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Electronic searches were conducted in the PubMed/MEDLINE, Scopus, Web of Science, The Cochrane Library and Embase databases, using the following terms: (dentifrices OR toothpaste) AND (sensitive OR sensitivity OR dental sensitivity) AND (dental bleaching OR tooth bleaching OR dental whitening OR tooth whitening). RESULTS Five studies involving 387 individuals undergoing in-office or at-home teeth bleaching were reviewed. Desensitizing toothpastes reduced sensitivity effectively after home bleaching with 22% carbamide peroxide and single-session in-office bleaching with 35% hydrogen peroxide. However, they were ineffective for home bleaching with 16% carbamide peroxide and in-office bleaching across two sessions with 35% or 38% hydrogen peroxide. CONCLUSION Desensitizing toothpastes are effective for home bleaching with high concentration carbamide peroxide and single-session in-office bleaching with highly concentrated hydrogen peroxide, but ineffective for home bleaching with low concentration carbamide peroxide and two-session in-office bleaching with concentrated hydrogen peroxide.
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Affiliation(s)
- Ana Estéfanny Alves Cabral
- Departament of Dentistry, Federal University of Rio Grande do Norte - UFRN, Av. Salgado Filho, 1787 - Lagoa Nova, Natal, Rio Grande do Norte, CEP 59056-000, Brazil
| | | | - Bianca Souto de Medeiros Santos
- Departament of Dentistry, Federal University of Rio Grande do Norte - UFRN, Av. Salgado Filho, 1787 - Lagoa Nova, Natal, Rio Grande do Norte, CEP 59056-000, Brazil
| | - Mateus Guedes Carvalho
- Departament of Dentistry, Federal University of Rio Grande do Norte - UFRN, Av. Salgado Filho, 1787 - Lagoa Nova, Natal, Rio Grande do Norte, CEP 59056-000, Brazil
| | - Rafael Barroso Pazinatto
- Departament of Dentistry, Federal University of Juiz de Fora - UFJF, Juiz de Fora, Minas Gerais, Brazil
| | | | - Laércio Almeida de Melo
- Departament of Dentistry, Federal University of Rio Grande do Norte - UFRN, Av. Salgado Filho, 1787 - Lagoa Nova, Natal, Rio Grande do Norte, CEP 59056-000, Brazil.
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Motevasselian F, Kermanshah H, Dortaj D, Lippert F. Effect of pH of In-Office Bleaching Gels and Timing of Fluoride Gel Application on Microhardness and Surface Morphology of Enamel. Int J Dent 2023; 2023:1041889. [PMID: 37705827 PMCID: PMC10497361 DOI: 10.1155/2023/1041889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/16/2023] [Accepted: 08/18/2023] [Indexed: 09/15/2023] Open
Abstract
Objective To assess microhardness (VH) of enamel treated with two in-office bleaching agents with different pH and to study the effect of post- and prebleaching fluoride therapy. Materials and Methods Eighty bovine incisors were divided into eight groups: G1-Unbleached group; G2-2% NaF; G3-Pola Office (pH = 3.8); G4-Pola Office+ (pH = 7); G5-Pola Office followed by 2% NaF; G6-2% NaF followed by Pola Office; G7-Pola Office+ followed by 2% NaF; G8-2% NaF followed by Pola Office+. Bleaching was conducted 3x with 1-week intervals (T1/T7/T14). Specimens were kept in artificial saliva. VH was measured at T1, T7, and T14. Data were analyzed using repeated measure ANOVA. Surface morphology was assessed using scanning electron microscopy. Result There was no significant difference among the groups at T1. No significant difference was found between G3 and G4 at all intervals. 2% NaF (G5/G6 vs. G3) significantly prevented softening at T7 and T14. Some nonsignificant hardening was observed for 2% NaF for G7/G8 vs. G4. At T14, G3 showed the lowest VH values. G5 showed higher VH values compared to other groups apart from G6-G7. No relationship between bleaching protocols and surface morphology was observed. Conclusion Pola Office caused the most softening. 2% NaF gel application after Pola Office bleaching was effective in recovering enamel hardness. Fluoride application after Pola Office+ bleaching provided little benefit.
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Affiliation(s)
- Fariba Motevasselian
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Kermanshah
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Dorara Dortaj
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Frank Lippert
- Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA
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Favoreto MW, de Souza Carneiro T, Forville H, Burey A, Simas Dreweck FD, Loguercio AD, Reis A. Use of calcium-containing bioactive desensitizers in dental bleaching: A systematic review and meta-analysis. J Am Dent Assoc 2023; 154:245-259.e12. [PMID: 36717350 DOI: 10.1016/j.adaj.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/26/2022] [Accepted: 11/28/2022] [Indexed: 01/30/2023]
Abstract
BACKGROUND Topical application of calcium-containing bioactive desensitizers (CBs) has been used to minimize bleaching-induced tooth sensitivity (TS). This study answered the research question "Is the risk of TS lower when CBs are used with dental bleaching in adults compared with bleaching without desensitizers?" TYPES OF STUDIES REVIEWED The authors included randomized clinical trials comparing topical CB application with a placebo or no intervention during bleaching. Searches for eligible articles were performed in MEDLINE via PubMed, Cochrane Library, Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature, Scopus, Web of Science, Embase, and gray literature without language and date restrictions and updated in September 2022. The risk of bias was evaluated using Risk of Bias Version 2.0. The authors conducted meta-analyses with the random-effects model. The authors assessed heterogeneity with the Cochrane Q test, I2 statistics, and prediction interval. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence. RESULTS After database screening, 22 studies remained, with most at high risk of bias. No difference in the risk of TS was detected (risk ratio, 0.95; 95% CI, 0.90 to 1.01; P = .08, low certainty). In a visual analog scale, the intensity of TS (mean difference, -0.98; 95% CI, -1.36 to -0.60; P < .0001, very low certainty) was lower for the CB group. The color change was unaffected (P > .08). PRACTICAL IMPLICATIONS Although topical CB dental bleaching did not reduce the risk of TS and color change, these agents slightly reduced the TS intensity, but the certainty of the evidence is very low.
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Martini EC, Favoreto MW, de Andrade HF, Coppla FM, Loguercio AD, Reis A. One-year follow-up evaluation of reservoirs in bleaching trays for at-home bleaching. J ESTHET RESTOR DENT 2021; 33:992-998. [PMID: 34212493 DOI: 10.1111/jerd.12797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/05/2021] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the color change stability and patient satisfaction after one-year of at-home bleaching with 10% carbamide peroxide (CP) in trays with or without reservoirs. MATERIALS AND METHODS Forty-six patients were subjected to bleaching with CP (3 h/daily; 21 days) with a bleaching tray with or without reservoirs. The color was measured one-month and one-year after the completion of bleaching using the spectrophotometer (ΔEab, Δ00 and ΔWi), and shade guide units (ΔSGU). Patients' satisfaction were assessed using a 5-point Likert Scale questionnaire. Data were submitted to paired t-test (α = 0.05). RESULTS No significant difference between color change after one-month and one-year was observed (VITA Classical shade guide unit and the ΔWi; p > 0.53). Significant differences were observed for the VITA Bleachedguide 3D-MASTER shade guide, ΔEab and ΔE00 (p < 0.03). The level of patient satisfaction was similar between groups (p = 1.00). CONCLUSIONS Bleaching tray design did not have any influence on the bleaching stability for the 10% CP (Opalescence PF, Ultradent). Patients were very satisfied with the bleaching outcomes regardless of the bleaching tray design. CLINICAL RELEVANCE Placement of reservoirs in bleaching trays does not increase longevity of dental bleaching. No clinically important color rebound was observed 1 year after bleaching with 10% CP.
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Affiliation(s)
- Eveline Claudia Martini
- Department of Restorative Dentistry, University Paranaense, Francisco Beltrão, Paraná, Brazil
| | - Michael Willian Favoreto
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | - Fabiana Madalozzo Coppla
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil.,Department of Restorative Dentistry, Cescage, Ponta Grossa, Paraná, Brazil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
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Meireles SS, Santos ME, Lustosa ÍMC, Leite ELL. Effects of a reduced in-office bleaching protocol with 37.5% hydrogen peroxide on effectiveness and tooth sensitivity: A double-blind randomized clinical trial. J ESTHET RESTOR DENT 2021; 33:824-831. [PMID: 34180574 DOI: 10.1111/jerd.12744] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/31/2021] [Accepted: 04/30/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This randomized clinical trial evaluated the effectiveness and tooth sensitivity (TS) of 37.5% hydrogen peroxide (37.5HP) in-office bleaching with reduced protocol. MATERIALS AND METHODS Forty participants with shade mean C2 or darker for the six maxillary anterior teeth were randomly allocated into two treatment groups (n = 20): two (37.5HP2) or three (37.5HP3) 8 min applications/clinical session. Three clinical sessions were performed with a 1 week interval. Color evaluations were done with a spectrophotometer at baseline and 1 week post-bleaching. TS was measured during and up to 48 h after bleaching using a five-point numeric rating scale. Color change was evaluated by Student's t-test for independent samples. The absolute risk and intensity of TS were analyzed by Fisher's and Mann-Whitney/Friedman tests (p < 0.05). RESULT Both treatment groups resulted in a significant tooth whitening 1 week post-bleaching (p < 0.001). There were no significant differences between 37.5HP2 and 37.5HP3 for ΔE*ab , ΔE00 and ∆WID . Also, there were not differences between groups regarding high absolute risk (p = 1.0) and low intensity of TS at all time assessments (p > 0.7). CONCLUSIONS The in-office bleaching with two 37.5% HP applications produced the same whitening degree, risk and intensity of TS to that performed with three gel applications. CLINICAL SIGNIFICANCE Clinicians should opt to use a neutral 37.5% HP in-office bleaching gel for two 8 min applications/clinical session because produces the same whitening effectiveness, risk and low intensity of TS as the protocol proposed by manufacturer (three 8 min applications).
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Affiliation(s)
- Sônia Saeger Meireles
- Department of Operative Dentistry, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
| | | | | | - Eva Lis Lopes Leite
- Department of Operative Dentistry, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
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Pompeu DDS, de Paula BLF, Barros APO, Nunes SC, Carneiro AMP, Araújo JLN, Silva CM. Combination of strontium chloride and photobiomodulation in the control of tooth sensitivity post-bleaching: A split-mouth randomized clinical trial. PLoS One 2021; 16:e0250501. [PMID: 33909659 PMCID: PMC8081218 DOI: 10.1371/journal.pone.0250501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 04/06/2021] [Indexed: 01/10/2023] Open
Abstract
Objective This split-mouth randomized controlled clinical trial assessed the effect of 10% strontium chloride in combination with photobiomodulation (PBM) for the control of tooth sensitivity (TS) post-bleaching. Methods The upper/lower, right and left quadrants of fifty volunteers were randomized and allocated to four groups (n = 25): PLACEBO—placebo gel + simulation of PBM; Placebo + PBM; STRONTIUM—10% strontium chloride + simulation of PBM; and PBM + STRONTIUM—10% strontium chloride + PBM. All groups received tooth bleaching treatment with 35% hydrogen peroxide. For the PBM treatment, the laser tip was positioned in the apical and cervical regions of the teeth bleached in the respective hemi-arch. The laser system was operated in continuous mode, using 1.7 J of energy. A dose of 60 J/cm2 was applied to each point for 16 seconds under 808 nm near-infrared light (100mW of power), with a point area of 0.028 cm2. TS was assessed during a 21-day follow-up, using the modified visual analogue scale. Results In the intragroup assessment, the Friedman test indicated that PBM + STRONTIUM promoted the greatest reduction in TS after the second week of treatment (p ≤ 0.05). The Wilcoxon-Mann-Whitney test indicated that the groups Placebo + PBM, STRONTIUM, and STRONTIUM + PBM did not differ statistically (p ≥ 0.05) in the first and third weeks of treatment The group PLACEBO exhibited the greatest TS in the first three days after each bleaching session. Conclusion The combination of 10% strontium chloride with PBM was effective in reducing post-bleaching TS; however, the combination of 10% strontium chloride with PBM was effective in reducing post-bleaching TS; however, it did not differ from the individual use of Placebo + PBM or STRONTIUM groups assessed after 21 days of follow-up.
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Affiliation(s)
| | | | | | | | | | | | - Cecy Martins Silva
- Postgraduate Program in Dentistry of the Federal University of Pará, Belem, Brazil
- * E-mail:
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The combined use of systemic analgesic/anti-inflammatory drugs and a bioactive topical desensitizer for reduced in-office bleaching sensitivity without jeopardizing the hydrogen peroxide efficacy: a randomized, triple blinded, split-mouth clinical trial. Clin Oral Investig 2021; 25:6623-6632. [PMID: 33884504 DOI: 10.1007/s00784-021-03948-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the effect of combined systemic administration of paracetamol 500 mg/codeine phosphate 30 mg (PACO) and postoperative topical application of a bioactive desensitizer on in-office bleaching sensitivity and tooth color change. MATERIALS AND METHODS A randomized, triple-blind, split-mouth clinical trial was conducted. Forty volunteers ingested PACO (n = 20) or placebo (PLA) (n = 20). Their left/right hemiarches received topical application of a bioactive desensitizer [Nano-P™(NP)] and prophylactic paste (PAS), generating four treatment approaches: PACO/NP, PACO/PAS, PLA/NP, and PLA/PAS. Two bleaching sessions (35% hydrogen peroxide) were performed, and the PAS/NP were applied after the procedure. Sensitivity was obtained since the first bleaching session up to 7 days post-bleaching. The color change was evaluated using CIEDE2000 and whiteness index parameters up to 7 days post-bleaching. Data were analyzed using one- and two-way ANOVA/Tukey post hoc tests (p < 0.05). RESULTS The PLA/PAS showed a sensitivity average of at least two times higher than the PACO/NP. The treatment approaches promoted statistically similar bleaching patterns (p > 0.05). CONCLUSION The combined approach of systemic administration of PACO and postoperative topical application of NP reduced the level of in-office bleaching sensitivity without jeopardizing hydrogen peroxide efficacy. CLINICAL RELEVANCE Professionals can adopt the combined approach of systemic administration of analgesic/anti-inflammatory drugs and topical application of a bioactive desensitizer for decreased bleaching sensitivity caused by 35% hydrogen peroxide in-office.
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