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Zeni TC, Cardoso PMDF, Vanolli RDS, Mendonça MJ, Ueda JK, Camilotti V. Single-session associative protocol for dentin hypersensitivity management: a 1-year randomized, blinded clinical study. Restor Dent Endod 2024; 49:e15. [PMID: 38841389 PMCID: PMC11148406 DOI: 10.5395/rde.2024.49.e15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/14/2024] [Accepted: 01/23/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives This study aimed to establish a single-session associative protocol for non-restorative management of dentin hypersensitivity (DH). Materials and Methods Twenty-four individuals with DH and a minimum sensitivity level of 4 on the visual analog scale (VAS) were selected. The study was conducted in a split-mouth design, with each participant (n = 20) having at least 1 affected tooth in all quadrants. The management protocols consisted of control group: universal adhesive, Neural Desensitizing Protocol group: 5% potassium nitrate, Mixed Desensitizing Protocol (PAM) group: 5% sodium fluoride and 5% potassium nitrate, Remineralizing Desensitizing Protocol (PDR) group: surface-partially reacted glass technology photopolymerizable varnish. Evaluations were performed immediately after application, at 1 week, 1 month, 2 months, and 12 months using the VAS sensitivity test. Results The scores were subjected to statistical analysis using the Friedman test (p < 0.05), Durbin-Conover test (p < 0.05), and Wilcoxon test (p < 0.05). At the 12-month evaluation, all groups showed statistically significant differences compared to the initial assessment. For the evaluation after 12 months, there was a statistically significant difference between the PAM group, the control group, and the PDR group. Conclusions It can be concluded that all groups were effective in controlling DH, but there were significant results in the control group and PDR group. The clinical relevance of this study is to demonstrate that the application of single-session desensitizing protocols can be effective in controlling DH for up to 12 months. Trial Registration Brazilian Clinical Trials Registry Identifier: RBR-4r63d7s.
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Affiliation(s)
- Thayna Carolina Zeni
- Department of Restorative Dentistry, School of Dentistry, Western State University of Paraná, Cascavel, PR, Brazil
| | | | - Rafael da Silva Vanolli
- Department of Restorative Dentistry, School of Dentistry, Western State University of Paraná, Cascavel, PR, Brazil
| | - Márcio José Mendonça
- Department of Restorative Dentistry, School of Dentistry, Western State University of Paraná, Cascavel, PR, Brazil
| | - Julio Katuhide Ueda
- Department of Restorative Dentistry, School of Dentistry, Western State University of Paraná, Cascavel, PR, Brazil
| | - Veridiana Camilotti
- Department of Restorative Dentistry, School of Dentistry, Western State University of Paraná, Cascavel, PR, Brazil
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Batista LAS, dos Reis-Prado AH, Chaves HGDS, de Arantes LC, Morgan LFSA, André CB, Suzuki TY, Benetti F. Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research. Restor Dent Endod 2023; 48:e39. [PMID: 38053785 PMCID: PMC10695728 DOI: 10.5395/rde.2023.48.e39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells. Materials and Methods Electronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed. Results Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%-38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (n = 3). However, orally administered drugs did not reduce pulp inflammation (n = 4). Cytotoxicity (n = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies. Conclusions Few in vivo studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings. Trial Registration PROSPERO Identifier: CRD42022337192.
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Affiliation(s)
- Letícia Aparecida Silva Batista
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | | | | | - Lara Cancella de Arantes
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | | | - Carolina Bosso André
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - Thaís Yumi Suzuki
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
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da Silva A, Deschamps Muniz RP, Almeida Lago MC, da Silva Júnior EP, Braz R. Clinical Efficacy of Mouthwashes with Potassium Salts in the Treatment of Dentinal Hypersensitivity: A Systematic Review and Meta-analysis. Oper Dent 2023; 48:33-50. [PMID: 36445973 DOI: 10.2341/21-181-lit] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
Abstract
AIM This systematic review and meta-analysis evaluated whether the home use of mouthwashes containing potassium salts is effective in reducing and controlling dentin hypersensitivity (DH). METHODS AND MATERIALS This study is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist and was registered in PROSPERO (CRD42021228410). Randomized clinical trials evaluating the use of mouthwashes containing potassium salt for daily household mouthwash for at least four weeks to reduce DH compared with a control mouthwash were selected, with no limitation on year of publication. Electronic research was carried out in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library by two independent researchers. One hundred thirty-three articles were obtained, and nine were selected according to the inclusion criteria. RESULTS The selected studies evaluated DH through tests of sensitivity to tactile and evaporative stimuli and showed that, for the tactile stimulus, there were no baseline differences between groups (p=0.12; mean difference: -0.33; confidence intervals [CI]: -0.73 to 0.08). However, there were significant differences after two weeks of use (p=0.00001; mean difference: 4.67; CI: 4.53 to 4.81), after four weeks (p=0.00001; mean difference: 13.29; CI: 13.03 to 13.55), and after eight weeks (p=0.00001; mean difference: 8.88; CI: 5.73 to 12.02) favoring the experimental group. The results of the evaporative test showed no differences in the baseline assessment between the two groups (p=0.50; mean difference: -0.02; CI: -0.09 to 0.04), but after four weeks (p=0.00001; mean difference: -0.32; CI: -0.44 to -0.20), and eight weeks of use (p=0.00001; mean difference: -0.42; CI: -0.57 to -0.27) there were differences favoring the experimental group. The incidence of side effects showed no differences between the two groups (p=0.89; mean difference: 1.03; CI: 0.67 to 1.58). CONCLUSION The daily use of mouthwashes containing potassium salt is effective in the treatment of dentinal hypersensitivity, as a complementary step to brushing at least twice a day for two weeks, four weeks, and up to eight weeks, without presenting side effects.
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Affiliation(s)
- Arj da Silva
- *André Rodrigo Justino da Silva, DDS, MS student, School of Dentistry, Pernambuco University (UPE), Recife, Pernambuco, Brazil
| | - R P Deschamps Muniz
- Rafaela Pereira Deschamps Muniz, DDS, School of Dentistry, Pernambuco University (UPE), Recife, Pernambuco, Brazil
| | - M C Almeida Lago
- Maria Catarina Almeida Lago, DDS, MS, PhD student, School of Dentistry, Pernambuco University (UPE), Recife, Pernambuco, Brazil
| | - E P da Silva Júnior
- Eneas Pereira da Silva Júnior, DDS, MS, PhD student, School of Dentistry, Pernambuco University (UPE), Recife, Pernambuco, Brazil
| | - R Braz
- Rodivan Braz, DDS, MS, PhD, adjunct professor, School of Dentistry, Pernambuco University (UPE), Recife, Pernambuco, Brazil
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Alshehri A, Kolker J, Teixeira E, Xie XJ, Fiegel J, Wertz P. Time Frame Analysis of Potassium Nitrate and Hydrogen Peroxide Diffusion into the Pulp Chamber. Oper Dent 2022; 47:357-365. [PMID: 35671228 DOI: 10.2341/21-006-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The primary objective of this study was to evaluate the effect of an innovative double-layer, single-application desensitizing/whitening technique of potassium nitrate (PN) and hydrogen peroxide (HP) diffusion at different time points. METHODS AND MATERIALS Specimens were prepared from extracted caries-free human molars (n=90). Teeth were randomly assigned into four groups: Group A (HP CTRL) treated with 25% HP for 45 minutes, group B (PN CTRL) received a single-layer treatment of 5% PN for 45 minutes, group C received the double-layer treatment of 5% PN and 25% HP for 45 minutes, and group D received a 3% PN incorporated in a 40% HP gel for 45 minutes. PN and HP concentrations were measured at 5, 15, 30, and 45 minutes using standard chemical kits. Group comparisons were made using a repeated measures analysis of variance (ANOVA) test. Pairwise tests for differences in diffusion were done, using the Tukey adjustment of p values for multiple comparisons. A significance level of 5% was used. RESULTS Group A showed no significant difference in HP diffusion rates between the 5- and 15- minute, 15- and 30-minute, or 30- and 45-minute time points; group D showed a similar trend; however, group C differed significantly at the 5-and 15-minute time points (p=0.0004), at the 15-and 30-minute time points (p=0.0026), and the 30- and 45-minute time points (p=0.0014). For PN diffusion, groups B and C had significantly different levels at the 15-, 30-, and 45-minute time points (p=0.0005, p=0.0002, and p<0.0001, respectively); and at the 15-, 30-, and 45-minute time points, groups D and C had significantly different PN diffusion (p=0.0327, p=0.0004, and p< 0.0001, respectively). Group C had significantly different PN diffusion at the 5- and 15-minute time points (p=0.0004), the 15- and 30-minute time points (p=0.0026), and at the 30- and 45-minute time points (p=0.0014). CONCLUSION The double-layer technique showed superior diffusion of PN into the pulp chamber and did not affect the diffusion of HP when compared to other techniques. The double-layer technique may be suggested as an alternative tooth-whitening treatment to minimize tooth sensitivity.
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Affiliation(s)
- A Alshehri
- *Abdullah Alshehri, BDS, MS, PhD, Conservative Dental Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - J Kolker
- Justine Kolker, DDS, MS, PhD, College of Dentistry, Department of Operative Dentistry, University of Iowa, Iowa City, IA, USA
| | - E Teixeira
- Erica Teixeira, DDS, MS. PhD, College of Dentistry, Department of Operative Dentistry, University of Iowa, Iowa City, IA, USA
| | - X J Xie
- Xian Jin Xie, MS, MS, PhD, College of Dentistry, Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - J Fiegel
- Jennifer Fiegel, BS, PhD, College of Engineering Department of Chemical and Biochemical Engineering, University of Iowa, Iowa City, IA, USA
| | - P Wertz
- Philip Wertz, MS, PhD, Department of Oral Pathology, Radiology and Medicine, Dows Institute for Dental Research, University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA, USA
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Torres C, Moecke SE, Mafetano A, Cornélio LF, Di Nicoló R, Borges AB. Influence of Viscosity and Thickener on the Effects of Bleaching Gels. Oper Dent 2022; 47:E119-E130. [PMID: 35649221 DOI: 10.2341/20-309-l] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study investigated the influence of the viscosity and kind of thickener of 35% hydrogen peroxide bleaching gels on the tooth (color change, demineralization of enamel, and permeation) and on the gel [reactive oxygen species (ROS), pH, and peroxide concentration]. METHODS AND MATERIALS Two hundred forty specimens were divided into groups of bleaching gels with different thickeners (CAR, carbomer; ASE, alkali swellable emulsion; MSA, modified sulfonic acid polymer; SSP, semisynthetic polysaccharide; PAC, particulate colloids) in three viscosities (low: 50,000 cP; medium: 250,000 cP; high: 1,000,000 cP). Color change (ΔEab), demineralization of enamel by Knoop microhardness (KHN) reduction analysis, and peroxide permeation (PP) were analyzed in the specimens, while pH, peroxide concentration (PC), and ROS were evaluated in the gels. Data were analyzed by two-way ANOVA (α=0.05). RESULTS The higher viscosity gels reduced ΔEab, PP, enamel softening, and ROS in relation to the lower viscosity gels. However, the drop in pH and PC were higher in the more viscous gels. Gels with MSA produced higher ΔEab compared with SSP and ASE. The PP was higher for PAC, and smaller for SSP and CAR. The KHN reduction was higher for CAR and smaller for PAC. The higher pH reduction was seen for ASE and CAR, and the smaller for SSP. The PC reduction was higher for SSP and smaller for CAR. More ROS were observed for MSA and fewer for ASE. CONCLUSIONS Increased gel viscosity was associated with reduced color change, permeation, demineralization of enamel, and ROS, and led to increased peroxide decomposition and pH alteration during the treatment. The kind of thickener significantly interfered with the treatment effects.
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Affiliation(s)
- Crg Torres
- *Carlos Rocha Gomes Torres, DDS, PhD, associate professor, Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Sao Jose dos Campos, SP, Brazil
| | - S E Moecke
- Sabrina Elise Moecke, DDS, MS, Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Sao Jose dos Campos, SP, Brazil
| | - Apvp Mafetano
- Ana Paula Valente Pinho Mafetano, DDS, MS, Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Sao Jose dos Campos, SP, Brazil
| | - L F Cornélio
- Leticia Fernanda Cornélio, DDS, Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Sao Jose dos Campos, SP, Brazil
| | | | - A B Borges
- Alessandra Bühler Borges, DDS, MS, PhD, associate professor, Department of Restorative Dentistry, Institute of Science and Technology, Sao Paulo State University - UNESP, Sao Jose dos Campos, SP, Brazil
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Ortecho-Zuta U, de Oliveira Duque CC, de Oliveira Ribeiro RA, Leite ML, Soares DG, Hebling J, Briso ALF, de Souza Costa CA. Strategy for reducing cytotoxicity and obtaining esthetic efficacy with 15 min of in-office dental bleaching. Clin Oral Investig 2022; 26:4099-4108. [PMID: 35199193 DOI: 10.1007/s00784-022-04379-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Evaluate in vitro the esthetic efficacy and cytotoxicity of a bleaching gel containing 35% hydrogen peroxide (BG-35%H2O2), applied for different time intervals, on enamel coated or not with polymeric biomaterials. MATERIALS AND METHODS Nanofiber scaffolds (NSc) and a primer catalyst (PrCa) were used to coat the bovine enamel/dentin discs before the application of BG-35%H2O2, according to the following groups: G1-negative control (NC, without treatment); G2, G3, and G4-BG-35%H2O2 applied for 3 × 15, 2 × 15, and 15 min; G5, G6, and G7-BG-35%H2O2 applied on enamel coated with NSc and PrCa for 3 × 15; 2 × 15, and 15 min, respectively. The culture medium with components of gel diffused through the discs was applied on MDPC-23 cells, which were evaluated regarding to viability (VB), integrity of the membrane (IM), and oxidative stress (OxS). The quantity of H2O2 diffused and esthetic efficacy (ΔE/ΔWI) of the dental tissues were also analyzed (ANOVA/Tukey; p < 0.05). RESULTS Only G7 was similar to G1 regarding VB (p > 0.05). The lowest value of H2O2 diffusion occurred in G4 and G7, where the cells exhibited the lowest OxS than G2 (p < 0.05). Despite G5 showing the greatest ΔE regarding other groups (p < 0.05), the esthetic efficacy observed in G7 was similar to G2 (p > 0.05). ΔWI indicated a greater bleaching effect for groups G5, G6, and G7 (p < 0.05). CONCLUSION Coating the dental enamel with polymeric biomaterials reduced the time and the cytotoxicity of BG-35%H2O2. CLINICAL SIGNIFICANCE Coating the dental enamel with polymeric biomaterials allows safer and faster BG-35%H2O2 application.
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Affiliation(s)
- Uxua Ortecho-Zuta
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Carla Caroline de Oliveira Duque
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Rafael Antonio de Oliveira Ribeiro
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Maria Luísa Leite
- Department of Dental Materials and Prosthodontics, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - Diana Gabriela Soares
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Rua Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, SP, 17012-901, Brazil
| | - Josimeri Hebling
- Departament of Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, University São Paulo State (Unesp), Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
| | - André Luiz Fraga Briso
- Department of Restorative Dentistry, Araçatuba, School of Dentistry University São Paulo State University (Unesp), Rua José Bonifácio 1193, Vila Mendonça, 16015-050, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, Araraquara School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, Araraquara, SP, 168014801-903, Brazil.
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Lima VP, da Silva LM, Nuñez A, Armas-Vega A, Loguercio AD, Martins LM. Sonic Activation of a Desensitizing Gel Prior to In-Office Bleaching. Oper Dent 2021; 46:151-159. [PMID: 34143199 DOI: 10.2341/19-283-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 11/23/2022]
Abstract
This double-blind, randomized, and controlled clinical trial evaluated the effect of sonic activation during the application of a desensitizing agent (DA) containing 5% potassium nitrate and 2% sodium fluoride on the occurrence of tooth sensitivity (TS) associated with in-office dental bleaching. Treatment with or without sonic activation of the DA was randomly assigned to one-half of the maxillary teeth of 34 patients in a split-mouth design. On the side without sonic activation (noSA), the DA was applied and maintained in contact with the teeth for 10 minutes. On the sonic activation side (SA), the DA was activated 30 seconds per tooth. The DA application was followed by application of 35% hydrogen peroxide in two bleaching sessions separated by a one-week interval. The primary outcome was the absolute risk of TS, recorded using a numeric rating scale and a visual analog scale. Color was evaluated with a digital spectrophotometer and a value-oriented shade guide. No significant difference between treatments was observed in the absolute risk of TS, which occurred in 93% (p=1.00) of both noSA and SA groups. The TS intensity was higher in the 24-hour interval after sessions, for both treatments, without differences between them. There was no difference in the color change for the treatments, with the average change in number of shade guide units of the Vita Classical scale of 6.35 for both (p=0.87). Sonic activation of DA containing 5% potassium nitrate and 2% sodium fluoride did not reduce the absolute risk and intensity of TS associated with in-office bleaching.
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Martini EC, Favoreto MW, Rezende M, de Geus JL, Loguercio AD, Reis A. Topical application of a desensitizing agent containing potassium nitrate before dental bleaching: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4311-4327. [PMID: 34075489 DOI: 10.1007/s00784-021-03994-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 05/17/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis to evaluate the risk and intensity of tooth sensitivity (TS) after topical application of desensitizers containing potassium nitrate before dental bleaching. METHODS We searched PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE. We also surveyed gray literature without restrictions. We meta-analyzed the data using the random-effects model to compare potassium nitrate and placebo in terms of risk and intensity of TS and color change (∆SGU or ∆E). The quality of the evidence was rated using the GRADE approach. The risk of bias (RoB) of the included studies was analyzed using the Cochrane RoB tool. RESULTS After the database screening, 24 articles remained. A significant 12% lower risk for the groups where desensitizing agents were applied (p = 0.02), with a risk ratio of 0.88 (95% CI 0.78 to 0.98). About the intensity of TS, a significant average mean difference of - 0.77 units of VAS units (95%CI - 1.34 to - 0.19; p = 0.01) in favor of the desensitizer group. In the NRS scale, a significant average mean difference of - 0.36 (95% CI - 0.61 to - 0.12; p value = 0.004) in favor of the desensitizer group. No significant difference was observed in color change (p > 0.28) in ∆SGU and ∆E. CONCLUSIONS Although a significant reduction in the risk and intensity of TS was observed in groups treated with a potassium nitrate at some point during the bleaching, the clinical significance of this reduction is subtle and clinically questionable. Color change is not affected by the use of agents. CLINICAL RELEVANCE The reduction in the risk and intensity of TS with the topical application of potassium nitrate-based desensitizing agents in dental bleaching is subtle and maybe clinically questionable.
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Affiliation(s)
- E C Martini
- Department of Restorative Dentistry, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Bloco M, Sala 04, Ponta Grossa, Paraná, 84030-900, Brazil.
| | - M W Favoreto
- Department of Restorative Dentistry, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Bloco M, Sala 04, Ponta Grossa, Paraná, 84030-900, Brazil
| | - M Rezende
- Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil
| | - J L de Geus
- Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil
| | - A D Loguercio
- Department of Restorative Dentistry, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Bloco M, Sala 04, Ponta Grossa, Paraná, 84030-900, Brazil
| | - A Reis
- Department of Restorative Dentistry, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Bloco M, Sala 04, Ponta Grossa, Paraná, 84030-900, Brazil
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Using Laser-Doppler Flowmetry to Evaluate the Therapeutic Response in Dentin Hypersensitivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238787. [PMID: 33256192 PMCID: PMC7731012 DOI: 10.3390/ijerph17238787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 01/08/2023]
Abstract
Dentin hypersensitivity (DH) is a common medical condition with underreported prevalence and it is difficult to quantify. This study aimed to investigate whether assessing dental pulp vascular micro-dynamics by laser-Doppler flowmetry (LDF) would be functional for therapeutic evaluation, in contrast to a verbal rating scale (VRS). A split-mouth single-blind randomized study was conducted on seven patients and a total of 36 teeth. Two DH therapeutic methods were employed: (i) fluoride gel; (ii) Nd:YAG radiation combined with fluoride gel. For each tooth, five consecutive LDF determinations of pulp blood flow were made (before and immediately after desensitizing treatment, then after 24 h, 7 days, and 1 month), and the VRS was applied each time. Spearman’s correlation was applied for concurrent validation. Two-way (treatment and patient) repeated measures ANOVA full factorial was applied, followed by Tukey’s post-hoc comparisons and Pillai’s trace multivariate statistic. While VRS scores had moderate reliability, LDF could objectively estimate treatment effects. Based on partial eta-squared values, treatment and patient characteristics were estimated to explain about 84% and 50% of the variability, respectively. In conclusion, LDF is an objective technique that can quantitatively assess DH evolution, and it is effective in reliably monitoring oral health therapeutic interventions.
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10
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Parreiras SO, Favoreto MW, Lenz RE, Serra ME, Borges CPF, Loguercio AD, Reis A. Effect of Prior Application of Desensitizing Agent on the Teeth Submitted to In-Office Bleaching. Braz Dent J 2020; 31:236-243. [PMID: 32667516 DOI: 10.1590/0103-6440202003365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/07/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to quantify the penetration of hydrogen peroxide, color change evaluation, surface morphology, and composition after application of desensitizing agents before in-office bleaching. Fifty premolars were sectioned, an acetate buffer was placed in the pulp chamber and divided into five groups (n=10). In the positive control group, only the in-office bleaching gel was used, and in the negative control group, no treatment was used. Three different desensitizing agents were applied: Desensibilize KF2%® group; Mi Paste® group, and Desensibilize Nano-P® group. The bleaching procedure was carried out with 35% HP. The absorbance of the resulting solution was determined in a spectrophotometer. Color change was assessed by using a digital spectrophotometer. Four additional premolars were assigned to the same groups above for analysis under scanning electron microscope, as well as to evaluate the elemental composition with X-ray dispersive energy spectrometry. Data were subjected to ANOVA and Tukey's test (α=0.05). All products reduced the penetration of HP in the pulp chamber. Mi Paste and Nano P were the products that yielded the lowest HP penetration, which was similar to the negative control group (p<0.001). No significant difference was detected in color change (p<0.001). Concerning enamel morphology, the groups that were analyzed after bleaching were observed a greater deposition of desensitizing agents on the surface. The use of desensitizing agents before tooth bleaching seems to be an alternative to reduce adverse effects of the tooth.
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Affiliation(s)
| | | | - Rubia Elisa Lenz
- School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Maria Eduarda Serra
- School of Chemistry, UniversidadeEstadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | | | | | - Alessandra Reis
- School of Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
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11
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Rezende M, da Silva KL, Miguel TC, Farago PV, Loguercio AD, Martins LD, Reis A. Prior Application of 10% Potassium Nitrate to Reduce Postbleaching Sensitivity: A Randomized Triple-Blind Clinical Trial. J Evid Based Dent Pract 2020; 20:101406. [PMID: 32473797 DOI: 10.1016/j.jebdp.2020.101406] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/07/2019] [Accepted: 08/20/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate if the topical application of 10% potassium nitrate applied before in-office bleaching is effective to reduce the risk and intensity of tooth sensitivity (TS), as well as to evaluate if its application can jeopardize color change. MATERIALS AND METHODS A randomized, split-mouth triple-blind clinical trial was conducted on 43 young patients with incisors A2 or darker. Half of the patient's upper arch received either the application of a 10% potassium nitrate or placebo gel for 10 min in a university setting. In-office bleaching was performed in three 15-min applications in two clinical sessions (1-week interval) using 35% hydrogen peroxide. Risk and intensity of TS was recorded with a 0-4 Numeric Rating Scale and a 0-10 Visual Analogue Scale during bleaching, 1 hour, 24 hours, and 48 hours after bleaching. Color was evaluated before and 1 month after bleaching with shade guides (Vita Classical and Vita Bleachedguide) and a spectrophotometer. The risk of TS (McNemar's test) and intensity of TS (Wilcoxon signed-rank for Numeric Rating Scale and paired t-test for Visual Analogue Scale) were statistically evaluated. Color change was compared using paired t-test. Significant level was set at 5%. RESULTS No significant difference was observed in the absolute risks of TS between groups (RR = 1.11; 95% CI 0.97 to 1.27; P = .12), which exceeded 87% for both groups. Similarly, no difference in TS intensities was detected (P > .05). Significant whitening was observed with all color measurement instruments with no difference between groups (P > .05). CONCLUSION The topical application of 10% potassium nitrate, before in-office bleaching, did not reduce the risk and intensity of TS and did not jeopardize color change.
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Affiliation(s)
- Márcia Rezende
- School of Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil
| | | | | | - Paulo Vitor Farago
- School of Pharmacy, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | | | - Alessandra Reis
- State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil.
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12
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Martins LM, Lima e Souza LA, Sutil E, da Silva LM, Silva JOS, Reis A, Loguercio AD. Clinical Effects of Desensitizing Prefilled Disposable Trays in In-office Bleaching: A Randomized Single-blind Clinical Trial. Oper Dent 2020; 45:E1-E10. [DOI: 10.2341/18-149-c] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
This study aimed to evaluate the desensitizing effect of a prefilled disposable tray containing potassium nitrate and fluoride on the self-reported tooth sensitivity (TS) and the bleaching efficacy of 40% hydrogen peroxide bleaching agent used for in-office bleaching in comparison with potassium nitrate and fluoride gel applied in a conventional-delivered tray system in an equivalence clinical trial.
Methods and Materials:
Seventy-eight patients, with a right maxillary canine darker than A3, were selected for this single-blind (evaluators), randomized clinical trial. Teeth were bleached in two sessions with a one-week interval in between. Before in-office bleaching, the prefilled disposable tray or conventional tray containing potassium nitrate and fluoride was used for 15 minutes. Subsequently, the bleaching agent was applied in two 20-minute applications (per the manufacturer's directions) in each session. The color change was evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Advance Spectrophotometer) methods at baseline and 30 days after the first bleaching session. TS was recorded for up to 48 hours using a 0-10 visual analog scale. The absolute risk was evaluated by chi-square test, while the intensity of TS was evaluated by McNemar test (α=0.05). Color change in shade guide units and ΔE was analyzed by Student t-test for independent samples (α=0.05).
Results:
Significant whitening was observed in both groups after 30 days of clinical evaluation. The use of different methods of desensitizer in a tray did not influence the absolute risk and intensity of TS (p>0.05), although a tendency of lower risk of TS with the prefilled disposable tray containing potassium nitrate and fluoride was observed.
Conclusion:
The use of a prefilled disposable tray containing potassium nitrate and fluoride before the application of the in-office bleaching product did not affect the whitening degree and decreased self-reported TS when compared with a conventional-delivered tray system.
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Affiliation(s)
- LM Martins
- Leandro de Moura Martins, DDS, Ms, PhD, professor, Faculdade de Odontologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - LA Lima e Souza
- Larissa Alves Lima e Souza, DDS, MS, Faculdade de Odontologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - E Sutil
- Elisama Sutil, DDS, Ms student, University Estadual de Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil
| | - LM da Silva
- Luciana Mendonça da Silva, DDS, PhD, professor, Faculdade de Odontologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - JOS Silva
- Luciana Mendonça da Silva, DDS, PhD, professor, Faculdade de Odontologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, professor, State University of Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil
| | - AD Loguercio
- Alessandro D Loguercio, DDS, Ms, PhD, professor, State University of Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil. Professor, Faculdad de Ciencias de la Salud Eugenio Espejo, University UTE, Quito, Ecuador
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13
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Martini EC, Parreiras SO, Szesz AL, Coppla FM, Loguercio AD, Reis A. Bleaching-induced tooth sensitivity with application of a desensitizing gel before and after in-office bleaching: a triple-blind randomized clinical trial. Clin Oral Investig 2019; 24:385-394. [DOI: 10.1007/s00784-019-02942-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/02/2019] [Indexed: 01/24/2023]
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14
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Martins IEB, Onofre S, Franco N, Martins LM, Montenegro A, Arana-Gordillo LA, Reis A, Loguercio AD, da Silva LM. Effectiveness of In-office Hydrogen Peroxide With Two Different Protocols: A Two-center Randomized Clinical Trial. Oper Dent 2018; 43:353-361. [DOI: 10.2341/17-128-c] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
The aim of this study was to compare the bleaching efficacy and tooth sensitivity (TS) of a 38% hydrogen peroxide bleaching agent used for in-office bleaching, applied under different time protocols: a 40-minute application or two 20-minute applications.
Methods and Materials:
Forty-four patients from Brazil and Colombia, with right superior canines darker than C2, were selected for this multicenter, single-blind, randomized trial. The teeth were bleached in two sessions, with a one-week interval between them, in a split-mouth design. The bleaching agent was applied in two 20-minute (2×20) applications or one 40-minute (1×40) application in each session according to the manufacturer's instructions. The color changes were evaluated by using subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Spectrophotometer) methods at baseline and 30 days after the second session. Tooth sensitivity was recorded up to 48 hours with a 0-10 visual analog scale. Also, the pH values during the application of bleaching were recorded. Color change in shade guide units and ΔE were analyzed by using the Student t-test (α=0.05). The absolute risk and intensity of TS were evaluated with the McNemar test, the Wilcoxon signed-rank test, and the Friedman test, respectively (α= 0.05).
Results:
Significant whitening was observed in both groups after 30 days of clinical evaluation. The use of a 40-minute application did not significantly influence the absolute risk of TS (68%, 95% confidence interval [CI] = 53-80) as well as the intensity of TS compared with the acid bleaching gel (absolute risk of 82%, 95% CI = 68-91). The pH values did not differ significantly between groups and at the different assessment periods (p=0.42).
Conclusion:
The use of a 40-minute in-office bleaching agent gel application produced the same whitening degree and TS that the two 20-minute bleaching agent applications did. The former preferably should be applied because one 40-minute application does not require gel refreshing.
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Affiliation(s)
- IEB Martins
- Izabelly EB Martins, DDS, MS, Department of Restorative Dentistry, School of Dentistry, Federal University of Amazonas, Manaus, Brazil
| | - S Onofre
- Stefania Onofre, DDS, School of Dentistry, University of Santiago de Cali, Cali, Colombia
| | - N Franco
- Natalia Franco, DDS, School of Dentistry, University of Santiago de Cali, Cali, Colombia
| | - LM Martins
- Izabelly EB Martins, DDS, MS, Department of Restorative Dentistry, School of Dentistry, Federal University of Amazonas, Manaus, Brazil
| | - A Montenegro
- Andres Montenegro, DDS, MS, Ponta Grossa State University, Ponta Grossa, Brazil
| | - LA Arana-Gordillo
- Luis Alfonso Arana-Gordillo, DDS, MS, PhD, Department of Restorative Dentistry, School of Dentistry, University of Santiago de Cali, Cali, Colombia
| | - A Reis
- Alessandra Reis, DDS, PhD, Restorative Dentistry, Universidade Estadual de Ponta Grossa, Ponta Grossa, Brazil
| | - AD Loguercio
- Alessandro D Loguercio, DDS, MS, PhD, Restorative Dentistry, Ponta Grossa State University, Ponta Grossa, Brazil
| | - LM da Silva
- Luciana Mendonça da Silva, DDS, PhD, Federal University of Amazonas, Manaus, Brazil
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15
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Kwon SR, Pallavi FNU, Shi Y, Oyoyo U, Mohraz A, Li Y. Effect of Bleaching Gel Viscosity on Tooth Whitening Efficacy and Pulp Chamber Penetration: An In Vitro Study. Oper Dent 2018; 43:326-334. [DOI: 10.2341/17-099-l] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
Whitening efficacy has been related to hydrogen peroxide (HP) diffusion into tooth structure. However, little information is available relating rheological properties to whitening efficacy. The purpose was to evaluate the whitening efficacy and HP penetration level of a 10% HP gel at three different viscosities and to compare them to a strip delivery system.
Methods and Materials:
Extracted molars (n=120) were randomly assigned into five groups (n=24/ group): NC_MED (negative control; median): medium viscosity gel without HP; LOW: 10% HP gel (low viscosity experimental gel, Ultradent Products Inc); MED: 10% HP gel (medium viscosity experimental gel, Ultradent); HIGH: 10% HP gel (high viscosity gel, Ultradent); and CWS: Crest 3D Whitestrips 1-Hour Express (Procter & Gamble). All teeth were subjected to five 60-minute whitening sessions. Instrumental color measurements were performed at baseline (T0), and 1-day after each application (T1-T5), and 1-month after whitening (T6). HP penetration was estimated with leucocrystal violet and horseradish peroxidase. A Kruskal-Wallis test and post hoc Bonferroni test were performed to assess the difference in tooth color change and HP penetration among the groups (α=0.05).
Results:
Hydrogen peroxide penetration levels and overall color changes at T6 were 0.24 μg/mL / 2.80; 0.48 μg/mL / 8.48; 0.44 μg/mL / 7.72; 0.35 μg/mL / 8.49; 0.36 μg/mL / 7.30 for groups NC, LOW, MED, HIGH, and CWS, respectively. There was a significant difference for HP penetration, while there was no significant difference among the four experimental groups for tooth color change.
Conclusion:
Rheological properties should be considered when developing new whitening formulations.
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Affiliation(s)
- SR Kwon
- So Ran Kwon, DDS, MS, PhD, MS, professor, Center for Dental Research, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - FNU Pallavi
- FNU Pallavi, BDS, MDS, volunteer, Center for Dental Research, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - Y Shi
- Yanli Shi, DDS, assistant professor, Shandong Provincial Hospital affiliated with Shandong University, Shandong, China
| | - U Oyoyo
- Udochukwu Oyoyo, MPH, PhD, assistant professor, Dental Education Services, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - A Mohraz
- Ali Mohraz, BS, ME, PhD, associate professor, Department of Chemical Engineering and Materials Science, University of California Irvine, Irvine, CA, USA
| | - Y Li
- Yiming Li, DDS, MSD, PhD, professor, Center for Dental Research, Loma Linda University School of Dentistry, Loma Linda, CA, USA
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16
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Parreiras SO, Szesz AL, Coppla FM, Martini EC, Farago PV, Loguercio AD, Reis A. Effect of an experimental desensitizing agent on reduction of bleaching-induced tooth sensitivity: A triple-blind randomized clinical trial. J Am Dent Assoc 2018; 149:281-290. [PMID: 29439773 DOI: 10.1016/j.adaj.2017.10.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND In this randomized study, split-mouth, triple-blind clinical trial, the authors evaluated the efficacy of a desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde applied before in-office bleaching with 35% hydrogen peroxide (HP). METHODS Treatment with the desensitizing or placebo control gels was randomly assigned to one-half of the maxillary teeth of 42 patients in a split-mouth design. The desensitizing gels were applied and maintained in contact with the tooth enamel for 10 minutes, followed by 2 HP bleaching sessions separated by 1 week. The primary outcome variable was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a value-oriented shade guide. RESULTS The difference in risk of developing tooth sensitivity between the desensitizing gel group (31.7%, 95% confidence interval [CI], 19.6 to 46.9) and the control group (70.7%; 95% CI, 55.5 to 82.3%) was statistically significant (P < .0001), as well as the difference in pain intensity in the first 24 hours (P < .001). No statistically significant difference was found in color change between teeth that received the desensitizing gel and those that received the placebo gel. CONCLUSIONS Application of desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde before HP whitening reduced the risk and severity of dental sensitivity, without altering the effectiveness of whitening. PRACTICAL IMPLICATIONS A single application of desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde can reduce tooth sensitivity after dental bleaching systems.
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17
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Tooth sensitivity with a desensitizing-containing at-home bleaching gel-a randomized triple-blind clinical trial. J Dent 2018; 72:64-70. [PMID: 29551346 DOI: 10.1016/j.jdent.2018.03.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Desensitizing agents are usually included in the composition of bleaching agents to reduce bleaching-induced tooth sensitivity (TS). This randomized clinical trial (RCT) evaluated the risk and intensity of TS and color change after at-home bleaching with a desensitizing-containing (3% potassium nitrate and 0.2% sodium fluoride) and desensitizing-free 10% carbamide peroxide (CP) gel (Whiteness Perfect, FGM). METHODS A triple-blind, within-person RCT was conducted on 60 caries-free adult patients. Each participant used the gel in a bleaching tray for 3 h daily for 21 days in both the upper and lower dental arches. The absolute risk and intensity of TS were assessed daily through the 0-10 VAS and NRS scale for 21 days. Color change was recorded using shade guides (Vita Classical and Vita Bleachedguide) and the Easyshade spectrophotometer at baseline, weekly and 30 days after the end of the bleaching. The risk and intensity of TS were evaluated by the McNemar and Wilcoxon Signed Rank tests, respectively. Color change (ΔSGU and ΔE) were evaluated by the Mann-Whitney test and a paired t-test, respectively (α = 0.05). RESULTS No difference in the TS and color change was observed (p > 0.05). CONCLUSIONS The incorporation of potassium nitrate and sodium fluoride in 10% carbamide peroxide at-home bleaching gel tested in this study did not reduce the TS and did not affect color change (RBR-4M6YR2).
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18
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Park S, Kwon SR, Qian F, Wertz PW. The Effect of Delivery System and Light Activation on Tooth Whitening Efficacy and Hydrogen Peroxide Penetration. J ESTHET RESTOR DENT 2016; 28:313-320. [PMID: 27513289 DOI: 10.1111/jerd.12238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the whitening efficacy of a new two-layer technology in-office system compared to a conventional gel-type system and determine hydrogen peroxide penetration (HPP) into the pulp cavity. MATERIALS AND METHODS Extracted molars (n = 60) were assigned to group NC: glycerol gel; group QPRO: 20% HP varnish (Zoom Quick Pro, Philips Oral Healthcare); group ZOOM_NL: 25% HP gel (Zoom Chairside Whitening); and group ZOOM_WL: 25% HP gel (Zoom Chairside Whitening) with light-activation. HPP levels were estimated with leucocrystal-violet and horseradish-peroxidase. Instrumental color measurements were performed at baseline (T0 ), 1-day post first whitening (T1 ), 1-day post second whitening (T2 ), 1-day post third whitening (T3 ), and 1-month post whitening (T4 ). One-way analysis of variance followed by post hoc Tukey's HSD test was performed to detect difference in ΔE* and HP penetration levels (α = 0.05). RESULTS ΔE* of NC was lower than other groups, whereas ΔE* of ZOOM_WL was greater than the other three groups, at T3 and T4 . Mean HPP level obtained from ZOOM_WL (1.568 ± 0.753 μg/mL) was significantly greater than those obtained from the other groups, whereas the mean HPP level observed in NC group (-0.131 ± 0.003 μg/mL) was significantly lower than the other groups. CONCLUSIONS Tooth whitening efficacy and HPP levels vary based on whitening systems used. CLINICAL SIGNIFICANCE The two-layer technology in-office varnish system may be an alternative whitening option to reduce chair time in the office. (J Esthet Restor Dent 28:313-320, 2016).
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Affiliation(s)
- Soyoung Park
- Dentistry, University of Iowa College of Dentistry & Dental Clinics, Iowa City, Iowa, USA
| | - So Ran Kwon
- Associate Professor, Program Director, Student Research Program, Loma Linda University School of Dentistry Center for Dental Research, 11175 Campus Street CSP A1010C, Loma Linda, California, 92350, USA.
| | - Fang Qian
- Associate Research Scientist/Adjunct Assistant Professor, Division of Biostatistics and Research Design and Department of Preventive and Community Dentistry, University of Iowa College of Dentistry & Dental Clinics, Iowa City, Iowa, USA
| | - Philip W Wertz
- Professor, Oral Pathology, Radiology and Medicine, Dows Institute for Dental Research, University of Iowa College of Dentistry & Dental Clinics, Iowa City, Iowa, USA
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19
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Kwon SR, Dawson DV, Wertz PW. Time Course of Potassium Nitrate Penetration into the Pulp Cavity and the Effect of Penetration Levels on Tooth Whitening Efficacy. J ESTHET RESTOR DENT 2016; 28 Suppl 1:S14-22. [PMID: 27079767 DOI: 10.1111/jerd.12192] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To establish time-course of potassium nitrate (PN) penetration into the pulp cavity, and determine whether PN pretreatment would affect whitening efficacy. MATERIALS AND METHODS Extracted teeth (n = 100) were randomized into five groups of 20 specimens each. Relief ACP (Philips Oral Healthcare, Los Angeles, CA, USA) was applied for 0, 5, 15, 30, and 60 minutes for groups 15, respectively. A nitrate/nitrite assay kit was used for colorimetric detection of nitrate. Whitening was performed using a Zoom White Speed system (Philips Oral Healthcare) for 60 minutes. Tooth color was measured with a spectrophotometer at baseline (T0 ), 1-day post PN application (T1 ), 1-day post-whitening (T2 ), and 1-month post-whitening (T3 ). Kruskal-Wallis test was used to assess group differences in PN penetration and tooth color change. RESULTS PN penetration differed among all groups except 2 and 3. There were no differences among groups for any baseline color parameters (p > 0.30). At T2 there was no change relative to baseline for individual components L*, a*, and b*. At T3 and T4 there was significant change relative to baseline for ΔL*, Δb*, and ΔE*, for all groups. CONCLUSIONS PN penetration is time dependent and pretreatment with PN does not affect whitening efficacy. CLINICAL SIGNIFICANCE Postassium nitrate penetration into the pulp cavity occurred as early as 5 minutes after application, and pretreatment with potassium nitrate containing desensitizers did not adversely affect tooth whitening efficacy. (J Esthet Restor Dent 28:S14-S22, 2016).
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Affiliation(s)
- So Ran Kwon
- Associate Professor-Program Director, Center for Dental Research, Loma Linda University School of Dentistry, 11175 Campus St. CSP #A1010, Loma Linda, CA, 92354, USA
| | - Deborah V Dawson
- Professor and Director, Division of Biostatistics and Research Design, Departments of Pediatric Dentistry & Biostatistics and the Interdisciplinary Programs in Genetics and in Informatics, University of Iowa College of Dentistry & Dental Clinics, 801 Newton Road #451, DSB N101-9, Iowa City, IA, 52242-1001, USA
| | - Philip W Wertz
- Professor Oral Pathology, Radiology and Medicine, Dows Institute for Dental Research, University of Iowa College of Dentistry & Dental Clinics, 801 Newton Road #451, DSB N449, Iowa City, IA, 52242-1001, USA
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