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Xavier GMB, Gil GS, Paes YFO, de Meneses Costa Ferreira LM, Silva CM, Ribeiro-Costa RM, Araújo JLN. Assessment of the effect of experimental gel of pregabalin associated with 35% hydrogen peroxide bleaching on bovine dental enamel: an in vitro study. Odontology 2024:10.1007/s10266-024-00978-2. [PMID: 39060896 DOI: 10.1007/s10266-024-00978-2] [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: 11/28/2023] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
To assess the effect of bleaching with gel of pregabalin associated with 35% hydrogen peroxide on the mechanical and chemical properties and ultramorphology of dental enamel. Thirty-six (36) specimens of bovine dental incisors were obtained and divided into three groups (n = 12), namely: CG = bleaching with 35% hydrogen peroxide; KFG = bleaching with 5% potassium nitrate and 2% sodium fluoride gel + 35% hydrogen peroxide; and PGG = bleaching with experimental gel of pregabalin + 35% hydrogen peroxide. The specimens were assessed with respect to Knoop microhardness, surface roughness, and colour change, before and after bleaching. They were also assessed using scanning electron microscopy and energy-dispersive spectroscopy after treatments. All groups exhibited an increase in surface roughness and a reduction in Knoop microhardness after the protocols. There was colour change in all groups, with no difference between them. In addition, there were changes in enamel morphology and non-significant loss of calcium and phosphorus. The experimental gel of pregabalin did not influence the action of 35% hydrogen peroxide, yielding results similar to those of the other groups assessed in all the parameters. Therefore, the gel of pregabalin can be an alternative for topical application on the surfaces of the teeth in association with bleaching treatments.
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Affiliation(s)
- Gabriela Monteiro Barbosa Xavier
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | - Giovana Sholheid Gil
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | - Yngrid Fernanda Oliveira Paes
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | | | - Cecy Martins Silva
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | - Roseane Maria Ribeiro-Costa
- Pharmaceutical Nanotechnology Laboratory, Faculty of Pharmacy, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil
| | - Jesuína Lamartine Nogueira Araújo
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Pará, Av. Augusto Corrêa, nº 01, Belém, PA, 66.075-110, Brazil.
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Lima NLB, Sette-de-Souza PH, Siqueira AHCD, Costa SGDA, Alves PVDM, Silvestre FA, Meneses NED, Santiago SL, Peixoto RF. Preemptive use of ibuprofen and desensitizer decreases immediate tooth sensitivity after in-office bleaching: A triple-blind, randomized, placebo-controlled clinical trial. J Am Dent Assoc 2024; 155:304-311. [PMID: 38244017 DOI: 10.1016/j.adaj.2023.11.011] [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: 08/16/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND The authors evaluated the synergistic analgesic effect of preemptive administration of 400 mg of ibuprofen (IBU) and potassium fluoride 2% (KF2), both in isolation or combination, on the painful perception of tooth sensitivity after tooth bleaching. METHODS Fifteen patients participated in this triple-blind, randomized, placebo-controlled clinical trial. The study used a crossover design for drug administration and a split-mouth design for desensitizer agent. Four paired groups were formed: IBU plus KF2 (IBU + KF2); IBU (IBU + placebo KF); KF2 (placebo IBU + KF2), and placebo (placebo IBU + placebo KF). The outcome measure was the perception of tooth sensitivity, assessed using a visual analog scale. Data were collected at 4 different times: immediately after tooth bleaching (baseline) and after 6, 30, and 54 hours. Statistical analysis was performed using the Friedman test and relative risk. RESULTS IBU plus KF2 was found to be more effective in reducing tooth sensitivity immediately after bleaching (baseline) compared with the placebo group (P < .05). The risk of experiencing moderate or severe tooth sensitivity was approximately 4 times higher in the placebo group than in the IBU plus KF2 group (relative risk, 4.00; 95% CI, 1.01 to 15.81; P = .025). CONCLUSIONS The combined use of 400 mg of IBU and KF2 appears to be beneficial in managing postbleaching tooth sensitivity. It provides a superior analgesic effect compared with placebo. PRACTICAL IMPLICATIONS The preemptive administration of IBU plus KF2 reduces tooth sensitivity after tooth whitening when compared with placebo. This clinical trial was registered in the Brazilian Clinical Trials Registry Platform. The registration number is U1111-1249-8191.
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Hortkoff D, da Silva KL, Farago PV, Gomes JC, Reis A, Gomes GM. Effect of topical application of ibuprofen/arginine on the in-office bleaching-induced tooth sensitivity: A randomized, triple-blind controlled trial. J Dent 2024; 142:104875. [PMID: 38309571 DOI: 10.1016/j.jdent.2024.104875] [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: 11/20/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVE The application of anti-inflammatories as topical desensitizers before dental bleaching is an approach to reduce bleaching-induced tooth sensitivity (TS). This randomized controlled trial compared the risk and intensity of TS and the color change resulting from in-office dental bleaching after using an experimental desensitizing gel containing ibuprofen and arginine. METHODS Sixty-two participants with upper canine shades A2 or darker were randomly assigned to either the ibuprofen-arginine desensitizing group or the placebo group. The desensitizing gel was applied for 15 min before in-office bleaching with 35 % hydrogen peroxide gel for 50 min (2 sessions). To assess the absolute risk and intensity of TS, visual (0-10) and numeric rating (0-5) scales were used, and group comparisons were made using the McNemar test, Wilcoxon test, and paired Student t-test (α = 0.05). Color change was evaluated using Vita Classical, Vita Bleachedguide (ΔSGU), and Vita EasyShade (ΔEab, ΔE00, and ΔWID) before and one month after the bleaching procedure. Group comparisons for color change were done using a paired t-test (α = 0.05). RESULTS The odds ratio for TS was 0.14 [95 % CI 0.02 to 0.6], meaning lower odds of TS for the desensitizing gel. A lower intensity of TS was also observed for the experimental group (p < 0.005) up to 48 h after bleaching. All color evaluation tools demonstrated effective and similar whitening for both groups (p > 0.05). CONCLUSIONS Using the experimental desensitizing gel containing ibuprofen and arginine effectively reduced the risk and intensity of TS without compromising the bleaching efficacy. CLINICAL RELEVANCE The topical application of ibuprofen/arginine on the in-office bleaching reduced risk and intensity of bleaching-induced tooth sensitivity.
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Affiliation(s)
- Diego Hortkoff
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil
| | - Karine Letícia da Silva
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil
| | - Paulo Vitor Farago
- Department of Pharmacy, State University of Ponta Grossa - UEPG, Ponta Grossa, Paraná, Brazil
| | - João Carlos Gomes
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil
| | - Giovana Mongruel Gomes
- Department of Dentistry, State University of Ponta Grossa - UEPG, 4748, Uvaranas - Ponta Grossa, Ponta Grossa, Paraná 84030-900, Brazil.
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Costa MJF, Sette-DE-Souza PH, Borges BCD. In silico affinity between analgesic/anti-inflammatory drugs and the transient receptor potential A1 to predict potential pharmacological managing approaches for bleaching sensitivity. AN ACAD BRAS CIENC 2023; 95:e20230555. [PMID: 38055565 DOI: 10.1590/0001-3765202320230555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/17/2023] [Indexed: 12/08/2023] Open
Abstract
Reducing in-office tooth bleaching sensitivity represents a challenge for professionals. Researchers have associated the block of the pain receptor TRPA1 with reducing bleaching sensitivity. However, the chemical affinity of analgesic/anti-inflammatory drugs to the TRPA1 needs to be verified. To perform a virtual screening of multiple drugs (analgesic and anti-inflammatory drugs) to verify chemical affinity for the TRPA1 receptor. The crystal structure of the TRPA1 receptor proteins was retrieved from the Protein Data Bank. The SMILES codes of the ligands were extracted from PubChem. The binding energy of the complex was obtained in ∆G - kcal/mol by AutoDock Vina© and replicated in the webservers SwissDock©, Dockthor©, and CbDock©. LigPlus© confirmed the binding sites. Codeine and dexamethasone showed regularity among all servers, even showing binding energy values of -7.9 kcal/mol for codeine and -8.1 kcal/mol for dexamethasone. Codeine and dexamethasone may be potential drugs to manage tooth bleaching sensitivity if they reach the dental pulp TRPA1 receptor.
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Affiliation(s)
- Moan J F Costa
- Programa de Pós-Graduação em Ciências Odontológicas, Universidade Federal do Rio Grande do Norte, Departamento de Odontologia, Av. Sen. Salgado Filho, 1787, Lagoa Nova, 59056-000 Natal, RN, Brazil
| | - Pedro H Sette-DE-Souza
- Programa de Pós-Graduação em Saúde e Desenvolvimento Socioambiental, Universidade de Pernambuco, Rua Cap. Pedro Rodrigues, 105, São José, 55294-902 Garanhuns, PE, Brazil
| | - Boniek C D Borges
- Programa de Pós-Graduação em Ciências Odontológicas, Universidade Federal do Rio Grande do Norte, Departamento de Odontologia, Av. Sen. Salgado Filho, 1787, Lagoa Nova, 59056-000 Natal, RN, Brazil
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Effect of an experimental desensitizing gel on bleaching-induced tooth sensitivity after in-office bleaching—a double-blind, randomized controlled trial. Clin Oral Investig 2022; 27:1567-1576. [PMID: 36418502 PMCID: PMC9685084 DOI: 10.1007/s00784-022-04778-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/06/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the risk and intensity of tooth sensitivity (TS), and the efficacy of in-office bleaching after applying an experimental desensitizing gel composed of 10% calcium gluconate, 0.1% dexamethasone acetate, 10% potassium nitrate, and 5% glutaraldehyde. MATERIAL AND METHODS In a split-mouth, double-blind, placebo-controlled study, 50 participants had their upper hemiarches randomized into experimental and placebo groups. Desensitizing and placebo gels were applied for 10 min before in-office bleaching (35% hydrogen peroxide, 1 × 50 min; two bleaching sessions; 1-week interval). TS was recorded immediately after bleaching, 1, 24, and 48 h after each session, with a 0-10 visual analogue scale (VAS) and a five-point numerical rating scale (NRS). The color was recorded in all groups at baseline, 1 week after each session, and 1 month after the end of bleaching using shade guide units (ΔSGUs) and a spectrophotometer (ΔEab, ΔE00, and ΔWID). RESULTS Most participants (96%) felt some discomfort during treatment regardless of the study group. The odds ratio for pain was 0.65 (95% CI 0.1 to 4.1; p = 1.0). The intensity of TS did not differ between groups (p > 0.31), and it was only 0.34 VAS units lower in the experimental group. A significant color change occurred in both groups regardless of the group. CONCLUSIONS The desensitizing experimental gel applied before in-office bleaching did not reduce the risk and the intensity of TS and did not affect color change. CLINICAL RELEVANCE Although the experimental desensitizing agent with varying mechanisms of action did not jeopardize the color change, it did not reduce the risk or intensity of in-office bleaching. CLINICAL TRIAL REGISTRATION NUMBER RBR-7T7D4D.
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LED photobiomodulation effect on the bleaching-induced sensitivity with hydrogen peroxide 35%-a controlled randomized clinical trial. Clin Oral Investig 2022; 26:3853-3864. [PMID: 34997849 DOI: 10.1007/s00784-021-04352-2] [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: 07/01/2021] [Accepted: 12/27/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of a protocol of photobiomodulation (PBM) with light-emitting diodes (LED) on the clinical risk of bleaching-induced sensitivity. MATERIALS AND METHODS Sixty-four volunteers were selected and randomly divided in two groups, placebo (PG) and LED (LG). The LG received PBM irradiation and tooth bleaching, while the PG received tooth bleaching and simulation of the irradiation. The occurrence of painful sensitivity was recorded during the dental bleaching; immediately after bleaching; and 24, 48, and 72 h after tooth bleaching. At the same measurement times, data were collected on the intensity of sensitivity (VAS and NRS scale) and teeth affected by bleaching-induced sensitivity. A questionnaire sought to measure how the painful sensitivity influenced basic daily activities. Tooth color measures were performed using subjective and objective methods. RESULTS LED irradiation decreased the occurrence of sensitivity at all studied evaluation times as well as its intensity, with the exception of the 72-h data when both groups presented no difference. Teeth affected by bleaching-induced sensitivity were significantly greater in the PG. Color measurements presented no differences between the groups in the recently after and later measures. CONCLUSIONS PBM with LED decreases sensitivity risk and sensibility intensity during and after office bleaching and causes no influence on the shade degree of whitening achieved. The decrease in tooth sensitivity provided more comfort and less suffering while drinking. CLINICAL RELEVANCE LED irradiation is a promising intervention in the control of bleaching-induced sensitivity. TRIAL REGISTRATION RBR-7hpfwj. Sensitivity intensity measured by the VAS scale (0-10) in the first whitening session (Graphic A) and second whitening session (Graphic B). Significance level set at ≤ 5%. *Mann-Whiteney U test. Columns followed by the same letter are significant different (ap < 0.001; bp < 0.001; cp < 0.001; dp =0.013; ep < 0.001; fp < 0.001; gp < 0.001; hp = 0.002).
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Topical application of Otosporin® before in-office bleaching: a split mouth, triple-blind, multicenter randomized clinical trial. Clin Oral Investig 2021; 26:2555-2564. [PMID: 34668065 DOI: 10.1007/s00784-021-04224-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/10/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate if the topical application of Otosporin® before in-office bleaching with a 35% hydrogen peroxide (HP) gel reduces the risk and intensity of tooth sensitivity (TS), as well as the bleaching effectiveness. MATERIALS AND METHODS Twenty participants were selected for this split mouth, triple-blind, multicenter randomized clinical trial. Before each bleaching session, the placebo was applied in the patient's hemi-arch and the other half received the Otosporin®, according to the randomization procedure. Both products were applied topically for 10 min. The 35% HP was applied in two sessions with a 1-week interval. The risk and intensity of TS were assessed using the Numerical Scale (NRS) and the Visual Analog Scale (VAS). The bleaching effectiveness were evaluated with the visual scales and with a digital spectrophotometer. The absolute risk of TS was compared by McNemar's test. To compare the intensity of TS, the Wilcoxon signed-rank test was used to evaluate the NRS, while the paired t test was used to evaluate VAS. Bleaching effectiveness (ΔSGUs and ΔEab, ΔE00, and ΔWID) was compared between groups using the paired t-test (α = 0.05). RESULTS No significant difference at risk (p = 1.0) and intensity of TS (p > 0.59; VAS and p = 1.00 for NRS) was detected between groups. For both groups, a significant bleaching was observed after 30 days of evaluation (p < 0.39). CONCLUSIONS The previous application of Otosporin® in the in-office bleaching did not reduce the risk and intensity of TS and did not affect the effectiveness of the bleaching. CLINICAL RELEVANCE The application of Otosporin® before in-office bleaching with 35% HP was not able to reduce the risk and intensity of TS.
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de Bragança RMF, Moraes RR, Faria-E-Silva AL. Color assessment of resin composite by using cellphone images compared with a spectrophotometer. Restor Dent Endod 2021; 46:e23. [PMID: 34123759 PMCID: PMC8170378 DOI: 10.5395/rde.2021.46.e23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 11/15/2022] Open
Abstract
Objectives This study assessed the reliability of digital color measurements using images of resin composite specimens captured with a cellphone. Materials and Methods The reference color of cylindrical specimens built-up with the use of resin composite (shades A1, A2, A3, and A4) was measured with a portable spectrophotometer (CIELab). Images of the specimens were obtained individually or pairwise (compared shades in the same photograph) under standardized parameters. The color of the specimens was measured in the images using RGB system and converted to CIELab system using image processing software. Whiteness index (WID) and color differences (ΔE00) were calculated for each color measurement method. For the cellphone, the ΔE00 was calculated between the pairs of shades in separate images and in the same image. Data were analyzed using 2-way repeated-measures analysis of variance (α = 0.05). Linear regression models were used to predict the reference ΔE00 values of those calculated using color measured in the images. Results Images captured with the cellphone resulted in different WID values from the spectrophotometer only for shades A3 and A4. No difference to the reference ΔE00 was observed when individual images were used. In general, a similar ranking of ΔE00 among resin composite shades was observed for all methods. Stronger correlation coefficients with the reference ΔE00 were observed using individual than pairwise images. Conclusions This study showed that the use of cellphone images to measure the color difference seems to be a feasible alternative providing outcomes similar to those obtained with the spectrophotometer.
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Affiliation(s)
| | - Rafael Ratto Moraes
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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In-office bleaching with low/medium vs. high concentrate hydrogen peroxide: A systematic review and meta-analysis. J Dent 2020; 103:103499. [PMID: 33068711 DOI: 10.1016/j.jdent.2020.103499] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/25/2020] [Accepted: 10/10/2020] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To answer the following research question: "Dolow/medium hydrogen peroxide (HP) concentrations used for in-office bleaching in patients with permanent dentition have similar color change and bleaching sensitivity (BS) to high HP concentrations?" DATA Randomized controlled trials that compared low/medium vs. high concentrate HP were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. Meta-analyses were conducted for color change (ΔE*ab, ΔSGU/SGU), risk, and intensity of BS, using the random-effects model. Heterogeneity was assessed with the Cochrane Q test, I2 statistics, and prediction interval. The GRADE assessed the certainty of the evidence. SOURCES Search was performed in PubMed, Cochrane Library, BBO, LILACS, Scopus, Web of Science and grey literature on 15th September 2018 (updated on 13th May 2020). STUDY SELECTION 25 studies remained. Five were at low RoB; thirteen were at unclear RoB, and seven were at high RoB. The risk of having BS was, on average, 33 % lower (RR = 0.67; 95 % CI 0.51 to 0.86) for low/medium concentrate HP than high HP. No significant difference in color change was detected among groups, except from the subgroup low vs. high HP for the immediate color change, but this difference is not clinically relevant. The certainty of evidence for color change was low and very low, and moderate for the BS. CONCLUSIONS Low and medium hydrogen peroxide concentrate products for in-office bleaching have lower risk and intensity of bleaching sensitivity than the high concentrate hydrogen peroxide group, with no difference in color change efficacy. CLINICAL SIGNIFICANCE The use of low concentrate hydrogen peroxide products may produce the same color change efficacy with the bonus of having lower risk and intensity of bleaching sensitivity. However, the ideal concentration at which this occurs is yet unknown and deserves further investigations. No funding. PROSPERO CRD42018108266.
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Almassri HNS, Zhang Q, Yang X, Wu X. The effect of oral anti-inflammatory drugs on reducing tooth sensitivity due to in-office dental bleaching: A systematic review and meta-analysis. J Am Dent Assoc 2019; 150:e145-e157. [PMID: 31561766 DOI: 10.1016/j.adaj.2019.05.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/16/2019] [Accepted: 05/22/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The authors' aim was to evaluate the effectiveness of anti-inflammatory drugs on tooth sensitivity (TS) during and after in-office dental bleaching procedures. TYPES OF STUDIES REVIEWED The authors selected randomized controlled trials in which the investigators compared anti-inflammatory drugs with a placebo to evaluate in-office dental bleaching TS. The authors performed an electronic search by using PubMed, ScienceDirect, and Embase. In addition, the authors searched other Web sites, such as ClinicalTrials.gov, to identify ongoing studies. RESULTS The authors included 7 randomized controlled trials (324 adults) in the review. According to the extracted data, the authors performed the meta-analysis by using risk ratios and their 95% confidence intervals or by using the mean difference with a 95% confidence interval. The authors used the Cochrane Collaboration's tool to assess study quality. After the evaluation, the authors considered 6 studies to be high quality and a single study to be low quality. The overall results of the evaluation process revealed the absence of a clinically significant effect of anti-inflammatory drugs. CONCLUSIONS AND PRACTICAL IMPLICATIONS The results of this analytic process indicated that anti-inflammatory drugs have no clinically significant effect on the TS that occurs due to in-office bleaching. Readers must analyze these results carefully given the limitations of this review, such as the small samples size and the heterogeneity among the studies in some stages of the evaluation process. The results of this analytical study highlight the need for more clinical studies to reach a significant conclusion because TS is one of the most important reasons for the cessation of bleaching treatment.
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Costa R, Moraes S, Lemos C, SoutoMaior JR, Vasconcelos BDE, Pellizzer EP. Effect of Analgesic Drugs on Tooth Sensitivity Induced by In-office Dental Bleaching: A Systematic Review and Meta-analysis. Oper Dent 2019; 45:E66-E76. [PMID: 31750804 DOI: 10.2341/18-250-l] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This systematic review evaluates the effect of preemptive analgesia on tooth sensitivity induced by in-office tooth bleaching. METHODS The review was structured based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The methods were recorded at PROSPERO (CRD42018095440). Randomized clinical trials, studies published in English, and studies in which the efficacy of preemptive analgesia with analgesic and anti-inflammatory medications prior to in-office tooth bleaching was compared with that of placebo were included. PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library were used for searching. The electronic search provided 373 articles, and seven of them were selected based on the inclusion criteria. RESULTS Immediately after time point, a significant reduction of dental sensitivity was observed in the drug group compared to the control group (p=0.02; mean difference [MD]: -0.90; confidence interval [CI]: -1.63 to -0.16), while there was no significant difference at up to one-hour (p=0.22; MD: -0.42; CI: -1.09 to -0.25), at 1-24-hour (p=0.88; MD: -0.05; CI: -0.61 to 0.72), or 24-48-hour (p=0.69; MD: 0.05; CI: -0.21 to 0.32) time points. The incidence of sensitivity during the procedure was not statistically different between the groups (p=0.64; MD: 0.91; CI: 0.92 to 1.15). The nonsteroidal anti-inflammatory drug group showed a statistically significant reduction (p=0.04; MD: -0.69; CI: -1.36 to -0.03) in tooth sensitivity compared with the other groups. CONCLUSIONS This systematic review and meta-analysis demonstrated that the medications analyzed did not interfere with the incidence of sensitivity symptoms. Regarding the intensity, no difference was observed between the drug and placebo groups at the up to one-hour, 1-24-hour, or 24-48-hour time points, and there was a statistically significant difference at the zero-hour time point in favor of the drug group. However, based on the variables that influenced this result, it should be considered with prudence because a small difference was observed.
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Peixoto ADC, Vaez SC, Soares KD, Ferreira LF, Loguercio AD, Faria-E-Silva AL. Preemptive Use of Piroxicam on Tooth Sensitivity Caused By In-Office Bleaching: A Randomized Clinical Trial. Braz Dent J 2019; 30:498-504. [PMID: 31664303 DOI: 10.1590/0103-6440201902762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022] Open
Abstract
This clinical trial evaluated the effect of preemptive use of the non-steroidal anti-inflammatory drug piroxicam in a single dose 30 min prior to in-office bleaching on the prevention of tooth sensitivity (TS) reported by patients. Fifty patients were submitted to two sessions of in-office tooth bleaching with 35% hydrogen peroxide used for 2 sessions, each consisting of a single 45-min application, with an interval of 7 days between session. Thirty minutes prior to the procedure, the patient randomly received a single dose of piroxicam (200 mg) or placebo in a double-blind, randomized, crossover design. The TS was evaluated using verbal rate (VRS) and visual analog (VAS) scales during the bleaching procedure and at 24 h after each session. The color changes were assessed by the Vita Bleachedguide scale 1 week after each bleaching session. Risk of TS was calculated from the VRS and analyzed by the McNemar test, while the level of TS was analyzed by the Mann-Whitney test. For the VAS, t-tests were used to compare data from the treatments at each assessment time. Data regarding color changes were subjected to Wilcoxon and Mann-Whitney tests (α=0.05). The preemptive administration of piroxicam did not affect the risk and level of TS compared to placebo, irrespective of the assessment time. The treatment sequence did not affect bleaching effectiveness. In conclusion, the administration of a single dose of piroxicam prior to in-office tooth bleaching was unable to significantly reduce the risk and level of TS.
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Affiliation(s)
| | - Savil Costa Vaez
- Graduate Program in Health Sciences, UFS - Universidade Federal de Sergipe, Aracaju, SE, Brazil
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Carregosa Santana ML, Leal PC, Reis A, Faria-E-Silva AL. Effect of anti-inflammatory and analgesic drugs for the prevention of bleaching-induced tooth sensitivity: A systematic review and meta-analysis. J Am Dent Assoc 2019; 150:818-829.e4. [PMID: 31446977 DOI: 10.1016/j.adaj.2019.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/15/2019] [Accepted: 05/07/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND In-office dental bleaching results in a high risk of tooth sensitivity caused by the inflammatory process of the pulpal tissue. In this systematic review, the authors aimed to evaluate the effect of administering anti-inflammatory and analgesic drugs for the prevention of tooth sensitivity associated with in-office dental bleaching. TYPES OF STUDIES REVIEWED The authors searched the databases MEDLINE via PubMed, Scopus, Web of Science, and Cochrane Library for clinical trials. They searched in ClinicalTrials.gov for unpublished trials. The authors included only randomized clinical trials comparing anti-inflammatory and analgesic drugs with a placebo and evaluating tooth sensitivity after in-office bleaching. They imposed no restrictions regarding publication dates or languages. RESULTS The authors identified 5,050 studies after the removal of duplicates. They qualitatively and quantitatively analyzed the 11 studies remaining after the title and abstract screening. Nine studies showed a low risk of bias. The authors found no effect of the drugs on the risk (9 studies evaluated this outcome). Using a visual analog scale, the authors identified a similar level of sensitivity evaluated up to 1 hour (10 studies evaluated this outcome) and 24 hours (8 studies evaluated this outcome). They observed similar results using the numeric rate scale (8 and 6 studies used this tool, up to 1 hour and 24 hours respectively). The Grading of Recommendations Assessment, Development, and Evaluation approach showed a high level of evidence for all outcomes. CONCLUSIONS AND PRACTICAL IMPLICATIONS The high level of evidence available does not support the administration of anti-inflammatory and analgesic drugs to prevent tooth sensitivity caused by in-office dental bleaching.
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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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Benetti F, Briso ALF, Ferreira LL, Carminatti M, Álamo L, Ervolino E, Dezan-Júnior E, Cintra LTA. In Vivo Study of the Action of a Topical Anti-Inflammatory Drug In Rat Teeth Submitted To Dental Bleaching. Braz Dent J 2019; 29:555-561. [PMID: 30517478 DOI: 10.1590/0103-6440201802177] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/13/2018] [Indexed: 12/11/2022] Open
Abstract
Bleaching gel containing hydrogen peroxide (H2O2) cause damages in pulp tissue. This study investigated the action of a topical anti-inflammatory, the Otosporin®, in rats' bleached teeth with the null hypothesis of which the Otosporin® is no able to minimize the pulp inflammation that bleaching gel generates. The rat's molars were divided into groups: BLE: bleached (35% H2O2 concentration /single application of 30 min); BLE-O: bleached followed by Otosporin® (10 min); and control: placebo gel. In the second day after dental bleaching, the rats were killed, and the jaws were processed for hematoxylin-eosin and immunohistochemistry analysis for tumor necrosis factor alpha (TNF-α), interleukin (IL)-6 and IL-17. The data collected were subjected to Kruskal-Wallis and Dunn statistical tests with at a 5% level of significance (p<0.05). The BLE group had moderate to strong inflammation in the occlusal third of the coronary pulp, with necrotic areas; and BLE-O, mild inflammation (p<0.05). There was a significant difference in the occlusal and middle thirds of the coronary pulp between the BLE with BLE-O and control groups (p<0.05). There was no difference in the cervical third (p>0.05). The BLE group had a high immunoexpression of TNF-α than BLE-O and control groups (p<0.05), with moderate and mild immunoexpression, respectively. Regarding IL-6 and IL-17, the BLE group had higher immunoexpression than control (p<0.05); the BLE-O was similar to the control (p>0.05). The topical anti-inflammatory Otosporin® can reduce pulp inflammation after dental bleaching in the rat teeth.
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Affiliation(s)
- Francine Benetti
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - André Luiz Fraga Briso
- Restorative Dentistry, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Luciana Louzada Ferreira
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Marina Carminatti
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Larissa Álamo
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Edilson Ervolino
- Basic Science, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Eloi Dezan-Júnior
- Endodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, SP, Brazil
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Jiang N, Zhang C, Agingu C, Attin T, Cheng H, Yu H. Comparison of Whitening Dentifrices on the Effectiveness of In-office Tooth Bleaching: A Double-blind Randomized Controlled Clinical Trial. Oper Dent 2018; 44:138-145. [PMID: 30106335 DOI: 10.2341/17-333-c] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES: To investigate the effect of whitening dentifrices on the effectiveness of in-office tooth bleaching. METHODS AND MATERIALS: A double-blind randomized controlled clinical trial was performed. The participants were randomly allocated into three groups according to the different dentifrices used during this clinical trial: regular dentifrice (group C), conventional whitening dentifrice (group CW), and whitening dentifrice containing blue covarine (group CU). All participants received in-office tooth bleaching for the maxillary anterior teeth (two sessions conducted at a one-week interval). Tooth color was measured with a spectrophotometer at baseline (T1), after the first bleaching session (T2), after the second bleaching session (T3); one week after the completion of in-office bleaching (T4); and three weeks after the completion of in-office bleaching (T5). The data were statistically analyzed through repeated analysis of variance and the Tukey test (α=0.05). RESULTS: Sixty participants completed the study (n=20 per group). At T3, group CU exhibited the lowest ΔE values ( p=0.008). The ΔE values increased from T4 to T5 in the CW and CU groups, whereas a decrease in ΔE values was observed for group C. CONCLUSIONS: The use of a whitening dentifrice containing blue covarine during in-office bleaching reduced color changes. After tooth bleaching, brighter tooth colors were observed in the participants who brushed with whitening dentifrices compared to those who brushed with a regular dentifrice.
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