Bonafé Elize, Loguercio Alessandro Dourado, Reis Alessandra, Kossatz Stella
Clin Oral Investig. 2014 Apr;18(3):839-45. doi: 10.1007/s00784-013-1055-7.
The aim of this clinical trial was to evaluate the effectiveness and tooth sensitivity associated with bleaching in patients with composite restorations in anterior teeth after the application of a desensitizing agent.
Bleaching was performed with 35 % hydrogen peroxide gel in 30 patients with composite restorations in anterior teeth, divided according to the prior application of a desensitizing agent (De), or a placebo (Pl), on maxillary superior teeth. Color was recorded at baseline, 1 week after each session and 6 months after treatment. The experience of tooth sensitivity (TS) was recorded on an NRS (0-4) during bleaching and 24 h after each session. Bleaching effectiveness was evaluated by one-way ANOVA and Tukey's tests (α = 0.05). The percentage of TS was evaluated by Fisher's exact test. For each treatment, periods were compared using the Wilcoxon signed-rank test (α = 0.05), and at each period, treatments were compared using Mann-Whitney U test.
Both groups showed similar tooth color enhancement and color stability after 6 months (p < 0.05). No significant difference in prevalence of sensitivity was detected between groups (p < 0.001). Higher TS intensity (median [first/third quartiles]) was observed for Pl (1.5 [1/1.75]) compared with De (0.5 [0/1]) during treatment (p < 0.05).
The use of a desensitizing gel (5 % potassium nitrate, 2 % sodium fluoride) before tooth bleaching in patients with composite restorations did not reduce the prevalence of tooth sensitivity, but reduced the intensity of TS during bleaching.
Although the use of a desensitizing agent before bleaching, in patients with composite resin restorations, did not reduce the prevalence of TS, a reduction of the TS intensity during the protocol was observed without jeopardizing the whitening outcome.
本临床试验旨在评估在前牙复合树脂修复患者中,应用脱敏剂后进行牙齿漂白的有效性及牙齿敏感性。
对30例前牙复合树脂修复患者使用35%过氧化氢凝胶进行漂白,根据在上颌前牙预先应用脱敏剂(De)或安慰剂(Pl)进行分组。在基线、每次治疗后1周及治疗后6个月记录牙齿颜色。在漂白过程中及每次治疗后24小时,使用数字评定量表(0 - 4)记录牙齿敏感(TS)情况。通过单因素方差分析和Tukey检验(α = 0.05)评估漂白效果。通过Fisher精确检验评估TS的发生率。对于每种治疗方法,使用Wilcoxon符号秩检验(α = 0.05)比较不同时期,在每个时期,使用Mann - Whitney U检验比较不同治疗方法。
6个月后,两组牙齿颜色均有相似程度的改善且颜色稳定性良好(p < 0.05)。两组间敏感性发生率无显著差异(p < 0.001)。治疗期间,与De组(0.5 [0/1])相比,Pl组(1.5 [1/1.75])观察到更高的TS强度(中位数[第一/第三四分位数])(p < 0.05)。
对于复合树脂修复患者,在牙齿漂白前使用脱敏凝胶(5%硝酸钾,2%氟化钠)并未降低牙齿敏感的发生率,但降低了漂白过程中TS的强度。
尽管在复合树脂修复患者中,漂白前使用脱敏剂并未降低TS的发生率,但在不影响美白效果的前提下,观察到在治疗过程中TS强度有所降低。