Chan Wyman
Warwick Dentistry University of Warwick.
Br Dent J. 2013 Nov 8;215(9):466-7. doi: 10.1038/sj.bdj.2013.1070.
The study was performed to assess the risk of at-home and in-office bleaching procedures, and to recognise potential predictors for side effects.
Multi-centre, questionnaire-based prospective study with follow-ups at around 14 days and around one year post-treatment.
General practices and university clinics during the years 2007-2009 in Scandinavia.
Patients with tooth bleaching as part of the treatment plan.Results The prevalence of experienced tooth sensitivity at first follow-up was independent of bleaching procedure (at-home = 50.3% [n = 143]; in-office = 39.3% [n = 28]; p >0.05; 95% CI [OR]: 0.198-1.102) whereas prevalence of gingival irritation was higher after in-office treatment (at-home = 14.0%; in-office = 35.7%; p <0.05) (mean age: 37.3 years; 73.7% women; n = 171). At the second follow-up, two and three patients reported side effects attributed to the bleaching treatment in the at-home and in-office groups, respectively. Predictors for side effects were tooth sensitivity, surface loss and gingivitis when observed at inclusion. Treatment-related predictors were bleaching concentration and contact between tray and gingiva.
Bleaching treatment, irrespective of method, caused a high prevalence of side effects. Patients associated with the predictors at inclusion mentioned above should be notified of the risk for side effects and treated only if bleaching is indicated based on a proper diagnosis.
本研究旨在评估家庭漂白和诊室漂白程序的风险，并识别副作用的潜在预测因素。
多中心、基于问卷的前瞻性研究，在治疗后约14天和约1年进行随访。
2007年至2009年期间斯堪的纳维亚半岛的普通诊所和大学诊所。
作为治疗计划一部分接受牙齿漂白的患者。结果首次随访时牙齿敏感的发生率与漂白程序无关（家庭漂白=50.3%[n = 143]；诊室漂白=39.3%[n = 28]；p>0.05；95%CI[OR]：0.198 - 1.102），而诊室治疗后牙龈刺激的发生率更高（家庭漂白=14.0%；诊室漂白=35.7%；p<0.05）（平均年龄：37.3岁；女性占73.7%；n = 171）。在第二次随访时，家庭漂白组和诊室漂白组分别有2例和3例患者报告了与漂白治疗相关的副作用。纳入时观察到的副作用预测因素为牙齿敏感、表面损失和牙龈炎。与治疗相关的预测因素为漂白浓度以及托盘与牙龈之间的接触。
无论采用何种方法，漂白治疗都会导致较高的副作用发生率。对于上述纳入时与预测因素相关的患者，应告知其副作用风险，并且只有在基于正确诊断表明需要漂白时才进行治疗。
