Luque-Martinez Issis, Reis Alessandra, Schroeder Marcos, Muñoz Miguel Angel, Loguercio Alessandro D, Masterson Danielle, Maia Lucianne C
Dentistry Academic Unit, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Department of Restorative Dentistry, State University of Ponta, Grossa, PR, Brazil.
Clin Oral Investig. 2016 Sep;20(7):1419-33. doi: 10.1007/s00784-016-1863-7. Epub 2016 Jun 11.
The aim of the study was to compare the color change produced by tray-delivered carbamide peroxide [CP] versus hydrogen peroxide products [HP] for at-home bleaching through a systematic review and meta-analysis.
MEDLINE via PubMeb, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), and Cochrane Library and Grey literature were searched without restrictions. The abstracts of the International Association for Dental Research (IADR) and unpublished and ongoing trial registries were also searched. Dissertations and theses were explored using the ProQuest Dissertations and Periodicos Capes Theses databases. We included randomized clinical trials that compared tray-delivered CP versus HP for at-home dental bleaching. The color change in shade guide units (SGU) and ΔE were the primary outcomes, and tooth sensitivity and gingival irritation were the secondary outcomes. The risk of bias tool of the Cochrane Collaboration was used for quality assessment.
After duplicate removal, 1379 articles were identified. However, only eight studies were considered to be at "low" risk of bias in the key domains of the risk bias tool and they were included in the analysis. For ΔE, the standardized mean difference was -0.45 (95 % CI -0.69 to -0.21), which favored tray-delivered CP products (p < 0.001). The color change in ΔSGU (p = 0.70), tooth sensitivity (p = 0.83), and gingival irritation (p = 0.62) were not significantly different between groups.
Tray-delivered CP gels showed a slightly better whitening efficacy than HP-based products in terms of ΔE, but they were similar in terms of ΔSGU. Both whitening systems demonstrated equal level of gingival irritation and tooth sensitivity.
Tray-delivered CP gels have a slightly better whitening efficacy than HP-based products in terms of ΔE. This should be interpreted with caution as the data of ΔSGU did not show statistical difference between the products.
本研究旨在通过系统评价和荟萃分析，比较托盘式过氧化脲[CP]与过氧化氢产品[HP]用于家庭漂白所产生的颜色变化。
对通过PubMed的MEDLINE、Scopus、科学网、拉丁美洲和加勒比健康科学文献数据库（LILACS）、巴西牙科图书馆（BBO）以及Cochrane图书馆和灰色文献进行无限制检索。还检索了国际牙科研究协会（IADR）的摘要以及未发表和正在进行的试验注册信息。利用ProQuest学位论文和Periodicos Capes学位论文数据库探索学位论文。我们纳入了比较托盘式CP与HP用于家庭牙齿漂白的随机临床试验。比色板单位（SGU）的颜色变化和ΔE为主要结局，牙齿敏感度和牙龈刺激为次要结局。采用Cochrane协作网的偏倚风险工具进行质量评估。
在去除重复项后，共识别出1379篇文章。然而，在偏倚风险工具的关键领域中，只有8项研究被认为处于“低”偏倚风险，这些研究被纳入分析。对于ΔE，标准化均差为-0.45（95%CI -0.69至-0.21），这表明托盘式CP产品更具优势（p < 0.001）。两组之间在ΔSGU的颜色变化（p = 0.70）、牙齿敏感度（p = 0.83）和牙龈刺激（p = 0.62）方面无显著差异。
就ΔE而言，托盘式CP凝胶在美白效果上略优于基于HP的产品，但在ΔSGU方面两者相似。两种美白系统在牙龈刺激和牙齿敏感度方面表现相当。
就ΔE而言，托盘式CP凝胶在美白效果上略优于基于HP的产品。由于ΔSGU的数据未显示产品之间存在统计学差异，对此应谨慎解读。
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