School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Parana, Brazil.
Department of Restorative Dentistry, School of Dentistry, Faculdade de Odontologia, Universidade Estadual de Ponta Grossa, Rua Carlos Cavalcanti, 4748, São Paulo, CEP 84030-900, Brazil.
Clin Oral Investig. 2017 Dec;21(9):2811-2818. doi: 10.1007/s00784-017-2083-5. Epub 2017 Mar 17.
The study aimed to compare the tooth sensitivity (TS) and bleaching efficacy of two hydrogen peroxide gels with different pHs (acid pH [Pola Office, SDI] and the neutral pH [Pola Office+, SDI]) used for in-office bleaching.
Fifty-four patients from Brazil and Chile, with right superior incisor darker than A2, were selected for this double-blind, split-mouth randomized trial. Teeth were bleached in two sessions, with 1-week interval. Each session had three applications of 8 min each, according to the manufacturer's instructions. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easy shade spectrophotometer) methods. Participants recorded TS with 0-10 visual analog scale. Color change in shade guide units (SGU) and ΔE was analyzed by Student's t test (α = 0.05). The absolute risk and intensity of TS were evaluated by McNemar's test and Wilcoxon-paired test, respectively (α = 0.05).
All groups achieved the same level of whitening after 30 days of clinical evaluation. The use of a neutral in-office bleaching gel significantly decreases the absolute risk of TS (28%, 95% CI 18-41) and intensity of TS when compared to the acid bleaching gel (absolute risk of 50%, 95% CI 37-63).
The use of a neutral in-office bleaching agent gel produced the same whitening degree than an acid bleaching gel but with reduced risk and intensity of tooth sensitivity.
Clinicians should opt to use in-office bleaching with a neutral gel than an acid product because the former causes a significant lower risk and intensity of tooth sensitivity.
本研究旨在比较两种 pH 值不同的过氧化氢凝胶（酸性 pH 值 [Pola Office，SDI] 和中性 pH 值 [Pola Office+，SDI]）用于诊室漂白时的牙齿敏感性（TS）和漂白效果。
从巴西和智利选择了 54 名右侧上门牙比 A2 更暗的患者进行这项双盲、分口随机试验。牙齿在两次治疗中漂白，间隔 1 周。根据制造商的说明，每次治疗进行 3 次 8 分钟的应用。使用主观（Vita Classical 和 Vita Bleachedguide）和客观（Easy shade 分光光度计）方法评估颜色变化。参与者使用 0-10 视觉模拟量表记录 TS。使用 Student's t 检验（α=0.05）分析比色单位（SGU）和 ΔE 的颜色变化。使用 McNemar 检验和 Wilcoxon 配对检验分别评估 TS 的绝对风险和强度（α=0.05）。
所有组在 30 天的临床评估后均达到相同的美白水平。与酸性漂白凝胶相比，使用中性诊室漂白凝胶可显著降低 TS 的绝对风险（28%，95%CI 18-41%）和强度（50%，95%CI 37-63%）。
使用中性诊室漂白剂凝胶产生的美白效果与酸性漂白凝胶相同，但牙齿敏感性的风险和强度降低。
临床医生应选择使用中性凝胶进行诊室漂白，而不是酸性产品，因为前者会显著降低牙齿敏感性的风险和强度。
