Fernandes M T, Vaez S C, Lima C M, Nahsan F P, Loguércio A D, Faria-E-Silva A L
Oper Dent. 2017 Sep/Oct;42(5):486-496. doi: 10.2341/16-100-C.
A triple-blind, randomized, crossover clinical trial evaluated prior use of nonsteroidal anti-inflammatory naproxen on sensitivity reported by patients undergoing in-office tooth bleaching.
Fifty patients were subjected to two sessions of in-office tooth bleaching with 35% hydrogen peroxide in a single application of 40 minutes for two sessions, with an interval of seven days between applications. One hour prior to the procedure, each patient randomly received a single dose of naproxen (500 mg) or placebo. The patient's sensitivity level was evaluated during and immediately after the bleaching using two scales (verbal and visual analog); the verbal scale only was repeated after 24 hours. The effectiveness of the bleaching procedures was evaluated with the Bleachedguide scale. Relative risk to sensitivity was calculated and adjusted by session, while comparison of overall risk was performed by the McNemar test. Data on the sensitivity level for both scales and shade were subjected to the Friedman, Wilcoxon, and Mann-Whitney tests (α=0.05).
The use of naproxen only decreased the absolute risk and intensity of tooth sensitivity reported immediately after the second session. On the other hand, no measurable effect was observed during or 24 hours after either session. The sequence of drug administration did not affect the bleaching effectiveness.
Preemptive use of naproxen only reduced tooth sensitivity reported by patients immediately after the second session of bleaching.
一项三盲、随机、交叉临床试验评估了非甾体抗炎药萘普生先前的使用情况对接受诊室牙齿美白患者报告的牙齿敏感程度的影响。
50名患者接受了两疗程的诊室牙齿美白，使用35%的过氧化氢单次涂抹40分钟，共两疗程，两次涂抹间隔7天。在治疗前1小时，每位患者随机接受单剂量的萘普生（500毫克）或安慰剂。在美白过程中及结束后立即使用两种量表（语言和视觉模拟量表）评估患者的敏感程度；仅在24小时后重复使用语言量表。使用Bleachedguide量表评估美白程序的效果。计算并按疗程调整敏感的相对风险，同时通过McNemar检验进行总体风险比较。对两种量表的敏感程度数据和牙齿色度数据进行Friedman检验、Wilcoxon检验和Mann-Whitney检验（α = 0.05）。
仅使用萘普生降低了第二疗程结束后立即报告的牙齿敏感的绝对风险和强度。另一方面，在任何一个疗程期间或之后24小时均未观察到可测量的效果。药物给药顺序不影响美白效果。
预防性使用萘普生仅降低了患者在第二疗程牙齿美白后立即报告的牙齿敏感程度。
