Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College and Hospital, Bangalore, India.
Department of Conservative Dentistry and Endodontics, K.L.E. Society's Institute of Dental Sciences, Bangalore, India.
J Esthet Restor Dent. 2018 May;30(3):254-258. doi: 10.1111/jerd.12374. Epub 2018 Mar 9.
Aim of this clinical trial was to investigate the effect of a calcium phosphate based desensitizer paste applied prior to in-office tooth whitening on bleaching sensitivity (BS).
This crossover study was designed as randomized double-blinded, placebo-controlled trial. The desensitizer paste Teethmate AP (TAP) contains tetracalcium phosphate and dicalcium phosphate anhydrous in glycerol and polyethylene glycol, whereas placebo (PLA) is a calcium phosphate free analog. Fifty patients with sound maxillary incisors and canines were enrolled. Tooth shades were determined with a Vitapan Classic Shade guide. Randomly, TAP and PLA were applied to the left or to the right anterior teeth. After rinsing and air-drying the bleaching gel (Opalescence Boost PF 40%) was applied and left on the labial surfaces for 15 minutes. Sensitivity was recorded using a 10 cm visual analog scale (VAS) before, at 5, 10, and 15 minutes during, and at 1 hour, 1, 2, and 7 days after bleaching. Tooth whitening was determined with the shade guide after 1 day and 1 week.
Prebleaching desensitization with TAP reduced BS significantly when compared with PLA. Between 1 and 7 days the average sensitivity scores were close to zero, whereas the average scores for PLA were significantly higher during this time interval. Independent from the desensitizing treatment after 1 and 7 days the medians of the shades were between 5 and 3.5 units brighter.
Prebleaching desensitization with TAP was effective in reducing BS during and after tooth whitening treatment and had no adverse effect on the bleaching result.
Prebleaching topical application of a calcium phosphate containing compound reduced significantly bleaching sensitivity during a single 15 minutes treatment and up to one week with a 40% hydrogen peroxide containing gel without compromising tooth whitening.
本临床试验旨在研究在诊室牙齿美白前应用基于磷酸钙的脱敏剂对美白敏感（BS）的影响。
本交叉研究设计为随机双盲、安慰剂对照试验。脱敏剂糊剂 Teethmate AP（TAP）含有甘油和聚乙二醇中的四钙磷酸钙和二水磷酸钙无水物，而安慰剂（PLA）是一种不含钙的磷酸钙类似物。招募了 50 名上颌切牙和尖牙健康的患者。用 Vitapan Classic Shade guide 确定牙齿颜色。随机将 TAP 和 PLA 应用于左侧或右侧前牙。冲洗和风干后，将漂白凝胶（Opalescence Boost PF 40%）应用于唇面 15 分钟。在漂白前、漂白过程中的 5、10 和 15 分钟以及漂白后 1 小时、1 天、2 天和 7 天使用 10cm 视觉模拟量表（VAS）记录敏感性。漂白后 1 天和 1 周用比色板确定牙齿美白效果。
与 PLA 相比，TAP 预处理脱敏可显著降低 BS。在 1 天到 7 天期间，平均敏感评分接近零，而 PLA 的平均评分在此期间显著更高。无论脱敏治疗如何，在 1 天和 7 天后，颜色中位数在 5 到 3.5 个单位之间更亮。
TAP 预处理脱敏在牙齿美白治疗期间和之后可有效降低 BS，并且对漂白效果没有不利影响。
在单次 15 分钟的治疗中，使用含有钙的磷酸化合物预处理应用可显著降低漂白敏感性，使用含有 40%过氧化氢的凝胶可降低至 1 周，并且不会影响牙齿美白效果。
