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双氯芬酸凝胶局部应用对诊室牙漂白后牙本质敏感减轻效果的随机、三盲、多中心临床试验。

Effect of topical application of dipyrone on dental sensitivity reduction after in-office dental bleaching: A randomized, triple-blind multicenter clinical trial.

出版信息

J Am Dent Assoc. 2018 May;149(5):363-371. doi: 10.1016/j.adaj.2017.11.003. Epub 2018 Mar 15.

Abstract

BACKGROUND

Tooth sensitivity commonly occurs during and immediately after dental bleaching. The authors conducted a trial to compare tooth sensitivity after in-office bleaching after the use of either a topical dipyrone or placebo gel.

METHODS

A split-mouth, triple-blind, randomized, multicenter clinical trial was conducted among 120 healthy adults having teeth that were shade A2 or darker. The facial tooth surfaces of the right or left sides of the maxillary arch of each patient were randomly assigned to receive either topical dipyrone or placebo gel before 2 in-office bleaching sessions (35% hydrogen peroxide) separated by 2 weeks. Visual analog and numerical rating scales were used to record tooth sensitivity during and up to 48 hours after bleaching. Tooth color change from baseline to 1 month after bleaching was measured with shade guide and spectrophotometer measures. The primary outcome variable was absolute risk of tooth sensitivity. An intention-to-treat analysis was used to analyze data from all patients who were randomly assigned to receive the dipyrone and placebo gels.

RESULTS

No statically significant difference was found in the absolute risk of tooth sensitivity between the dipyrone and placebo gels (83% and 90%, respectively, P = .09; relative risk, 0.92; 95% confidence interval, 0.8 to 1.0). A whitening effect was observed in both groups with no statistically significant difference (P > .05) between them. No adverse effects were observed.

CONCLUSION

Topical use of dipyrone gel before tooth bleaching, at the levels used in this study, did not reduce the risk or intensity of bleaching-induced tooth sensitivity.

PRACTICAL IMPLICATIONS

Topical application of dipyrone gel does not reduce bleaching-induced tooth sensitivity.

摘要

背景

牙齿敏感通常发生在牙齿漂白过程中和之后立即发生。作者进行了一项试验,比较了使用局部双氯芬酸或安慰剂凝胶后诊室漂白后牙齿敏感的情况。

方法

一项分口、三盲、随机、多中心临床试验在 120 名健康成年人中进行,这些成年人的牙齿颜色为 A2 或更暗。每位患者上颌弓的右侧或左侧的面部牙齿表面随机分配接受局部双氯芬酸或安慰剂凝胶,然后进行 2 次诊室漂白(35%过氧化氢),间隔 2 周。视觉模拟和数字评分量表用于记录漂白过程中和漂白后 48 小时内的牙齿敏感程度。使用比色指南和分光光度计测量从基线到漂白后 1 个月的牙齿颜色变化。主要观察变量是牙齿敏感的绝对风险。对所有随机分配接受双氯芬酸和安慰剂凝胶的患者进行意向治疗分析。

结果

双氯芬酸凝胶和安慰剂凝胶之间牙齿敏感的绝对风险无统计学显著差异(分别为 83%和 90%,P=0.09;相对风险,0.92;95%置信区间,0.8 至 1.0)。两组均观察到美白效果,且两者之间无统计学显著差异(P>0.05)。未观察到不良反应。

结论

在本研究中使用的水平下,在牙齿漂白前局部使用双氯芬酸凝胶不会降低漂白引起的牙齿敏感的风险或强度。

实用意义

局部应用双氯芬酸凝胶不能减轻漂白引起的牙齿敏感。

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