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低水平激光疗法联合硝酸钾光生物调节对控制牙齿漂白后敏感的效果:临床、随机、对照、双盲、分口研究。

Effect of photobiomodulation with low-level laser therapy combined with potassium nitrate on controlling post-bleaching tooth sensitivity: clinical, randomized, controlled, double-blind, and split-mouth study.

机构信息

Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil.

School of Dentistry, Federal University of Pará, Belém, PA, Brazil.

出版信息

Clin Oral Investig. 2019 Jun;23(6):2723-2732. doi: 10.1007/s00784-018-2715-4. Epub 2018 Oct 25.

DOI:10.1007/s00784-018-2715-4
PMID:30361793
Abstract

OBJECTIVES

To evaluate the effect of photobiomodulation with low-level laser therapy (PBM-LLLT) combined with 5% potassium nitrate (KNO) on controlling tooth sensitivity (TS) after in-office tooth bleaching.

MATERIALS AND METHODS

Fifty volunteers were selected based on the inclusion and exclusion criteria and were randomly allocated into four groups: G1 (control): placebo gel application, 35% hydrogen peroxide bleaching (HP35) and mock PBM-LLLT without light emission; G2: placebo gel application, bleaching with HP35 and PBM-LLLT; G3: application of KNO, bleaching with HP35 and mock PBM-LLLT; and G4: application of KNO, bleaching with HP35 and PBM-LLLT. A pain assessment questionnaire was used to evaluate TS during the 21 days of treatment. The Friedman test was used for intragroup analysis, and the Wilcoxon and Mann-Whitney tests were used for intergroup comparisons.

RESULTS

The intragroup evaluation showed significant differences among the evaluation times in all groups (p ≤ 0.05). The highest pain sensitivity levels were recorded on the 1st, 8th, and 15th days. In G1, TS manifested for up to 3 days after each bleaching session, while G2, G3, and G4 presented TS only on the days of the bleaching sessions. Intergroup analysis showed that TS manifestation differed significantly between G1 and the other groups (p ≤ 0.05) but did not differ significantly among G2, G3, and G4 (p ≥ 0.05).

CONCLUSION

PBM-LLLT and KNO are effective at reducing pain sensitivity after tooth bleaching, but no synergistic effect between these treatments was observed for the different evaluation periods.

CLINICAL RELEVANCE

The effect of PBM-LLLT combined with KNO on post-bleaching tooth sensitivity is similar to their individual use alone.

摘要

目的

评估低水平激光疗法(PBM-LLLT)联合 5%硝酸钾(KNO)对控制诊室牙齿美白后牙齿敏感(TS)的效果。

材料和方法

根据纳入和排除标准选择了 50 名志愿者,并将其随机分为四组:G1(对照组):安慰剂凝胶应用,35%过氧化氢漂白(HP35)和无发光模拟 PBM-LLLT;G2:安慰剂凝胶应用,HP35 漂白和 PBM-LLLT;G3:应用 KNO,HP35 漂白和模拟 PBM-LLLT;G4:应用 KNO,HP35 漂白和 PBM-LLLT。使用疼痛评估问卷评估治疗的 21 天内的 TS。采用 Friedman 检验进行组内分析,Wilcoxon 和 Mann-Whitney 检验进行组间比较。

结果

组内评估显示,所有组在评估时间上均存在显著差异(p≤0.05)。最高的疼痛敏感性水平记录在第 1、8 和 15 天。在 G1 中,TS 在每次漂白后持续 3 天,而 G2、G3 和 G4 仅在漂白日出现 TS。组间分析显示,G1 与其他组之间的 TS 表现存在显著差异(p≤0.05),但 G2、G3 和 G4 之间没有显著差异(p≥0.05)。

结论

PBM-LLLT 和 KNO 可有效降低牙齿漂白后的疼痛敏感性,但在不同评估期内,这些治疗方法之间没有协同作用。

临床意义

PBM-LLLT 联合 KNO 对漂白后牙齿敏感的效果与单独使用相似。

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