Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Rua Engenharia, 464 - Universitário, Cascavel, Paraná, 85819-190, Brazil.
Statistics Department and Post-Graduation Program in Epidemiology, Federal University of Rio Grande do Sul, Rua Paulo Gama, 110 - Farroupilha, Porto Alegre, Rio Grande do Sul, 90040-060, Brazil.
Clin Oral Investig. 2019 Apr;23(4):1499-1512. doi: 10.1007/s00784-019-02835-x. Epub 2019 Feb 14.
A systematic review and a network meta-analysis were performed to answer the following research question: "Is there any light-activation protocol capable of improving color change efficacy when associated with an in-office bleaching gel in adults?"
A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE without date and/or language restrictions in April 23, 2017 (updated on March 30, 2018). IADR abstracts (1990-2018), unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials conducted in adults that included at least one group treated with in-office dental bleaching with light activation were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. A random-effects Bayesian-mixed treatment comparison (MTC) model was used to combine light-activated versus light-free in-office bleaching with direct light-free comparison trials. A meta-analysis with independent analysis (high- and low-concentrate hydrogen peroxide [HP]) was conducted for color change (∆E*, ∆SGU).
After the removal of duplicates, title, and abstract screening, 28 studies remained. Nine were considered to be at a low RoB, five were at a high RoB, and the remaining were at an unclear RoB. The MTC analysis showed no significant difference in color change (ΔE* and ΔSGU) between light-activation protocols and light-free in-office bleaching, regardless of the HP concentration in the efficacy of the bleaching.
No type of light-activated in-office bleaching was superior to light-free in-office bleaching for both high- and low-concentrate in-office bleaching gels (PROSPERO-CRD42017078743).
Although many times dental professionals use "laser whitening" as a form of marketing, this study confirmed that no type of light-activation for in-office bleaching can improve the bleaching efficacy.
通过系统评价和网络荟萃分析来回答以下研究问题：“当与诊室用漂白凝胶联合使用时，是否存在任何能够提高颜色变化效果的光激活方案？”
于 2017 年 4 月 23 日（2018 年 3 月 30 日更新）在 PubMed、Scopus、Web of Science、LILACS、BBO、Cochrane Library 和 SIGLE 中，没有日期和/或语言限制地进行检索。还搜索了 IADR 摘要（1990-2018 年）、未发表和正在进行的试验登记处、论文和论文。仅纳入了包含至少一组接受诊室牙齿漂白加光激活治疗的成年人随机临床试验。使用 Cochrane 协作工具评估偏倚风险（RoB）。使用随机效应贝叶斯混合治疗比较（MTC）模型将光激活与无光照诊室漂白进行组合，并与直接无光照比较试验进行比较。对于颜色变化（∆E*，∆SGU），进行了具有独立分析（高浓度和低浓度过氧化氢[HP]）的荟萃分析。
在去除重复项、标题和摘要筛选后，仍有 28 项研究。其中 9 项被认为是低 RoB，5 项是高 RoB，其余的 RoB 不明确。MTC 分析显示，无论漂白凝胶的 HP 浓度如何，光激活方案与无光照诊室漂白之间在颜色变化（ΔE*和ΔSGU）方面没有显著差异。
对于高浓度和低浓度的诊室用漂白凝胶，没有任何一种光激活诊室漂白方法优于无光照诊室漂白（PROSPERO-CRD42017078743）。
尽管牙医经常将“激光美白”作为一种营销形式，但本研究证实，任何一种光激活诊室漂白方法都不能提高漂白效果。
