Ahrari Farzaneh, Akbari Majid, Mohammadipour Hamideh Sadat, Fallahrastegar Amir, Sekandari Salehe
Associate Professor of Orthodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Professor of Restorative and Cosmetic Dentistry, Dental Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Swiss Dent J. 2020 Jun 15;130(6):493-501. doi: 10.61872/sdj-2020-06-02.
This study aimed to evaluate the efficacy and complications of several bleaching methods in patients with discolored teeth after orthodontic treatment. This randomized clinical trial involved 60 volunteers (31 women, 29 men) aged 14 to 30 years, who finished fixed orthodontic therapy at least three months before the study commencement and complained of discoloration on upper front teeth. The subjects were divided into four groups by treatment. The patients in group 1 received home bleaching, whereas those in groups 2 to 4 underwent in-office bleaching using a diode laser, a plasma arc and no light source, respectively. Tooth color was measured at baseline, one hour after the end of the bleaching procedure, and one week later, and the color alteration between different stages was compared among the groups. The severity of tooth sensitivity and the occurrence of other post-treatment complications were recorded. The color change between baseline and one week after treatment was greatest in the home-bleaching and the laser-assisted bleaching groups, and lowest in the plasma-arc bleaching group, although the difference between the groups was not significant (p > 0.05). Tooth sensitivity over 24 hours after bleaching was lowest in subjects who had undergone laser-assisted bleaching and highest in those who had received in-office bleaching without light (p < 0.05). All methods were effective in managing tooth discoloration after orthodontic treatment. Home bleaching produced favorable color alteration. Amongst the in-office approaches, laser-assisted bleaching should be considered as the best option, as it produced effective results with lowest tooth sensitivity and over a shorter period of time.
本研究旨在评估几种漂白方法对正畸治疗后牙齿变色患者的疗效及并发症。这项随机临床试验纳入了60名年龄在14至30岁之间的志愿者（31名女性，29名男性），他们在研究开始前至少三个月完成了固定正畸治疗，并主诉上前牙变色。受试者按治疗方法分为四组。第1组患者接受家庭漂白，而第2至4组患者分别使用二极管激光、等离子弧且不使用光源进行诊室漂白。在基线、漂白程序结束后1小时以及1周后测量牙齿颜色，并比较各组不同阶段之间的颜色变化。记录牙齿敏感的严重程度及其他治疗后并发症的发生情况。尽管各组之间差异不显著（p>0.05），但家庭漂白组和激光辅助漂白组在基线与治疗后1周之间的颜色变化最大，等离子弧漂白组最小。漂白后24小时以上牙齿敏感程度在接受激光辅助漂白的受试者中最低，在未使用光源的诊室漂白受试者中最高（p<0.05）。所有方法对正畸治疗后的牙齿变色均有效。家庭漂白产生了良好的颜色变化。在诊室治疗方法中，激光辅助漂白应被视为最佳选择，因为它能在较短时间内产生有效效果且牙齿敏感程度最低。
