Department of Restorative Dentistry, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Bloco M, Sala 04, Ponta Grossa, Paraná, 84030-900, Brazil.
Paulo Picanço School of Dentistry, Fortaleza, Ceará, Brazil.
Clin Oral Investig. 2021 Jul;25(7):4311-4327. doi: 10.1007/s00784-021-03994-6. Epub 2021 Jun 1.
To conduct a systematic review and meta-analysis to evaluate the risk and intensity of tooth sensitivity (TS) after topical application of desensitizers containing potassium nitrate before dental bleaching.
We searched PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE. We also surveyed gray literature without restrictions. We meta-analyzed the data using the random-effects model to compare potassium nitrate and placebo in terms of risk and intensity of TS and color change (∆SGU or ∆E). The quality of the evidence was rated using the GRADE approach. The risk of bias (RoB) of the included studies was analyzed using the Cochrane RoB tool.
After the database screening, 24 articles remained. A significant 12% lower risk for the groups where desensitizing agents were applied (p = 0.02), with a risk ratio of 0.88 (95% CI 0.78 to 0.98). About the intensity of TS, a significant average mean difference of - 0.77 units of VAS units (95%CI - 1.34 to - 0.19; p = 0.01) in favor of the desensitizer group. In the NRS scale, a significant average mean difference of - 0.36 (95% CI - 0.61 to - 0.12; p value = 0.004) in favor of the desensitizer group. No significant difference was observed in color change (p > 0.28) in ∆SGU and ∆E.
Although a significant reduction in the risk and intensity of TS was observed in groups treated with a potassium nitrate at some point during the bleaching, the clinical significance of this reduction is subtle and clinically questionable. Color change is not affected by the use of agents.
The reduction in the risk and intensity of TS with the topical application of potassium nitrate-based desensitizing agents in dental bleaching is subtle and maybe clinically questionable.
系统评价和荟萃分析评估在牙齿漂白前使用含有硝酸钾的脱敏剂局部应用后牙齿敏感（TS）的风险和强度。
我们检索了 PubMed、Scopus、Web of Science、LILACS、BBO、Cochrane 图书馆和 SIGLE。我们还对无限制的灰色文献进行了调查。我们使用随机效应模型对数据进行荟萃分析，以比较硝酸钾和安慰剂在 TS 风险和强度以及颜色变化（∆SGU 或 ∆E）方面的差异。使用 GRADE 方法评估证据质量。使用 Cochrane RoB 工具分析纳入研究的偏倚风险（RoB）。
在数据库筛选后，仍有 24 篇文章。应用脱敏剂的组风险显著降低 12%（p = 0.02），风险比为 0.88（95%CI 0.78 至 0.98）。关于 TS 的强度，脱敏剂组的平均 VAS 单位差异有统计学意义，为 -0.77 单位（95%CI -1.34 至 -0.19；p = 0.01）。在 NRS 量表中，脱敏剂组的平均平均差异为 -0.36（95%CI -0.61 至 -0.12；p 值 = 0.004）。在 ∆SGU 和 ∆E 中，颜色变化无显著差异（p > 0.28）。
尽管在漂白过程中的某个时间点用硝酸钾处理的组中观察到 TS 的风险和强度显著降低，但这种降低的临床意义是微妙的，临床上存在疑问。颜色变化不受使用药物的影响。
在牙齿漂白中局部应用基于硝酸钾的脱敏剂可降低 TS 的风险和强度，但这种降低是微妙的，可能在临床上存在疑问。
