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37.5%过氧化氢诊室浓度降低漂白方案对疗效和牙齿敏感性的影响:一项双盲随机临床试验。

Effects of a reduced in-office bleaching protocol with 37.5% hydrogen peroxide on effectiveness and tooth sensitivity: A double-blind randomized clinical trial.

机构信息

Department of Operative Dentistry, Federal University of Paraiba, João Pessoa, Paraiba, Brazil.

Post-Graduate Program in Dentistry, Federal University of Paraiba, João Pessoa, Paraiba, Brazil.

出版信息

J Esthet Restor Dent. 2021 Jul;33(5):824-831. doi: 10.1111/jerd.12744. Epub 2021 Jun 28.

Abstract

OBJECTIVE

This randomized clinical trial evaluated the effectiveness and tooth sensitivity (TS) of 37.5% hydrogen peroxide (37.5HP) in-office bleaching with reduced protocol.

MATERIALS AND METHODS

Forty participants with shade mean C2 or darker for the six maxillary anterior teeth were randomly allocated into two treatment groups (n = 20): two (37.5HP2) or three (37.5HP3) 8 min applications/clinical session. Three clinical sessions were performed with a 1 week interval. Color evaluations were done with a spectrophotometer at baseline and 1 week post-bleaching. TS was measured during and up to 48 h after bleaching using a five-point numeric rating scale. Color change was evaluated by Student's t-test for independent samples. The absolute risk and intensity of TS were analyzed by Fisher's and Mann-Whitney/Friedman tests (p < 0.05).

RESULT

Both treatment groups resulted in a significant tooth whitening 1 week post-bleaching (p < 0.001). There were no significant differences between 37.5HP2 and 37.5HP3 for ΔE* , ΔE and ∆WI . Also, there were not differences between groups regarding high absolute risk (p = 1.0) and low intensity of TS at all time assessments (p > 0.7).

CONCLUSIONS

The in-office bleaching with two 37.5% HP applications produced the same whitening degree, risk and intensity of TS to that performed with three gel applications.

CLINICAL SIGNIFICANCE

Clinicians should opt to use a neutral 37.5% HP in-office bleaching gel for two 8 min applications/clinical session because produces the same whitening effectiveness, risk and low intensity of TS as the protocol proposed by manufacturer (three 8 min applications).

摘要

目的

本随机临床试验评估了 37.5%过氧化氢(37.5HP)在减少方案下的诊室漂白的有效性和牙齿敏感性(TS)。

材料和方法

40 名上颌前六颗牙齿平均 C2 或更暗的患者被随机分配到两组(n=20):两次(37.5HP2)或三次(37.5HP3)8 分钟/次的应用。每 1 周进行 3 次临床治疗。在基线和漂白后 1 周使用分光光度计进行颜色评估。在漂白过程中和漂白后 48 小时内使用五点数字评分量表测量 TS。使用学生 t 检验对独立样本进行颜色变化评估。通过 Fisher 和 Mann-Whitney/Friedman 检验分析绝对风险和 TS 强度(p<0.05)。

结果

两组治疗后 1 周均显著美白(p<0.001)。37.5HP2 和 37.5HP3 之间的 ΔE*、ΔE 和 ∆WI 无显著差异。此外,两组之间在高绝对风险(p=1.0)和所有时间评估中的低强度 TS(p>0.7)方面没有差异。

结论

两次 37.5% HP 应用的诊室漂白产生了相同的美白效果、风险和 TS 强度,与三次凝胶应用的效果相同。

临床意义

临床医生应选择使用中性 37.5% HP 诊室漂白凝胶进行两次 8 分钟/次的应用,因为它产生与制造商建议的方案(三次 8 分钟应用)相同的美白效果、风险和低强度 TS。

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