Moran B M, Ziegelmann P K, Berger S B, Burey A, de Paris Matos T, Fernández E, Loguercio A D, Reis A
*Bianca M Maran, DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Cascavel, Paraná, Brazil; Postgraduate Program in Dentistry, School of Dentistry, University of North Paraná, Londrina, Paraná, Brazil.
Patrícia K Ziegelmann, DDS, MS, PhD, associate professor, Statistics Department and Post-Graduation Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Oper Dent. 2021 Sep 1;46(5):E199-E223. doi: 10.2341/20-127-L.
A systematic review and network meta-analysis were performed to answer the following research question: Are there differences in the risk and the intensity of tooth sensitivity (TS) among eight light activation systems for in-office bleaching in adults?
Randomized controlled trials (RCTs) that compared at least two different in-office bleaching light activations were included. The risk of bias (RoB) was evaluated with the RoB tool version 1.0 from the Cochrane Collaboration tool. A random-effects Bayesian mixed treatment comparison (MTC) model was used independently for high- and low-concentration hydrogen peroxide. The certainty of the evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. A comprehensive search was performed in PubMed, Bridge Base Online (BBO), Latin American and Caribbean Health Sciences Literature database (LILACS), Cochrane Library, Scopus, Web of Science, and grey literature without date and language restrictions on April 23, 2017 (updated on September 26, 2019). Dissertations and theses, unpublished and ongoing trials registries, and IADR (International Association for Dental Research) abstracts (2001-2019) were also searched.
After title and abstract screening and the removal of duplicates, 32 studies remained. Six were considered to be at low RoB, three had high RoB, and the remaining had an unclear RoB. The MTC analysis showed no significant differences among the treatments in each network. In general, the certainty of the evidence was graded as low due to unclear RoB and imprecision.
There is no evidence that the risk and intensity of TS are affected by light activation during in-office bleaching.
进行一项系统评价和网状Meta分析，以回答以下研究问题：在成人诊室漂白的八种光激活系统中，牙齿敏感（TS）的风险和强度是否存在差异？
纳入比较至少两种不同诊室漂白光激活方式的随机对照试验（RCT）。使用Cochrane协作工具的1.0版偏倚风险（RoB）工具评估偏倚风险。针对高浓度和低浓度过氧化氢分别独立使用随机效应贝叶斯混合治疗比较（MTC）模型。采用GRADE（推荐分级、评估、制定与评价）方法评估证据的确定性。于2017年4月23日（2019年9月26日更新）在PubMed、Bridge Base Online（BBO）、拉丁美洲和加勒比健康科学文献数据库（LILACS）、Cochrane图书馆、Scopus、科学网以及灰色文献中进行全面检索，无日期和语言限制。还检索了学位论文、未发表和正在进行的试验注册信息以及国际牙科研究协会（IADR）摘要（2001 - 2019年）。
经过标题和摘要筛选以及去除重复项后，剩余32项研究。六项被认为偏倚风险低，三项偏倚风险高，其余偏倚风险不明确。MTC分析显示各网络中各治疗方法之间无显著差异。总体而言，由于偏倚风险不明确和不精确，证据的确定性被评为低。
没有证据表明诊室漂白期间光激活会影响TS的风险和强度。
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