Krishnakumar Karishma, Tandale Anita, Mehta Vini, Khade Shruti, Talreja Twinkle, Aidasani Gaurav, Arya Anukriti
Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND.
Public Health Dentistry, People's College Of Dental Science and Research Center (PCDS) People's University Campus, Bhopal, IND.
Cureus. 2022 Apr 11;14(4):e24028. doi: 10.7759/cureus.24028. eCollection 2022 Apr.
Bleaching agents can cause certain surface alterations on the enamel, such as depressions, surface porosity, and surface irregularities; this makes the dentin more susceptible to post-operative tooth sensitivity (PoS). In addition, the presence of flawed or leaky restorations, gingival recession, or defects in the cementoenamel junction can also cause severe tooth sensitivity post tooth bleaching.Hence, the current study aimed to perform a systematic review to determine the efficacy of various desensitizing agents (DA) in managing post-operative tooth sensitivity and color alteration when applied before in-office bleaching procedures. Randomized clinical trials were searched to conduct an SR where the post-operative tooth sensitivity was evaluated after in-office bleaching with various desensitizing agents used before the procedure. Post-operative pain assessment was measured using the Visual Analogue Scale (VAS). Outcomes were evaluated up to an hour and 24 hours post the procedure. Out of 163 articles, only 13 titles were selected that met the eligibility criteria. Eight hundred and forty-one adult patients with vital pulp status were included. The participants receiving prior desensitizing agent applications reported significantly lower pain scores in the VAS reports. The most significant reduction of post-operative sensitivity was observed in the immediate (up to an hour) and 24 hours after the in-office bleaching. The popular desensitizing agent that could manage post-operative tooth sensitivity (TS) is 5% potassium nitrate and 2% sodium fluoride used before the in-office bleaching procedure.
漂白剂可导致牙釉质表面出现某些改变，如凹陷、表面孔隙和表面不规则；这使得牙本质更容易出现术后牙齿敏感（PoS）。此外，存在有缺陷或渗漏的修复体、牙龈退缩或牙骨质釉质界的缺陷也可能导致牙齿漂白后出现严重的牙齿敏感。因此，本研究旨在进行一项系统评价，以确定在诊室漂白程序前应用各种脱敏剂（DA）在管理术后牙齿敏感和颜色改变方面的疗效。检索随机临床试验以进行一项系统评价，其中在诊室漂白后使用术前应用的各种脱敏剂评估术后牙齿敏感情况。使用视觉模拟量表（VAS）测量术后疼痛评估。在术后1小时和24小时对结果进行评估。在163篇文章中，仅选择了13篇符合纳入标准的文章。纳入了841名牙髓活力正常的成年患者。在VAS报告中，接受术前脱敏剂应用的参与者报告的疼痛评分显著更低。在诊室漂白后的即刻（长达1小时）和24小时观察到术后敏感性的最显著降低。在诊室漂白程序前使用的能够管理术后牙齿敏感（TS）的常用脱敏剂是5%硝酸钾和2%氟化钠。
