J Am Dent Assoc. 2023 Mar;154(3):245-259.e12. doi: 10.1016/j.adaj.2022.11.012. Epub 2023 Jan 28.
Topical application of calcium-containing bioactive desensitizers (CBs) has been used to minimize bleaching-induced tooth sensitivity (TS). This study answered the research question "Is the risk of TS lower when CBs are used with dental bleaching in adults compared with bleaching without desensitizers?"
The authors included randomized clinical trials comparing topical CB application with a placebo or no intervention during bleaching. Searches for eligible articles were performed in MEDLINE via PubMed, Cochrane Library, Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature, Scopus, Web of Science, Embase, and gray literature without language and date restrictions and updated in September 2022. The risk of bias was evaluated using Risk of Bias Version 2.0. The authors conducted meta-analyses with the random-effects model. The authors assessed heterogeneity with the Cochrane Q test, I statistics, and prediction interval. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence.
After database screening, 22 studies remained, with most at high risk of bias. No difference in the risk of TS was detected (risk ratio, 0.95; 95% CI, 0.90 to 1.01; P = .08, low certainty). In a visual analog scale, the intensity of TS (mean difference, -0.98; 95% CI, -1.36 to -0.60; P < .0001, very low certainty) was lower for the CB group. The color change was unaffected (P > .08).
Although topical CB dental bleaching did not reduce the risk of TS and color change, these agents slightly reduced the TS intensity, but the certainty of the evidence is very low.
局部应用含钙的生物活性脱敏剂 (CBs) 已被用于最大限度地减少牙齿漂白引起的敏感性 (TS)。本研究回答了一个研究问题,“与不使用脱敏剂的漂白相比,成人在使用 CBs 进行牙齿漂白时,TS 的风险是否更低?”
作者纳入了比较局部应用 CB 与安慰剂或在漂白过程中不进行干预的随机临床试验。通过 PubMed 中的 MEDLINE、Cochrane 图书馆、巴西牙科文献库、拉丁美洲和加勒比健康科学文献库、Scopus、Web of Science、Embase 以及无语言和日期限制的灰色文献进行了合格文章的检索,并于 2022 年 9 月进行了更新。使用风险偏倚评估工具 2.0 评估了偏倚风险。作者使用随机效应模型进行了荟萃分析。作者使用 Cochrane Q 检验、I 统计量和预测区间评估了异质性。作者使用推荐评估、制定和评估方法来评估证据的确定性。
经过数据库筛选,有 22 项研究仍然存在,其中大多数存在高度偏倚风险。未发现 TS 风险的差异(风险比,0.95;95%CI,0.90 至 1.01;P =.08,低确定性)。在视觉模拟评分中,CB 组的 TS 强度(平均差异,-0.98;95%CI,-1.36 至-0.60;P <.0001,极低确定性)较低。颜色变化不受影响(P >.08)。
尽管局部应用 CB 牙齿漂白并不能降低 TS 和颜色变化的风险,但这些药物确实略微降低了 TS 的强度,但证据的确定性非常低。