Bruna Gaidarji, Post-Graduate Program in Oral Science, Division of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
Bibiana Gabardo Perez, Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
Oper Dent. 2024 Sep 1;49(5):519-530. doi: 10.2341/24-005-C.
Various techniques, products, and protocols are used for the bleaching of non-vital teeth. The walking bleach technique involves sealing the bleaching agent in the pulp chamber. In the inside/outside technique, a low-concentration bleaching agent is applied at home using a custom tray. In the in-office technique, a high-concentration bleaching agent is applied by a dental professional. Limited research has compared the effectiveness of these techniques.
This clinical trial aimed to evaluate the effectiveness of the walking bleach, the inside/outside, and the in-office bleaching techniques.
Fifty-four discolored teeth were selected according to eligibility criteria, randomized, and assigned to three treatment groups (n=18): walking bleach (sodium perborate - SP), inside/outside bleaching (7.5% hydrogen peroxide -HP7.5), and in-office bleaching (35% hydrogen peroxide - HP35). A cervical seal was placed in all the teeth, and nonvital bleaching was performed according to each technique. The CIELab color coordinates were measured using a clinical spectrophotometer at baseline, weekly, and at the 1-week follow-up. ΔE00 and ΔWID were calculated between the baseline and each evaluation time point. The ANOVA, Fisher exact, and Kruskal-Wallis tests were used to compare the quantitative variables, and the Fisher exact test, to determine the association among categorical variables. Bleaching effectiveness was interpreted by 50:50% perceptibility and acceptability thresholds.
As the treatment progressed, all techniques presented a significant increase in L* and WID (p<0.001), and a significant decrease in a* and b* (p<0.001). HP7.5 and HP35 presented greater increases in WID mean values, in comparison with SP (p=0.006). No significant differences were observed among the techniques for ΔE00 after treatment completion (p=0.383). There were no statistical differences in bleaching effectiveness among the techniques after treatment completion (p=0.098).
All techniques presented excellent effectiveness after treatment completion. However, HP7.5 and HP35 techniques provided a more rapid whitening response.
各种技术、产品和方案都被用于非活性牙齿的漂白。步行漂白技术涉及将漂白剂密封在牙髓腔内。在内外技术中，使用定制托盘在家中应用低浓度漂白剂。在诊室技术中，由牙医专业人员应用高浓度漂白剂。有限的研究比较了这些技术的有效性。
本临床试验旨在评估步行漂白、内外漂白和诊室漂白技术的有效性。
根据入选标准选择了 54 颗变色牙，进行随机分组，并分配到三个治疗组（n=18）：步行漂白（过硼酸钠-SP）、内外漂白（7.5%过氧化氢-HP7.5）和诊室漂白（35%过氧化氢-HP35）。所有牙齿均放置颈圈密封，根据每种技术进行非活性漂白。使用临床分光光度计在基线、每周和 1 周随访时测量 CIELab 颜色坐标。在每个评估时间点计算基线和ΔE00 和ΔWID。使用方差分析、Fisher 确切检验和 Kruskal-Wallis 检验比较定量变量，使用 Fisher 确切检验确定分类变量之间的关联。根据 50:50%可察觉性和可接受性阈值解释漂白效果。
随着治疗的进展，所有技术的 L和 WID 均显著增加（p<0.001），a和 b*显著降低（p<0.001）。与 SP 相比，HP7.5 和 HP35 呈现出更大的 WID 均值增加（p=0.006）。治疗完成后，三种技术的ΔE00 之间没有观察到显著差异（p=0.383）。治疗完成后，三种技术的漂白效果之间没有统计学差异（p=0.098）。
所有技术在治疗完成后均表现出优异的效果。然而，HP7.5 和 HP35 技术提供了更快的美白反应。
