de Melo Priscila Borges Gobbo, Benati Marcos Roberto de Lima, Matos Iago César Ribeiro Teles, Santos Guilherme Silva Dos, Kury Matheus, Florez Fernando Luís Esteban, Cavalli Vanessa
Department of Restorative Dentistry, University of Campinas - Piracicaba Dental School, Piracicaba, SP, Brazil.
Dental Division Research, Paulista University, São Paulo, SP, Brazil.
J Dent. 2025 Nov;162:106095. doi: 10.1016/j.jdent.2025.106095. Epub 2025 Sep 9.
To evaluate the bleaching efficacy, tooth sensitivity (TS), pulpal oxygen saturation (SaO), and patient satisfaction following in-office bleaching using experimental gels containing hyaluronic acid (HA) or carbomer 940 (CAR), co-doped TiO nanoparticles with nitrogen and fluoride (NP; NF_TiO₂), and 6 % hydrogen peroxide (HP), activated by violet LED.
Seventy-two participants were randomly assigned to three groups (n = 24): HP35 (commercial bleaching gel), HA-NP-HP6+LED, and CAR-NP-HP6+LED. Bleaching was performed in three weekly sessions (1 × 30 min; 1-week interval). TS (VAS) and SaO were recorded before and after each session, with TS reassessed seven days post-treatment. Tooth color was evaluated at baseline, 14 days, and 6 months post-treatment. The parameters ΔEab, ΔE, ΔWI, and ΔSGU were calculated. Patient satisfaction was assessed using a subjective scale. Statistical analysis was performed using one-way ANOVA with Tukey post hoc and non-parametric tests (α = 0.05).
The HP35 group showed significantly higher bleaching efficacy after 14 days. However, at the 6-month evaluation, the experimental gels exhibited similar performance. TS was significantly lower in the experimental groups (p < 0.05), while SaO levels remained stable across all groups. All participants (100 %) reported satisfaction with the outcomes.
Low-concentration bleaching gels containing 6 % hydrogen peroxide and NF_TiO₂ nanoparticles showed comparable efficacy to a 35 % hydrogen peroxide gel after 6 months, with less tooth sensitivity and no adverse effects on pulp oxygen saturation. Patient satisfaction was high across all groups, supporting the clinical viability of these safer experimental gels.
Low-concentration gels enhanced with NF_TiO₂ nanoparticles and activated by violet LED may provide an effective and patient-centered bleaching option, maintaining long-term results while minimizing sensitivity.
评估使用含有透明质酸（HA）或卡波姆940（CAR）、氮氟共掺杂二氧化钛纳米颗粒（NP；NF_TiO₂）以及6%过氧化氢（HP）并由紫光发光二极管激活的实验性凝胶进行诊室漂白后的漂白效果、牙齿敏感度（TS）、牙髓氧饱和度（SaO）以及患者满意度。
72名参与者被随机分为三组（每组n = 24）：HP35（市售漂白凝胶）、HA-NP-HP6+LED组以及CAR-NP-HP6+LED组。漂白每周进行一次，共三次（每次30分钟；间隔1周）。每次治疗前后记录TS（视觉模拟评分法）和SaO，并在治疗后7天重新评估TS。在基线、治疗后14天和6个月时评估牙齿颜色。计算参数ΔEab、ΔE、ΔWI和ΔSGU。使用主观量表评估患者满意度。采用单因素方差分析及Tukey事后检验和非参数检验进行统计分析（α = 0.05）。
14天后，HP35组的漂白效果显著更高。然而，在6个月评估时，实验性凝胶表现出相似的性能。实验组的TS显著更低（p < 0.05），而所有组的SaO水平保持稳定。所有参与者（100%）均对结果表示满意。
含有6%过氧化氢和NF_TiO₂纳米颗粒的低浓度漂白凝胶在6个月后显示出与35%过氧化氢凝胶相当的效果，牙齿敏感度更低，且对牙髓氧饱和度无不良影响。所有组的患者满意度都很高，支持了这些更安全的实验性凝胶的临床可行性。
用NF_TiO₂纳米颗粒增强并由紫光发光二极管激活的低浓度凝胶可能提供一种有效且以患者为中心的漂白选择，在保持长期效果的同时将敏感度降至最低。
