Administration of Ascorbic Acid to Prevent Bleaching-induced Tooth Sensitivity: A Randomized Triple-blind Clinical Trial

Paula, E de; Kossatz, Stella; Fernandes, Daniel; Loguércio, AD; Reis, Alessandra

doi:10.2341/12-483-c

“…This is similar to outcomes from other studies that evaluated sensitivity of in-office bleaching with 35% H P (12,13,16). On the other hand, covering the bleaching agent during the procedure reduced the risk of TS to 40%.…”

Section: Discussionsupporting

confidence: 78%

Randomized controlled trial of sealed in-office bleaching effectiveness

Nahsan

¹

,

Santana

²

,

Loguércio

³

et al. 2014

Dental Materials

0

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Regardless of the high success rate, patients commonly report the occurrence of tooth sensitivity during the in-office bleaching procedures. Recently, it has been demonstrated that using a customized tray (called sealed in-office bleaching technique) reduces peroxide penetration. The aim of this randomized clinical study was to evaluate tooth sensitivity and bleaching efficacy of sealed bleaching, in comparison with a conventional in-office technique. Twenty patients were randomized allocated in two groups in which 35% hydrogen peroxide gel was used in a single 45-min application. For the sealed technique, a customized bleaching tray was fabricated and carefully positioned over the bleaching agent during the session. The color was recorded at a baseline, 7 and 28 days after the bleaching session, using Vita Easy Shade spectrophotometer. Tooth sensitivity was recorded during (20 and 40 min) and immediately after the treatment using a visual analogue scale. The bleaching efficacy was evaluated by repeated-measures ANOVA, while the absolute risk of tooth sensitivity and its intensity were evaluated by Fisher's exact and Mann-Whitney tests, respectively (α=0.05). No significant difference on bleaching efficacy was observed between the conventional (7.4 and 8.1 ΔE) and sealed techniques (7.8 and 8.3 ΔE) at both evaluation periods. No significant difference was observed regarding the absolute risk of tooth sensitivity (p=0.15). Sealed technique showed a significant decrease of sensitivity intensity after 40 min (p=0.03). Sealed bleaching technique was able to reduce the sensitivity intensity during the bleaching procedure, without jeopardizing the bleaching efficacy.

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“…Even though TS is transitory and quickly disappears after the end of the procedure, the presence of sensitivity during the bleaching can lead to an interruption of the procedure and compromise the results. Thus, previous use of desensitizing agents (8-10), preoperative anti-inflammatory drugs (11)(12) and anti-oxidative agents (13) has attempted to reduce the TS associated with in-office bleaching procedures. The success of this pretreatment remains controversial.…”

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trial of Sealed In-Office Bleaching Effectiveness

Santana

¹

,

Nahsan

²

,

Oliveira

³

et al. 2014

View full text Add to dashboard Cite

Regardless of the high success rate, patients commonly report the occurrence of tooth sensitivity during the in-office bleaching procedures. Recently, it has been demonstrated that using a customized tray (called sealed in-office bleaching technique) reduces peroxide penetration. The aim of this randomized clinical study was to evaluate tooth sensitivity and bleaching efficacy of sealed bleaching, in comparison with a conventional in-office technique. Twenty patients were randomized allocated in two groups in which 35% hydrogen peroxide gel was used in a single 45-min application. For the sealed technique, a customized bleaching tray was fabricated and carefully positioned over the bleaching agent during the session. The color was recorded at a baseline, 7 and 28 days after the bleaching session, using Vita Easy Shade spectrophotometer. Tooth sensitivity was recorded during (20 and 40 min) and immediately after the treatment using a visual analogue scale. The bleaching efficacy was evaluated by repeated-measures ANOVA, while the absolute risk of tooth sensitivity and its intensity were evaluated by Fisher's exact and Mann-Whitney tests, respectively (α=0.05). No significant difference on bleaching efficacy was observed between the conventional (7.4 and 8.1 ΔE) and sealed techniques (7.8 and 8.3 ΔE) at both evaluation periods. No significant difference was observed regarding the absolute risk of tooth sensitivity (p=0.15). Sealed technique showed a significant decrease of sensitivity intensity after 40 min (p=0.03). Sealed bleaching technique was able to reduce the sensitivity intensity during the bleaching procedure, without jeopardizing the bleaching efficacy.

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“…7,8,9 While laboratory testing is a very useful method to study the diffusion of the components of bleaching gels, such H 2 O 2 , into dental pulp, 10,11 clinical trials can provide reliable and direct evidence to guide clinicians in their choice of materials for in-office and at-home bleaching. 12,13,14,15 Hence, randomized controlled trials (RCTs) are considered the standard research design for the evaluation of health interventions. In fact, RCTs and systematic reviews are at the top level of the evidence hierarchy.…”

Section: Introductionmentioning

confidence: 99%

Randomized clinical trials of dental bleaching – Compliance with the CONSORT Statement: a systematic review

Loguércio

¹

,

Maran

²

,

Hanzen

³

et al. 2017

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We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at "low" risk; 62.1% were classified as "unclear"; and 30.3% as "high" risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.

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Administration of Ascorbic Acid to Prevent Bleaching-induced Tooth Sensitivity: A Randomized Triple-blind Clinical Trial

Cited by 53 publications

References 39 publications

Randomized controlled trial of sealed in-office bleaching effectiveness

Randomized controlled trial of sealed in-office bleaching effectiveness

Randomized Controlled Trial of Sealed In-Office Bleaching Effectiveness

Randomized clinical trials of dental bleaching – Compliance with the CONSORT Statement: a systematic review

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