Effect of dental bleaching on pulp oxygen saturation in maxillary central incisors - a randomized clinical trial

Abstract

Objective To assess pulp oxygen saturation levels (SaO 2 ) in maxillary central incisors after dental bleaching. Materials and Methods 80 participants (160 teeth) were randomly allocated to four groups: G1 In-office bleaching with two applications of 35% hydrogen peroxide (HP) (20 minutes), followed by at-home bleaching with 10% carbamide peroxide (CP) (2 hours/day for 16 days); G2 - Same protocol as G1, plus desensitizing toothpaste; G3 - In-office bleaching with 35% HP and one application of placebo gel (20 minutes), followed by at-home bleaching with 10% CP (2 hours/day for 16 days); and G4 - Same protocol as G3, plus desensitizing toothpaste. Pulp SaO 2 levels were measured before (T0) and immediately after (T1) in-office bleaching; on the 5 th (T2), 8 th (T3), 12 th (T4), and 16 th days of at-home bleaching (T5); and on the 7 th (T6) and 30 th (T7) days. Mean (SD) pulp SaO 2 levels were compared within groups by generalized estimating equations (GEE) and Student’s t-test (P<0.05). Results Mean pulp SaO 2 at T0 was 84.29% in G1, 84.38% in G2, 84.79% in G3, and 85.83% in G4. At T1, these values decreased to 81.96%, 82.06%, 82.19%, and 81.15% in G1, G2, G3, and G4 respectively, with significant difference in G4 (P<0.05). During home bleaching, pulp SaO 2 levels varied in all groups, with 86.55%, 86.60%, 85.71%, and 87.15% means at T7 for G1, G2, G3, and G4, respectively; G2 presented significant difference (P<0.05). Conclusions Pulp SaO 2 level in maxillary central incisors was similar at baseline, reducing immediately after in-office bleaching, regardless of using desensitizing toothpaste and increasing at 30 days after dental bleaching.

Interference of coronal enamel and dentin thickness and ambient light on pulse oximetry interpretation

“…In a vital tooth, dentinal tubules are not empty, since the odontoblast process occurs in the tubular compartment, filled with tissue fluid, and lined by an organic sheath. Lima et al 32 used the findings of a randomized clinical trial to assess pulp oxygen saturation (SaO 2 ) in maxillary central incisors after dental bleaching. Pulp SaO 2 in maxillary central incisors was similar at baseline, and decreased immediately after in-office bleaching, regardless of the use of desensitizing toothpaste, but increased at 30 days after dental bleaching.…”

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

“…In the meta-analysis by tooth group, 18 studies [ 3 4 9 11 16 17 18 19 20 21 22 23 25 26 27 28 29 30 ] were included in the central incisor group, for a total of 2,054 teeth. The mean fixed-effect measure of SpO 2 in the dental pulp of these teeth was 84.94% (95% confidence interval [CI], 84.85%–85.04%).…”

“…The quality of 13 studies [ 4 9 11 16 18 22 23 24 25 26 27 29 30 ] was assessed using the QUADAS-2 ( Table 3 ), while that of the remaining studies [ 3 17 19 20 21 28 ] was evaluated using the adapted NOS ( Table 4 ). The studies were predominantly of low quality due to the high risk of bias related to the applicability and interpretation of the index test, unclear risk regarding patient selection, and concerns about overall applicability ( Table 3 ).…”

Evaluation of the Pulp Oxygen Saturation Reading after Tooth Bleaching: A Randomized Clinical Trial

“…Findings in the literature suggest that in-office dental bleaching causes changes in the normal pulp tissue response, such as the short-term occurrence of greater tooth sensitivity [ 20 ]. Studies have shown that the upper central incisors had a temporary decrease in SpO 2 p levels after in-office and/or at-home tooth bleaching [ 21 , 22 ]. However, SpO 2 p levels returned to the normal levels at the end of the bleaching procedure [ 21 , 22 ].…”