Preemptive use of piroxicam on tooth sensitivity caused by in-office bleaching: a randomized clinical trial

Abstract This clinical trial evaluated the effect of preemptive use of the non-steroidal anti-inflammatory drug piroxicam in a single dose 30 min prior to in-office bleaching on the prevention of tooth sensitivity (TS) reported by patients. Fifty patients were submitted to two sessions of in-office tooth bleaching with 35% hydrogen peroxide used for 2 sessions, each consisting of a single 45-min application, with an interval of 7 days between session. Thirty minutes prior to the procedure, the patient randomly received a single dose of piroxicam (200 mg) or placebo in a double-blind, randomized, crossover design. The TS was evaluated using verbal rate (VRS) and visual analog (VAS) scales during the bleaching procedure and at 24 h after each session. The color changes were assessed by the Vita Bleachedguide scale 1 week after each bleaching session. Risk of TS was calculated from the VRS and analyzed by the McNemar test, while the level of TS was analyzed by the Mann-Whitney test. For the VAS, t-tests were used to compare data from the treatments at each assessment time. Data regarding color changes were subjected to Wilcoxon and Mann-Whitney tests (α=0.05). The preemptive administration of piroxicam did not affect the risk and level of TS compared to placebo, irrespective of the assessment time. The treatment sequence did not affect bleaching effectiveness. In conclusion, the administration of a single dose of piroxicam prior to in-office tooth bleaching was unable to significantly reduce the risk and level of TS.

Resumo Este ensaio clínico avaliou o efeito do uso preemptivo do anti-inflamatório não-esteroidal piroxicam em dose única 30 minutos antes do clareamento de consultório na prevenção de sensibilidade dentária (SD) relatada pelos pacientes. Cinquenta pacientes foram submetidos a duas sessões de clareamento dental em consultório com peróxido de hidrogênio a 35% por 2 sessões, consistindo de aplicação única de 45 minutos, com um intervalo de 7 dias entres as sessões. Trinta minutos antes do procedimento, o paciente recebia aleatoriamente dose única de piroxicam (200 mg) ou do placebo em um desenho duplo-cego, randomizado e cruzado. A SD foi avaliada usando a escalas de gradação verbal (EGV) e visual analógica (EVA) durante o procedimento clareador e 24h após o procedimento. As mudanças de cor foram avaliadas usando a escala Vita Bleachedguide uma semana após cada sessão de clareamento. O risco de SD foi calculado a partir de EGV a analisado pelo teste de McNemar, enquanto o nível de SD foi analisada pelo teste de Mann-Whitney. Para EVA, testes T foram usados para comparar dados dos tratamentos em cada tempo de avaliação. Dados de mudança de cor foram submetidos aos testes de Wilcoxon e Mann-Whitney (α=0.05). A administração preemptiva de piroxicam não afetou o risco e nível de SD quando comparado ao placebo, independentemente do tempo de avaliação. A sequencia de tratamento não afetou a efetividade do clareamento. Como conclusão, a administração de dose única de piroxicam previamente ao clareamento dental de consultório não foi efetiva em reduzir significantemente o risco e nível de SD.

High-concentration carbamide peroxide can reduce the sensitivity caused by in-office tooth bleaching: a single-blinded randomized controlled trial

Abstract Objectives A single-blinded, randomized, parallel clinical trial evaluated the use of 37% carbamide peroxide (CP) on bleaching effectiveness and tooth sensitivity reported by patients undergoing in-office tooth bleaching, in comparison with the results of using 35% hydrogen peroxide. Material and Methods Forty patients were allocated to receive two sessions of in-office tooth bleaching using either 35% hydrogen peroxide (HP) or 37% CP. Each patient's sensitivity level was evaluated during and up to 24 h after bleaching. The effectiveness of the bleaching procedures was evaluated with a spectrophotometer one week after each session and 30 days after the last session. The impact of tooth bleaching on the patients' perceptions regarding smile changes, in addition to the bleaching procedures and their results, were also recorded. Absolute and relative sensitivity risks were calculated. Data on sensitivity level were analyzed using the Mann-Whitney or T-test, and data from the color evaluation were subjected to 2-way repeated measures ANOVA. Results The use of CP reduced the risk and level of tooth sensitivity to values close to zero, whereas the difference between the bleaching agents disappeared after 24 h. An increased bleaching effect was observed for HP, mainly due to an improved reduction of redness and yellowness. Participants perceived improved tooth bleaching for HP and reduced sensitivity for CP, but no differences regarding the comfort of the techniques were noted. Conclusions In our study, 37% CP resulted in reduced tooth sensitivity but decreased the tooth bleaching effectiveness. However, both bleaching agents resulted in high levels of patient satisfaction.

Preemptive use of etodolac on tooth sensitivity after in-office bleaching: a randomized clinical trial

Abstract Purpose: This study determined the effectiveness of the preemptive administration of etodolac on risk and intensity of tooth sensitivity and the bleaching effect caused by in-office bleaching using 35% hydrogen peroxide. Material and methods: Fifty patients were selected for this tripleblind, randomized, crossover, and placebo-controlled clinical trial. Etodolac (400 mg) or placebo was administrated in a single-dose 1 hour prior to the bleaching procedure. The whitening treatment with 35% hydrogen peroxide was carried out in two sessions with a 7-day interval. Tooth sensitivity was assessed before, during, and 24 hours after the procedure using the analog visual scale and the verbal rating scale. Color alteration was assessed by a bleach guide scale, 7 days after each session. Relative risk of sensitivity was calculated and adjusted by session, while overall risk was compared by the McNemar's test. Data on the sensitivity level of both scales and color shade were subjected to Friedman, Wilcoxon, and Mann-Whitney tests, respectively (α=0.05). Results: The preemptive administration of etodolac did not affect the risk of tooth sensitivity and the level of sensitivity reported, regardless of the time of evaluation and scale used. The sequence of treatment allocation did not affect bleaching effectiveness, while the second session resulted in additional color modification. The preemptive administration of etodolac in a single dose 1 hour prior to in-office tooth bleaching did not alter tooth color, and the risk and intensity of tooth sensitivity reported by patients. Conclusion: A single-dose preemptive administration of 400 mg of etodolac did not affect either risk of tooth sensitivity or level of sensitivity reported by patients, during or after the in-office tooth bleaching procedure.

Polishing techniques effect on microhybrid, nanohybrid and nanofilled composites color and surface roughness stability / Efeito de técnicas de polimento na estabilidade da cor e rugosidade superficial de resinas compostas microhibridas nanohibridas e nanoparticuladas

Resin roughness and staining is a common problem in dentistry. Objective: the aim of this study was to verify the influence of single and multiple-steps polishing techniques on color stability and surface roughness of differents composite resins. Groups were (n=10): FS+CS. Filtek Supreme XT + clear strip; FS+PG. Filtek Supreme XT+PoGo; FS+SF. Filtek Supreme XT+Sof-Lex; AM+CS. Amelogen+clear strip; AM+PG. Amelogen+PoGo; AM+SF. Amelogen+Sof-Lex; TEC+CL .TetricEvoCeram + clear strip; TEC+PG .Tetric EvoCeram+ PoGo; TEC+SF .Tetric EvoCeram+Sof-Lex; CED+CS .Ceram X Duo+clear strip; CED+PG. Ceram X Duo+PoGo; CED+SF. Ceram X Duo+Sof- Lex. The initial color and roughness were determined before and after the polishing procedures. All specimens were stored for 7 days in coffee solution and the color assessment was performed. Two specimens from each group were evaluated by scanning electron microscopy. Roughness and color data were submitted to ANOVA and Tukey tests(p<0.05). All tested materials presented color alterations after coffee solution storage; the highest E values were observed for clear strips and all composite resins, as following: G4 (9h)>G7(5.8f)=G10(5.7ef)>G1(3.7c), followed by the G6(5.9f)>G9(3.1bc)=G12(2.1ab)>G3(1.7a). G3, after 7 days, presented the lowest values for E(1.704). The lowest roughness values were observed when the clear strips were used regardless material type. The Sof-Lex system provided the lowest surface roughness values for all tested composite resins. Among composite resins the highest roughness values were found for Amelogen (G5­0.49 and G6­0.35), regardless polishing technique. All tested materials presented changes in color after immersion in coffee solution. The roughness surface and the staining of composite resins are material and polishing technique dependents.

Rugosidade e pigmentação de resinas são problemas comuns em odontologia. Objetivo: Avaliar influência das técnicas de um e múltiplos-passos de polimento na estabilidade de cor e rugosidade de resinas. Os grupos (n=10): G1.Filtek Supremo XT+Tira poliéster; G2.Filtek SupremeXT+PoGo; G3.Filtek Supreme XT+ Sof-Lex; G4.Amelogen+Tira poliéster; G5.Amelogen + PoGo; G6.Amelogen + Sof-Lex; G7.Tetric EvoCeram +Tira poliéster; G8.Tetric EvoCeram+PoGo; G9.Tetric EvoCeram+Sof-Lex; G10.CeramXDuo+Tira poliéster; G11.Ceram X Duo+PoGo; G12.Ceram X Duo+Sof-Lex. A Cor inicial e rugosidade foram determinadas antes e apóso polimento. Após, foram armazenadas durante 7 dias em solução de café e nova avaliação da cor foi realizada. Dois espécimes de cada grupo foram avaliados pela microscopia eletrônica de varredura. Dados de rugosidade e cor foram submetidos à ANOVA e teste Tukey (p <0,05). Todas as resinas testadas apresentaram alterações de cor após armazenamento em solução de café; foram observados os maiores valores de AE em tiras de poliésterpara as resinas,a seguir: G4 (9h)>G7 (5,8f) = G10 (5,7ef)>G1 (3,7c), seguindo-se a G6 (5,9f)>9 (3,1bc)=G12 (2,1ab)>G3 (1,7a). G3, após 7 dias, apresentaram os menores valores para AE (1,704). Menores valores de rugosidade foram observados para as tiras de poliéster, independentemente do material. Menores valores de rugosidade foram encontrados no sistema Sof-Lex. Entre as resinas valores maiores de rugosidade foram encontrados para Amelogen (G5-0,49 e G6-0,35), para as duas técnicas. Todos os materiais testados apresentaram alterações na cor após imersão em solução de café. A rugosidade e pigmentação das resinas compostas são dependentes da técnica e material.