ABSTRACT
This study aimed to answer the question through a systematic review: Can carbamide peroxide be as effective as hydrogen peroxide and cause less in-office bleaching sensitivity? A literature survey was performed in PubMed/MEDLINE, Embase, Scopus, ISI Web of Science, and gray literature. Primary clinical trials that compared the efficacy or the in-office bleaching sensitivity between carbamide and hydrogen peroxides were included. The risk of bias was evaluated using the RoB2. The certainty of the evidence was assessed using the GRADE approach. DPI training significantly improved the mean scores of the dental undergraduates from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training. The limited evidence suggests that the 37% carbamide peroxide may be similarly effective to the 35% hydrogen peroxide for bleaching teeth in-office and causes less bleaching sensitivity. However, more well-designed split-mouth clinical trials are necessary to strengthen the evidence.
ABSTRACT
Este estudo objetivou avaliar a eficácia do clareamento dentário em consultório quando utilizada medicação sistêmica com paracetamol/codeína (PACO) pré- e pós-operatória e aplicação pósoperatória de dessensibilizante tópico. Tratou-se de um ensaio clínico controlado, randomizado, triplo cego do tipo boca dividida com 14 dias de acompanhamento. Quarenta voluntários participaram do estudo. Metade ingeriu a medicação PACO e a outra metade placebo (PLA) uma hora antes do procedimento clareador e por 48 horas após a cada 6 horas, e tiveram seus hemiarcos direitos e esquerdos aleatoriamente designados a receber aplicação de uma pasta profilática (PAS) e o Dessensibilize Nano P® (NP), gerando-se quatro grupos de manejos terapêuticos por hemiarcos: G1 (PLA+PAS), G2 (PLA+NP), G3 (PACO+PAS) e G4 (PACO+NP) (n=20). Duas sessões de clareamento foram realizadas em toda amostra com peróxido de hidrogênio a 35% com duas aplicações de 20 minutos, com intervalo de uma semana entre cada sessão. A avaliação da cor foi realizada pela Escala VITA Classical® e Colorímetro ShadeEye NCC®. A análise estatística foi feita através do teste ANOVA a 2 fatores com pós teste de Tukey utilizando-se o software GraphPad Prism 8.0. O tratamento clareador com peróxido de hidrogênio a 35% produziu alteração de padrão de cor após o clareamento (p<0,001) e sem diferenças estatisticamente significativas entre os manejos terapêuticos (p>0,05). Portanto, o clareamento dentário em consultório utilizando-se o peróxido de hidrogênio a 35 % não mostrou comprometimento de sua eficácia clínica relacionada à cor após aplicação dos protocolos dessensibilizantes testados (AU).
This study aimed to evaluate the effectiveness of dental bleaching in the office when pre- and postoperative systemic use of paracetamol/codeine (PACO) and postoperative application of topical desensitizer were made. This was a controlled, randomized, triple-blind, split-mouth clinical trial with 14 days of follow-up. Forty volunteers participated of this study. Half took the PACO medication and the other half a placebo (PLA) one hour before the bleaching procedure, and their hemiarchs were randomly assigned to receive a prophylactic paste (PAS) and Desensibilize Nano P™ (NP), generating four groups of therapeutic management by hemiarchs: G1 (PLA + PAS), G2 (PLA + NP), G3 (PACO + PAS) and G4 (PACO + NP) (n = 20). Two whitening sessions were performed on the entire sample with 35% hydrogen peroxide with two 20-minute applications, with an interval of one week between each session. Color evaluation was performed using the VITA Classical™ Scale and ShadeEye NCC™ Colorimeter. The statistical analysis was performed using the ANOVA 2-factor test with Tukey's post-test with the aid of the GraphPad Prism 8.0 software. The bleaching treatment with 35% hydrogen peroxide produced a change in color pattern after bleaching (P <0.005) and without statistically significant differences between therapeutic management (P> 0.005). Therefore, in-office tooth whitening using 35% hydrogen peroxide did not show any compromise in its clinical efficacy related to color after application of the tested desensitizing protocols (AU).
