Stella Kossatz

Perioperative use of an anti-inflammatory drug on tooth sensitivity caused by in-office bleaching: a randomized, triple-blind clinical trial

ObjectivesThe aim of this study was to determine the effect of etoricoxib 60xa0mg on tooth sensitivity (TS) caused by in-office bleaching.Materials and methodsA triple-blind, parallel design, randomized clinical trial was conducted on 30 healthy, young adults who received either a placebo or etoricoxib. The drugs were administered 1xa0h before the bleaching process and after 24xa0h. Treatment was performed with 35xa0% hydrogen peroxide gel. The TS was recorded on three scales: VAS, 0–4, and 0–100. Shade evaluations were performed before and 30xa0days after bleaching with a visual shade guide and a spectrophotometer. The percentage of patients who reported TS at least once during treatment and the TS intensity were evaluated by Fisher’s exact and Mann–Whitney U tests, respectively. Tooth color changes were evaluated by repeated measures ANOVA.ResultsThere were no significant differences in the percentage of patients with TS, intensity of TS, and color between the groups.Conclusions and clinical significanceThe anti-inflammatory medication etoricoxib 60xa0mg was unable to reduce the presence and intensity of TS. NCT01300780 (protocol No. 17838/2010).

Administration of ascorbic acid to prevent bleaching-induced tooth sensitivity: a randomized triple-blind clinical trial.

This study evaluated the effect of ascorbic acid, 500 mg every eight hours, on bleaching-induced tooth sensitivity. A triple-blind, parallel design, and placebo-controlled randomized clinical trial was conducted on 39 adults. The pills (placebo or ascorbic acid) were administered three times per day for 48 hours; the first dose was given one hour prior to each bleaching session. Two bleaching sessions with 35% hydrogen peroxide gel were performed with a one-week interval. Tooth sensitivity was recorded up to 48 hours after bleaching. The color evaluation was performed before and 30 days after bleaching. The absolute risk and intensity of tooth sensitivity were evaluated by Fisher exact and Mann-Whitney U-tests, respectively. Color changes were evaluated by unpaired t-test (α=0.05). There were no significant differences in the absolute risk and intensity of tooth sensitivity and color change between the groups. Both groups showed a similar risk of tooth sensitivity (p>0.05). The perioperative use of an antioxidant, such as ascorbic acid (500 mg, three times daily) perorally, was not able to prevent bleaching-induced tooth sensitivity or reduce its intensity.

Effects of Light Activated In-office Bleaching on Permeability, Microhardness, and Mineral Content of Enamel

The aim of this study was to evaluate the permeability (PE), microhardness (KHN), and mineral change in enamel after LED/laser activated in-office bleaching. For PE, the coronal portion of premolars (n=51) was subjected to bleaching with 35% hydrogen peroxide (Whiteness HP Maxx, FGM Dental Products, Joinville, SC, Brazil). The samples were stained via the histochemical method, which involves a copper sulphate solution and rubeanic acid. The penetration of dye into the enamel was measured. The KHN of enamel was assessed before treatment, immediately after the bleaching treatment, and again after one week. The calcium and phosphorus content were analyzed with a scanning electron microscope with energy-dispersive X-ray (JSM 6360LV, Jeol Ltd, Tokyo, Japan). The data set from each test was subjected to appropriate parametric statistical analysis (α=0.05). No significant differences were observed for PE in NLA and LA compared to the control group (p=0.98), as well as for calcium (p=0.16) and phosphorus (p=0.80) content. Significant reduction of KHN after bleaching occurred for both groups (p<0.001). After immersion in artificial saliva, the KHN of the enamel for all groups was similar to that seen before bleaching. Light activation during in-office bleaching does not produce significant changes in the enamel compared to a non-light-activated technique.

Combined Bleaching Technique Using Low and High Hydrogen Peroxide In-Office Bleaching Gel

OBJECTIVESnThe aim of this study was to evaluate the efficacy, color stability, risk, and intensity of tooth sensitivity (TS) of combined bleaching techniques performed with 20% or 35% hydrogen peroxide for an in-office protocol.nnnMETHODSnThirty patients were randomly divided into two groups and submitted to a single 45-minute in-office bleaching session with 35% hydrogen peroxide or 20% hydrogen peroxide. At-home bleaching was performed with 10% carbamide peroxide for two hours daily over the course of two weeks. The color was evaluated with the value-oriented shade guide Vita Classical at different periods up to 12 months after bleaching. Patients recorded the intensity of TS using a five-point verbal scale. Color change data were submitted to a two-way repeated-measures analysis of variance and Tukey test (α=0.05). The absolute risk and intensity of TS were compared with the Fisher exact test and Mann-Whitney test, respectively (α=0.05).nnnRESULTSnOn average, an effective and similar whitening of three units in shade guide was observed for both groups, which remained stable for 12 months. When both protocols were compared, the one with hydrogen peroxide 35% showed a higher risk (p=0.02) and intensity of TS (p=0.04). In regard to the TS intensity, no significant difference was observed up to 48 hours after in-office bleaching (p=0.09) and during the at-home bleaching phase of the study (p=0.71).nnnCONCLUSIONnThe combined bleaching technique using at-home bleaching associated with in-office bleaching was effective and stable over the course of 12 months, regardless of the concentration of the hydrogen peroxide used for in-office bleaching. However, the protocol with 20% hydrogen peroxide produced lower risk and intensity of TS.

Effectiveness of and Dental Sensitivity to At-home Bleaching With 4% and 10% Hydrogen Peroxide: A Randomized, Triple-blind Clinical Trial

OBJECTIVESnTo evaluate the risk for and intensity of tooth sensitivity and color change of at-home dental bleaching with 4% and 10% hydrogen peroxide (HP).nnnMETHODSnFor this study, 78 patients were selected according to the inclusion and exclusion criteria and randomized into two groups: HP 4 (White Class 4%, FGM) and HP 10 (White Class 10%, FGM). In both groups, the at-home bleaching was performed for a period of 30 minutes twice a day for two weeks. The color was assessed by Vita Classical, Vita Bleachedguide 3D-MASTER and spectrophotometer Vita Easyshade (Vita Zahnfabrik) at baseline, during bleaching (first and second weeks) and after bleaching (one month). Patients recorded their tooth sensitivity using a numeric rating scale (0-4) and visual analog scale (0-10). Data from color change (DeltaE data) was submitted to two-way analysis of variance. The color change data in Delta SGU from the two shade guide units were compared with the Mann Whitney test. The risk of tooth sensitivity was evaluated by χ2 test and the intensity of tooth sensitivity from both scales was evaluated by a Mann-Whitney test (α=0.05).nnnRESULTSnThe absolute risk and intensity of tooth sensitivity was higher in the group that used HP 10 than the one that used HP 4. Data from change in the number of shade guide units and color variation after one month of bleaching for both groups showed significant whitening, with no difference between groups.nnnCONCLUSIONSnAt-home bleaching is effective with 4% and 10% HP concentrations, but 10% HP increased the absolute risk and intensity of tooth sensitivity during at-home bleaching.

Combination of Acetaminophen/Codeine Analgesics Does Not Avoid Bleaching-Induced Tooth Sensitivity: A Randomized, Triple-Blind Two-Center Clinical Trial

Bleaching-induced tooth sensitivity (TS) is highly prevalent.nnnOBJECTIVEnThis study aimed to determine if the combination of opioids and nonopioids analgesics (Tylex) may provide a better analgesic effect.nnnMETHODnA triple-blind, parallel, randomized two-center clinical trial was conducted with 105 healthy patients who received either a placebo or a combination of acetaminophen/codeine. The first dose of Tylex 30 mg (acetaminophen 500 mg/codeine 30 mg) or placebo was administered one hour before the in-office bleaching (35% hydrogen peroxide), and extra doses were administered every six hours for 48 hours. The TS was recorded using a visual analog scale of 0 to 10 and a numeric rating scale of 0 to 4 in different periods: during bleaching, one hour up to 24 hours, and 24 hours up to 48 hours postbleaching. The color was measured before and one month after dental bleaching with a visual shade guide (Vita Classical), Vita Bleachedguide 3D-MASTER, and the spectrophotometer Vita Easyshade. The absolute risk of TS was evaluated using the Fisher exact test. Data of TS intensity with numeric rating scale of the two groups were compared with the Mann-Whitney U-test and the Friedman test, while data from the visual analog scale were evaluated by two-way repeated measures analysis of variance and the Tukey test for pairwise comparison. The color changes between groups were compared using the Student t-test (α=0.05).nnnRESULTSnNo significant differences between the groups were observed in the risk and intensity of TS. The overall absolute risk of TS was approximately 96%. No significant differences between groups were observed in terms of color change ( p>0.05) for any scale.nnnCONCLUSIONnThe use of an acetaminophen/codeine combination prior to in-office bleaching does not reduce the risk and intensity of bleaching-induced TS.