Efficacy of topical drug application to manage in-office bleaching sensitivity: a systematic review and meta-analysis of randomized clinical trials.

OBJECTIVES: To answer whether the topical drug application can reduce in-office tooth bleaching sensitivity without impairing the color change. MATERIALS AND METHODS: This review was registered on PROSPERO (CRD42024524171). Two reviewers screened PubMed, Web of Science, Scopus, Embase, and clinicaltrials.gov in March 2024 independently for randomized clinical trials investigating the efficacy of topical drug application to manage in-office tooth bleaching sensitivity. The risk of bias was assessed using Cochrane's Risk of Bias tool (RoB2). Certainty of the evidence was assessed using the Grading of Recommendations: Assessment, Development, and Evaluation tool (GRADE). The meta-analyses evaluated the bleaching sensitivity and color change with RevMan 5.4 software. RESULTS: 334 articles were retrieved. The final sample was composed of four articles. Tested drugs were Otosporin, Eugenol, Ibuprofen with arginine, and Dipyrone. The meta-analysis evidenced no difference in bleaching sensitivity up to 1 h (MD, -0.39; 95% CI, -0.89, 0.11), 24 h (MD, -0.26, 95% CI, -0.71, 0.18), or 48 h (MD, 0.00, 95% CI, -0.16, 0.16). Meta-analysis for color change evidenced no difference for color change (MD, 0.03; 95% IC, -0.56, 0.61). The risk of bias was low. The certainty of the evidence was rated moderate for bleaching sensitivity and high for color change. CONCLUSIONS: Although topical drug application did not impair color change, it was ineffective in reducing in-office tooth bleaching sensitivity. CLINICAL RELEVANCE: topical drug application on dental enamel is not an effective approach in reducing bleaching sensitivity, but several modifications can be made in future studies to possibly achieve a better outcome.

Can carbamide peroxide be as effective as hydrogen peroxide for in-office tooth bleaching and cause less sensitivity? A systematic review.

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.

Functional Ability of Dental Materials After Inclusion of Nanocarriers Containing Functional Substances: A Systematic Review.

BACKGROUND: Nanocarriers are nanoparticles used to transport functional substances. OBJECTIVE: This study aimed to perform a systematic review analyzing the functional ability of dental materials after the inclusion of nanocarriers containing functional substances. MATERIALS AND METHODS: We searched PubMed, Web of Science, EMBASE, SciELO, and Science Direct from (02/03/21) to (02/06/21) without restriction on the year of publication. We included studies evaluating the incorporation of Chitosan, PEG-PCL (poly(ethylene glycol)-poly(ε-caprolactone), PLGA (poly(lactic-co-glycolic acid), and mesoporous silica into dental materials. We analyzed the risk of bias with CRIS guidelines and consolidated all analyses using Microsoft Office Excel. RESULTS: In total, we found 656 studies and included 11. The articles investigated materials to eliminate microorganisms, interference with materials' mechanical properties, elution of remineralizing substances, and reduction of oral anesthetic toxicity. Chitosan and mesoporous silica were the most prevalent nanocarriers. Among all properties, the antibacterial activity was the most analyzed. The functional ability of dental materials provided by all nanocarriers improved. CONCLUSION: The use of nanocarriers may be a useful way to produce dental materials with improved functional abilities. We registered this manuscript in the Open Science Framework platform - DOI 10.17605/OSF.IO/RP5XK, available at https://osf.io/qg49x.