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OBJECTIVE: To compare the color change, the risk and intensity of tooth sensitivity (TS), and gingival irritation (GI) of at-home bleaching applied on the buccal surface only or the buccal and lingual surfaces. MATERIALS AND METHODS: Sixty patients with canines A2 or darker were selected and their superior arches were randomized in two groups: at-home bleaching on the buccal-only or on the buccal and lingual surfaces, with 7.5% hydrogen peroxide, for 1 h daily/2 weeks. The color change was evaluated at baseline, 7, 14 days, and 1 month after bleaching using shade guides scales (ΔSGU) and a spectrophotometer (ΔEAB, ΔE00, and ΔWID). Risk and intensity of TS and GI were recorded daily using visual analogic scale (0-10). Patient satisfaction was evaluated with the orofacial esthetics. Paired t-test, McNemar's, and Wilcoxon signed-rank test were used for data analysis (α = 5%). RESULTS: Neither the color change nor the risk/intensity of TS was statistically different between groups (p > 0.05). Patient satisfaction increased after bleaching for both groups (p < 0.05). CONCLUSION: The addition of one contact surface does not result in an increased whitening degree compared to bleaching applied solely on the buccal surface. CLINICAL SIGNIFICANCE: Understanding the influence of surfaces interacting with the bleaching agent is crucial for comprehending the bleaching mechanism and avoiding unnecessary material expenses. Notably, employing the buccal-only technique is sufficient to achieve the desired efficacy.
Assuntos
Clareamento Dental , Humanos , Clareamento Dental/métodos , Método Simples-Cego , Feminino , Masculino , Adulto , Peróxido de Hidrogênio/administração & dosagem , Adulto JovemRESUMO
Abstract Despite the availability of in-office bleaching gels with a 6% concentration of hydrogen peroxide (HP), these gels have not been evaluated in younger patients. They are commercially available with a tip, associated or not with a brush, where the tip with a brush spreads the gel over the entire surface to have a smaller thickness (thin layer) since the manufacturers indicate the application of a thin layer of gel. Objective This randomized, split-mouth, double-blind clinical trial evaluated the efficacy of in-office bleaching with 6% HP in adolescents using different application tips, as well tooth sensitivity (TS) and aesthetic self-perception. Methodology Sixty participants were randomized for 6% HP self-mixing bleaching gel tip design: without brush and with brush. In-office bleaching was performed in 3 sessions of 50 minutes. Color change was evaluated using a digital spectrophotometer (ΔE ab , ΔE 00 , and ΔWI D ) and color guide (ΔSGU), the absolute risk and intensity of TS with a visual analogue scale and aesthetic self-perception with the oral aesthetic scale (a=0.05). Results The groups achieved similar bleaching regardless of the application tip (p>0.05). However, only for ΔWI D , a significant mean difference (MD) was observed in the third week (MD 2.3; 95% CI 1.2 to 3.3; p < 0.001) and at one month (MD 1.6; 95% CI 0.6 to 2.6; p < 0.03) favoring the tip without brush. Regarding TS, 45% in the tip-without-brush group and 33% in the tip-with-brush group reported TS (odds ratio 0.61; 95% CI 0.29 to 1.28; p<0.02), with low TS intensity (MD 0.05; 95% CI -0.06 to 0.17; p>0.36). All patients reported improved aesthetic self-perception after bleaching (MD -1.3; 95% -1.8 to -0.9; p<0.001). Conclusions Regardless of the tip used bleaching with 6% HP achieved a bleaching efficacy and improved the aesthetic self-perception. However, a lower risk of TS for application using the tip with brush was observed.
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Objetivo: Este ensaio clínico randomizado, duplo-cego e boca dividida avaliou o desempenho clínico de um novo compósito termoviscoso com pré-aquecimento (PHT) em comparação com uma resina composta sem aquecimento (NHT) em restaurações de lesões cervicais não cariosas (LCNCs) durante um período de 6 meses. Material e Métodos: 120 restaurações foram realizadas em LCNCs com dois materiais restauradores (n = 60). Após a profilaxia, os dentes foram isolados com isolamento de fio retrator/rolos de algodão e um adesivo universal foi aplicado na estratégia de condicionamento seletivo do esmalte. Para o grupo PHT o aquecimento foi realizado a 68°C usando um aquecidor de bancada por 3 min. Por outro lado, para o grupo NHT, nenhum aquecimento foi aplicado. Ambos os materiais restauradores foram colocados no dispensador de cápsulas e inseridos nas LCNCs. Após 6 meses, o desempenho clínico das restaurações foi avaliado de acordo com os critérios FDI. A análise estatística foi realizada com teste Qui-quadrado para todos parâmetros da FDI (α = 0,05). Resultados: Apenas três restaurações no grupo NHT foram perdidas/fraturadas após seis meses de acompanhamento. As taxas de retenção (intervalo confiança 95%) por seis meses foram de 97,5% (88,6% - 99,0%) para o grupo NHT e 100% (93,9% - 100%) para o grupo PHT (p > 0,05). Vinte e duas restaurações (8 para NHT e 14 para PHT) apresentaram pequenos defeitos de adaptação marginal aos seis meses de acompanhamento (p > 0,05). Vinte e seis restaurações apresentaram alguma retenção de biofilme aos seis meses de acompanhamento (11 para NHT e 15 para PHT; p > 0,05). Em relação a todos os outros parâmetros de FDI avaliados, todas as restaurações foram consideradas clinicamente aceitáveis. Conclusão: O desempenho clínico do novo compósito termoviscoso de pré-aquecimento mostrou-se promissor após 6 meses de avaliação clínica quando aplicado em LCNCs.(AU)
Objective: This double-blind, split-mouth randomized clinical trial evaluate the clinical performance of a new preheating (PHT) thermoviscous composite compared to a non-heating (NHT) composite resin in restorations of non-carious cervical lesions (NCCLs) over a period of 6-month. Material and Methods: 120 restorations were performed on NCCLs with two restorative materials (n = 60). After prophylaxis, the teeth were isolated with retraction cord isolation/cotton rolls and one universal adhesive was applied in the selective enamel etching strategy. For the PHT group heating was carried out at 68°C using a heater bench for 3 min. On the other side, for the NHT group, no heating was applied. Both restorative materials were placed in the caps dispenser and inserted in the NCCLs. The restorations were evaluated after 6-month of clinical performance according to the FDI criteria. Statistical analysis was performed with Chi-square test for all FDI parameters (α = 0.05). Results: Three restorations only in the NHT group were lost/fractured after six months follow-up. The retention rates (confidential interval 95%) for six months were 97.5% (88.6% - 99.0%) for the NHT group and 100% (93.9% - 100%) for the PHT group (p > 0.05). Twenty-two restorations (8 for NHT and 14 for PHT) presented small marginal adaptation defects at the six-months follow-up (p > 0.05). Twenty-six restorations were found to have biofilm retention in the six-month recall (11 for NHT and 15 for PHT; p > 0.05). Regarding all others FDI parameters evaluated, all restorations were considered clinically acceptable. Conclusion: The clinical performance of the new preheating thermoviscous was found to be promise after 6-month of clinical evaluation when applied in NCCLs (AU)