Effect of topical application of ibuprofen/arginine on the in-office bleaching-induced tooth sensitivity: A randomized, triple-blind controlled trial.

OBJECTIVE: The application of anti-inflammatories as topical desensitizers before dental bleaching is an approach to reduce bleaching-induced tooth sensitivity (TS). This randomized controlled trial compared the risk and intensity of TS and the color change resulting from in-office dental bleaching after using an experimental desensitizing gel containing ibuprofen and arginine. METHODS: Sixty-two participants with upper canine shades A2 or darker were randomly assigned to either the ibuprofen-arginine desensitizing group or the placebo group. The desensitizing gel was applied for 15 min before in-office bleaching with 35 % hydrogen peroxide gel for 50 min (2 sessions). To assess the absolute risk and intensity of TS, visual (0-10) and numeric rating (0-5) scales were used, and group comparisons were made using the McNemar test, Wilcoxon test, and paired Student t-test (α = 0.05). Color change was evaluated using Vita Classical, Vita Bleachedguide (ΔSGU), and Vita EasyShade (ΔEab, ΔE00, and ΔWID) before and one month after the bleaching procedure. Group comparisons for color change were done using a paired t-test (α = 0.05). RESULTS: The odds ratio for TS was 0.14 [95 % CI 0.02 to 0.6], meaning lower odds of TS for the desensitizing gel. A lower intensity of TS was also observed for the experimental group (p < 0.005) up to 48 h after bleaching. All color evaluation tools demonstrated effective and similar whitening for both groups (p > 0.05). CONCLUSIONS: Using the experimental desensitizing gel containing ibuprofen and arginine effectively reduced the risk and intensity of TS without compromising the bleaching efficacy. CLINICAL RELEVANCE: The topical application of ibuprofen/arginine on the in-office bleaching reduced risk and intensity of bleaching-induced tooth sensitivity.

In vitro bleaching efficacy of violet LED associated with 10% hydrogen peroxide and 10% carbamide peroxide.

BACKGROUND: This in vitro study evaluated the efficacy and the effect over the dental enamel surface of violet LED dental bleaching associated to different concentrations of carbamide and hydrogen peroxide. METHODS: Human dental blocks (n = 100) were randomly distributed into 5 groups: 10% hydrogen peroxide (HP10), 10% carbamide peroxide (CP10), 10% hydrogen peroxide with violet LED (VHP10), 10% carbamide peroxide with violet LED (VCP10) and 35% hydrogen peroxide (HP35). The specimens were analyzed by Vickers microhardness test (n = 50) initially, immediately after and seven days after ending the bleaching protocol. For color analysis (n = 50), the specimens were evaluated for bleaching effectiveness (ΔE2000, ΔE1976) and whiteness index (ΔWID) with EasyShade spectrophotometer, before bleaching protocol and seven days after ending the bleaching protocol. The microhardness and color data were analyzed using one-way ANOVA with post-hoc Tukey test (α = 0.05). RESULTS: The microhardness values showed difference among the investigated groups only immediately after the end of the dental bleaching (p < 0.05), with reduction for the groups HP35 (p < 0.01) and HP10 (p < 0.05), however the microhardness values were reestablished after seven days. Regarding the color changes, a difference between VHP10 and the others groups evaluated for ΔE2000 and ΔE1976 index was observed (p < 0.05). For ΔWID, there was no difference between the studied groups. CONCLUSIONS: Violet LED associated with low concentration bleaching agents did not show a negative effect on dental enamel regarding the surface microhardness. All bleaching protocols were effective, therefore, perceptible to human eyes.

Effectiveness of violet LED dental bleaching compared to 35% hydrogen peroxide: An in vitro study.

AIM: This in vitro study assessed the efficacy and adverse effects of violet LED bleaching with or without bleaching agents. MATERIAL AND METHODS: Dental blocks (n=40) were randomly distributed in 4 groups: violet LED (VL), 35% hydrogen peroxide (HP35), the association of hydrogen peroxide 35% with violet LED (VHP35) and the association of hydrogen peroxide 35% with blue LED (BHP35). Specimens were analyzed for Vickers microhardness initially, immediately after and seven days after ending bleaching protocol. The color analysis of the specimens was evaluated for bleaching effectiveness (ΔE2000, ΔE1976) and whiteness index (ΔWID) with EasyShade spectrophotometer, before bleaching protocol and seven days after ending bleaching protocol. The mineral composition of the enamel was evaluated by percentage of phosphorus and calcium on the enamel surface with energy dispersive spectroscopy (EDS). The color and the microhardness data were analyzed using one-way ANOVA with post-hoc Tukey (α=0.05). RESULTS: The microhardness test showed a difference among the groups only immediately after the completion of the protocol, in which there was a reduction in the value for the groups HP35 from 277,36 ± 21,56 to 198,76 ±32,2 (p<0,01); and BHP35 from 261,14 ± 36,01 to 212,66 ± 25,99 (p<0,01), but the microhardness was reestablished after seven days. Regarding EDS analysis, a reduction in the mineral percentage immediately after bleaching with the use of VL was observed, however, after seven days it was reestablished. Regarding the color analysis, there was no difference among the groups evaluated. CONCLUSIONS: The use of VL was effective as a dental bleaching tool and did not adversely affect the enamel surface after seven days of the ending of the bleaching protocol.

Coadministration of ibuprofen/caffeine on bleaching-induced tooth sensitivity: A randomized clinical trial.

This clinical trial evaluated the effect of the coadministration of ibuprofen/caffeine on bleaching-induced tooth sensitivity (TS). A triple-blind, parallel-design, randomized clinical trial was conducted on 84 patients who received ibuprofen/caffeine or placebo capsules. The drugs were administered for 48 hours, starting 1 hour before the in-office bleaching. Two bleaching sessions were performed with 35% hydrogen peroxide gel with 1-week interval. TS was recorded up to 48 hours after dental bleaching with a 0-10 visual analogic scale (VAS) and a 5-point numeric rating scale (NRS). The color was evaluated with VITA Classical and VITA Bleachedguide scales (ΔSGU) and VITA Easyshade spectrophotometer (ΔE*ab and ΔE00). The absolute risk of TS in both groups was evaluated using Fischer's exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney test and a two-way repeated measures ANOVA, respectively. The color alteration between the groups was compared with the Student's t test. The significance level was 5%. There was no statistically significant difference between the groups for the absolute risk of TS (p = 1.00) or for the intensity of TS (p > 0.05). A bleaching of approximately 7 shade guide units was observed on the Vita Classical and Vita Bleachedguide scales, with no statistical difference between the groups. It was concluded that coadministration of ibuprofen and caffeine did not reduce the absolute risk or intensity of TS and did not interfere with the efficacy of dental bleaching.

Coadministration of ibuprofen/caffeine on bleaching-induced tooth sensitivity: A randomized clinical trial

Abstract This clinical trial evaluated the effect of the coadministration of ibuprofen/caffeine on bleaching-induced tooth sensitivity (TS). A triple-blind, parallel-design, randomized clinical trial was conducted on 84 patients who received ibuprofen/caffeine or placebo capsules. The drugs were administered for 48 hours, starting 1 hour before the in-office bleaching. Two bleaching sessions were performed with 35% hydrogen peroxide gel with 1-week interval. TS was recorded up to 48 hours after dental bleaching with a 0-10 visual analogic scale (VAS) and a 5-point numeric rating scale (NRS). The color was evaluated with VITA Classical and VITA Bleachedguide scales (ΔSGU) and VITA Easyshade spectrophotometer (ΔE*ab and ΔE00). The absolute risk of TS in both groups was evaluated using Fischer's exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney test and a two-way repeated measures ANOVA, respectively. The color alteration between the groups was compared with the Student's t test. The significance level was 5%. There was no statistically significant difference between the groups for the absolute risk of TS (p = 1.00) or for the intensity of TS (p > 0.05). A bleaching of approximately 7 shade guide units was observed on the Vita Classical and Vita Bleachedguide scales, with no statistical difference between the groups. It was concluded that coadministration of ibuprofen and caffeine did not reduce the absolute risk or intensity of TS and did not interfere with the efficacy of dental bleaching.

Resumo Este ensaio clínico avaliou o efeito da coadministração de ibuprofeno/cafeína na sensibilidade dental decorrente de clareamento (SD). Um estudo clínico randomizado, paralelo, triplo-cego, foi realizado em 84 pacientes que receberam cápsulas de ibuprofeno/cafeína ou placebo. Os fármacos foram administrados por 48 horas, começando 1 hora antes do clareamento em consultório. Duas sessões de clareamento foram realizadas com gel de peróxido de hidrogênio 35% com intervalo de 1 semana. A SD foi registrada até 48 horas após o clareamento dental com uma escala visual analógica (VAS) de 0-10 e uma escala de classificação numérica (NRS) de 5 pontos. A cor foi avaliada com as escalas Vita Classical e Vita Bleachedguide (ΔSGU) e com o espectrômetro Vita Easyshade (ΔE*ab e ΔE00). O risco absoluto de SD em ambos os grupos foi avaliado por meio do teste exato de Fischer. As comparações da intensidade da SD (NRS e VAS) foram realizadas utilizando-se o teste Mann-Whitney e uma ANOVA de dois fatores com medidas repetidas, respectivamente. A alteração de cor entre os grupos foi comparada com a o teste t de Student. O nível de significância foi de 5%. Não houve diferença estatisticamente significante entre os grupos para o risco absoluto de SD (p = 1,00) ou para a intensidade de SD (p > 0,05). Observou-se clareamento de aproximadamente 7 unidades nas escalas Vita Classical e Vita Bleachedguide, sem diferença estatística entre os grupos. Concluiu-se que a coadministração de ibuprofeno e cafeína não reduziu o risco absoluto ou intensidade da SD e não interferiu na eficácia do clareamento dental.

Bleaching sensitivity with a desensitizing in-office bleaching gel: a randomized double-blind clinical trial.

OBJECTIVES: This split-mouth study assessed the bleaching sensitivity (risk and intensity) and color change after in-office bleaching using a desensitizing-containing (5% potassium nitrate) and a desensitizing-free 35% hydrogen peroxide gel. The null hypothesis was that there would be no differences between study groups regarding bleaching sensitivity. METHOD AND MATERIALS: Sixty patients participated in this split-mouth study. The subjects received desensitizing-containing hydrogen peroxide in half of the maxillary arch, and the other half received a desensitizing-free hydrogen peroxide, defined by random sequence, in two dental bleaching sessions. The bleaching sensitivity was evaluated during bleaching and from 1 h to 48 h after each bleaching session using a visual analog scale and numeric rating scale; the McNemar test, the Wilcoxon signed-rank test, and the Student-Newman-Keuls test were used for statistical analysis. The color was measured at baseline and 30 days post-bleaching, evaluated with paired t tests (P = .05). RESULTS: Statistically similar risks of bleaching sensitivity were observed (P = 1.000), but the intensity of bleaching sensitivity was lower (P < .011) on average by 1.32 visual analog scale units in the group bleached with the desensitizer-containing gel during up to 24 h assessment times. No statistical difference in color change was observed between groups (P > .321). CONCLUSION: The incorporation of 5% potassium nitrate into in-office bleaching gels does not reduce the risk of bleaching sensitivity, but it reduces its intensity slightly without jeopardizing color change.

Tooth sensitivity with a desensitizing-containing at-home bleaching gel-a randomized triple-blind clinical trial.

OBJECTIVES: Desensitizing agents are usually included in the composition of bleaching agents to reduce bleaching-induced tooth sensitivity (TS). This randomized clinical trial (RCT) evaluated the risk and intensity of TS and color change after at-home bleaching with a desensitizing-containing (3% potassium nitrate and 0.2% sodium fluoride) and desensitizing-free 10% carbamide peroxide (CP) gel (Whiteness Perfect, FGM). METHODS: A triple-blind, within-person RCT was conducted on 60 caries-free adult patients. Each participant used the gel in a bleaching tray for 3 h daily for 21 days in both the upper and lower dental arches. The absolute risk and intensity of TS were assessed daily through the 0-10 VAS and NRS scale for 21 days. Color change was recorded using shade guides (Vita Classical and Vita Bleachedguide) and the Easyshade spectrophotometer at baseline, weekly and 30 days after the end of the bleaching. The risk and intensity of TS were evaluated by the McNemar and Wilcoxon Signed Rank tests, respectively. Color change (ΔSGU and ΔE) were evaluated by the Mann-Whitney test and a paired t-test, respectively (α = 0.05). RESULTS: No difference in the TS and color change was observed (p > 0.05). CONCLUSIONS: The incorporation of potassium nitrate and sodium fluoride in 10% carbamide peroxide at-home bleaching gel tested in this study did not reduce the TS and did not affect color change (RBR-4M6YR2).