Avaliação clínica prospectiva randomizada do monitoramento digital de pacientes submetidos ao clareamento caseiro: efeito do tempo de uso do produto clareador nos graus de colaboração e satisfação do paciente, na efetividade e ocorrência de sensibilidade / Clinical prospective randomized evaluation of the digital monitoring of patients submitted to home bleaching: effect of the wear time of the bleaching product on the levels of collaboration and patient satisfaction, on the effectiveness and occurrence of sensitivity

Este estudo prospectivo, randomizado e paralelo analisou a alteração de cor, sensibilidade dental, grau de cooperação e satisfação de voluntários quando submetidos ao clareamento dental com peróxido de carbamida a 10%, empregado durante 21 dias por 2, 4 e 8 horas/dia. O tempo preciso do uso diário das moldeiras/produto clareador foi mensurado por meio de um microssensor TheraMon (Sales Agency Gschladt, Hargelsberhg, Áustria). Sessenta e seis voluntários, de ambos os gêneros, com idades entre 18 e 22 anos foram selecionados e distribuídos aleatoriamente em três grupos de estudo (n = 22), os quais receberam as informações sobre a presença do microssensor em suas moldeiras. O fator estudado foi o tempo de uso das moldeiras em três níveis: 2 (GI), 4 (GII) e 8 (GIII) hrs/dia. Para a análise clínica, as variáveis de resposta foram: grau de cooperação diária dos voluntários de acordo com o tempo de uso diário das moldeiras; grau de satisfação dos voluntários com o clareamento dental; eficácia do clareamento dental nos incisivos e caninos superiores e inferiores pelo método visual (Vita Classical) e digital (Vita Easyshade), assim como o grau de sensibilidade dental que foi avaliado com método analógico-visual. Os voluntários foram avaliados no período inicial (baseline), aos 7, 14 e 21 dias após o início do tratamento clareador e 14 dias após apenas para as observações da cor, sensibilidade e grau de satisfação. Os dados foram analisados com aplicação do teste ANOVA e pelo post teste de Tukey. Para o grau de cooperação diária dos voluntários, foram utilizadas observações dos tempos de uso das moldeiras (escores/dias) para cada arco e correspondentes a cada semana de tratamento. A análise digital apontou um mesmo nível de alteração de cor em todos os tempos de análise e de uso das moldeiras/produto clareador; exceção para o tempo de análise 7 dias do arco superior, que evidenciou uma maior alteração de cor para os maiores tempos de uso das moldeiras/produto clareador. A análise visual evidenciou que os maiores tempos de uso das moldeiras/produto clareador apresentou uma maior alteração de cor, após o tratamento clareador. A sensibilidade dental foi observada durante o tratamento clareador, mas postou-se praticamente ausente 14 dias após o clareamento. A maioria dos voluntários não seguiram as prescrições sugeridas do tempo de uso diário das moldeiras/produto clareador, sendo que os voluntários que as usaram pelo menor tempo apresentaram um maior grau de cooperação. A utilização das moldeiras/produto clareador por mais tempo foi capaz de proporcionar maior efetividade na alteração de cor e no grau de satisfação dos voluntários. Quanto mais prolongado o tempo de uso diário das moldeiras/produto clareador, maiores as chances de os voluntários não seguirem o protocolo recomendado(AU)

This prospective, randomized, parallel study analyzed the color change, tooth sensitivity, degrees of cooperation, and satisfaction of volunteers when submitted to at home dental bleaching with 10% carbamide peroxide (Opalescence - Ultradent Products, Inc. South Jordan, USA) for 21 consecutive days for 2, 4 and 8 hours/day. The wear time of acetate trays/dental bleaching was measured through a TheraMon microsensor (TheraMon® microelectronic system; Sales AgencyGschladt, Hargelsberhg, Austria). Sixty six volunteers, both sexes, with ages ranging from 18 to 22 years were selected and randonly distributed into 3 study groups (n=22). The volunters received information about presence of the microsensor in their trays. The fator studied was the wear time of the trays in three levels: during 2 (GI), 4 (GII) and 8 (GIII) hours/day. For the clinical analysis the response variables were: the degree of daily cooperation of the volunteers as the wear time/daily of the trays, microelectrically collected by micro sensor TheraMon®; the degree of satisfaction of volunteers with dental bleaching; the effectiveness of dental bleaching in the upper and lower incisors and canines teeth, by the visual method (Vita Classical) and digital (Vita Easyshade) and dental sensitivity was evaluated by the volunteers with a scale visual analog method on a scale of 0 to 10. The volunteers were evaluated at baseline period, at one, two and three weeks after the beginning of the bleaching treatment, and again two weeks after the bleaching treatment only for the observations of the color, sensitivity and degree of satisfaction. The data were analyzed using the ANOVA test and the Tukey post test. The digital analysis showed the same level of color change in all times of analysis and wear time of the trays; exception for the analysis time 7 days of the upper arch, which evidenced a greater color change for the longer time of wear time of the trays. The visual analysis evidenced that the greater wear time of the trays presented a greater color change, after the bleaching treatment. Dental sensitivity was observed throughout the bleaching treatment, but it was practically absent 14 days after treatment. Most of the volunteers did not follow the suggested prescriptions of the wear time daily of the trays, with those who used them for the shortest time presenting the highest degree of cooperation. The wear time of the trays/bleaching product for 8 hours/day, provided greater effectiveness of the color change in the visual and digital analysis, as well as greater degree of satisfaction of the volunteers. A discreet sensitivity was observed throughout the bleaching treatment, but it was practically absent 14 days after bleaching. It was observed that the volunteers did not follow correctly the prescriptions of the wear times of the trays/bleaching product, evidencing less the degree of collaboration of the volunteers for the greater wear times of the trays(AU)

The effects of at-home whitening on patients' oral health, psychology, and aesthetic perception.

BACKGROUND: The aesthetic self-perception and psychosocial impact of whitening is poorly explored in the literature; it is even less clear whether the effect of whitening may influence the psychology or social relations of patients. Therefore, the aim of this trial is to evaluate the impact of an at-home whitening procedure on patients' quality of life. Also, this study's secondary objective is the adaptation and validation of the Spanish version of the OES questionnaire (OES-SP). METHODS: Fifty eight patients underwent whitening with 10% carbamide peroxide (CP) gel for 1 h daily for 3 weeks. For these participants, the OHIP-Esthetics, PIDAQ, and OES surveys were applied before, one week after, and one month after the whitening procedure. Oral health-related quality of life was measured using the OHIP-Esthetics survey and the psychosocial impact using the PIDAQ survey. The orofacial aesthetics was measured by OES and validated for the Spanish Chilean context. The treatment efficacy (ΔE and ΔSGU) and data from the OHIP-Esthetics PIDAQ and OES surveys were compared using the Wilcoxon Signed-Rank test. RESULTS: The whitening procedure was effective (ΔE = 5.9 ± 1.8). The OHIP-Esthetics results were significant when comparing the initial baseline survey prior to the treatment and one week after whitening (p < 0.001) and when comparing the baseline and one-month results (p < 0.001). The overall score on the PIDAQ, after one week post-whitening, was separated into factors and all factors were statistically significant (p < 0.03); the factors for the one-month results were also all statistically significant (p < 0.001), except the social impact factor. The OES questionnaire had statistically significantly increased scores both one week and one month post-treatment (p < 0.0001). The reliability, validity, and responsiveness of the OES-SP were satisfactory. CONCLUSION: The at-home whitening procedure with carbamide peroxide 10% had a positive effect on patients' oral health-related quality of life, psychology, and aesthetic perception after one month post-whitening. The Chilean Spanish version of the OES showed satisfactory psychometric characteristics to evaluate dental whitening. TRIAL REGISTRATION: NCT02605239 . Date that the study was retrospectively registered: 11-11-2015.

Desire for tooth bleaching and treatment performed in Brazilian adults: findings from a birth cohort.

Population-based studies estimating the prevalence of tooth bleaching desire or the percentage of individuals who had performed this treatment are rare. Thus, the aim of this study was to evaluate the desire to perform tooth bleaching and the prevalence of adult individuals who had performed the treatment and investigate the association of these outcomes. A subsample (n = 536) of the 1982 Pelotas birth cohort in southern Brazil was investigated at the ages 15, 24 and 31 by clinical examinations and interviews. The prevalence of bleaching at 31 years was 15.6% [95%CI 12.6-18.9] while 85.9% [95%CI 82.7-88.7] reported they desired the treatment. Multivariate Poisson regression analysis showed that individuals who have visited the dentist within the last year showed a treatment prevalence ratio (PR) 2.31 times [95%CI 1.40-3.83] higher compared with those who had the last dental visit more than a year before the interview. Similarly, individuals with smoking habits presented an elevated PR of 1.60 [95%CI 1.00-2.55], and the low-income trajectory group showed the largest PR of desire for tooth bleaching (1.17 [95%CI 1.07-1.28]). Moreover, individuals from the high-risk caries trajectory group presented a higher prevalence of desire for tooth bleaching than individuals from low caries trajectory group. Individuals who have declared being "dissatisfied" with their dental color presented a prevalence of desire for tooth bleaching 16% greater than "satisfied" ones. Thus, the present findings confirm that tooth bleaching has become a frequently desired dental treatment to improve dental aesthetics in the population and a considerable rate of adults has performed the treatment.

Desire for tooth bleaching and treatment performed in Brazilian adults: findings from a birth cohort

Abstract: Population-based studies estimating the prevalence of tooth bleaching desire or the percentage of individuals who had performed this treatment are rare. Thus, the aim of this study was to evaluate the desire to perform tooth bleaching and the prevalence of adult individuals who had performed the treatment and investigate the association of these outcomes. A subsample (n = 536) of the 1982 Pelotas birth cohort in southern Brazil was investigated at the ages 15, 24 and 31 by clinical examinations and interviews. The prevalence of bleaching at 31 years was 15.6% [95%CI 12.6-18.9] while 85.9% [95%CI 82.7-88.7] reported they desired the treatment. Multivariate Poisson regression analysis showed that individuals who have visited the dentist within the last year showed a treatment prevalence ratio (PR) 2.31 times [95%CI 1.40-3.83] higher compared with those who had the last dental visit more than a year before the interview. Similarly, individuals with smoking habits presented an elevated PR of 1.60 [95%CI 1.00-2.55], and the low-income trajectory group showed the largest PR of desire for tooth bleaching (1.17 [95%CI 1.07-1.28]). Moreover, individuals from the high-risk caries trajectory group presented a higher prevalence of desire for tooth bleaching than individuals from low caries trajectory group. Individuals who have declared being "dissatisfied" with their dental color presented a prevalence of desire for tooth bleaching 16% greater than "satisfied" ones. Thus, the present findings confirm that tooth bleaching has become a frequently desired dental treatment to improve dental aesthetics in the population and a considerable rate of adults has performed the treatment.

One-year follow-up of at-home bleaching in smokers before and after dental prophylaxis.

OBJECTIVE: This clinical study evaluated the color longevity after one-year of at-home bleaching with 10% carbamide peroxide (CP) in smokers and nonsmokers. METHODS: Sixty patients, 30 smokers and 30 non-smokers were subjected to bleaching with 10% CP during three hours daily for three weeks. The color was measured at baseline and one week, one month and one year after the completion of dental bleaching using the spectrophotometer Vita Easyshade (ΔE*), shade guide Vita classical organized by value and Vita Bleachedguide 3D-MASTER (ΔSGU). In the one-year recall, the color was assessed before and after dental prophylaxis with Robinson brush and prophylaxis paste. Data from color evaluation were analyzed by two-way repeated measures ANOVA and Tukey's test for the contrast of means (α=0.05). RESULTS: Twenty-seven smokers and 28 non-smokers attended the one-year recall. For both study groups, only the main factor assessment time was statistically significant for ΔSGU (Vita classical) and ΔE* (p<0.001). Effective whitening was observed for both groups at baseline, which was stable at one-month and one year after dental prophylaxis. A slight darkening was observed after one year when the color was measured without prophylaxis. For the Vita Bleachedguide 3D-MASTER, color rebound was observed irrespectively of dental prophylaxis. CONCLUSION: The bleaching with 10% CP remained stable in both groups as long as extrinsic stains from diet and cigarette smoke were removed by professional dental prophylaxis. CLINICAL TRIALS REGISTRY: NCT02017873. CLINICAL RELEVANCE: The results of this study indicate that the bleaching is effective in smokers even after one-year, but dental prophylaxis may be necessary to remove extrinsic stains caused by diet and smoking.

Clareamento dental: uma contribuiçäo à base teórica / Bleaching teeth: a contribution to a theoric base

Sendo a estética uma das grandes preocupaçöes - talvez a maior delas - da maioria dos pacientes que procuram a clínica Odontológica, os autores fazem um breve relato a respeito de clareamento dental, citando técnicas de clareamento dental para dentes näo vitais e possíveis efeitos indesejáveis advindos dessa técnica