Abstract
The objective of this clinical study was to determine the effect of adding desensitizing agents in homemade experimental whitening gel Carbamide peroxide 16%. 60 young patients were selected (between 18-28 years), who used randomly (by lottery) the whitening gel DA (with desensitizing agent) or whitening gel CO (without desensitizing agent) characterized as control of a double-blind study, ie the patient and the evaluator did not know the product that was being used. Teeth 15, 14, 13, 12, 11, 21, 22, 23, 24 and 25 were bleached. The guidelines of how to apply the bleaching agents were performed by an experienced and calibrated team, and the application accompanied by examiners in several phases. To measure the color we used a Visual Range Vita Classical through visual inspection by the evaluators and patient information. A comparative test regarding each individual stimulation caused by mechanical attrition and thermal probe with clinical test was done (air syringe) in order to verify the presence of sensitivity in three phases: before treatment, after 7 and 14 days. Data were collected using Visual Analogue Scale (VAS) adapted to four criteria: no pain, mild pain, moderate pain and severe pain. The correlation of the data x teeth sensitivity were obtained separately, and tabulated for further comparative analysis. The results showed that there was no difference between the groups in terms of bleaching effect. In the post-operative sensitivity test, the subjects who used the product without desensitizing showed higher levels of sensitivity in different types of teeth, regardless of sex or age. It was concluded that the addition of desensitizing agent in the carbamide peroxide 16% whitening gel produced less post-bleaching sensitivity index. We emphasize that from the teeth evaluated, the premolars showed higher sensitivity index, followed by the canines and incisors. There was no difference in the bleaching capacity of the products used, demonstrating that the addition of desensitizing did not affect the efficacy of the treatment.
Highlights
Increased concern has been given to the aesthetic appearance in dentistry in recent years
The most conservative way to modify the color of teeth is the use of a bleaching procedure and it can be made by in-office or at-home bleaching (HAYWOOD, 1989), which is commonly related with the adverse effect of tooth sensitivity, in cases of vital tooth bleaching
On the other hand, during the final clinical exams, they reported that this sensitivity only occurred when stimulated by the evaluators, not occurring in their daily routine. The results of this Randomized clinical trial study demonstrated that dentist-supervised at-home bleaching with both tested products for 14 days led to increased tooth sensitivity; the 16% carbamide peroxide gel with the desensitizing agents induced lower hypersensitivity than the product without it
Summary
Increased concern has been given to the aesthetic appearance in dentistry in recent years. Sensitivity is caused by the passage of hydrogen peroxide, which is only slightly larger than water molecules, through enamel and dentin to the pulp where it directly activates nerves that cause pain (BROWNING et al, 2008)
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