Abstract
ObjectiveThis split-mouth randomized controlled clinical trial assessed the effect of 10% strontium chloride in combination with photobiomodulation (PBM) for the control of tooth sensitivity (TS) post-bleaching.MethodsThe upper/lower, right and left quadrants of fifty volunteers were randomized and allocated to four groups (n = 25): PLACEBO—placebo gel + simulation of PBM; Placebo + PBM; STRONTIUM—10% strontium chloride + simulation of PBM; and PBM + STRONTIUM—10% strontium chloride + PBM. All groups received tooth bleaching treatment with 35% hydrogen peroxide. For the PBM treatment, the laser tip was positioned in the apical and cervical regions of the teeth bleached in the respective hemi-arch. The laser system was operated in continuous mode, using 1.7 J of energy. A dose of 60 J/cm2 was applied to each point for 16 seconds under 808 nm near-infrared light (100mW of power), with a point area of 0.028 cm2. TS was assessed during a 21-day follow-up, using the modified visual analogue scale.ResultsIn the intragroup assessment, the Friedman test indicated that PBM + STRONTIUM promoted the greatest reduction in TS after the second week of treatment (p ≤ 0.05). The Wilcoxon-Mann-Whitney test indicated that the groups Placebo + PBM, STRONTIUM, and STRONTIUM + PBM did not differ statistically (p ≥ 0.05) in the first and third weeks of treatment The group PLACEBO exhibited the greatest TS in the first three days after each bleaching session.ConclusionThe combination of 10% strontium chloride with PBM was effective in reducing post-bleaching TS; however, the combination of 10% strontium chloride with PBM was effective in reducing post-bleaching TS; however, it did not differ from the individual use of Placebo + PBM or STRONTIUM groups assessed after 21 days of follow-up.
Highlights
Tooth bleaching is one of the most prescribed procedures in cosmetic dentistry [1], because it is a simple, effective, minimally invasive, and low-cost technique [2,3]
The Friedman test indicated that PBM + STRONTIUM promoted the greatest reduction in tooth sensitivity (TS) after the second week of treatment (p 0.05)
The Wilcoxon-Mann-Whitney test indicated that the groups Placebo + PBM, STRONTIUM, and STRONTIUM + PBM did not differ statistically (p 0.05) in the first and third weeks of treatment The group PLACEBO exhibited the greatest TS in the first three days after each bleaching session
Summary
Tooth bleaching is one of the most prescribed procedures in cosmetic dentistry [1], because it is a simple, effective, minimally invasive, and low-cost technique [2,3]. A positive impact on smiling without embarrassment was reported after tooth bleaching treatments [4]. The low molecular weight of H2O2 favors its rapid diffusion in the interprismatic spaces [6], reaching the pulp chamber and producing a strong oxidative stress in the pulp cells [7]. This fact leads to the release of inflammatory mediators [8,9], which can excite or sensitize nociceptors [10], causing the most common adverse effect of bleaching treatments, i.e., tooth sensitivity (TS) [2]
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