Comparative evaluation of effectiveness of sodium fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in treating postoperative sensitivity associated with in-office vital tooth bleaching: A clinical study

Abstract

Aim: To clinically compare the effectiveness of sodium fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in reducing postoperative sensitivity associated with in-office vital tooth bleaching. Materials and Methods: In-office vital tooth bleaching was performed on 45 patients using 40% hydrogen peroxide gel in a single visit. After the procedure, the patients were randomly divided into three study groups based on the use of desensitizing agent: Group 1 - experimental gel without desensitizing agent (n = 15), Group 2 - cream with 1.1% sodium fluoride (n = 15), and Group 3 - cream with 10% CPP-ACP (n = 15). Gel or cream assigned for each patient was applied directly on the labial surfaces of teeth and left undisturbed for 3 min. Furthermore, the patients were asked to apply the agent given to them for 3 min twice daily after brushing for 14 days. Follow-up was done on 3rd, 7th, and 14th day, at which time tooth shade changes was assessed using a value-oriented Vita classic shade guide. The incidence, duration, and intensity of tooth sensitivity experienced were self-assessed on a daily basis for the 14-day study period using a visual analog scale. Results: Significant higher incidence and intensity of tooth sensitivity was found in experimental gel without desensitizing agent in comparison to sodium fluoride and CPP-ACP groups. Significant decrease in Vita classic tab values was seen in experimental gel group after 14 days; however, in sodium fluoride group, tab change was not significant. Conclusion: Sodium fluoride and CPP-ACP both reduced incidence and intensity of tooth sensitivity after tooth bleaching. Sodium fluoride showed better shade stability than CPP-ACP; however, the difference was not significant.