Abstract

ObjectiveThis study verified the occurrence of dental sensitivity in patients submitted to a 35% hydrogen peroxide based product (Whiteness HP Maxx 35% – FGM), skin cold sensation threshold (SCST) and its influence on dental sensitivity.Material and MethodsSixty volunteers were divided into 4 groups (n = 15), according to SCST (low: GI and GIII, and high: GII and IV) and bleaching treatment (hydrogen peroxide: GI and GII, and placebo: GIII and GIV). SCST was determined in the inner forearm for 6 different times using a neurosensory analyzer, the TSA II (Medoc Advanced Medical Systems, Ramat Yishai, Northern District, Israel). Dental sensitivity measurements were performed 10 different times using a thermal stimulus and an intraoral device attached to TSA II, positioned in the buccal surface of the upper right central incisor. Spontaneous dental sensitivity was also determined using the Visual Analogue Scale (VAS). Data were submitted to Student's t-test and Pearson's Correlation Test (α=0.05). SCST remained the same during bleaching treatment.ResultsDistinct responses of dental sensitivity were found in patients with low and high SCST during the first and third bleaching session (p≤0.05). The teeth submitted to the bleaching treatment became more sensitive to cold than those treated with placebo. Moreover, data obtained with TSA and VAS presented moderate correlation.ConclusionsBleaching treatment increased dental sensitivity and skin cold sensation threshold might represent a determining factor in this occurrence, since low and high SCST patients had different responses to the thermal stimulus in the teeth.

Highlights

  • Tooth bleaching is one of the most popular esthetic procedures requested by patients and a conservative approach with efficient results7

  • It has been established that the mechanisms of the bleaching agent action are based on the presence of reactive forms of oxygen, which are extremely unstable and promote oxidation of pigments embedded in dental tissues, giving them a lighter appearance24

  • The analysis of skin cold sensation threshold during dental bleaching showed no statistical difference between the periods (p>0.05), revealing no alteration in skin cold sensation threshold regardless of the initial classification as low or high threshold (Table 2)

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Summary

Introduction

Tooth bleaching is one of the most popular esthetic procedures requested by patients and a conservative approach with efficient results. Recent studies showed that patients submitted to dental bleaching reported different intensities of dental sensitivity. Recent studies showed that patients submitted to dental bleaching reported different intensities of dental sensitivity11,15,19,24,26 This symptom is a concern for dentists and patients as a limitation for treatment evolution and satisfaction. It has been established that the mechanisms of the bleaching agent action are based on the presence of reactive forms of oxygen, which are extremely unstable and promote oxidation of pigments embedded in dental tissues, giving them a lighter appearance. Upon penetrating the dental tissues to oxidize the pigmenting agents, the reactive forms of oxygen diffuse quickly in the dental tissues reaching the chemosensitive ion channel (TRPA1), activating the intradental nerve and causing discomfort

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