Abstract
ObjectiveThe objective of this study was to evaluate dental sensitivity using visual analogue scale, a Computerized Visual Analogue Scale (CoVAS) and a neurosensory analyzer (TSA II) during at-home bleaching with 10% carbamide peroxide, with and without potassium oxalate.Materials and MethodsPower Bleaching 10% containing potassium oxalate was used on one maxillary hemi-arch of the 25 volunteers, and Opalescence 10% was used on the opposite hemi-arch. Bleaching agents were used daily for 3 weeks. Analysis was performed before treatment, 24 hours later, 7, 14, and 21 days after the start of the treatment, and 7 days after its conclusion. The spontaneous tooth sensitivity was evaluated using the visual analogue scale and the sensitivity caused by a continuous 0°C stimulus was analyzed using CoVAS. The cold sensation threshold was also analyzed using the TSA II. The temperatures obtained were statistically analyzed using ANOVA and Tukey's test (α=5%).ResultsThe data obtained with the other methods were also analyzed. 24 hours, 7 and 14 days before the beginning of the treatment, over 20% of the teeth presented spontaneous sensitivity, the normal condition was restored after the end of the treatment. Regarding the cold sensation temperatures, both products sensitized the teeth (p<0.05) and no differences were detected between the products in each period (p>0.05). In addition, when they were compared using CoVAS, Power Bleaching caused the highest levels of sensitivity in all study periods, with the exception of the 14th day of treatment.ConclusionWe concluded that the bleaching treatment sensitized the teeth and the product with potassium oxalate was not able to modulate tooth sensitivity.
Highlights
At-home bleaching technique is recognized as a simple, biologically safe, and aesthetically effective therapy[4,10,17]
Upon penetrating the dental tissues, they quickly diffuse in the dental tissues reaching the chemosensitive ion channel (TRPA1), this activates the intradental nerves, causing discomfort[18,19]
This study aimed to evaluate the occurrence of spontaneous dental sensitivity and tooth sensitivity to cold produced through a thermal stimulus during and after whitening with carbamide peroxide, with or without oxalate
Summary
At-home bleaching technique is recognized as a simple, biologically safe, and aesthetically effective therapy[4,10,17]. Post-bleaching sensitivity was related to the morphological changes that presumably alter the permeability, resulting in temporary sensitivity after the procedure[5,20]. For this reason, products that repair these superficial changes are continually added in the composition of the bleaching agent[5], blocking dentin tubules[2,5,6], or acting in the transmission of nerve impulses, decreasing the ability of nerve fibers in the dental pulp to repolarize after an initial depolarization due to pain sensation[2]. A systematic review by Cunha-Cruz, et al.[7] (2011) concluded that available evidence suggests that oxalates are not effective in decreasing dentin hypersensitivity They found a great variability across clinical trial leading to the need for standardization of pain stimuli and scales. Potassium oxalate was recently added to an at-home bleaching product in an attempt to reduce sensitivity resultant from bleaching therapies
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