Eficácia e segurança do clareamento dental caseiro em indivíduos com restaurações estéticas: ensaio clínico randomizado

Abstract

Dental bleaching is one of the most requested treatments for patients, since well-aligned white teeth are considered the main factors that interfere with the beauty of the smile. The objective of this randomized clinical trial was to evaluate the effectiveness and safety of home bleaching performed with 10% carbamide peroxide in individuals with aesthetic restorations. Forty individuals with mean A2 or darker tooth staining of six antero-superior teeth were randomized into two treatment groups (n = 20): GI- absence of aesthetic restorations in the six anterior-superior teeth and GII: presence of at least two Aesthetic restorations in the six anterior-superior teeth. Bleaching was performed 4h / day for two weeks. Tooth sensitivity (TS) and gingival irritation (GI) were assessed using visual analogue scale (VAS), whose scores ranged from 1 (none) to 5 (severe). The aesthetic perception regarding the appearance of tooth color was also evaluated through VAS. Both treatment groups had both the mean color and the L * a * b * parameters lighter than the baseline in all assessment periods (p <0.05). However, GI was clearer than GII in all evaluation periods for the mean color, a * and ΔE * (p <0.05). The luminosity (L *) was significantly higher for GI only immediately after treatment (p = 0.005) and no significant differences were observed between groups for the parameter b * in the different evaluation periods (p> 0.1). In the first week of treatment, GII had a higher mean dentin sensitivity than GI (p <0.05), however, no differences were observed between groups in the second week (p> 0.05). Over 59% of treatment days were not associated with any sensitivity, but a higher frequency was reported by GII subjects (p = 0.02). However, a greater frequency was observed in GII (11.4%) than in GI (8.6%) (p = 0.01) . Over 80% of subjects in both treatment groups reported a good to exceptional improvement in tooth appearance after bleaching (p = 0.2). It was concluded that home bleaching with 10% carbamide peroxide was effective in patients with aesthetic restorations, however, the bleaching effect was lower in this group than in individuals without restorations. In addition, although most individuals have reported no dentin sensitivity or gingival irritation, these effects were more frequent in the group of individuals with aesthetic restorations.