Desensitizing Agent Previously Applied During In-Office Bleaching: A Double-Blind Randomized Clinical Trial

Isabel Ferreira Barbosa; Suelem Chasse Barreto; Josué Junior Araujo Pierote; João Victor Frazão Câmara; Lucia Trazzi Prieto; Débora Alves Nunes Leite Lima; Luis Alexandre Maffei Sartini Paulillo

Authors

Isabel Ferreira Barbosa
Suelem Chasse Barreto
Josué Junior Araujo Pierote
João Victor Frazão Câmara
Lucia Trazzi Prieto
Débora Alves Nunes Leite Lima
Luis Alexandre Maffei Sartini Paulillo

Keywords:

Tooth Bleaching, Hypersensitivity, Fluorides, Hydrogen Peroxide

Abstract

Objective: To compare the clinical effect of two desensitizing agents used before the application of a bleaching gel based on 35% hydrogen peroxide (HP). Material and Methods: 30 patients were selected, and two desensitizing agents with different mechanisms of action were applied: Fluorine Neutral 2% (FN), which acts by blocking dentinal canaliculi while Potassium Nitrate 5% with 2% Sodium Fluoride (PN/SF) that acts in nerve transmission and blockade. Desensitizers were used before the application of 35% HP. For whitening, three clinical sessions were performed, with an interval of seven days, with three applications of the bleaching gel for 15 minutes, totaling 45 minutes/session. Tooth sensitivity (TS) was assessed with the numerical analog scale, and a spectrophotometer was used to obtain the color variation (ΔE).ΔE were submitted to ANOVA and Tukey test (p<0.05), and TS data were submitted to a two-way ANOVA analysis. Results: For sensitivity experience, the Tukey test indicated differences between PN/SF and the placebo I, but there was no statistically significant difference between FN and the placebo II. The TS was lower when the desensitizing gel was used during the bleaching procedure compared to after treatment, regardless of the desensitizing agents. Conclusion: PN/SF before in-office tooth bleaching can reduce TS intensity, and the use of desensitizing gel before bleaching did not affect the bleaching efficacy.

References

Begum Z, Chheda P, Shrithi CS, Sonika R. Effect of ceramic thickness and luting agent shade on the color masking ability of laminate veneers. J Indian Prosthodont Soc 2014; 14(1):46-50. https://doi.org/10.1007/s13191-014-0362-2

Goldberg M, Grootveld M, Lynch E. Undesirable and adverse effects of tooth-whitenig products: a review. Clin Oral Invest 2010; 14(1):1-10. https://doi.org/10.1007/s00784-009-0302-4

Rezende M, Loguercio AD, Kossatz S, Reis A. Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: A multi regression and logistic analysis. J Dent 2016; 45:1-6. https://doi.org/10.1016/j.jdent.2015.11.003

Arrais CA, Chan DC, Giannini M. Effects of desensitizing agents on dentinal tubule occlusion. J Appl Oral Sci 2004; 12(2):144-148. https://doi.org/10.1590/s1678-77572004000200012

Mena-Serrano AP, Garcia E, Luque-Martinez I, Grande R, Loguercio AD, Reis A. A single-blind randomized trial about the effect of hydrogen peroxide concentration on light-activated bleaching. Oper Dent 2016; 41(5):455-464. https://doi.org/10.2341/15-077-C

Abouassi T, Wolkewitz M, Hahn P. Effect of carbamide peroxide and hydrogen peroxide on enamel surface: an in vitro study. Clin Oral Investig 2011; 15(5):673-680. https://doi.org/10.1007/s00784-010-0439-1

Lima DA, Aguiar FH, Liporini PC, Munin E, Ambrosano GM, Lovadino JR. Influence of chemical or physical catalysts on higrh concentration bleaching agents. Eur J Esthet Dent 2011; 6(4):454-466.

Kossatz S, Dalanhol AP, Cunha T, Loguercio A, Reis A. Effect of light activation on tooth sensitivity after in-office bleaching. Oper Dent 2011; 36(3):251-257. https://doi.org/10.2341/10-289-C

Tay LY, Kose C, Loguercio AD, Reis A. Assessing the effect of a desensitizing agent used before in-office tooth bleaching. JADA 2009; 140(10):1245-1251. https://doi.org/10.14219/jada.archive.2009.0047

Caviedes-Bucheli J, Ariza-Garcia G, Restrepo-Méndez S, Ríos-Osorio N, Lombana N, Muñoz HR. The effect of tooth bleaching on substance P express in human dental pulp. J Endod 2008; 34(12):1462-1465. https://doi.org/10.1016/j.joen.2008.09.013

Wang Y, Gao J, Jiang T, Liang S, Zhou Y, Matis BA. Evaluation of the efficacy of potassium nitrate and sodium fluoride as desensitizing agents during tooth bleaching treatment—A systematic review and meta-analysis. J Dent 2015; 43(8):913-923. https://doi.org/10.1016/j.jdent.2015.03.015

Markowitz K. A new treatment alternative for sensitive teeth: A desensitizing oral rinse. J Dent 2013; 41(1):1-11. https://doi.org/10.1016/j.jdent.2012.09.007

Charakorn P, Cabanilla LL, Wagner WC, Foong WC, Shaheen J, Pregitzer R, et al. The effect of preoperative ibuprofen on tooth sensitivity caused by in-office bleaching. Oper Dent 2009; 34(2):131-135. https://doi.org/10.2341/08-33

Bonafé E, Bacovis LB, Iensen S, Loguercio AD, Reis A, Kossatz S. Tooth sensitivity and efficacy of in-office bleaching in restored teeth. J Dent 2013; 41(4):363-369. https://doi.org/10.1016/j.jdent.2013.01.007

Browning WD, Cho SD, Deschepper EJ. Effect of a nano-hydroxyapatite paste on bleaching related tooth sensitivity. J Esthet Restor Dent 2012; 24(4):268-276. https://doi.org/10.1111/j.1708-8240.2011.00437.x

Basting RT, Amaral FLB, França FMG, Flório FM. Clinical comparative study of the effectiveness of and tooth sensitivity to 10% and 20% carbide peroxide home-use and 35% and 38% hydrogen peroxide in-office bleaching materials containing desensitizing agents. Oper Dent 2012; 37(5):464-473. https://doi.org/10.2341/11-337-C

Armênio RV, Fitarelli F, Armênio MF, Demarco FF, Reis A, Loguercio AD. The effect of fluoride gel use on bleaching sensitivity: A double-blind randomized controlled clinical trial. J Am Dent Assoc 2008; 139(5):592-597. https://doi.org/10.14219/jada.archive.2008.0220

Ajcharanukl O, Kraivaphan P, Wanachantararak S, Vongsavan N, Matthews B. Effect of potassium ions on dentine sensitivity in man. Arch Oral Biol 2007; 52(7):632-639. https://doi.org/10.1016/j.archoralbio.2006.12.015

Krishnakumar K, Tandale A, Mehta V, Khade S, Talreja T, Aidasani G, et al. Post-operative sensitivity and color change due to in-office bleaching with the prior use of different desensitizing agents: A systematic review. Cureus 2022;14(4):e24028. https://doi.org/10.7759/cureus.24028

Donassollo SH, Donassollo TA, Coser S, Wilde S, Uehara JLS, Chisini LA, et al. Triple-blinded randomized clinical trial comparing efficacy and tooth sensitivity of in-office and at-home bleaching techniques. J Appl Oral Sci 2021; 29:e20200794. https://doi.org/10.1590/1678-7757-2020-0794.

Costa CAS, Riehl H, Kina JF, Sacono NT, Hebling J. Human pulp response to in-office tooth bleaching. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109(4):59-64. https://doi.org/10.1016/j.tripleo.2009.12.002

Parreiras SO, Szesz AL, Coppla FM, Martini EC, Farago PV, Loguercio AD, et al. Effect of an experimental desensitizing agent on reduction of bleaching-induced tooth sensitivity: A triple-blind randomized clinical trial. J Am Dent Assoc 2018; 149(4):281-290. https://doi.org/10.1016/j.adaj.2017.10.025

Martin JMH, Almeida JB, Rosa EAR, Soares P, Torno V, Rached RN, et al. Effect of fluoride therapies on the surface roughness of human enamel exposed to bleaching agents. Quintessence Int 2010; 41(1):71-78.

Markowitz K, Bilotto G, Kim S. Decreasing intradental nerve activity in the cat with potassium and divalent cation. Arch Oral Biol 1991; 36(1):1-7. https://doi.org/10.1016/0003-9969(91)90047-x

Reis A, Dalanhol AP, Cunha TS, Kossatz S, Loguercio AD. Assessment of tooth sensitivity using a desensitizer before light-activated bleaching. Oper Dent 2011; 36(1):12-17. https://doi.org/10.2341/10-148-CR

Beltrami R, Ceci M, De Pani G, Vialba L, Federico R, Poggio C, et al. Effect of different surface finishing/polishing procedures on color stability of esthetic restorative materials: a spectrophotometric evaluation. Eur J Dent 2018; 12(1):49-56. https://doi.org/10.4103/ejd.ejd_185_17

Vieira-Junior WF, Ferraz LN, Pini NI, Ambrosano GM, Aguiar FH, Tabchoury CP, et al. Effect of toothpaste use against mineral loss promoted by dental bleaching. Oper Dent 2018; 43(2):190-200. https://doi.org/10.2341/17-024-TR

Martins CC, Firmino RT, Riva JJ, Ge L, Carrasco-Labra A, Brignardello-Petersen R, et al. Desensitizing toothpastes for dentin hypersensitivity: a network meta-analysis. J Dent Res 2020; 99(5):514-522. https://doi.org/10.1177/0022034520903036

Pierote JJ, Barbosa IF, Prieto LT, Lima DA, Paulillo LA, Aguiar FH. Effects of desensitizing dentifrices on the reduction on the reduction of pain sensitivity caused by in-office dental whitening: a double-blind controlled clinical study. Clin Cosmet Investig Dent 2019; 29(11):219- 226. https://doi.org/10.2147/CCIDE.S198940

Mehta D, Jyothi S, Moogi P, Finger WJ, Sasaki K. Novel treatment of in-office tooth bleaching sensitivity: a randomized, placebo-controlled clinical study. J Esthet Restor Dent 2018; 30(3):254-258. https://doi.org/10.1111/ jerd.12374

Kielbassa AM, Maier M, Gieren AK, Eliav E. Tooth sensitivity during and after vital tooth bleaching: a systematic review on an unsolved problem. Quintessence Int 2015; 46(10):881-897. https://doi.org/10.3290/j.qi.a34700

Pintado-Palomino K, Tirapelli C. The effect of home-use and in office bleaching desensitizing agents on enamel and dentin treatments combined with experimental desensitizing agents on enamel and dentin. Eur J Dent 2015; 9(1):66-73. https://doi.org/10.4103/1305-7456.149645

Pierote JJA, Prieto LT, Dias CTDS, Câmara JVF, Lima DANL, Aguiar FHB, et al. Effects of desensitizing products on the reduction of pain sensitivity caused by in-office tooth bleaching: a 24-week follow-up. J Appl Oral Sci 2020; 28:e20190755. https://doi.org/10.1590/1678-7757-2019-0755

Câmara JVF, Souza LPPS, Vargas DOA, Barbosa IF, Pereira GDS. Effect of tooth enamel staining by coffee consumption during at-home tooth bleaching with carbamide peroxide. Rev Odontol UNESP 2020; 49:e20200024. https://doi.org/10.1590/1807-2577.02420

Claudino DL, Câmara JVF, Agostinho Neto O, Santos EO, Pereira GDS, et al. Effect of pigmenting agents on tooth enamel staining during immediate tooth whitening: an in vitro study. Rev Odontol UNESP 2020;49:e20200045. https://doi.org/10.1590/1807-2577.04520

Costa D, Meireles A, Ferreira JL, Alcântara P, Torres LA, Câmara JVF, et al. Microabrasion effect on enamel susceptibility to penetration of hydrogen peroxide: an experimental and computational study. Odontology 2021; 109(4):770-778. https://doi.org/10.1007/s10266-021-00598-0