Martini, Eveline Claudia; Parreiras, Sibelli Olivieri; Acuña, Eric Dario; Loguercio, Alessandro Dourado; Reis, Alessandra

doi:10.1590/0103-6440201902422

Article • Braz. Dent. J. 30 (3) • May-Jun 2019 • https://doi.org/10.1590/0103-6440201902422 linkcopiar

Does the Use of Reservoirs Have Any Impact on the Efficacy of At-Home Bleaching? A Systematic Review

Para responder a seguinte questão de pesquisa através de uma revisão sistemática: "O risco e a intensidade de sensibilidade dentária (SD) e eficácia de clareamento são diferentes entre pacientes adultos que realizam clareamento caseiro usando moldeiras com reservatórios e aqueles que usam moldeiras sem reservatórios?”. Uma pesquisa abrangente foi realizada no MEDLINE via PubMed, Scopus, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Biblioteca Cochrane e literatura cinzenta, sem restrições. Os resumos da conferência anual da Associação Internacional para Pesquisa Dental além de estudos registrados ou em andamento também foram pesquisados. Dissertações e Teses foram pesquisados utilizando o Capes Journal Dissertações e Teses ProQuest. Apenas ensaios clínicos randomizados (ECR) foram incluídos. Usamos a ferramenta Risk of Bias (RoB) da Cochrane para avaliação de qualidade. Após a remoção de duplicatas, triagem de título e resumo e exame de texto completo, nove ECRs permaneceram para análises qualitativas. A grande maioria dos estudos não relatou o método de randomização, ocultação de alocação e cegamento do examinador durante a avaliação de cores. Dos nove estudos, oito estavam sob risco claro de viés. Em relação à mudança de cor, quatro estudos não relataram nenhuma mudança e dois relataram melhora na mudança de cor com reservatórios. Apenas quatro estudos registraram a sensibilidade dentária e não relataram diferenças significativas. Apenas um estudo relatou maior irritação gengival com reservatórios. A falta de relatórios de dados nos impediu de executar uma meta-análise. Outros ECR bem desenhados devem ser conduzidos para responder a esta questão de pesquisa. Até agora não há evidências que sustentem que reservatórios em moldeiras de clareamento melhorem a mudança de cor. PROSPERO - CRD42016037628

Study ID	Study design [setting]	Method of color Assessment	Subject’s age in mean ± SD [range] (yrs)	No. of subjects (male [%])	No. patients [drop-outs]	Groups/ materials	Bleaching protocol	Outcomes evaluated
Study ID	Study design [setting]	Method of color Assessment	Subject’s age in mean ± SD [range] (yrs)	No. of subjects (male [%])	No. patients [drop-outs]	Groups/ materials	Bleaching protocol	Color change	Tooth sensitivity	Gingival Inflammation
Bosma 2000 ¹⁷	Split mouth [n.r.]	Vita shade guide and narrative description based on photographies	n.r. ± n.r. [n.r.]	n.r.[n.r.]	34 [0]	n.r. 16% CP^c	4 h daily (2 weeks)	ΔSGU, but SD was not reported	Not evaluated	n.r.
Delgado 2000 ⁽¹⁸	Split mouth [University]	Narrative description based on photographies	n.r. ± n.r. [19-23]	n.r.	12 [0]	15% CP^d	8 h daily (15 days)	n.r. Only subjective description	Absolute risk, but data was partially reported	Not evaluated.
Ishikawa 2011 ¹⁶	Parallel [n.r.]	Colorimeter^a	n.r. ±n.r. [20-40]	n.r.[n.r.]	5 [0]	n.r. 10% CP^e	2 h daily (14 days)	ΔL, Δa, Δb, but SD was not reported.	Not evaluated	Not evaluated
Javaheri 2000 ¹⁹	Split mouth [n.r.]	Shade guide unit^b	n.r. ± n.r. [19-64]	8 [26]	30 [0]	10% CP^f	2 hours/twice a day (10 days)	ΔSGU but data was not reported.	Absolute risk	Absolute risk
Kirsten 2009 ²²	Split mouth [University]	n.r.	n.r. ± n.r. [18-25]	19 [100]	19 [0]	16% CP^g	2 h daily (21 days)	Not evaluated.	Not evaluated.	Not evaluated. Only histological evaluation of the gingival tissue.
Matis 2002 ¹⁵	Split mouth [n.r.]	Photos, Shade Guide and Colorimeter readings	48.3 ± n.r. [23-68]	12 [44]	27 [0]	15% CP^h	2 h daily (14 days)	ΔE and ΔSGU but SD was not reported in both measures	Absolute risk but SD was not reported	Intensity of pain, but SD was not reported
Miller 2000 ²⁰	Split mouth [n.r.]	Narrative description based on photographs	n.r. ± n.r. [20-50]	4 [19]	21 [0]	HP (5.5ⁱ and 7.5%ⁱ); Nonperoxide^j; CP (10^l, 10^f, 10^m; 16^c, 16^l, 16ⁿ, 16^m; 15^b, 20^o)	Not mentioned (followed manufacturer’s directions).	n.r.Only subjective description.	Not evaluated	Not evaluated
Morais e Moura 2007 ²⁵	Split mouth [n.r.]	Narrative description based on photographs	n.r. ± n.r.[15-40]	8 [22]	36 [0]	10% CP^p	4 h daily (14-30 days)	n.r.Only subjective description	Absolute risk, data was partially reported	Not evaluated
Martini 2018 ²⁴	Split mouth [University]	Shade Guide and Colorimeter readings	n.r.[18-50]	n.r.	n.r.	10% CP^q	3 h daily (21 days)	ΔE and ΔSGU	Risk and intensity (VAS and NRS scales)	Absolute risk

Study ID	Description of the results
Study ID	Color change	Tooth sensitivity	Gingival Inflammation
Bosma 2000 ¹⁷	Subjective description through photos with a reduction of 5.6 color units in the 2 groups, without significant differences (p> 0.05).	Not evaluated	Not observed in any group.
Delgado 2000 ⁽¹⁸	Subjective description through photos. The authors concluded that the groups were not different.	Only one patient reported tooth sensitivity and was treated with 1.1% NaF. No measurement in pain scale was reported by the authors.	Not evaluated
Ishikawa 2011¹⁶	5 patients were evaluated through objective color measurement. 8 units of color on the side with reservoirs and 6.8 on the side without reservoirs (p < 0.05).	Not evaluated	Not evaluated
Javaheri 2000 ¹⁹	30 patients evaluated with subjective color measurement, no difference between sides was noted and no statistical analysis was performed.	None of the patients reported tooth sensitivity.	None of the patients reported irritation in the mucosa..
Kirsten 2009 ²²	Not evaluated.	Not evaluated.	19 patients evaluated, sides with reservoir increase of inflammation only immediately after bleaching (p = .0075). Differences were found in the inflammation intensity between groups immediately after and 45 days after bleaching (p < 0.01). Mild inflammation in the group without reservoir and moderate inflammation with a reservoir.
Matis 2002 ¹⁵	Group with reservoirs had significantly higher ΔE than group without reservoirs in all time assessments (p<0.01), except week 6 (p = 0.11).	No significant difference (p = 0.90).	No significant difference (p = 0.46).
Miller 2000 ²⁰	Subjective description through photos and without differences between groups.	No significant difference.	Not evaluated.
Morais e Moura 2007 ²⁵	Not evaluated.	18^th day only - same tooth sensitivity in both groups.	Not evaluated.
Martini 2018 ²⁴	Results not collected yet (study found in a clinical trial registry)	Results not collected yet	Results not collected yet

location_on

Fundação Odontológica de Ribeirão Preto Av. do Café, S/N, 14040-904 Ribeirão Preto SP Brasil, Tel.: (55 16) 3602-3982, Fax: (55 16) 3633-0999 - Ribeirão Preto - SP - Brazil
E-mail: bdj@forp.usp.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

[TFN1] CP, carbamide peroxide; HP, hydrogen peroxide; n.r., not reported; SD, standard deviation; DSGU, shade guide units; DE* (color difference measured with a spectrophotometer). Absolute risk of TS is the percentage of patients that presented TS during bleaching, while intensity of TS is the pain intensity measured in a pain scale. ^a Shofu Shade Eye NCC, Shofu, Kyoto, JP; ^b VITAPAN classical, VITA Zahnfabrik, Bad Säckingen, GE; ^c Nite White Classic 16%, Discus Dental, Culver City, CA, USA; ^d Opalescence 15%, Ultradent, South Jordan, UT, USA; ^e HiLite Shade Up, Shofu Dental Products, Tonbridge, Kent, UK; ^f Nupro White Gold 10%, Dentsply, York, PA, USA; ^g Whiteness Perfect 16%, FGM, Joinville, SC, BR; ^h Rembrandt Xtra-Comfort Non- Sensitizing Bleaching Gel Regular Strength , Den-Mat Corporation, Santa Maria, CA, USA; ⁱ Day White 2, Discus Dental, Culver City, CA, USA; ^j Hi Lite 2, Shofu Dental Products, Tonbridge, Kent, UK; ^I Nite White Excel 2Z, Discus Dental, Culver City, CA, USA; ^m Zaris 3M dental, Zaris White & Brite; 3M ESPE, St. Paul, USA; ⁿ Nite White Excel 2NSF, Discus Dental, Culver City, CA, USA; ^o Opalescence 20%, Ultradent, South Jordan, UT, USA; ^p Whiteness Perfect 10%, FGM, Joinville, SC, Brazil; ^q Opalescence 10%, Ultradent, South Jordan, UT, USA