Prevention of Bleaching Induced Sensitivity

Study Overview
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Brief Summary
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This study aims to evaluate the use of different desensitizing agents before in-office bleaching. A total of 64 volunteers were randomly divided into four groups. Before undergoing in-office bleaching with 38% hydrogen peroxide gel (three applications of 15 minutes each, one session), clinicians applied a placebo gel (control group), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), neutral sodium fluoride gel (NSF), or nano-hydroxyapatite solution (n-HAP) on all buccal surfaces of teeth. The gel was left undisturbed for 4 minutes. Patients recorded their tooth sensitivities on the VAS scale. Kruskal-Wallis test followed by Mann-Whitney U test were used to compare changes in tooth color and intensity of tooth sensitivity between groups.

Detailed Description
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Color evaluation was performed with Vita Shade Guide Classical (Vitapan Classical, Vita, Bad Sakingen, Germany). The shades were evaluated with shade guide units (SGUs). Vita Classical Shade Guide consisted of 16 shades, and the shades were aligned light-to-dark from B1-C4.21, 22 The shades were taken before and after 24 hours and 7 days of treatment.Next, the hypersensitivity was recorded by asking each subject to establish his or her perception of sensitivity before treatment using a visual analog scale (VAS). A stimulus of an evaporative blowing triple syringe (25 psi at ambient conditions) was applied for 3 seconds on the upper central incisors from a distance of 1 cm. After 24 hours and 7 days of bleaching treatment, stimuli testing was performed again.The subjects were divided into four groups. Group 1. Subjects were treated with a placebo gel. The agent was applied for 4 min. to all the teeth to be bleached. Group 2. Subjects were treated with ACP-CCP gel (Tooth Mousse, GC Corp., Tokyo, Japan) for 4 min. to all the teeth to be bleached. Group 3. Subjects were treated with nano-hydroxyapatite solution for 4 min. to all the teeth to be bleached. Group 4. Subjects were treated with neutral sodium fluoride (NSF) gel for 4 min. to all the teeth to be bleached. After treatment, the agent was removed by washing with water in all groups. Each subject underwent one session of bleaching on the anterior teeth from canine-to-canine. Bleaching systems were applied according to the manufacturer's instructions by one of the authors. Subjects were treated with hydrogen peroxide at 38% activated by a light source composed of 12 LEDs with blue light generators. The calculated hypersensitivity values and color change values were tested with Shapiro-Wilk and Levene tests for normal data distribution and homogeneity of variances. Kruskal-Wallis test followed by Mann-Whitney U test was performed to compare groups.

Official Title
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Effectiveness of Remineralization Agents on the Prevention of Dental Bleaching Induced Sensitivity

Conditions
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Tooth Bleaching, Tooth Sensitivity

Intervention / Treatment
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* Other: neutral sodium fluoride
* Other: ACP-CCP gel
* Other: nano-hydroxyapatite solution
* Other: glycerine


Participation Criteria
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Eligibility Criteria
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INCLUSION CRITERIA: Must have all their upper and lower anterior teeth Must have good oral hygiene EXCLUSION CRITERIA: Pregnancy or breastfeeding Systemic disease Taking NSAIDs or other drug treatment. Periodontal disease Enamel hypoplasia Teeth stained by tetracycline or fluorosis Dental malposition or orthodontic treatment with fixed appliances Canine teeth lighter than A1 Restoration on anterior teeth Cervical lesions Symptoms of dental pain Previous tooth whitening experience.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Control<br> | Other: glycerine<br>* Topically applied<br>|
| Active Comparator: Topical neutral sodium fluoride<br> | Other: neutral sodium fluoride<br>* Topically applied<br>|
| Active Comparator: ACP-CCP gel<br> | Other: ACP-CCP gel<br>* Topically applied<br>|
| Active Comparator: nano-hydroxyapatite solution<br> | Other: nano-hydroxyapatite solution<br>* Topically applied<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of reducing hypersensitivity after bleaching | VAS scale (Visual Analog Scale) was measured before and after bleaching | 1 week |