Influência da inclusão de nitrato de potássio em géis de peróxido de carbamida na sensibilidade dentária e efetividade do clareamento caseiro

• Ano de defesa: 2019
• Autor(a) principal: Costacurta, Adriana Osten
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Positivo; Brasil; Pós-Graduação; Programa de Pós-Graduação em Odontologia Clínica; UP
• Palavras-chave em Português: Odontologia; Dentes - Clareamento; Dessensibilizantes dentinários; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA
• Link de acesso: https://repositorio.cruzeirodosul.edu.br/handle/123456789/2176

The objectives of this thesis are: 1) to evaluate the effect of potassium nitrate inclusion on carbamide peroxide gels on bleaching efficacy and on reducing the risk and intensity of tooth sensitivity; e 2) evaluate the influence of peroxide concentration and inclusion of a desensitizing agent in the carbamide peroxide (CP) gels on the effectiveness of at-home bleaching. In the first manuscript, a systematic review with meta-analysis was performed to evaluate the effect of the inclusion of potassium nitrate on carbamide peroxide-based gels on the effectiveness of tooth whitening, risk and intensity. The study sought clinical studies comparing carbamide peroxide gel with the inclusion of potassium nitrate versus carbamide peroxide gel without the addition of potassium nitrate for assessment of tooth sensitivity and bleaching effectiveness. The search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and gray literature. Abstracts of the IADR, records of unpublished essays, dissertations and theses were also searched. The Cochrane Collaboration bias risk tool was applied to assess the quality of the studies. Only six studies were included in the systematic review presenting most of the risk studies of undefined bias for key domains, of which only five studies were included in the meta-analysis. The risk of sensitivity was 0.93 (95% confidence interval [95%CI]=0.73 to 1.19, p=0.56), for pain intensity was -0.10 confidence interval [95%CI]=-0.36 to 0.16, p=0.45), the color change was already 0.12 (confidence interval [95%CI]=-0.22-0, 46, p=0.49). For all data, no significant differences were observed between the groups with and without the desensitizing agent in the gel. In the second manuscript, forty bovine incisors were divided into four groups (n=10), according to CP concentrations (10% or 22%), and inclusion or not of 3% potassium nitrate (PN) in the bleaching gel. The gels were applied 2 hours/day for 4 weeks. The bleaching effectiveness was evaluated using a Vita Classical shade guide (ΔSGU); and a spectrophotometer to obtain the CIELab parameters (ΔE). Data were collected at the following times: initial (before bleaching, baseline), 7, 14, 21, and 28, and 35 days after the first bleaching application. ΔSGU and ΔE data were statistically analyzed by repeated-measures two-way ANOVA and Tukey’s test (α=0.05). For ΔSGU, no significant differences were observed for all factors and interactions (p>0.05). For ΔE, significant differences were observed for inclusion of PN (p=0.0447) and time (p<0.0001); no statistical significance was obtained for the gel concentration (p=0.9133) and triple interaction (p=0.3668). For the first manuscript, it can be concluded that the inclusion of the desensitizing agent potassium nitrate in a carbamide peroxide gel did not reduce the risk and the intensity of dental sensitivity during home bleaching; in addition, the color change was also not influenced by the inclusion of potassium nitrate in the gel. Regarding the second manuscript, CP concentration did not influence the effectiveness of at-home bleaching. Gels with PN presented a lower bleaching efficiency than gels without PN when evaluated by ΔE.