Effect of preventive use of nonsteroidal anti-inflammatory drugs on sensitivity after dental bleaching

Faria-e-Silva, André Luís; Nahsan, Flávia Pardo Salata; Fernandes, Micaelle Tenório Guedes; Martins-Filho, Paulo Ricardo

doi:10.1016/j.adaj.2014.10.007

Cited by 29 publications

(13 citation statements)

References 21 publications

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“…The tooth sensitivity reported by patients subjected to in-office bleaching remains the main concern related to this procedure 14 , 21 . Several approaches have been used by clinicians to reduce this adverse effect, including preemptive use of desensitizers 3 , 26 or anti-inflammatory drugs 10 , 24 , 26 . The use of low-concentration peroxides can also be a promising alternative for painless in-office tooth bleaching if the pain response is strongly related to an inflammatory process caused by the presence of peroxides and sub-products in the pulp tissue 4 , 14 , 18 .…”

Section: Discussionmentioning

confidence: 99%

High-concentration carbamide peroxide can reduce the sensitivity caused by in-office tooth bleaching: a single-blinded randomized controlled trial

et al. 2018

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Objectives A single-blinded, randomized, parallel clinical trial evaluated the use of 37% carbamide peroxide (CP) on bleaching effectiveness and tooth sensitivity reported by patients undergoing in-office tooth bleaching, in comparison with the results of using 35% hydrogen peroxide.Material and Methods Forty patients were allocated to receive two sessions of in-office tooth bleaching using either 35% hydrogen peroxide (HP) or 37% CP. Each patient’s sensitivity level was evaluated during and up to 24 h after bleaching. The effectiveness of the bleaching procedures was evaluated with a spectrophotometer one week after each session and 30 days after the last session. The impact of tooth bleaching on the patients’ perceptions regarding smile changes, in addition to the bleaching procedures and their results, were also recorded. Absolute and relative sensitivity risks were calculated. Data on sensitivity level were analyzed using the Mann-Whitney or T-test, and data from the color evaluation were subjected to 2-way repeated measures ANOVA.Results The use of CP reduced the risk and level of tooth sensitivity to values close to zero, whereas the difference between the bleaching agents disappeared after 24 h. An increased bleaching effect was observed for HP, mainly due to an improved reduction of redness and yellowness. Participants perceived improved tooth bleaching for HP and reduced sensitivity for CP, but no differences regarding the comfort of the techniques were noted.Conclusions In our study, 37% CP resulted in reduced tooth sensitivity but decreased the tooth bleaching effectiveness. However, both bleaching agents resulted in high levels of patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

High-concentration carbamide peroxide can reduce the sensitivity caused by in-office tooth bleaching: a single-blinded randomized controlled trial

et al. 2018

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“…Investigating the effects of bleaching on the pulp tissue is crucial given the rising demand for aesthetic bleaching among patients and the availability of HP-based gels on the market (Kury et al, 2022). This importance is further emphasized by studies revealing inflammatory events and alterations in the pulp-dentine complex (Cartagena et al, 2015;Costa et al, 2010;Kiyuna et al, 2021;Kury et al, 2022;Terayama et al, 2020), as well as reports of tooth sensitivity from patients (Faria-E-Silva et al, 2015;Moncada et al, 2013;Rezende et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Influence of dental bleaching on the pulp tissue: A systematic review of in vivo studies

Donato,

dos Reis‐Prado,

Abreu

et al. 2024

Int Endodontic J

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BackgroundAlthough several studies indicate the harmful effects of bleaching on pulp tissue, the demand for this procedure using high concentrations of hydrogen peroxide (HP) is high.ObjectivesTo investigate the influence of bleaching on the pulp tissue.MethodsElectronic searches were conducted (PubMed/MEDLINE, Scopus, Cochrane Library and grey literature) until February 2021. Only in vivo studies that evaluated the effects of HP and/or carbamide peroxide (CP) bleaching gels on the inflammatory response in the pulp tissue compared with a non‐bleached group were included. Risk of bias was performed according to a modified Methodological Index for Non‐Randomized Studies scale for human studies and the Systematic Review Centre for Laboratory Animal Experimentation's RoB tool for animal studies. Meta‐analysis was unfeasible.ResultsOf the 1311 studies, 30 were eligible. Of these, 18 studies evaluated the inflammatory response in animal models. All these studies reported a moderate‐to‐strong inflammatory response in the superficial regions of pulp, characterized by cell disorganization and necrotic areas, particularly during the initial periods following exposure to 35%–38% HP, for 30–40 min. In the evaluation of human teeth across 11 studies, seven investigated inflammatory responses, with five observing significant inflammation in the pulp of bleached teeth. In terms of tertiary dentine deposition, 11 out of 12 studies noted its occurrence after bleaching with 35%–38% HP in long‐term assessments. Additionally, three studies reported significant levels of osteocalcin/osteopontin at 2 or 10 days post‐treatment. Other studies indicated an increase in pro‐inflammatory cytokines ranging from immediately up to 10 days after bleaching. Studies using humans' teeth had a low risk of bias, whereas animal studies had a high risk of bias.DiscussionDespite the heterogeneity in bleaching protocols among studies, High‐concentrations of HP shows the potential to induce significant pulp damage.ConclusionsHigh‐concentrations of bleaching gel increases inflammatory response and necrosis in the pulp tissue at short periods after bleaching, mainly in rat molars and in human incisors, in addition to greater hard tissue deposition over time. However, further well‐described histological studies with long‐term follow‐up are encouraged due to the methodological limitations of these studies.RegistrationPROSPERO (CRD42021230937).

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“…However, a prior study did not find any effect of dexamethasone (a glucocorticoid) to prevent tooth sensitivity following inoffice tooth bleaching (25). In fact, no anti-inflammatory drug used preemptively in a single dose demonstrated effectiveness for preventing tooth sensitivity caused by bleaching procedures (9)(10)(11)(12)(13). The pulpal tissue is densely innervated with afferent sensitive nervous fibers with a speed of transmission at bands A"β, Aδ and C (3).…”

Section: N a D D I T I O N T O P H A R M A C O K I N E T I C S Favomentioning

confidence: 99%

“…In contrast, the preemptive administration of antiinflammatory agents could reduce the anti-inflammatory response of pulpal tissue without compromising the number of clinical steps. The preemptive administration of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (9)(10)(11), etoricoxib (12), and naproxen (13) did not show promising results for prevention of tooth sensitivity following in-office bleaching procedures.…”

Section: Introductionmentioning

confidence: 99%

Preemptive Use of Piroxicam on Tooth Sensitivity Caused By In-Office Bleaching: A Randomized Clinical Trial

et al. 2019

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This clinical trial evaluated the effect of preemptive use of the non-steroidal anti-inflammatory drug piroxicam in a single dose 30 min prior to in-office bleaching on the prevention of tooth sensitivity (TS) reported by patients. Fifty patients were submitted to two sessions of in-office tooth bleaching with 35% hydrogen peroxide used for 2 sessions, each consisting of a single 45-min application, with an interval of 7 days between session. Thirty minutes prior to the procedure, the patient randomly received a single dose of piroxicam (200 mg) or placebo in a double-blind, randomized, crossover design. The TS was evaluated using verbal rate (VRS) and visual analog (VAS) scales during the bleaching procedure and at 24 h after each session. The color changes were assessed by the Vita Bleachedguide scale 1 week after each bleaching session. Risk of TS was calculated from the VRS and analyzed by the McNemar test, while the level of TS was analyzed by the Mann-Whitney test. For the VAS, t-tests were used to compare data from the treatments at each assessment time. Data regarding color changes were subjected to Wilcoxon and Mann-Whitney tests (α=0.05). The preemptive administration of piroxicam did not affect the risk and level of TS compared to placebo, irrespective of the assessment time. The treatment sequence did not affect bleaching effectiveness. In conclusion, the administration of a single dose of piroxicam prior to in-office tooth bleaching was unable to significantly reduce the risk and level of TS.

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Effect of preventive use of nonsteroidal anti-inflammatory drugs on sensitivity after dental bleaching

Cited by 29 publications

References 21 publications

High-concentration carbamide peroxide can reduce the sensitivity caused by in-office tooth bleaching: a single-blinded randomized controlled trial

High-concentration carbamide peroxide can reduce the sensitivity caused by in-office tooth bleaching: a single-blinded randomized controlled trial

Influence of dental bleaching on the pulp tissue: A systematic review of in vivo studies

Preemptive Use of Piroxicam on Tooth Sensitivity Caused By In-Office Bleaching: A Randomized Clinical Trial

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