O uso de luz ultravioleta é eficiente para o clareamento e redução da sensibilidade em dentes vitais? Uma revisão sistemática de ensaios clínicos randomizados

Abstract

Dental bleaching is a common procedure in dental practice, but the high level of operative sensitivity promotes the search for new materials and techniques capable of replacing conventional bleaching gels. Ultraviolet LED was proposed to whiten tooth structure through physical interaction with pigment molecules dispensing the use of the gels. The objective of this systematic review was to evaluate the change in color and operative sensitivity caused by the equipment. It was registered in PROSPERO and followed the PRISMA guidelines. The search was carried out in the databases: Pubmed, Web of Science, Scopus and ProQuest. Ten studies were selected. Regarding color change, four of the five studies that compared the use of ultraviolet LED with 35% hydrogen peroxide showed better results from the gel. Among the studies that compared carbamide peroxide, there was no consensus between the results. Regarding sensitivity, 35% hydrogen peroxide showed significant results in all groups. There was no significant difference between carbamide peroxide and ultraviolet LED. In all studies, the association between LED and bleaching gels (carbamide peroxide or hydrogen peroxide) showed better color change and lower sensitivity than the gels used alone. Higher concentrations of gel showed similar color change and greater sensitivity than the association of LED and gels with lower concentrations. It is concluded that ultraviolet LED has a lower bleaching effect when compared to bleaching gels and lower operative sensitivity. The association between 35% hydrogen peroxide and ultraviolet LED has a greater whitening effect, with less risk of sensitivity, than when used individually. The same bleaching effect was observed when comparing with carbamide peroxide. However, the risk of operative sensitivity does not seem to change. The association between hydrogen peroxide at low concentrations and ultraviolet LED has the same bleaching capacity as the gel of higher concentration with lower sensitivity.