Avaliação da sensibilidade, cor e pigmentação por dieta no clareamento dental assistido comparado ao clareamento supervisionado

Abstract

The demand for aesthetic treatments has been increasing, and the search for whiter teeth has become more constant. Therefore, whitening treatments (in-office and at- home) have been widely used, whether with hydrogen peroxide or carbamide. This study aims to evaluate the effectiveness of gels in relation to changing the color of teeth, the degree of dental sensitivity and the influence of eating habits on the color variation (in the pigmentation) of teeth during and after whitening treatment following supervised and assisted dental whitening techniques. This is a clinical study involving 33 individuals divided into 4 groups, with the first 3 groups receiving the supervised whitening technique with carbamide peroxide at concentrations of 10%, 16% and 22% respectively. Group 04 underwent the assisted whitening technique using 35% hydrogen peroxide gel. Treatment for groups 01 to 03 lasted 4 weeks, and participants returned for appointments every 7 days for evaluation. Group 04 had 3 assisted bleaching sessions, with an interval of every 7 days, and in each of the consultations, three applications of 15 minutes each were performed, being interrupted in case of pain or severe sensitivity. During the consultations, color and pain were assessed before and after the sessions, and also after 30 and 60 days after the end of the treatment. A dietary diary was also kept. Tooth color analysis was performed using the Vitapan Classical A1-D4® scale (Vita Zahnfabrik. H.Rauter GmbH & Co, Bäd Sackingen, Germany), and dental sensitivity was assessed using a visual analog scale (VAS). Eating habits were assessed using a questionnaire at the beginning of the bleaching treatment. The data obtained were organized and analyzed in the statistical program SPSS version 20.0 (SPSS Inc., Chicago, IL, USA). A descriptive analysis of the variables was performed using absolute and relative frequencies, and measures of central tendency, mean and standard deviation. For the comparative analysis of the variables, the Shapiro-Wilk normality and homoscedasticity tests - White's test were performed, and the Mann-Whitney, Kruskal-Wallis, Fisher's exact, multinomial logistic regression, two-way mixed ANOVA and Spearman's correlation tests were applied. For all tests, a confidence level of 5% was adopted. The result was that the sensitivity levels for both techniques were predominantly mild, with some moderate episodes in the assisted technique, but no reports of intense sensitivity. The highest frequency of sensitivity episodes was for the supervised whitening technique. The assisted whitening technique resulted in significantly whiter teeth at the end of the protocol compared to the supervised technique. The dietary analysis indicated a positive and weak correlation between the consumption of cola-based soft drinks and tooth coloration, suggesting that a higher intake of these products is related to darker teeth. Thus, this research will assist dentists in formulating an individualized whitening protocol for each individual, choosing the best composition and concentration of the gel, to obtain effectiveness in the whitening procedure with the lowest risk of dental sensitivity for the patient.