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OBJECTIVES: To answer whether the topical drug application can reduce in-office tooth bleaching sensitivity without impairing the color change. MATERIALS AND METHODS: This review was registered on PROSPERO (CRD42024524171). Two reviewers screened PubMed, Web of Science, Scopus, Embase, and clinicaltrials.gov in March 2024 independently for randomized clinical trials investigating the efficacy of topical drug application to manage in-office tooth bleaching sensitivity. The risk of bias was assessed using Cochrane's Risk of Bias tool (RoB2). Certainty of the evidence was assessed using the Grading of Recommendations: Assessment, Development, and Evaluation tool (GRADE). The meta-analyses evaluated the bleaching sensitivity and color change with RevMan 5.4 software. RESULTS: 334 articles were retrieved. The final sample was composed of four articles. Tested drugs were Otosporin, Eugenol, Ibuprofen with arginine, and Dipyrone. The meta-analysis evidenced no difference in bleaching sensitivity up to 1 h (MD, -0.39; 95% CI, -0.89, 0.11), 24 h (MD, -0.26, 95% CI, -0.71, 0.18), or 48 h (MD, 0.00, 95% CI, -0.16, 0.16). Meta-analysis for color change evidenced no difference for color change (MD, 0.03; 95% IC, -0.56, 0.61). The risk of bias was low. The certainty of the evidence was rated moderate for bleaching sensitivity and high for color change. CONCLUSIONS: Although topical drug application did not impair color change, it was ineffective in reducing in-office tooth bleaching sensitivity. CLINICAL RELEVANCE: topical drug application on dental enamel is not an effective approach in reducing bleaching sensitivity, but several modifications can be made in future studies to possibly achieve a better outcome.

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OBJECTIVE: To evaluate the effectiveness of desensitizing toothpastes in reducing post-bleaching tooth sensitivity. MATERIALS AND METHODS: A systematic review of randomized clinical trials was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Electronic searches were conducted in the PubMed/MEDLINE, Scopus, Web of Science, The Cochrane Library and Embase databases, using the following terms: (dentifrices OR toothpaste) AND (sensitive OR sensitivity OR dental sensitivity) AND (dental bleaching OR tooth bleaching OR dental whitening OR tooth whitening). RESULTS: Five studies involving 387 individuals undergoing in-office or at-home teeth bleaching were reviewed. Desensitizing toothpastes reduced sensitivity effectively after home bleaching with 22% carbamide peroxide and single-session in-office bleaching with 35% hydrogen peroxide. However, they were ineffective for home bleaching with 16% carbamide peroxide and in-office bleaching across two sessions with 35% or 38% hydrogen peroxide. CONCLUSION: Desensitizing toothpastes are effective for home bleaching with high concentration carbamide peroxide and single-session in-office bleaching with highly concentrated hydrogen peroxide, but ineffective for home bleaching with low concentration carbamide peroxide and two-session in-office bleaching with concentrated hydrogen peroxide.

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The aim of this clinical, prospective, randomized, and parallel study was to evaluate different in-office treatments for dentin hypersensitivity (DH). One hundred ninety-two teeth with non-cavitated root exposures were treated using different desensitizers: fluoride varnish (Duraphat - FLU); bioactive ceramic solution (Biosilicate - BIOS); universal self-etching adhesive (Single Bond Universal - SBU); bioactive photoactivated varnish (PRG filler - SPRG). The degree of DH was analyzed using a visual analog scale (VAS) and computerized visual scale (CoVAS), before treatments and after 7, 15, and 30 days from the first session. Comparisons among desensitizers were performed using the Kruskal-Wallis and Dunn's tests. Friedman test was used to compare between times (p ≤ 0.05). Comparing desensitizers FLU presented a higher value of DH than BIOS using VAS at 7 days, however, no differences were found using CoVAS analysis. Comparing times, BIOS and SBU showed a reduction in DH after 7 days and SBU showed a reduction at 30 days compared to 7 days using VAS. FLU and SPRG groups reduced DH from 15 days to 30 days using VAS. There was a reduction in DH for FLU, BIOS, and SBU after 7 days and for BIOS this reduction also occurred at 30 days when compared to 15 days using CoVAS. SPRG group showed a reduction from 15 to 30 days. All desensitizers tested were able to reduce the initial sensitivity. The bioactive ceramic solution reduced the DH gradually after 30 days using computerized analysis.

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OBJECTIVE: The objective of this study was to compare the efficacy of Biosilicate and Duraphat in the treatment of dentin hypersensitivity (DH). METHODS AND MATERIALS: This clinical trial was conducted with young adults presenting DH. A visual analogue scale (VAS) was used to assess the level of pain, using volatile and tactile tests. Forty participants presenting two teeth with DH were included, and these teeth were divided into two groups according to the treatment: Biosilicate or Duraphat. Each product was randomly applied on one tooth per participant once a week for 4 weeks and evaluated every 15 days for 60 days after the last application. RESULTS: The mean and standard deviation (SD) of VAS values for the initial volatile sensitivity evaluation were 6.18 (1.99) and 6.08 (1.98) for the Biosilicate and Duraphat groups, respectively, and at the fourth week 0.48 (1.5) and 0.83 (1.58). After 60 days, the volatile sensitivity showed the following values: 0.63 (1.19) for Biosilicate and 1.03 (1.07) for Duraphat. The intragroup comparison showed a significant reduction of mean VAS values for DH-related pain assessed by volatile testing for both groups (p<0.001), and the assessment at the 60-day follow-up showed mean values statistically similar to those obtained at the end of treatment. Initial tactile sensitivity observed was 1.48 (2.39) for the Biosilicate and 1.4 (2.2) for the Duraphat group and at the 60-day follow-up 0.23 (0.73) and 0.15 (0.36), respectively, with significant statistical difference (p<0.002). When the reduction in tactile and volatile sensitivities between both groups was compared, no statistically significant difference was observed. CONCLUSION: This study indicated that both products were able to promote an important reduction in dentin hypersensitivity with similar results within a 60-day follow-up.

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The present study evaluated the efficacy of the mineralizing action of Casearia sylvestris ethanolic extract on bovine dentin blocks in its pure form and in dental paste, through scanning electron microscopy. The dentin blocks were immersed in artificial saliva and incubat ed at 37°C for 7 days. Subsequently, six groups were treated with different test substances and analysed qualitatively and quantitatively at 30 and 60 days. The tests used were Kruskal - Wallis and Dunn's. Shapiro - Wilk and ANOVA. The qualitative analysis at 30 days showed a difference between the groups treated with ethanolic extract and toothpaste. Quantitatively, at 30 days, treatment with ethanolic extract of Casearia showed a greater number of open dentinal tubules. At 60 days, the difference persisted on ly for the blocks treated with toothpaste. The results obtained indicated that there is a positive relationship between the use of Casearia sylvestris and obliteration of dentinal tubules

El presente estudio evaluó la eficacia de la acción mineralizante del extracto etanólico de Casearia sylvestris sobre bloques de dentina bovina en su forma pura y en pasta dental, mediante microscopía electrónica de barrido. Los bloques de dentina se sumergieron en saliva artificial y se incubaron a 37°C durante 7 días. Posteriormente, se trataron seis grupos con diferentes sustancias de ensayo y se analizaron cualitativa y cuantitativamente a los 30 y 60 días. Las p ruebas utilizadas fueron Kruskal - Wallis y Dunn's. Shapiro - Wilk y ANOVA. El análisis cualitativo a los 30 días mostró una diferencia entre los grupos tratados con extracto etanólico y pasta dentífrica. Cuantitativamente, a los 30 días, el tratamiento con ex tracto etanólico de Casearia mostró un mayor número de túbulos dentinarios abiertos. A los 60 días, la diferencia persistió sólo para los bloques tratados con pasta dentífrica. Los resultados obtenidos indicaron que existe una relación positiva entre el us o de Casearia sylvestris y la obliteración de los túbulos dentinarios

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OBJECTIVES: To assess color change efficacy and the adverse effects of varied over-the-counter (OTC) bleaching protocols. METHODOLOGY: The study included randomized clinical trials evaluating color changes from OTC bleaching agents. Nine databases were searched, including the partial capture of the grey literature. The RoB2 tool analyzed the individual risk of bias in the studies. Frequentist network meta-analyses compared treatments through common comparators (∆Eab* and ∆SGU color changes, and tooth sensitivity), integrating direct and indirect estimates and using the mean and risk differences as effect measures with respective 95% confidence intervals. The GRADE approach assessed the certainty of the evidence. RESULTS: Overall, 37 remaining studies constituted the qualitative analysis, and ten composed the meta-analyses. The total sample included 1,932 individuals. ∆Eab* was significantly higher in groups 6% hydrogen peroxide (HP) strips (≥ 14 h). ∆SGU was significantly higher in groups at-home 10% carbamide peroxide (CP) (≥ 14 h), followed by 6% HP strips (≥ 14 h) and 3% HP strips (≥ 14 h). At-home 10% CP (7-13 h) and placebo showed lower risks of tooth sensitivity without significant differences between these treatments. CONCLUSION: Considering the low level of evidence, OTC products presented satisfactory short-term effects on tooth bleaching compared to the placebo, with little to no impact on dentin hypersensitivity and gingival irritation. CLINICAL RELEVANCE: OTC products are proving to be practical alternatives for tooth whitening. However, patients should be advised about the possible risks of carrying out such procedures without professional supervision.

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OBJECTIVE: This randomized controlled clinical trial evaluated the whitening efficacy, tooth sensitivity (TS), and volunteers' satisfaction following the use of activated charcoal powder and toothpaste. METHODS: Fifty-six volunteers were randomly allocated into 4 groups (n = 14) according to a 14-day toothbrushing or whitening treatment with activated charcoal powder (ACPW), activated charcoal toothpaste (ACT), regular fluoridated toothpaste (RT), and 10 % carbamide peroxide (CP). Objective (ΔE00) and subjective (ΔSGU) color and whiteness index (ΔWID) changes were calculated. Patients self-reported the risk and intensity of TS using a visual analogue scale and the volunteer's satisfaction was determined by a questionnaire. Color assessments were analyzed by Kruskal-Wallis followed by Dwas-Steel-Crithlow-Fligner, and absolute TS risk and volunteer's satisfaction by Fisher exact test (p < 0.05). RESULTS: ACPW and ACT promoted similar effects in ΔE00, ΔSGU, and ΔWID to that observed for RT. No significant difference was found in terms of TS risk intensity. TS risk became high after 7 and 14 days, with higher TS prevalence in CP. Volunteers reported that ACPW exhibited the lowest ease-of-use, comfort, and whitening satisfaction among groups (p < 0.05). CONCLUSION: Activated charcoal-based products presented a minor and unsatisfactory whitening effect while CP resulted in optimal tooth whitening and the highest level of satisfaction among volunteers. Risk was higher from 7 days onwards and was more pronounced in the CP. CLINICAL RELEVANCE: Based on the whitening effect and patient satisfaction, this controlled-randomized clinical evidence supports that the use of activated charcoal-based products should be discouraged.

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BACKGROUND: Light-cured resins are widely used as gingival barriers to protect the gums from highly concentrated peroxides used in tooth bleaching. The impact of barrier brand on clinical outcomes is typically considered negligible. However, there is limited evidence on the effects of different brands on operator experience, barrier adaptation, and patient comfort. OBJECTIVE: This clinical trial assessed the impact of four commercial gingival barrier brands (Opaldam, Topdam, Lysadam, and Maxdam) on operator perception, adaptation quality, and patient comfort. METHODS: Twenty-one undergraduate students placed gingival barriers in a randomized sequence using blinded syringes. Photographs of the barriers were taken from frontal and incisal perspectives. After bleaching procedures, operators rated handling features and safety using Likert scale forms. Two experienced evaluators independently assessed barrier adaptation quality on a scale from 1 (perfect) to 5 (unacceptable). The absolute risk of barrier-induced discomfort was recorded. Data were analyzed using Friedman and Chi-square tests (α = 0.05). RESULTS: Opaldam and Topdam received the highest scores in most handling features, except for removal, which was similar among all brands. No significant difference was observed in barrier adaptation quality between the evaluated brands. Discomforts were mainly reported in the upper dental arch, with Maxdam having the highest absolute risk (35% for this arch and 24% overall). CONCLUSIONS: This study suggests that gingival barrier brands can influence operator perception and patient comfort. Opaldam and Topdam were preferred by operators, but all brands demonstrated comparable adaptation quality. CLINICAL TRIAL REGISTRATION: The study was nested in a randomized clinical trial registered in the Brazilian Clinical Trials Registry under identification number RBR-9gtr9sc.

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BACKGROUND: Laser protocols for the treatment of dentin hypersensitivity (DH) have not yet been studied systematically. OBJECTIVES: The present study aimed to review clinical trials on the treatment of DH with laser therapy through a systematic review and meta-analysis. MATERIAL AND METHODS: The search of electronic databases resulted in 562 publications up to April 2020. The inclusion criteria were studies carried out on humans and reporting on the treatment of DH with laser therapy. Case reports, literature reviews and systematic reviews were excluded. Selected by abstract, potentially eligible papers were read in full (n = 160). Independent examiners performed data extraction and the assessment of the risk of bias. RESULTS: A total of 34 studies were included in the analysis, and 11 in the quantitative analysis. It was observed that most studies followed up patients for a maximum of 6 months (55%). Through the meta-analysis, we observed statistically significant differences between the average pain before and after 3 months of treatment with highand low-power lasers. However, through indirect comparisons, it was observed that the high-power laser showed a greater tendency to reduce the pain levels after 3 months of treatment as compared to the low-power laser, but without a statistically significant difference. CONCLUSIONS: It was possible to conclude that regardless of the type of laser used in the treatment of DH, this treatment is an effective option for the control of pain symptoms. However, it was not possible to establish a defined treatment protocol, since the evaluation methods are very different from each other. Text for Rewiew and clinical cases.

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PURPOSE: This systematic scoping review aimed to survey the literature to answer the following questions: which instruments were used to measure the color change; which teeth were assessed for color; what was the follow-up period, and in which country was the recently published tooth bleaching clinical trial performed? METHODS: This research was registered in the Open Science Framework. The following databases were searched: PubMed, Scopus, Web of Science, EMBASE, Cochrane Library, and LILACS. Randomized clinical trials evaluating tooth bleaching with color change analysis, published between 2021 and 2017, were included. The data extracted from included studies were analyzed using a qualitative and descriptive analysis. RESULTS: 106 articles were analyzed. Most studies used only ΔEab to measure the color change (10.4%), assessed the color change in the maxillary central incisors (45.3%), and included a one-month follow-up (25.4%). The published papers were mostly from research performed in Brazil (51.9%). Many methods have been used in the tooth bleaching clinical trials examined, and a wide variety of instruments used to measure the color change was observed. CLINICAL SIGNIFICANCE: The large variation in the methodology criteria of most recent tooth bleaching clinical trials makes data comparison difficult among different studies and raises the need for a guideline for tooth bleaching clinical studies.

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BACKGROUND: Topical application of calcium-containing bioactive desensitizers (CBs) has been used to minimize bleaching-induced tooth sensitivity (TS). This study answered the research question "Is the risk of TS lower when CBs are used with dental bleaching in adults compared with bleaching without desensitizers?" TYPES OF STUDIES REVIEWED: The authors included randomized clinical trials comparing topical CB application with a placebo or no intervention during bleaching. Searches for eligible articles were performed in MEDLINE via PubMed, Cochrane Library, Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature, Scopus, Web of Science, Embase, and gray literature without language and date restrictions and updated in September 2022. The risk of bias was evaluated using Risk of Bias Version 2.0. The authors conducted meta-analyses with the random-effects model. The authors assessed heterogeneity with the Cochrane Q test, I2 statistics, and prediction interval. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence. RESULTS: After database screening, 22 studies remained, with most at high risk of bias. No difference in the risk of TS was detected (risk ratio, 0.95; 95% CI, 0.90 to 1.01; P = .08, low certainty). In a visual analog scale, the intensity of TS (mean difference, -0.98; 95% CI, -1.36 to -0.60; P < .0001, very low certainty) was lower for the CB group. The color change was unaffected (P > .08). PRACTICAL IMPLICATIONS: Although topical CB dental bleaching did not reduce the risk of TS and color change, these agents slightly reduced the TS intensity, but the certainty of the evidence is very low.

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OBJECTIVES: Perform a systematic review to evaluate the influence of smoking on the effectiveness of tooth whitening (TW) and to analyze whether tooth sensitivity is different between smokers and non-smokers. MATERIALS AND METHODS: A systematic review modeled according to the PRISMA guidelines was conducted. PubMed, Embase, Web of Science, Cochrane, Scopus, and OpenGrey databases were searched for related clinical trials. The population, exposure, comparison, outcomes (PECO) was individuals who had TW performed, smoking individuals, non-smoking individuals, and effectiveness of TW, respectively. Risk of bias was assessed with the ROBINS-I tool, and data from included studies were extracted by two researchers independently. The certainty of the evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. RESULTS: Five studies were selected for qualitative analysis. The ROBINS-I tool classified 3 studies as having a moderate risk of bias, one study as having a serious risk of bias, and one with a critical risk. GRADE performed only for color change results and showed a low certainty of evidence. Limited evidence suggests that effectiveness of TW between smokers and non-smokers is similar. The tooth sensitivity also does not seem to be influenced by smoking. Due to the heterogeneity of the data, a meta-analysis could not be performed. CONCLUSIONS: Effectiveness of TW between smokers and non-smokers is comparable. The tooth sensitivity also does not seem to be influenced by smoking. CLINICAL RELEVANCE: The effectiveness of bleaching among smokers and non-smokers appears to be similar. Tooth sensitivity during TW also appears not to be influenced by smoking.

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AIM: This systematic review and meta-analysis evaluated whether the home use of mouthwashes containing potassium salts is effective in reducing and controlling dentin hypersensitivity (DH). METHODS AND MATERIALS: This study is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist and was registered in PROSPERO (CRD42021228410). Randomized clinical trials evaluating the use of mouthwashes containing potassium salt for daily household mouthwash for at least four weeks to reduce DH compared with a control mouthwash were selected, with no limitation on year of publication. Electronic research was carried out in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library by two independent researchers. One hundred thirty-three articles were obtained, and nine were selected according to the inclusion criteria. RESULTS: The selected studies evaluated DH through tests of sensitivity to tactile and evaporative stimuli and showed that, for the tactile stimulus, there were no baseline differences between groups (p=0.12; mean difference: -0.33; confidence intervals [CI]: -0.73 to 0.08). However, there were significant differences after two weeks of use (p=0.00001; mean difference: 4.67; CI: 4.53 to 4.81), after four weeks (p=0.00001; mean difference: 13.29; CI: 13.03 to 13.55), and after eight weeks (p=0.00001; mean difference: 8.88; CI: 5.73 to 12.02) favoring the experimental group. The results of the evaporative test showed no differences in the baseline assessment between the two groups (p=0.50; mean difference: -0.02; CI: -0.09 to 0.04), but after four weeks (p=0.00001; mean difference: -0.32; CI: -0.44 to -0.20), and eight weeks of use (p=0.00001; mean difference: -0.42; CI: -0.57 to -0.27) there were differences favoring the experimental group. The incidence of side effects showed no differences between the two groups (p=0.89; mean difference: 1.03; CI: 0.67 to 1.58). CONCLUSION: The daily use of mouthwashes containing potassium salt is effective in the treatment of dentinal hypersensitivity, as a complementary step to brushing at least twice a day for two weeks, four weeks, and up to eight weeks, without presenting side effects.

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OBJECTIVES: This study investigates the dentin permeability (by hydraulic conductance) and tubule occlusion (by confocal and scanning electron microscopies) of in-office desensitizing materials. MATERIALS AND METHODS: Bovine dentin blocks were immersed in EDTA to open dentinal tubules. Placebo varnish (PLA), fluoride varnish (FLU), NaF 5% + 5% nanoparticulate sodium trimetaphosphate varnish (TMP), universal adhesive system (SBU), S-PRG filler varnish (SPRG), Biosilicate (BIOS), and amelotin (AMTN) solution were the materials tested. After application, the specimens underwent an erosive-abrasive challenge. Dentin permeability was evaluated at T0 (initial), T1 (after treatment), and T2 (after challenge). Confocal and scanning electron microscopy (SEM) were used to evaluate, respectively, length and number of dentinal tubule occlusions and opened dentinal tubules, after challenge. Permeability and SEM data were analyzed by two-way repeated measures ANOVA and Tukey's tests. Confocal data were analyzed by one-way ANOVA, Tukey's test, and Kruskal-Wallis and Dunn's tests. Spearman and Pearson's correlation tests were also used. Significance level was set at 5%. RESULTS: At T1, the AMTN group showed the lowest permeability value, following the increasing order at T2: AMTN = SBU < BIOS = SPRG < TMP < FLU < PLA. The SBU group had the highest value of occluded dentinal tubule length. The AMTN group presented more occluded dentinal tubules compared to PLA and FLU. AMTN and SBU had the lowest values of opened dentin tubules. Results showed a negative correlation between the analyses. CONCLUSION: The SBU and AMTN solution were more effective in reducing dentin permeability by occluding dentin tubules. CLINICAL RELEVANCE: All materials reduced permeability after challenge, except fluoride varnish.

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OBJECTIVE: This clinical trial evaluated the effect of 1.5% potassium oxalate (PO) in controlling sensitivity and color change after at-home tooth whitening. It also evaluated the influence of PO on health-related quality of life (HRQoL) and the degree of patient satisfaction after bleaching treatment. MATERIALS AND METHODS: Fifty volunteers were randomized into two groups (n = 25): At-home bleaching gel with 22% carbamide peroxide for 45 min + placebo gel (GP) or 1.5% PO (GPO) for 10 min. The intensity of tooth sensitivity was assessed daily through the visual analog scale. The color analysis was performed three times: baseline, 21 days, and 1 month after the last application of the whitening gel. The impact of the oral condition on the patient's quality of life (OIDP) was used to measure the impact caused by the whitening treatment in relation to the individuals' ability to carry out their daily activities and its influence on HRQOL. RESULTS: No difference in tooth sensitivity was observed (p > 0.05). In addition, there was no difference in color change between groups (p > 0.05). However, there was an intragroup statistical difference throughout the evaluation period (p <0.05). The OIDP analysis showed a statistical difference between the groups (p > 0.05) and there was no difference between the groups regarding the degree of satisfaction with the bleaching (p > 0.05). CONCLUSIONS: The 1.5% PO was effective in preventing sensitivity and did not interfere with tooth whitening. Desensitizing therapy had a positive impact on quality of life and patient satisfaction.

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OBJECTIVES: To assess the effect of an experimental 58S bioactive glass on dentin permeability (dP) and erosive tooth wear (dentin surface loss - dSL). METHODS: 58S bioactive glass was synthetized using a sol-gel methodology, following by lyophilization and calcination, then mixed with phosphoric acid to obtain a paste (BGP). Forty-eight dentin disks (1 mm-thick) were used for dP, and 48 dentin slabs (3 mm × 3 mm) for dSL, which were assessed at three time intervals: post-EDTA (5 min in 17% EDTA solution); post-treatment (C: distilled water; BGP: experimental bioactive glass paste; NP: Nupro prophylaxis paste; CXT: Clinpro XT varnish); and post-erosive/abrasive cycling. Data were statistically analyzed (α=0.05). RESULTS: For dP and dSL, Groups did not differ significantly post-EDTA (p>0.05). Post-treatment, all groups showed lower dP than C (p<0.05), without differing significantly among them. For the dSL analysis, Groups C, BGP and NP did not differ significantly, showing lower values than CXT (p<0.05). Post-cycling, C continued to show the highest dP (p<0.05). Specimens from Group CXT had the lowest dP and did not differ from NP (p=0.86) which did not differ from BGP (p=0.193). For C and BGP, dP value was higher post-cycling than post-treatment (p<0.05). For NP and CXT, these experimental times did not differ (p>0.05). Post-cycling, dSL for C, BGP and NP did not differ significantly; values were higher than those for CXT (p<0.05). CONCLUSIONS: BGP reduced dP after application, with a reduced effect after cycling. Nonetheless, it was not able to protect dentin against erosive tooth wear. CLINICAL SIGNIFICANCE: Minimizing dentin hypersensitivity is a challenge in the field of dentistry. The development of alternative products with potential to obliterate dentinal tubules and provide resistance to chemical/mechanical stimuli is, thus, highly desirable. We have proposed a material able to reduce dentin permeability, which has emerged as a promising alternative for this purpose.

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PURPOSE: To evaluate the influence of diet and exposure to red wine on the treatment velocity, clinical results, postoperative tooth sensitivity, and patient satisfaction after tooth bleaching. METHODS: 45 subjects undergoing home bleaching with 16% carbamide peroxide (CP) were randomly separated into three groups, depending on the restriction of colored food and the use of a red wine mouthwash. Shades of teeth 11 and 21 were assessed using a digital spectrophotometer (VITA Easy Shade) at T0 (before treatment), T7 (7 days after treatment), T15 (15 days after treatment), and T30 (30 days after treatment). The assessments were verified using the CIELab system (values of L*, a*, and b*) and the change in shade was calculated (ΔE, ΔL, Δa, and Δb). RESULTS: No statistically significant differences in ΔE, ΔL, Δa, and Δb were found between the groups. However, at T7, the group restricted from colored foods without red wine mouthwash had meaningful variations in L*, a*, and b*. Statistically, there was no difference in tooth sensitivity between the groups in the 7- and 15-day periods. Patients in the restricted colored foods without red wine mouthwash group were more satisfied after the end of treatment. CLINICAL SIGNIFICANCE: Tooth bleaching with 16% carbamide peroxide may be performed in subjects with colorant-rich diets without influencing the clinical outcome.

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OBJECTIVES: To assess the improvement on oral health-related quality of life (OHRQoL) of individuals with cervical dentin hypersensitivity (CDH) with the noncarious cervical lesion (NCCLs) subjected to different treatments. MATERIAL AND METHODS: A single-blind randomized clinical trial was conducted with patients (n = 74) randomly allocated into three groups according to the treatment performed: PO, potassium oxalate (Oxa-Gel BF); LL, low-power laser irradiation; and POLL, potassium oxalate (Oxa-Gel BF) associated with low-power laser irradiation. The treatments were applied in four steps, weekly. The questionnaire Oral Health Impact Profile (OHIP-14) was applied before initiating and immediately after the fourth session. The greater the sum of the score, the smaller the measurement of OHRQoL. RESULTS: The total mean values of the variables at the final moment were significantly lower than the initial one for all dimensions (p value ranging from < 0.001 to 0.006). Furthermore, the OHIP-14 scores final analysis between the groups indicated that the POLL group compared to LL had a significantly lower final score for the functional limitation (p = 0.009), physical pain (p = 0.049), and psychological discomfort (p = 0.035) dimensions and that group PO compared to group LL had a significantly lower final score for the functional limitation dimension (p = 0.024). CONCLUSIONS: There was a reduction in the OHIP-14 score for all dimensions, indicating an improvement in patients' quality of life after the use of desensitizing therapies. Patients in group LL had a higher functional limitation, physical pain, and psychological discomfort. CLINICAL RELEVANCE: This study indicated improvement of desensitizing therapies for CDH to improve patients' OHRQoL. TRIAL REGISTRATION: This trial was registered in the Brazilian Clinical Trials Registry Platform (REBEC protocol number RBR-4ybjmt).

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OBJECTIVES: This randomized controlled trial aimed to evaluate different protocols for dentin hypersensitivity treatment with low-power lasers and desensitizing agents, and the association between low-power lasers and desensitizing agents. MATERIALS AND METHODS: Fifty-four patients (303 teeth) were randomly allocated to three groups: G1, 3% nitrate potassium gel, UltraEZ (n = 17); G2, photobiomodulation therapy (PBM) with a low-level infrared laser (n = 17), 100 mW, spot size of 0.028 cm2, and dose of 1 J per point; and G3, nitrate potassium + PBM (n = 20). Treatments were applied to the buccal cervical region at intervals of 72 h, and all protocols were performed in three sessions. The patients' response to evaporative stimuli was rated using the visual analog scale (VAS). Re-evaluations were performed immediately after each application and 1 week, 1 month, and 3 months after treatment. A two-way repeated measures test and Tukey's post hoc test were used for multiple comparisons (α = 5%). RESULTS: There was a reduction in pain levels at the end of treatment in all groups. There were no significant differences in VAS score changes between the groups immediately after treatment and after the third month, compared to the baseline (p > 0.05). CONCLUSION: Under the limitations of this in vivo study, the proposed three-session protocol was effective in reducing dentin hypersensitivity after 3 months, regardless of the desensitization mechanism used. Conservative and long-term protocols are interesting for the control of pain caused by dentin hypersensitivity. CLINICAL RELEVANCE: The increase in cervical dentin hypersensitivity prevalence warrants easy-to-apply and long-lasting desensitizing protocols for pain control.

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OBJECTIVES: This study tested the ability of bioactive pastes containing niobophosphate and 45S5 glasses to reduce dentin permeability and to obliterate dentinal tubules, as a mean of reducing human dentin hypersensitivity. MATERIALS AND METHODS: Experimental pastes with concentrations of 10, 20, and 30 wt% of two bioactive glasses (45S5 or niobophosphate [NbG]) were formulated. A paste without bioactive glass (placebo) and a commercial paste (Nano P, FGM) were used as controls. Forty dentin disc specimens were obtained from caries-free extracted third human molars and divided in 8 groups (n = 5). Percentage of permeability (%Lp) was assessed in a dental permeability machine considering hydraulic conductance, immediately after pastes application and at day 7, day 14, and day 21. The precipitates formed on the surface of the dentin discs (and dentinal tubules) were analyzed by SEM/EDS and micro-Raman spectra. Data of dentin permeability (%) 2-way repeated-measures (ANOVA) and Holm-Sidak post-tests (α = 0.05). Dentinal tubule obliteration was visually (and elemental) evaluated and descriptively reported. RESULTS: The experimental bioactive glass pastes containing NbG and 45S5, regardless of the concentration, reduced dentin permeability in comparison with pastes without bioactive glasses (P < 0.05). The formulated placebo and commercial paste did not reduce permeability over time (P < 0.05). SEM/EDS and micro-Raman analyses showed that both type of bioactive pastes (NbG or 45S5-based) presented mineral precipitates obliterating the dentinal tubules at day 21. NbG seems to offer a better initial effect than 45S5, while at 21 days there is no difference between both glasses. CONCLUSION: Experimental bioactive pastes containing NbG and 45S5 (at concentrations of 10%, 20%, or 30%) have potential to reduce dentin permeability (over time) in comparison with pastes without bioactive glasses; and this occurs on behalf of obliteration of dentinal tubules by microparticle and precipitate formation. CLINICAL RELEVANCE: Bioactive pastes containing NbG and 45S5 may benefit patients presenting dentin hypersensitivity, because these pastes can start acting fast after application and maintain their action up to 21 days.

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