Avaliação da irritação gengival em pacientes submetidos ao clareamento caseiro com diferentes recortes da moldeira individualizada: ensaio clínico randomizado cego.

Abstract

The objective of this randomized, blind clinical trial, with a split-mouth design, was to evaluate the gingival irritation (GI) due to at-home bleaching when performed with individual trays with different cutouts, as well as the tooth sensitivity (TS) and the effectiveness of bleaching. One hundred and twenty patients were randomized as to which side would receive the type of whitening tray cutout: cutout at the gingival level (slightly below the gingival margin) and cutout above the gingival level (extended 2 mm above the cervical region of the canine [horizontally toward the central incisor and toward the first molar]). In both groups, home bleaching was performed for a period of 30 minutes with 10% hydrogen peroxide, once a day for two weeks. Absolute risk and GI intensity and TS were assessed using a visual analogue scale (VAS). Color was assessed using a digital spectrophotometer and color guide ( = 0.05). The percentage of patients reporting GI was 57.5% (Odds Ratio 95% CI = 1.1 [0.7 to 1.8]), with no significant difference between groups (p =0.66). The percentage of patients reporting TS was 64.1% (Odds ratio 95% CI = 1.0 [0.6 to 1.6]), with no significant difference between groups (p = 1.0). GI and SD were correlated in both groups by the VAS scale (p < 0.0001) in all evaluation periods. There was equivalence between the groups for GI intensity (p<0.01). Both groups resulted in significant bleaching. Although differences were observed between the groups (CIELab and CIEDE00; p < 0.02), these were not considered clinically noticeable. The different cutouts of the individualized trays were shown to be equivalent in relation to GI and TS when 10% HP was used for at-home bleaching. The differences detected in the color change were not considered clinically noticeable.