Tooth Discoloration Clinical Trial
Official title:
Efficacy of Laser Application in Dental Bleaching: A Randomized Clinical Trial
Objective: To establish the efficacy of laser application with chemical treatment in dental
bleaching compared to chemical treatment alone.
Methods: The investigators conducted a randomized controlled trial (RCT), single blind
(evaluator), in 24 patients randomized to laser and chemical intervention (12) or chemical
intervention aloe (12). The commercial products used were Whiteness Hp 35% Hydrogen Peroxide
and the LASER of DCM Equipments. The trial outcome measures were obtained using the Vita
EasyShade Spectrophotometer and the International CIELCh system. To stablish differences
before vs. after treatments and between groups, the T test and chi2 tests were applied.
New technologies continue to be launched in the field of dental esthetics, especially for
whitening, and many products advertise their efficacy. One new approach is the use of LASER
technology which has been purported to be the most powerful font light for bleaching Diverse
studies by different designs find different efficacies for LASER whitening Randomized
clinical trials (RCT) are needed for the most rigorous confirmation of efficacy. RCT are able
to control for characteristics that can cause bias, including factors related to dental care
such as diet and cleaning behavior after the bleaching procedure. The investigators therefore
conducted an RCT to make a side by side comparison of a LASER whitening technique with
chemical bleaching versus chemical bleaching without LASER.
Intervention: After the patient was informed and sign the consent; a dental prophylaxis was
done. Three days later the bleaching procedure started following the same protocol regarding
to the time and product used (35% Hydrogen Peroxide Whitening HP, 40 minutes divided in two
phases of 20 minutes each one) from premolar to premolar in superior and inferior teeth. The
difference was that one of the intervention groups used the Laser for ten minutes (starting
at the minute 5) and the other did not.. The Laser used was the Whitening Lase II (DCM
EQUIPMENTS).
The measure of the color was done to the superior canines by just one evaluator in three
stages: before bleaching (baseline), 15 minutes after bleaching, and three days after. It was
done with the Vita Easyshade Spectrophotometer.
The dental sensitivity also was asked at the three time points; however, as an exclusion
criterion the level had to be 0 to be entered into the study.
All the patients received verbal and written instructions about eating and cleaning behavior.
Cleaning materials for the three days after procedure were given.
As the clinical endpoint, the difference in color was calculated using the international
accepted system CIELCh (11,18-19). The formula is ∆E* = [(∆L*)2 + (∆C*)2 + (∆h*)2] ½; were L
is Luminosity, C is Chroma and h is Hue.
A verbal numeric scale was used to determine the dental sensitivity with values from 0 to 3.
The evaluator used the water and air from the dental chair syringe. The patient reports 0 for
no sensitivity; 1 for slight sensitivity, 2 for moderate sensitivity, and 3 for severe
sensitivity.
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