Tooth Discoloration Clinical Trial
Official title:
Effectiveness of Sealed In-office Bleaching Technique: Randomized Controlled Clinical Trial
Thus, the aim of this study is to evaluate the sealed bleaching technique on tooth sensitivity and bleaching efficacy. The hypothesis is that the sealed bleaching technique reduce the tooth sensitivity when compared to conventional technique, without alters the bleaching efficacy.
This is a randomized, single-blind, and controlled trial with a parallel group and an equal
allocation rate to receive either one of two treatments, whereas the sealed technique is the
experimental intervention and the conventional technique is control one.
PICO Question:
P (Population) - Patients of dentistry service of Federal University of Sergipe.
I: (Intervention) - In-office bleaching using 35% hydrogen peroxide bleaching agent covered
with a customized tray.
C: (Control) - In-office bleaching using 35% hydrogen peroxide bleaching agent covered
without a customized tray.
O: (Outcomes) - Primary outcomes: presence of tooth sensitivity during the bleaching
procedure; Secondary outcome: Bleaching efficacy.
Sample Patients attempted in clinical service of Federal University of Sergipe requiring
tooth bleaching will be recruited for this trial. For sample size calculation was considered
80% of test power, significance level of 5%, the presence of tooth sensitivity of 90% at
control intervention and 40% at experimental intervention. These levels of sensitivity were
based in pilot study. Thus the sample size for a proportions test (SigmaStat 3.5 (Systat
Software, Point Richmond, USA) was 17 participants for each intervention.
Randomization Previously to beginning of study, a blocked randomisation list will be created
using the website www.sealedenvelope.com, using block size of 4, by an operator different
from those who will be perform the bleaching procedures. The bleaching protocol for each
participant will be placed into a sealed envelope, while this only will be opened in the
moment of bleaching procedure.
Evaluations During the permanence of bleaching agent, the tooth sensitivity will be
monitored and the scores (VAS and verbal scale) will be recorded at 20th and 40th minute.
The score also will be recorded immediately after the bleaching agent removal. In the after
day, the participants will be argued (only verbal scale) about the maximum level of
sensitivity during the first 24 hours after bleaching procedure and in 24th hour after this.
A week after the bleaching procedure, the scores based on shade guides will be recorded
again. For CIE L*a*b* measurement, ΔE will be calculated by the following equation: ∆E=
[(∆L)2 + (∆a)2 + (∆b)2]1/2, while ∆L = L1 - L0; ∆a = a1 - a0; e ∆b = b1 - b0. After the
shade evaluation, a new bleaching procedure, using the same protocol, will be performed in
this second appointment and the same measurements of tooth sensitivity will be performed
similarly to first one. After a week of second session, only the shade will be evaluated.
Blinding Once that it is not possible to blind the operators responsible by bleaching
procedures and the participants, only the operators responsible by evaluations and by
statistical analysis will be blinded.
Analysis of data The average of scores corresponding to shade guides will be calculated for
each participant in the three moments of evaluation. Data will be submitted to Friedman and
Man-Whitney tests. The average of ∆E will be calculated for each participant in the two
moments of re-evaluation, while the data will be submitted to two-way ANOVA (protocol x
moment of evaluation). Data for tooth sensitivity scores will be submitted to Friedman and
Man-Whitney tests. The multiple-comparison test of Tukey will be used when necessary. The
number of participants presenting any sensitivity during each session of bleaching will be
calculated, while the percentage of these participants for each protocol will be calculated
using Chi-square test. All statistical analysis will be performed with significant level of
5%.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment
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