The combined use of systemic analgesic/anti-inflammatory drugs and a bioactive topical desensitizer for reduced in-office bleaching sensitivity without jeopardizing the hydrogen peroxide efficacy: a randomized, triple blinded, split-mouth clinical trial

• Published in: Clinical oral investigations Vol. 25; no. 12; pp. 6623 - 6632
• Main Authors: de Araújo, Isabela Dantas Torres, de Sousa Santos, Kaiza, das Neves Peixoto, Thauan Victor Oliveira, Costa, Moan Jéfter Fernandes, de Assunção, Isauremi Vieira, Borges, Boniek Castillo Dutra
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2021; Springer Nature B.V
• Subjects: Analgesics; Anti-inflammatory agents; Bleaching; Clinical trials; Codeine; Color; Dentistry; Hydrogen peroxide; Inflammation; Medicine; Mouth; Original Article; Paracetamol; Topical application; Tooth bleaching; Colorimetry; Hydrogen peroxide; Tooth sensitivity; Opioid analgesics
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-021-03948-y

Objective
To evaluate the effect of combined systemic administration of paracetamol 500 mg/codeine phosphate 30 mg (PACO) and postoperative topical application of a bioactive desensitizer on in-office bleaching sensitivity and tooth color change.
Materials and methods
A randomized, triple-blind, split-mouth clinical trial was conducted. Forty volunteers ingested PACO (
n
 = 20) or placebo (PLA) (
n
 = 20). Their left/right hemiarches received topical application of a bioactive desensitizer [Nano-P™(NP)] and prophylactic paste (PAS), generating four treatment approaches: PACO/NP, PACO/PAS, PLA/NP, and PLA/PAS. Two bleaching sessions (35% hydrogen peroxide) were performed, and the PAS/NP were applied after the procedure. Sensitivity was obtained since the first bleaching session up to 7 days post-bleaching. The color change was evaluated using CIEDE2000 and whiteness index parameters up to 7 days post-bleaching. Data were analyzed using one- and two-way ANOVA/Tukey post hoc tests (
p
 < 0.05).
Results
The PLA/PAS showed a sensitivity average of at least two times higher than the PACO/NP. The treatment approaches promoted statistically similar bleaching patterns (
p
 > 0.05)
.
Conclusion
The combined approach of systemic administration of PACO and postoperative topical application of NP reduced the level of in-office bleaching sensitivity without jeopardizing hydrogen peroxide efficacy.
Clinical relevance
Professionals can adopt the combined approach of systemic administration of analgesic/anti-inflammatory drugs and topical application of a bioactive desensitizer for decreased bleaching sensitivity caused by 35% hydrogen peroxide in-office.