Advertisement

Clinical Oral Investigations

, Volume 23, Issue 1, pp 435–444 | Cite as

Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial

  • Luiz Augusto da Costa Poubel
  • Cresus Vinicius Deppes de Gouvea
  • Fernanda Signorelli Calazans
  • Etyene Castro Dip
  • Wesley Veltri Alves
  • Stella Soares Marins
  • Roberta Barcelos
  • Marcos Oliveira BarceleiroEmail author
Original Article

Abstract

Objectives

This study evaluated the effect of the administration of pre-operative dexamethasone on tooth sensitivity stemming from in-office bleaching.

Materials and methods

A triple-blind, parallel-design, randomized clinical trial was conducted on 70 volunteers who received dexamethasone or placebo capsules. The drugs were administered in a protocol of three daily 8-mg doses of the drug, starting 48 h before the in-office bleaching treatment. Two bleaching sessions with 37.5% hydrogen peroxide gel were performed with a 1-week interval. Tooth sensitivity (TS) was recorded on visual analog scales (VAS) and numeric rating scales (NRS) in different periods up to 48 h after bleaching. The color evaluations were also performed. The absolute risk of TS and its intensity were evaluated by using Fisher’s exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney U test and a two-way repeated measures ANOVA and Tukey’s test, respectively.

Results

In both groups, a high risk of TS (Dexa 80% x Placebo 94%) was detected. No significant difference was observed in terms of TS intensity. A whitening of approximately 3 shade guide units of the VITA Classical was detected in both groups, which were statistically similar.

Conclusions

It was concluded that the administration pre-operatively of dexamethasone, in the proposed protocol, does not reduce the incidence or intensity of bleaching-induced tooth sensitivity.

Clinical relevance

The use of dexamethasone drug before in-office bleaching treatment does not reduce incidence or intensity of tooth sensitivity.

Clinical trial registration number

NCT02956070

Keywords

Dentin sensitivity Dental bleaching Hydrogen peroxide Dexamethasone 

Notes

Acknowledgements

The authors thank SDI Dental Limited for the donation of the bleaching gel used, and Bem Viver laboratory Ltda. for the donation of dexamethasone capsules and the gel placebo in this investigation.

Informed consent

Informed consent was obtained from all individual participants included in this study.

Funding

This work was supported by the National Council for Scientific and Technological Development (CNPq IC 166520) and Coordination for the Improvement of Higher Level Personnel (CAPES), in Brazil.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Tin-Oo MM, Saddki N, Hassan N (2011) Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics. BMC Oral Health 11:6.  https://doi.org/10.1186/1472-6831-11-6 CrossRefGoogle Scholar
  2. 2.
    Giniger M, Macdonald J, Ziemba S, Felix H (2005) The clinical performance of professionally dispensed bleaching gel with added amorphous calcium phosphate. J Am Dent Assoc 136:383–392CrossRefGoogle Scholar
  3. 3.
    Samorodnitzky-Naveh GR, Grossmann Y, Bachner YG, Levin L (2010) Patients’ self-perception of tooth shade in relation to professionally objective evaluation. Quintessence Int 41:80–83Google Scholar
  4. 4.
    Haywood VB, Heymann HO (1989) Nightguard vital bleaching. Quintessence Int 20:173–176Google Scholar
  5. 5.
    Leonard Jr RH, Bentley C, Eagle JC, Garland GE (2001) Nightguard vital bleaching: a long-term study on efficacy, shade retention, side effects, and patients’ perceptions. J Esthet Restor Dent 13:357–369CrossRefGoogle Scholar
  6. 6.
    Bernardon JK, Sartori N, Ballarin A, Perdigão J, Lopes G, Baratieri LN (2010) Clinical performance of vital bleaching techniques. Oper Dent 35:3–10.  https://doi.org/10.2341/09-008CR CrossRefGoogle Scholar
  7. 7.
    Rezende M, Loguercio AD, Reis A, Kossatz S (2013) Clinical effects of exposure to coffee during at-home vital bleaching. Oper Dent 38:E229–E236.  https://doi.org/10.2341/12-188-C CrossRefGoogle Scholar
  8. 8.
    Carey CM (2014) Tooth whitening: what we now know. J Evid Based Dent Pract 14(Suppl):70–76.  https://doi.org/10.1016/j.jebdp.2014.02.006 CrossRefGoogle Scholar
  9. 9.
    Dahl JE, Pallesen U (2003) Tooth bleaching—a critical review of the biological aspects. Crit Rev Oral Biol Med 14:292–304CrossRefGoogle Scholar
  10. 10.
    Perdigão J (2009) Dental whitening—revisiting the myths. Northwest Dent 89:19–21Google Scholar
  11. 11.
    Tay LY, Kose C, Loguercio AD, Reis A (2009) Assessing the effect of a desensitizing agent used before in-office tooth bleaching. J Am Dent Assoc 140:1245–1251CrossRefGoogle Scholar
  12. 12.
    Marson FC, Sensi LG, Vieira LCC, Araújo E (2008) Clinical evaluation of in-office dental bleaching treatments with and without the use of light-activation sources. Oper Dent 33:15–22.  https://doi.org/10.2341/07-57 CrossRefGoogle Scholar
  13. 13.
    Reis A, Kossatz S, Martins GC, Loguercio AD (2013) Efficacy of and effect on tooth sensitivity of in-office bleaching gel concentrations: a randomized clinical trial. Oper Dent 38:386–393.  https://doi.org/10.2341/12-140-C CrossRefGoogle Scholar
  14. 14.
    Alomari Q, El Dara E (2010) A randomized clinical trial of in-office dental bleaching with or without light activation. J Contemp Dent Pract 11:E017–E024Google Scholar
  15. 15.
    Gurgan S, Cakir FY, Yazici E (2010) Different light-activated in-office bleaching systems: a clinical evaluation. Lasers Med Sci 25:817–822.  https://doi.org/10.1007/s10103-009-0688-x CrossRefGoogle Scholar
  16. 16.
    Tay LY, Kose C, Herrera DR, Reis A, Loguercio AD (2012) Long-term efficacy of in-office and at-home bleaching: a 2-year double-blind randomized clinical trial. Am J Dent 25:199–204Google Scholar
  17. 17.
    De Paula EA, Nava JA, Rosso C, Benazzi CM, Fernandes KT, Kossatz S, Loguercio AD, Reis A (2015) In-office bleaching with a two-and seven-day intervals between clinical sessions: a randomized clinical trial on tooth sensitivity. J Dent 43:424–429.  https://doi.org/10.1016/j.jdent.2014.09.009 CrossRefGoogle Scholar
  18. 18.
    Giachetti L, Bertini F, Bambi C, Nieri M, Russo DS (2010) A randomized clinical trial comparing at-home and in-office tooth whitening techniques: a nine-month follow-up. J Am Dent Assoc 141:1357–1364CrossRefGoogle Scholar
  19. 19.
    He LB, Shao MY, Tan K, Xu X, Li JY (2012) The effects of light on bleaching and tooth sensitivity during in-office vital bleaching: a systematic review and meta-analysis. J Dent 40:644–653.  https://doi.org/10.1016/j.jdent.2012.04.010 CrossRefGoogle Scholar
  20. 20.
    De Paula EA, Kossatz S, Fernandes D, Loguercio AD, Reis A (2013) The effect of perioperative ibuprofen use on tooth sensitivity caused by in-office bleaching. Oper Dent 38:601–608.  https://doi.org/10.2341/12-107-C CrossRefGoogle Scholar
  21. 21.
    De Paula EA, Loguercio AD, Fernandes D, Kossatz S, Reis A (2013) Perioperative use of an anti-inflammatory drug on tooth sensitivity caused by in-office bleaching: a randomized, triple-blind clinical trial. Clin Oral Invest 17:2091–2097.  https://doi.org/10.1007/s00784-013-0918-2 CrossRefGoogle Scholar
  22. 22.
    Mehta D, Venkata S, Naganath M, LingaReddy U, Ishihata H, Finger WJ (2013) Clinical trial of tooth desensitization prior to in-office bleaching. Eur J Oral Sci 121:477–481.  https://doi.org/10.1111/eos.12067 CrossRefGoogle Scholar
  23. 23.
    Bonafé E, Bacovis CL, Iensen S, Loguercio AD, Reis A, Kossatz S (2013) Tooth sensitivity and efficacy of in-office bleaching in restored teeth. J Dent 41:363–369.  https://doi.org/10.1016/j.jdent.2013.01.007 CrossRefGoogle Scholar
  24. 24.
    Caviedes-Bucheli J, Ariza-García G, Restrepo-Méndez S, Ríos-Osorio N, Lombana N, Muñoz HR (2008) The effect of tooth bleaching on substance P expression in human dental pulp. J Endod 34:1462–1465.  https://doi.org/10.1016/j.joen.2008.09.013 CrossRefGoogle Scholar
  25. 25.
    De Souza Costa CA, Riehl H, Kina JF, Sacono NT, Hebling J (2010) Human pulp responses to in-office tooth bleaching. Oral Surg Oral Med Oral Pathol Oral Rad Endod 109:e59–e64.  https://doi.org/10.1016/j.tripleo.2009.12.002 CrossRefGoogle Scholar
  26. 26.
    Reis A, Dalanhol AP, Cunha TS, Kossatz S, Loguercio AD (2011) Assessment of tooth sensitivity using a desensitizer before light-activated bleaching. Oper Dent 36:12–17.  https://doi.org/10.2341/10-148-CR CrossRefGoogle Scholar
  27. 27.
    Bortolatto JF, Pretel H, Floros MC, Luizzi ACC, Dantas AA, Fernandez E, Moncada G, De Oliveira OB Jr (2014) Low concentration H2O2/TiO_N in office bleaching: a randomized clinical trial. J Dent Res 93(Suppl):66S–71S.  https://doi.org/10.1177/0022034514537466 CrossRefGoogle Scholar
  28. 28.
    Markowitz K (2010) Pretty painful: why does tooth bleaching hurt? Med Hypotheses 74:835–840.  https://doi.org/10.1016/j.mehy.2009.11.044 CrossRefGoogle Scholar
  29. 29.
    Wang T, Gao J, Jiang T, Liang S, Zhou Y, Matis BA (2015) Evaluation of the efficacy of potassium nitrate and sodium fluoride as desensitizing agents during tooth bleaching treatment—a systematic review and meta-analysis. J Dent 43:913–923.  https://doi.org/10.1016/j.jdent.2015.03.015 CrossRefGoogle Scholar
  30. 30.
    Palé M, Mayoral JR, Llopis J, Vallès M, Basilio J, Roig M (2014) Evaluation of the effectiveness of an in-office bleaching system and the effect of potassium nitrate as a desensitizing agent. Odontology 102:203–210.  https://doi.org/10.1007/s10266-013-0132-3 CrossRefGoogle Scholar
  31. 31.
    Loguercio AD, Martins LM, da Silva LM, Reis A (2016) In-office whitening. In: Perdigão J (ed) Tooth whitening., 1st edn. Springer Int. Pub, Switzerland, pp 145–167CrossRefGoogle Scholar
  32. 32.
    Moura GF, Teixeira DNR, Machado AC, Spini PH, Soares PV (2016) Analysis of bleaching products associated with desensitizing agents in experimental whitening gel—randomized clinical trial. Biosci J 32:279–287CrossRefGoogle Scholar
  33. 33.
    Hewlett ER (2007) Etiology and management of whitening-induced tooth hypersensitivity. J Calif Dent Assoc 35:499–506Google Scholar
  34. 34.
    Kossatz S, Martins G, Loguercio AD, Reis A (2012) Tooth sensitivity and bleaching effectiveness associated with use of a calcium-containing in-office bleaching gel. J Am Dent Assoc 143:e81-e87CrossRefGoogle Scholar
  35. 35.
    Charakorn P, Cabanilla LL, Wagner WC, Foong WC, Shaheen J, Pregitzer R, Schneider D (2009) The effect of preoperative ibuprofen on tooth sensitivity caused by in-office bleaching. Oper Dent 34:131–135.  https://doi.org/10.2341/08-33 CrossRefGoogle Scholar
  36. 36.
    Rezende M, Bonafé E, Vochikovski L, Farago PV, Loguercio AD, Reis A, Kossatz S (2016) Pre and postoperative dexamethasone does not reduce bleaching-induced tooth sensitivity: a randomized, triple-masked clinical trial. J Am Dent Assoc 147:41–49CrossRefGoogle Scholar
  37. 37.
    Sugimoto MA, Vago JP, Teixeira MM, Sousa LP (2016) Annexin A1 and the resolution of inflammation: modulation of neutrophil recruitment, apoptosis, and clearance. J Immunol Res 2016(8239258):1–13.  https://doi.org/10.1155/2016/8239258 CrossRefGoogle Scholar
  38. 38.
    Navari RM, Aapro M (2016) Antiemetic prophylaxis for chemotherapy-induced nausea and vomiting. New Eng J Med 374:1356–1367.  https://doi.org/10.1056/NEJMra1515442 CrossRefGoogle Scholar
  39. 39.
    Rhen T, Cidlowski JA (2005) Antiinflammatory action of glucocorticoids - new mechanisms for old drugs. New Eng J Med 353:1711–1723.  https://doi.org/10.1056/NEJMra050541 CrossRefGoogle Scholar
  40. 40.
    Falci SGM, Lima TC, Martins CC, Santos CRRD, Pinheiro MLP (2017) Preemptive effect of dexamethasone in third-molar surgery: a meta-analysis. Anesth Prog 64:136–143.  https://doi.org/10.2344/anpr-64-05-08 CrossRefGoogle Scholar
  41. 41.
    Paravina RD, Johnston WM, Powers JM (2007) New shade guide for evaluation of tooth whitening-colorimetric study. J Esthet Restor Dent 19:276–283.  https://doi.org/10.1111/j.1708-8240.2007.00118_1.x CrossRefGoogle Scholar
  42. 42.
    Nahsan FP, Fernandes MT, Martins-Filho PR (2015) Effect of preventive use of nonsteroidal anti-inflammatory drugs on sensitivity after dental bleaching: a systematic review and meta-analysis. J Am Dent Assoc 146:87–93.  https://doi.org/10.1016/j.adaj.2014.10.007 CrossRefGoogle Scholar
  43. 43.
    Paravina RD (2008) New shade guide for tooth whitening monitoring: visual assessment. J Prosthet Dent 99:178–184.  https://doi.org/10.1016/S0022-3913(08)60041-4 CrossRefGoogle Scholar
  44. 44.
    Brännström M (1986) The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. J Endod 12:453–457.  https://doi.org/10.1016/S0099-2399(86)80198-4 CrossRefGoogle Scholar
  45. 45.
    Pinheiro HB, Lopes B, Klautau EB, Cardoso J, Silva BR, Cardoso PEC (2010) Influence of bioactive materials used on the dentin surface whitened with carbamide peroxide 16%. Mat Res 13:273–278CrossRefGoogle Scholar
  46. 46.
    Gjorgievska E, Nicholson JW (2011) Prevention of enamel demineralization after tooth bleaching by bioactive glass incorporated into toothpaste. Aust Dent J 56:193–200.  https://doi.org/10.1111/j.1834-7819.2011.01323.x CrossRefGoogle Scholar
  47. 47.
    Rezende M, Loguercio AD, Kossatz S, Reis A (2016) Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: a multi regression and logistic analysis. J Dent 45:1–6.  https://doi.org/10.1016/j.jdent.2015.11.003 CrossRefGoogle Scholar
  48. 48.
    De Geus JL, Wambier LM, Kossatz S, Loguercio AD, Reis A (2016) At-home vs in-office bleaching: a systematic review and meta-analysis. Oper Dent 41:341–356.  https://doi.org/10.2341/15-287-LIT CrossRefGoogle Scholar
  49. 49.
    Pintado-Palomino K, Peitl Filho O, Zanotto ED, Tirapelli C (2015) A clinical, randomized, controlled study on the use of desensitizing agents during tooth bleaching. J Dent 43:1099–1105.  https://doi.org/10.1016/j.jdent.2017.05.019 CrossRefGoogle Scholar
  50. 50.
    Loguercio AD, Tay LY, Herrera DR, Bauer J, Reis A (2015) Effectiveness of nano-calcium phosphate paste on sensitivity during and after bleaching: a randomized clinical trial. Braz Oral Res 29:1–7.  https://doi.org/10.1590/1807-3107BOR-2015.vol29.0099 CrossRefGoogle Scholar
  51. 51.
    De Paula EA, Kossatz S, Fernandes D, Loguercio AD, Reis A (2014) Administration of ascorbic acid to prevent bleaching-induced tooth sensitivity: a randomized triple-blind clinical trial. Oper Dent 39:128–135.  https://doi.org/10.2341/12-483-C CrossRefGoogle Scholar
  52. 52.
    Hall JE (2016) Red blood cells, anemia, and polycythemia. In: Guyton AC, Hall JE (eds) Textbook of medical physiology, 13th edn. Elsevier Saunders, Philadelphia, pp 445–543Google Scholar
  53. 53.
    Filipsson Nyström H, Barbosa EJ, Nilsson AG, Norrman LL, Ragnarsson O, Johannsson G (2012) Discontinuing long-term GH replacement therapy—a randomized, placebo-controlled crossover trial in adult GH deficiency. J Clin Endocrinol Metab 97:3185–3195.  https://doi.org/10.1210/jc.2012-2006 CrossRefGoogle Scholar
  54. 54.
    Cronin J, Kennedy U, McCoy S, Fhailí SN, Crispino-O’Connell G, Hayden J, O’Sullivan R (2012) Single dose oral dexamethasone versus multi-dose prednisolone in the treatment of acute exacerbations of asthma in children who attend the emergency department: study protocol for a randomized controlled trial. Trials 13:141.  https://doi.org/10.1186/1745-6215-13-141 CrossRefGoogle Scholar
  55. 55.
    Bjornson CL, Klassen TP, Williamson J, Brant R, Mitton C, Plint A, Johnson DW (2004) A randomized trial of a single dose of oral dexamethasone for mild croup. New Eng J Med 351:1306–1313.  https://doi.org/10.1056/NEJMoa033534 CrossRefGoogle Scholar
  56. 56.
    Laureano Filho JR, Maurette PE, Allais M, Cotinho M, Fernandes C (2008) Clinical comparative study of the effectiveness of two dosages of dexamethasone to control postoperative swelling, trismus and pain after the surgical extraction of mandibular impacted third molars. Med Oral Pathol Oral Cir Bucal 13:E129–E132Google Scholar
  57. 57.
    Kravitz J, Dominici P, Ufberg J, Fisher J, Giraldo P (2011) Two days of dexamethasone versus 5 days of prednisone in the treatment of acute asthma: a randomized controlled trial. Ann Emerg Med 58:200–204.  https://doi.org/10.1016/j.annemergmed.2011.01.004 CrossRefGoogle Scholar
  58. 58.
    Haas ET, Rowland K, Gautam M (2011) Tooth injury increases expression of the cold sensitive TRP channel TRPA1 in trigeminal neurons. Arch Oral Biol 56:1604–1609.  https://doi.org/10.1016/j.archoralbio.2011.06.014 CrossRefGoogle Scholar
  59. 59.
    Bae YC, Yoshida A (2011) Ultrastructural basis for craniofacial sensory processing in the brainstem. Int Rev Neurobiol 97:99–141.  https://doi.org/10.1016/B978-0-12-385198-7.00005-9 CrossRefGoogle Scholar
  60. 60.
    Antunes AA, Avelar RL, Neto ECM, Frota R, Dias E (2011) Effect of two routes of administration of dexamethasone on pain, edema, and trismus in impacted lower third molar surgery. Oral Maxillofac Surg 15:217–223.  https://doi.org/10.1007/s10006-011-0290-9 CrossRefGoogle Scholar
  61. 61.
    El Karim I, McCrudden MT, Linden GJ, Abdullah H, Curtis TM, McGahon M, Lundy FT (2015) TNF-α–induced p38MAPK activation regulates TRPA1 and TRPV4 activity in odontoblast-like cells. Am J Pathol 185:2994–3002.  https://doi.org/10.1016/j.ajpath.2015.07.020 CrossRefGoogle Scholar
  62. 62.
    Brone B, Peeters PJ, Marrannes R, Mercken M, Nuydens R, Meert T, Gijsen HJ (2008) Tear gasses CN, CR, and CS are potent activators of the human TRPA1 receptor. Toxicol Appl Pharmacol 231:150–156.  https://doi.org/10.1016/j.taap.2008.04.005 CrossRefGoogle Scholar
  63. 63.
    Ferrer-Montiel A, Fernández-Carvajal A, Planells-Cases R, Fernández-Ballester G, González-Ros JM, Messeguer A, González-Muñiz R (2012) Advances in modulating thermosensory TRP channels. Expert Opin Ther Pat 22:999–1017.  https://doi.org/10.1517/13543776.2012.711320 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Luiz Augusto da Costa Poubel
    • 1
  • Cresus Vinicius Deppes de Gouvea
    • 2
  • Fernanda Signorelli Calazans
    • 1
  • Etyene Castro Dip
    • 1
  • Wesley Veltri Alves
    • 1
  • Stella Soares Marins
    • 1
  • Roberta Barcelos
    • 1
  • Marcos Oliveira Barceleiro
    • 1
    Email author
  1. 1.Fluminense Federal University / School of DentistryNova FriburgoBrazil
  2. 2.Fluminense Federal University / School of DentistryNiteróiBrazil

Personalised recommendations