Clareamento dental supervisionado em consultório com luz LED violeta (405 nm): ensaio clínico, randomizado, controlado e cego

Abstract

The aim this randomized controlled double-blind clinical trial was to evaluate the effect in the tooth color change with the violet LED(405nm) used to in-office bleaching, risk of sensitivity and use of medication after bleaching, quality of life, histomorphological alteration in gingival tissue and presence of cytokine IL-6 in crevicular gingival fluid Methods: Eighty patients were randomized into 4 groups (n = 20): G1 violet LED, G2 violet LED + 35% carbamide peroxide (CP),G3 35%CP e G4 35% hydrogen peroxide (HP). Separately the G5 (n=13) received whitening treatment with Violet LED followed by collection of gingival crevicular fluid (FCG) and gingivoplasty (inclusion criteria). For the groups G1-4 the color was measured at baseline,15 and 180 days follow-up by spectrophotometer Easyshade V. The color change was analyzed by ΔL, Δa e Δb (CieLab system). The sensitivity was reported by VAS and the quality of life by Psychosocial Impact Questionnaire on Dental Aesthetics (PIDAQ). For G5 was analyzed morfologic change and cytocine IL-6 in fluid crevicular gingival in the split mouth model. Results: The Analyse for ΔL, G4 and G2 showed showed brighter than G1 and G3 (p<0.05), implying that G2 is at least as good as G4 (p>0.05). For Δa, G4 showed better results being different from all the others groups (p<0.05). For Δb, both G4 and G2 showed greater tendency towards blue color than groups G1 and G3 (p<0.05). Only G4 showed sensitivity in the 24 hours and stoped after 48 hours. For this group, 33% of patients needed to take painkillers in the first 24h n the 3 treatment sessions. In PIDAQ, there was no statistically significant difference over time for all groups (p> 0,05). The histomorphological analysis and cytokine IL-6 were similar both sides (p>0,05). Conclusion: All the groups showed color change and the G4 had the better result; only the G4 showed sensitivity and used painkillers after tooth whitening; there is no need to use a gingival barrier protection for whitening with violet LED and all treatments suggested an improvement in quality of life.