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

Clin Oral Investig. 2021 Dec;25(12):6623-6632. doi: 10.1007/s00784-021-03948-y. Epub 2021 Apr 22.

Abstract

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.

Keywords: Colorimetry; Hydrogen peroxide; Opioid analgesics; Tooth bleaching; Tooth sensitivity.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Dentin Sensitivity* / drug therapy
  • Dentin Sensitivity* / prevention & control
  • Humans
  • Hydrogen Peroxide / therapeutic use
  • Pharmaceutical Preparations*
  • Tooth Bleaching Agents* / therapeutic use
  • Tooth Bleaching*
  • Tooth*
  • Treatment Outcome

Substances

  • Analgesics
  • Anti-Inflammatory Agents
  • Pharmaceutical Preparations
  • Tooth Bleaching Agents
  • Hydrogen Peroxide