Operative dentistry最新文献

{"title":"Effect of Water Flow on Bond Strength of Zirconia to Tooth Structure.","authors":"R V Monteiro, E Brown, J Itani, V S Bona, C Oliveira-Santos, D Donatelli, G M De Souza","doi":"10.2341/24-092-L","DOIUrl":"10.2341/24-092-L","url":null,"abstract":"<p><p>Bond strength tests are used as predictors of the clinical longevity of dental restorations. However, the aging of bond strength specimens is often simulated with static water storage, even though the saliva flows over teeth and restorations in the mouth. This study investigated the effect of water under static and flow conditions on the bond strength between zirconia and tooth structure using different test designs. Ninety human molars with prepared flat dentin surfaces were randomly divided into three groups according to the test design: Tensile, Shear, and Crown pull-off. The Crown pull-off group received additional standard full crown preparations. Zirconia specimens milled according to the shape of each test design (n=30) were bonded to the tooth structure using resin cement. There were three subgroups (n=10) according to the artificial aging procedure: NA - no aging (24 hours); SW - static water (30 days); FW - water flow (30 days). Bond strength was assessed using a universal testing machine, and the load at failure was recorded. Data were analyzed using two-way ANOVA and Tukey post hoc tests (α=0.05), and the mode of failure was also classified. Two-way ANOVA revealed a significant effect of the test design (p<0.001). However, no effect was observed for the aging procedure (p=0.166). The interaction aging*test design was significant (p=0.019). FW significantly decreased the retention of zirconia crowns to tooth structure (p<0.05) but did not affect the other test design specimens. The mode of failure was adhesive (100%) at the zirconia/cement interface for all specimens and aging conditions, except for Crown pull-off / FW, which were predominantly mixed (60%). FW negatively affected the retention of Y-PSZ crowns to the tooth structure.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":"50 4","pages":"410-419"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of a Combination of Catalysts to Improve the Outcomes of In-office Bleaching.","authors":"Lmb Esteves, C A de Souza Costa, J A da Fonseca Leopoldo, J K Silva Bezerra, R A de Oliveira Ribeiro, Kmc Aidar, T C Fagundes, Alf Briso","doi":"10.2341/24-167-L","DOIUrl":"10.2341/24-167-L","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of this study were to investigate (1) whether the addition of catalytic enzymes and violet LED light to the conventional in-office hydrogen peroxide (H2O2) bleaching protocol could improve esthetic results in a shorter time and (2) whether these strategies could minimize adverse effects on the enamel surface and the diffusion of H2O2 through the tooth structure.</p><p><strong>Methods: </strong>120 bovine dental discs were divided into two study phases. In phase I, 60 sectioned specimens were pigmented with black tea for analysis of chromatic change, bleaching index, and trans-amelodentinal diffusion. In phase II, 60 unpigmented specimens were evaluated for enamel roughness and microhardness. In both phases, the specimens were divided into four groups (n=15): NC (negative control): no treatment; G45: 35% H2O2 bleaching gel for 45 minutes; GT: 35% H2O2 bleaching gel with peroxidase enzyme for 15 minutes on enamel previously covered with a polycaprolactone nanofiber mesh scaffold; GTL: Same procedure as GT, irradiated with violet LED light for 15 minutes. Esthetic efficacy (ΔE00 and WID) was analyzed in three sessions (T1, T2, T3) and 7 days (T4) after treatment, and H2O2 diffusion was evaluated at T1 (phase I). In phase II, the specimens were evaluated for microhardness and surface roughness at T0 and T4. For the analysis of microhardness, roughness and chromatic alteration, a Two-Factor ANOVA with Repeated Measures was used to evaluate the groups over time, while H2O2 diffusion was analyzed by One-Way ANOVA.</p><p><strong>Results: </strong>GTL promoted the greatest change in ΔE00 in all sessions; however, ΔWID in GTL did not differ from G45 at T3 and T4. The diffusion of H2O2 in GT was 69% lower than G45. The enamel microhardness and roughness of the GT and NC groups were not altered by treatments, but were significantly worse in G45.</p><p><strong>Conclusion: </strong>When compared with conventional in-office whitening alone, the strategies tested achieved the same esthetic results in two-thirds less time, reduced alterations to the enamel surface, and reduced the trans-amelodentinal diffusion of H2O2.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":"50 4","pages":"390-401"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Margin Integrity of Experimental and Commercial Ion-releasing Restorative Materials.","authors":"P Burrer, A Costermani, M Par, T Attin, T T Tauböck","doi":"10.2341/24-042-L","DOIUrl":"10.2341/24-042-L","url":null,"abstract":"<p><strong>Objective: </strong>To investigate marginal integrity of experimental and commercial ion-releasing restorative materials before and after thermomechanical loading (TML).</p><p><strong>Methods: </strong>Standardized mesio-occlusal-distal (MOD) cavities (mesial margins 1 mm below the CEJ, distal margins 1 mm above the CEJ) were restored using six materials, following the manufacturer-recommended adhesive pretreatment, if applicable. One conventional, non-ion-releasing restorative material, Ceram.x Spectra ST (HV) (Dentsply Sirona, Charlotte, NC, USA), and five ion-releasing restorative materials were used (n=8 per group). Four of the ion-releasing materials were commercially available: Cention Forte (Ivoclar Vivadent, Schaan, Liechtenstein), Beautifil II LS (Shofu, Kyoto, Japan), ACTIVA BioACTIVE-RESTORATIVE (Pulpdent, Watertown, MA, USA), and Surefil one (Dentsply Sirona). In addition, an experimental resin composite restorative material with a fluoride-modified bioactive glass was specially produced for use in this study. TML was applied (1.2 M loading cycles, 1.7 Hz, 49 Newtons; 3000 thermal cycles, 5°C-50°C). Restoration margins were assessed before and after TML using scanning electron microscopy (200× magnification) and classified as continuous, noncontinuous, or nonjudgeable. Margin integrity was quantitatively expressed as the percentage of continuous margins in relation to the total measurable margin length. Data were analyzed using Wilcoxon signed-rank and Kruskal-Wallis tests, followed by Dunn post hoc tests and Bonferroni correction and Mann-Whitney U tests (α=0.05).</p><p><strong>Results: </strong>Each group exhibited significantly reduced marginal integrity after TML. The experimental resin composite showed the significantly highest continuous enamel margins before TML, whereas Surefil one had the lowest (p<0.001). Margin integrity in dentin did not differ significantly among groups (all p=0.236).</p><p><strong>Conclusions: </strong>The experimental resin composite with a fluoride-modified bioactive glass exhibited marginal integrity similar or superior to a conventional resin composite, while the self-adhesive resin composite Surefil one displayed the lowest marginal adaptation of all groups in enamel.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":"50 4","pages":"443-457"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Specimen Pre-staining on In Vitro Whitening Efficacy of Hydrogen Peroxide Gels.","authors":"A B Borges, K C Dos Santos, D F da Silva, V C Bottesini, Crg Torres, M C Mailart","doi":"10.2341/24-142-L","DOIUrl":"10.2341/24-142-L","url":null,"abstract":"<p><strong>Objectives: </strong>Various in vitro approaches have been used to evaluate whitening efficacy, utilizing both stained and non-stained tooth substrates, which may influence the outcomes. This study aimed to assess the effect of previous in vitro staining on whitening efficacy and the enamel surface using hydrogen peroxide (HP) gels with different concentrations.</p><p><strong>Methods: </strong>Bovine enamel/dentin specimens (n=16) were randomly allocated into groups according to the HP concentration [20% (HP20), 30% (HP30), 40% (HP40), and deionized water (negative control)]; and substrate condition (non-stained or stained). Tooth color was measured using a spectrophotometer, and the color difference (ΔE00) and whiteness index (WID and ΔWID) were calculated. Knoop surface microhardness (SMH) and roughness (Ra) of enamel were assessed at different times. Data from both non-stained and stained substrates were analyzed using ANOVA and Tukey post hoc tests (α<0.05).</p><p><strong>Results: </strong>Significant differences were observed in ΔE00 for different HP concentrations and substrate conditions (p<0.001). Greater tooth color change was found for HP 40, followed by HP30 and HP20. Stained groups exhibited higher ΔE00 values than non-stained ones, except for HP20. Higher values of ΔWID were observed in stained/bleached groups. The staining process reduced SMH and increased Ra.</p><p><strong>Conclusions: </strong>The bleaching patterns were similar for both non-stained and stained substrates, with higher concentrations of HP bleaching gels resulting in greater tooth color difference. Previous staining increased the variation in whiteness values (ΔWID) following bleaching, but specimens maintained a lower whiteness index after bleaching compared to the non-stained substrate. Staining induced alterations on the enamel surface. These factors indicate that pre-staining of specimens is not essential to evaluate the whitening efficacy of bleaching gels.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":" ","pages":"420-430"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of In-office Bleaching Gel One Week After Mixing: A Randomized Clinical Trial.","authors":"I M de Freitas, T S Carneiro, H Forville, M W Favoreto, M Wendlinger, R Ñaupari-Villasante, Sep Gonçalves, L Vallejo-Izquierdo, A D Loguercio","doi":"10.2341/24-115-C","DOIUrl":"10.2341/24-115-C","url":null,"abstract":"<p><strong>Objective: </strong>This randomized clinical trial aimed to evaluate the efficacy, risk and intensity of tooth sensitivity (TS) and gingival irritation (GI), and esthetic self-perception of in-office dental bleaching using a bleaching gel 1 week after mixing.</p><p><strong>Methods and materials: </strong>Forty subjects underwent in-office bleaching with 40% hydrogen peroxide (Opalescence Boost PF, Ultradent). In a splitmouth design, each maxillary hemiarch received bleaching gel that was mixed during, or 1 week before, the treatment session. The bleaching procedure was performed in two sessions of 40 minutes with a 7-day interval. Tooth color was assessed before treatment, and 1 week, 2 weeks, and 1 month after the end of bleaching, using a digital spectrophotometer (Vita Easyshade; ΔEab, ΔE00, and ΔWID) and subjective scales (Vita Classical and Vita Bleachedguide; ΔSGU). The risk and intensity of TS and GI were recorded using a Visual Analogue Scale (0-10). Esthetic self-perception was assessed using the Orofacial Esthetic Scale (0-10).</p><p><strong>Results: </strong>Satisfactory bleaching was achieved in both groups, with no significant differences for objective (ΔEab, ΔE00, and ΔWID; p>0.72) or subjective (ΔSGU [shade guide units], p>0.84) color assessments. No significant differences were found in the risk and intensity of TS (p=0.79; p=0.67) or GI (p=1.0; p=0.85). Patients' esthetic self-perceptions changed after the procedure (p<0.009), mainly on the tooth color question (p<0.001).</p><p><strong>Conclusion: </strong>In-office dental bleaching with Opalescence Boost PF 40% remained effective, without differences in risk and intensity of TS and GI, even 1 week after mixing.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":"50 4","pages":"358-368"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Polishing Systems on Surface Roughness of Universal Resin Composites.","authors":"G A Maghaireh, H Alzraikat, R Hameed","doi":"10.2341/24-183-L","DOIUrl":"10.2341/24-183-L","url":null,"abstract":"<p><strong>Rationale: </strong>Polishing of resin composites ensures optimal esthetics and longevity. Effective polishing techniques for conventional multi-shade resin composites are well documented. However, less is known regarding acceptable polishing for newer single-shade universal resin composites.</p><p><strong>Objective: </strong>This study compared the surface roughness of five universal resin composites (Omnichroma, Neo Spectra, Charisma Diamond One, One Shade) and one conventional multi-shade resin composite (Palfique Asteria) following the use of three polishing systems (one-step, Enhance PoGo; two-step, EVE Diacomp Plus Twist; three-step, Sof-Lex) and Mylar strip (without polishing).</p><p><strong>Methods: </strong>A total of 240 specimens were prepared (n=40 for each resin composite). The specimens were grouped into four subgroups (n=10) based on the polishing system applied. The surface roughness of all specimens was evaluated using a non-contact three-dimensional optical profilometer. One randomly selected specimen from each subgroup underwent scanning electron microscope examination.</p><p><strong>Results: </strong>Surface roughness was significantly affected by the resin composite type and the polishing system used (p<0.05). The study groups were ranked by surface roughness, from lowest to highest, across all tested materials as follows: Mylar strip < Enhance PoGo < Sof-Lex < EVE Diacomp. The surface roughness values of the universal resin composites were comparable to the multi-shade nanofilled resin composite in all polishing systems.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":"50 4","pages":"431-442"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Delayed Material Placement on In Vivo Intrapulpal Temperature Rise in Class V Resin Composite Restorations.","authors":"C Maucoski, Jag Guarneri, P Runnacles, D C Zarpellon, U Coelho, F A Rueggeberg, Cag Arrais","doi":"10.2341/23-167-C","DOIUrl":"10.2341/23-167-C","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the effect of delay of the etch-and-rinse bonding procedure on in vivo real-time intrapulpal temperature during restoration of Class V preparations on human premolars.</p><p><strong>Methods and materials: </strong>Intact premolars planned for orthodontic extraction from 11 volunteers received infiltrative anesthesia and were isolated using a dental dam. An occlusal preparation was performed using a high-speed diamond bur with air-water spray until obtaining minimal pulp exposure, followed by insertion of a sterile thermocouple probe. A buccal Class V preparation was made using a high-speed diamond bur cooled using air-water spray. To simulate the time spent on caries removal, material placement was delayed 15 minutes until physiologic pulpal temperature (PT) was reestablished (approximately 35°C). Preparations were acid etched and rinsed. A two-step etch-and-rinse bonding agent, Single Bond Universal (Solventum, St. Paul, MN, USA) or Tetric Nano Bond (Ivoclar Vivadent, Schaan, Lichtenstein), was applied and photocured following manufacturers' instructions. The teeth were restored using conventional (Filtek Z250 or Filtek Z350, Solventum) or bulk-fill (Tetric N Ceram Bulk-fill, Ivoclar Vivadent) resin composites, which were photocured with a dual-peak LED light-curing unit (Bluephase 20i, Ivoclar Vivadent). Peak PT and ΔT values were analyzed using two-way repeated measures ANOVA and Bonferroni post hoc tests.</p><p><strong>Results: </strong>Etch-and-rinse and solvent evaporation procedures reduced PT, despite restoration starting at physiologic PT. Only the 40-second exposure of Filtek Z350 resulted in significantly higher peak PT values compared to baseline (38.2°C ± 2.4°C). ΔT values for Z250 were not significantly different from those for Tetric N-Ceram Bulk-fill.</p><p><strong>Conclusion: </strong>Even when etch-and-rinse bonding procedures started at physiologic PT, PT decreased, preventing harmful levels of temperature rise in the pulp.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":"50 4","pages":"380-389"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities Lost.","authors":"Fred Eichmiller","doi":"10.2341/1559-2863-50-4-347","DOIUrl":"https://doi.org/10.2341/1559-2863-50-4-347","url":null,"abstract":"","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":"50 4","pages":"347"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Longevity of Complex Direct Posterior Resin Composite and Amalgam Restorations: A Systematic Review and Meta-analysis.","authors":"Mjmc Santos, S Saadaldin, Hmc Rêgo, N Tayan, N M Melo, M El-Najar","doi":"10.2341/24-007-LIT","DOIUrl":"10.2341/24-007-LIT","url":null,"abstract":"<p><strong>Objective: </strong>The use of resin composites (RC) for complex restorations, including those involving cusp coverage, has increased dramatically in recent years. However, reports in the literature regarding the performance of posterior multisurface RC and amalgam (AM) restorations show conflicting results. This systematic review and meta-analysis aims to assess the clinical performance of complex (involving two or more surfaces) direct posterior resin composite and amalgam restorations in permanent teeth.</p><p><strong>Methods: </strong>Inclusion criteria were for prospective randomized controlled trials (RCTs) of multisurface direct RC and AM restorations of permanent posterior teeth with a follow-up period of three years or more. The trials needed to include a minimum of 20 restored teeth for each evaluated material. Retrospective studies, studies lacking survival rates or clearly reported reasons for failure, and those with unclear randomization methods were excluded. Five bibliographic databases (Medline-OVID, Embase, Cochrane Library, Web of Science, and LILACS [Latin American and Caribbean Health Sciences Literature Database]) and manual searches were screened. The Cochrane Risk of Bias Tool was used to assess the included studies. Random-effects meta-analyses were conducted using the Freeman-Tukey double arcsine transformation and the DerSimonian-Laird random-effects model to evaluate restorative failures and compare the survival of AM and RC restorations.</p><p><strong>Results: </strong>From the 6303 identified studies, 198 underwent meticulous examination, and 15 RCTs met the inclusion criteria. Only two studies compared AM and RC restorations. Although the combined data from these studies showed a trend toward higher failure rates in multisurface RC restorations, the difference was not statistically significant (p=0.06). The most common reasons for the failure of RC restorations were secondary caries, restoration fracture, and tooth fracture. For AM, the most common reasons for failure were secondary caries and tooth fracture.</p><p><strong>Conclusions: </strong>The quality of the evidence was low. The scarcity of studies comparing RC and AM in complex restorations has resulted in insufficient evidence to substantiate superior performance by either material.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":" ","pages":"E30-E46"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At-home vs In-office Bleaching: An Updated Systematic Review and Meta-analysis.","authors":"J L de Geus, Acr Martins, A Reis, M Rezende","doi":"10.2341/24-078-LIT","DOIUrl":"10.2341/24-078-LIT","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a systematic review and meta-analysis to compare the efficacy, risk, and intensity of tooth sensitivity of at-home and in-office bleaching. This is an update of a systematic review first published in 2016, adding new evidence.</p><p><strong>Methods and materials: </strong>A comprehensive search was performed in seven databases, including MEDLINE, EMBASE, and Cochrane Library. Additionally, other sources were screened manually for any additional trials, and the reference lists and citation lists of included trials and relevant reviews were manually searched. WE included randomized clinical trials that compared the risk intensity of tooth sensitivity or bleaching efficacy of in-office and at-home treatments in adult patients. After data extraction and risk of bias assessment, mean differences or relative risks and the corresponding 95% confidence intervals were calculated and assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>A total of 910 articles were identified via databases and registers. After title and abstract screening, 11 studies remained. In addition, another 11 records were identified through websites, organizations, and citation searches. Including the previous studies from the earlier systematic review, 26 studies remained for qualitative analyses and 23 for meta-analysis. In 2024, six studies were added, totaling 32 studies included for qualitative analysis. The intensity of tooth sensitivity was significantly lower for at-home bleaching (standardized mean difference [SMD] -0.78; 95% confidence interval [CI] -1.53 to -0.03; p=0.04). There was no significant difference in the risk of tooth sensitivity (relative risk [RR] 0.82; 95% CI 0.61 to 1.10; p=0.19) or bleaching efficacy in ΔSGU (SMD 0.04; 95% CI -0.17 to 0.25; p=0.68). The color change in ΔE was significantly higher for at-home bleaching (SMD 0.49; 95% CI 0.14 to 0.84; p=0.006).</p><p><strong>Conclusion: </strong>Although there was a difference in the intensity of tooth sensitivity and color change in ΔE favoring at-home bleaching, the quality of the evidence was considered low. Neither the risk of tooth sensitivity nor the color change in shade guide units (ΔSGU) was influenced by the bleaching technique.</p>","PeriodicalId":19502,"journal":{"name":"Operative dentistry","volume":" ","pages":"E47-E69"},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}