家用漂白剂和浓度对漂白效果的影响：系统综述和网络荟萃分析。

IF 4.8 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-06-01 DOI:10.1016/j.jdent.2025.105857

Renata Maria Oleniki Terra , Michael Willian Favoreto , Tom Morris , Alessandro D. Loguercio , Alessandra Reis

{"title":"家用漂白剂和浓度对漂白效果的影响：系统综述和网络荟萃分析。","authors":"Renata Maria Oleniki Terra , Michael Willian Favoreto , Tom Morris , Alessandro D. Loguercio , Alessandra Reis","doi":"10.1016/j.jdent.2025.105857","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>This systematic review and network meta-analysis (NMA) aimed to compare the efficacy of at-home bleaching agents and concentrations in patients with permanent dentition (PROSPERO 2021 CRD42021265220).</div></div><div><h3>Data</h3><div>Randomized clinical trials (RCTs) comparing any two at-home bleaching systems were considered eligible. A Bayesian NMA was conducted for color change (ΔE, ΔSGU) to compare different carbamide peroxide (CP) or hydrogen peroxide (HP) concentrations. The risk of bias (RoB) was assessed using the Cochrane tool 2.0 and the quality of evidence (QoE) with the GRADE approach.</div></div><div><h3>Sources</h3><div>A comprehensive search was conducted in PubMed, Cochrane Central, LILACS/BBO, SCOPUS, Web of Science, EMBASE, and grey literature.</div></div><div><h3>Study selection/Results</h3><div>81 studies were eligible and 53 included in the NMA. A high RoB was observed in most studies included. No statistically significant differences were found in most of the comparisons, except for the extreme concentrations. For ΔE: CP 5 % vs. CP 15–17 % (mean difference, [95 % CrI]: -3.36 [-6.53 to -0.22]); HP 2–4 % vs. CP 15–17 % (-1.85 [-3.63 to -0.08]); CP 5 % vs. CP 35–37 % (-4.23 [-8.21 to -0.22]). For ΔSGU: HP 14–16 % vs. CP 5 % (4.66 [0.27 to 9.01]); HP 14–16 % vs. HP 2–4 % (4.06 [0.74 to 7.46]). The QoE was low.</div></div><div><h3>Conclusions</h3><div>Most at-home agents showed similar bleaching efficacy (ΔE, ΔSGU), except when the highest and lowest concentrations were compared one another with a low QoE. Further well-designed, low-bias RCTs is essential to achieve higher QoE.</div></div><div><h3>Clinical Significance</h3><div>Low-certainty evidence points to similar efficacy of most at-home bleaching agents across concentrations, suggesting their clinical versatility in dental practice.</div></div>","PeriodicalId":15585,"journal":{"name":"Journal of dentistry","volume":"160 ","pages":"Article 105857"},"PeriodicalIF":4.8000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of at-home agents and concentrations on bleaching efficacy: A systematic review and network meta-analysis\",\"authors\":\"Renata Maria Oleniki Terra , Michael Willian Favoreto , Tom Morris , Alessandro D. Loguercio , Alessandra Reis\",\"doi\":\"10.1016/j.jdent.2025.105857\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction/Objectives</h3><div>This systematic review and network meta-analysis (NMA) aimed to compare the efficacy of at-home bleaching agents and concentrations in patients with permanent dentition (PROSPERO 2021 CRD42021265220).</div></div><div><h3>Data</h3><div>Randomized clinical trials (RCTs) comparing any two at-home bleaching systems were considered eligible. A Bayesian NMA was conducted for color change (ΔE, ΔSGU) to compare different carbamide peroxide (CP) or hydrogen peroxide (HP) concentrations. The risk of bias (RoB) was assessed using the Cochrane tool 2.0 and the quality of evidence (QoE) with the GRADE approach.</div></div><div><h3>Sources</h3><div>A comprehensive search was conducted in PubMed, Cochrane Central, LILACS/BBO, SCOPUS, Web of Science, EMBASE, and grey literature.</div></div><div><h3>Study selection/Results</h3><div>81 studies were eligible and 53 included in the NMA. A high RoB was observed in most studies included. No statistically significant differences were found in most of the comparisons, except for the extreme concentrations. For ΔE: CP 5 % vs. CP 15–17 % (mean difference, [95 % CrI]: -3.36 [-6.53 to -0.22]); HP 2–4 % vs. CP 15–17 % (-1.85 [-3.63 to -0.08]); CP 5 % vs. CP 35–37 % (-4.23 [-8.21 to -0.22]). For ΔSGU: HP 14–16 % vs. CP 5 % (4.66 [0.27 to 9.01]); HP 14–16 % vs. HP 2–4 % (4.06 [0.74 to 7.46]). The QoE was low.</div></div><div><h3>Conclusions</h3><div>Most at-home agents showed similar bleaching efficacy (ΔE, ΔSGU), except when the highest and lowest concentrations were compared one another with a low QoE. Further well-designed, low-bias RCTs is essential to achieve higher QoE.</div></div><div><h3>Clinical Significance</h3><div>Low-certainty evidence points to similar efficacy of most at-home bleaching agents across concentrations, suggesting their clinical versatility in dental practice.</div></div>\",\"PeriodicalId\":15585,\"journal\":{\"name\":\"Journal of dentistry\",\"volume\":\"160 \",\"pages\":\"Article 105857\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of dentistry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S030057122500301X\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of dentistry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S030057122500301X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

摘要

简介/目的：本系统综述和网络荟萃分析（NMA）旨在比较家用漂白剂和浓度在恒牙患者中的效果（PROSPERO 2021 CRD42021265220）。数据：随机临床试验（rct）比较任何两种家庭漂白系统被认为是合格的。对颜色变化进行贝叶斯NMA （ΔE， ΔSGU）以比较不同过氧化脲（CP）或过氧化氢（HP）浓度。采用Cochrane工具2.0评估偏倚风险（RoB），采用GRADE方法评估证据质量（QoE）。资料来源：在PubMed， Cochrane Central, LILACS/BBO， SCOPUS, Web of Science， EMBASE和灰色文献中进行了全面的搜索。研究选择/结果：81项研究符合条件，53项纳入NMA。在包括的大多数研究中观察到较高的RoB。除了极端浓度外，在大多数比较中没有发现统计学上的显著差异。ΔE: CP 5% vs. CP 15-17%（平均差异，[95% CrI]: -3.36[-6.53至-0.22]）；HP 2-4% vs. CP 15-17%(-1.85[-3.63至-0.08])；CP 5% vs. CP 35-37%（-4.23[-8.21至-0.22]）。ΔSGU: HP 14-16% vs. CP 5%(4.66[0.27至9.01])；HP 14-16% vs. HP 2-4%（4.06[0.74至7.46]）。QoE较低。结论：大多数家用漂白剂表现出相似的漂白效果（ΔE， ΔSGU），除了最高和最低浓度相互比较时，QoE较低。进一步设计良好、低偏倚的随机对照试验对于获得更高的QoE至关重要。临床意义：低确定性证据表明，大多数家用漂白剂在不同浓度下的效果相似，这表明它们在牙科实践中的临床多功能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Effect of at-home agents and concentrations on bleaching efficacy: A systematic review and network meta-analysis

Introduction/Objectives

This systematic review and network meta-analysis (NMA) aimed to compare the efficacy of at-home bleaching agents and concentrations in patients with permanent dentition (PROSPERO 2021 CRD42021265220).

Data

Randomized clinical trials (RCTs) comparing any two at-home bleaching systems were considered eligible. A Bayesian NMA was conducted for color change (ΔE, ΔSGU) to compare different carbamide peroxide (CP) or hydrogen peroxide (HP) concentrations. The risk of bias (RoB) was assessed using the Cochrane tool 2.0 and the quality of evidence (QoE) with the GRADE approach.

Sources

A comprehensive search was conducted in PubMed, Cochrane Central, LILACS/BBO, SCOPUS, Web of Science, EMBASE, and grey literature.

Study selection/Results

81 studies were eligible and 53 included in the NMA. A high RoB was observed in most studies included. No statistically significant differences were found in most of the comparisons, except for the extreme concentrations. For ΔE: CP 5 % vs. CP 15–17 % (mean difference, [95 % CrI]: -3.36 [-6.53 to -0.22]); HP 2–4 % vs. CP 15–17 % (-1.85 [-3.63 to -0.08]); CP 5 % vs. CP 35–37 % (-4.23 [-8.21 to -0.22]). For ΔSGU: HP 14–16 % vs. CP 5 % (4.66 [0.27 to 9.01]); HP 14–16 % vs. HP 2–4 % (4.06 [0.74 to 7.46]). The QoE was low.

Conclusions

Most at-home agents showed similar bleaching efficacy (ΔE, ΔSGU), except when the highest and lowest concentrations were compared one another with a low QoE. Further well-designed, low-bias RCTs is essential to achieve higher QoE.

Clinical Significance

Low-certainty evidence points to similar efficacy of most at-home bleaching agents across concentrations, suggesting their clinical versatility in dental practice.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.