家用漂白剂及其浓度对牙齿敏感性的影响：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 : 2025-06-06 DOI:10.1016/j.jdent.2025.105891

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

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引用次数: 0

摘要

本系统综述和网络荟萃分析（NMA）评估了永久性牙列患者使用家用漂白剂的牙齿敏感（TS）风险和强度以及浓度（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。贝叶斯NMA评估不同过氧化氢（HP）和过氧化脲（CP）浓度下TS的风险和强度，采用两种疼痛量表：0-10视觉模拟量表（VAS）和0-4数值评定量表（NRS）。采用Cochrane协作2.0工具评估偏倚风险（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：纳入77项研究，其中50项符合meta分析。大多数研究的RoB都很高。NMA显示CP 20-22%和HP 14-16%比HP 2-4%的TS风险更高（RR [95% CrI]: 2.8 [1.15-8.16], 2.9 [1.06-9.21]）， CP 20-22%比CP 10-11%（2.0[1.07-4.31]）。在NRS量表上，CP 20-22% （MD [95% CrI]: 0.51[0.14-0.91]）和HP 7-8%（0.50[0.10-0.84]）的TS强度高于CP 10-11%。VAS评分差异无统计学意义。QoE较低。结论：较高的家用漂白浓度增加了TS的风险和强度，平均而言，所有漂白剂和浓度对TS的影响都是轻微的。由于低QoE和研究方案的可变性，研究结果应谨慎解释。临床：意义：家用漂白剂通常导致低牙齿敏感性。然而，较高浓度（如HP 14-16%和CP 20-22%）与较低浓度（如CP 10%）相比，可能会略微增加风险，因此应谨慎用药并在更密切的监督下使用。

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

Introduction/objectives

This systematic review and network meta-analysis (NMA) evaluated the risk and intensity of tooth sensitivity (TS) 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 assessed TS risk and intensity for different hydrogen peroxide (HP) and carbamide peroxide (CP) concentrations, using two pain scales: the 0–10 Visual Analog Scale (VAS) and the 0–4 Numerical Rating Scale (NRS). The risk of bias (RoB) was assessed using the Cochrane Collaboration’s tool 2.0, and the quality of evidence (QoE) was evaluated by 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

77 studies were included, and 50 of these were eligible for meta-analysis. Most studies had high RoB. The NMA showed a higher TS risk with CP 20–22 % and HP 14–16 % compared to HP 2–4 % (RR [95 % CrI]: 2.8 [1.15–8.16], 2.9 [1.06–9.21]) and CP 20–22 % vs. CP 10–11 % (2.0 [1.07–4.31]). On the NRS scale, CP 20–22 % (MD [95 % CrI]: 0.51 [0.14–0.91]) and HP 7–8 % (0.50 [0.10–0.84]) had greater TS intensity than CP 10–11 %. No statistically significant differences were found on the VAS scale. The QoE was low.

Conclusions

High at-home bleaching concentrations increase the risk and intensity of TS. On average, TS is mild for all bleaching agents and concentrations. The findings should be interpreted cautiously due to the low QoE and variability in the study protocols.

Clinical significance

At-home bleaching agents typically cause low tooth sensitivity. However, higher concentrations, such as HP 14–16 % and CP 20–22 %, may slightly increase the risk compared to lower concentrations like CP 10 %, and should be prescribed with care and under closer supervision.

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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.