Fatores preditores da eficácia e sensibilidade no clareamento dentário

Abstract

Objectives: This study aimed to identify predictive factors related to teeth whitening outcomes and the risk of tooth sensitivity caused by dental bleaching. The analysis utilized pooled data from 16 clinical trials conducted by the same research group. Materials and Methods: The individual patient data (n=841) in 16 published and ongoing clinical trials on tooth whitening, conducted by the whitening research group at the Faculty of Dentistry of the Federal University of Amazonas (Manaus, Amazonas, Brazil), were collected and retrospectively analyzed. Data relating to the characteristics of the intervention groups, as well as outcomes related to the incidence of sensitivity and proportion of patients with a variation of five units or more in delta E (BERSEZIO et al., 2018)) were entered into the Stata SE software, version 17.0. Initially, pooling proportions were obtained through meta-analyses of the multiple study groups, through a random effects model using the method of DerSimonian and Laird, estimating heterogeneity from the inverse-variance fixed-effect model (metaprop command). The results were presented in forest plots. Once the presence of heterogeneity between the study groups was identified, meta-regression analyzes were performed to identify the studies covariates that explained heterogeneity in the treatment effects (metareg command). Results: For color, a significant relationship was detected between the initial color difference and the patient's age (P<0.001). The analysis shows that an increase of one unit in the ratio between the number of female and male participants implies a relative increase of 9.8% in risk. Home whitening presented a 23.6% lower risk than in-office whitening and each unit increase in pH resulted in an 11.5% reduction in the risk of sensitivity. An increase of one unit in the pH of the gel implies a relative increase of 9.1% in effectiveness. Studies with a median age of participants equal to or greater than 23 years were 8.2% less effective than studies with participants with a younger median age. Conclusion: Younger patients and those with darker teeth exhibited greater whitening effectiveness, while patients with previous sensitivity and those who conducted a higher number of applications per whitening session demonstrated a higher risk of sensitivity.