Clareamento dental: longevidade, qualidade de vida relacionada à saúde bucal e impacto da estética dental

Abstract

Tooth whitening is considered an effective treatment for patients who want to improve the aesthetics of their teeth. This aesthetic treatment must be in accordance with the patient's expectations in order to satisfy their needs and desires. This study aimed to evaluate the longevity of tooth whitening, the Impact on Oral Health-Related Quality of Life (HRQoL) and the Psychosocial Impact of patients with the tooth bleaching treatment. This was an observational, longitudinal, retrospective study. Individuals undergoing tooth whitening after five years of follow-up were evaluated at the outpatient clinic of the Faculty of Dentistry of UFAM. For longevity, tooth color was evaluated using subjective (Vita Classical, Vita BleachedGuide scale) and objective (spectrophotometer) scales. The HRQoL and the psychosocial impact of dental esthetics were assessed using the instruments Oral Health Impact Questionnaire -14, Oral Health Impact Questionnaire–Aesthetic and the Psychosocial Impact of Dental Esthetics Questionnaire. A total of 162 medical records were evaluated, in which 72 patients answered the questionnaires and attended the follow-up and 20 patients answered only the questionnaires, totaling 92 patients evaluated at the end of the study. Five studies were evaluated in total (four corresponded to in-office bleaching and one to at-home bleaching). Outcomes were evaluated using the Shapiro-Wilk test, rejecting the null hypothesis of data normality (p<0.05). Then, the Wilcoxon non-parametric paired test was used to assess whether the OHIP and OHIP-Aes scores differed between study times, as well as nonlinear regression analyzes to test the association of clinical measures of longevity (ΔE and ΔSGU) with the bleaching technique and psychosocial variables. The significance level established for all tests was 0.05. The OHIP and OHIP-Aes scores differed between baseline and end of treatment (p<0.001), however no difference was found between the end of treatment and five years of follow-up (OHIP, p=0.067; OHIP-Aes, p=0.287), evidencing that the improvement in the instrument score was maintained throughout the follow-up period. Individuals who had better clinical longevity reported higher scores in the PIDAQ dental self-confidence domain. A difference in longevity was identified by ΔSGU according to the bleaching technique. Individuals submitted to the at-home bleaching technique showed a smaller increase in the indicator over the follow-up period. It can be concluded that there was no difference in terms of longevity between at-home bleaching and in-office bleaching. In addition, patients with better clinical longevity had better scores on the dental self-confidence factor on the PIDAQ questionnaire. Patients maintained their scores on the OHIP and OHIP-Aes questionnaires, suggesting a positive impact on quality of life.