ESTUDO LABORATORIAL E CLÍNICO DE DOIS AGENTES CLAREADORES EM PACIENTES COM APARELHO ORTODÔNTICO FIXO

Abstract

This study was evaluated clinically and laboratorially the effects of the application of two types of bleaching agents, Tréswhite Ortho (TWO) and Trés white Supreme (TWS) in patients with fixal orthodontic appliance. In the laboratorial study 50 healthy human teeth were used. For the microhardness, roughness and AFM tests, 60 enamel fragments, obtained from the crowns of 20 molars were divided depending on the treatment TWO and TWS (n=10). For each test it was performed a baseline measurement and a one week after treatment measurement. For the permeability test 30 healthy human premolars were used, divided into three groups: TWO, TWS and CTRL (SA). The variability of the pH of TWO and TWS was analyzed. For the clinical study 40 patients with fixal orthodontic appliance were recruited and divided into two groups TWO and TWS (n=20) , for each patient a color measurement was performed before the treatment and one week after the treatment; for the evaluation of sensitivity the patients received orientation in order to fill a NRS101 form before, during and after the treatment. After these tests, the normality of the obtained results was analyzed by using Kolmogorov Smirnov and Shapiro-Wilk tests. In the laboratorial assessment, there was a significant reduction on the microhardness values when compared with the initial measurements; for the roughness test there was a significant decrease on the (Ra) values when compared with the initial values for the TWO group, for the TWS group non significant alterations were observed; on the permeability test the TWS group obtained higher values of the mg/mL concentration when compared to TWO, which presented higher values than CTRL group. The pH values of both groups were statistically different with tendency to alkalinity and acidity for the groups TWO and TWS respectively. On the clinical study there was a significant decrease of tooth color values for both groups when compared with the initial values, and showed non-significant differences between groups when compared to each other; for dental sensitivity, when each of the evaluated days were compared to day 0, there was a significant increase for both groups, however, non-significant statistical differences were also found. It was concluded that the tested products on the laboratorial assessment can modify the superficial properties of the enamel, and have the capacity of permeabilizing the dentin-enamel complex until reaching the pulp chamber, also showing variability on the pH values due to the time of application, clinically, both products showed treatment effectiveness and a increase of tooth sensitivity.