Clinical and cytological evaluation of patients submitted to the technique of tooth bleaching with 10% carbamide peroxide gel / AvaliaÃÃo clÃnica e citolÃgica de pacientes submetidos a clareamento com perÃxido de carbamida a 10%

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Tooth bleaching has been a widely used procedure because of the great concern that people have nowadays for their physical appearance. The effectiveness of this treatment, as well as the occurrence of side effects on the teeth and gingival tissue, require further study. Cytological changes caused by the contact of chemical substances with, the gingival mucosa can be detected by means of exfoliative cytology. The purpose of the present study was to make a clinical and cytological assessment of patients submitted to the technique of tooth bleaching supervised by the dentist using 10% carbamide peroxide gel (Whiteness-FGM). Thirty-two patients of both genders with ages ranging from 18 to 40 years, whose teeth presented vitality and altered colour and who had indication for bleaching treatment, were selected. From these sample, of these, twenty were randomly selected to be submitted to three cytological collections on the gingival mucosa, the first made one day prior to the start of bleaching treatment, the second one day after the end of the bleaching and the third 30 days after the second. A clinical examination, first cytological collection and selection of initial colour of the anterior teeth were made and tray obtaied for bleaching with 10% carbamide peroxide gel (Whiteness-FGM) for four hours per day for four weeks. The colour of the teeth was verified on, a weekly basis using the VITA scale (Lumin Vacum Shade Guide), the presence of tooth sensitivity, discomfort and gingival irritation also being observed. The clinical results were submitted to statistical analysis using the Wilcoxon, Student-t and Cochran tests. It was found that all the patients achieved a decrease in the values of the colours in all the teeth studied. Sensitivity was seen in 43.7% of the patients, remaining constant over the four weeks. Only two patients presented discomfort during the treatment. Gingival irritation occurred in 31.2% of the patients, decreasing significantly over the four weeks. The results of the three cytological collections were analyzed statistically using the Cochran and Friedman tests, statistically significant differences being found in relation to the number of sites classified as class II (inflammation) between the first and second collections. There were no statistically significant differences between the distributions of the number of sites with inflammations in patients of either gender in any of the collections. The resuts indicate that bleaching technique for four weeks was effective from an esthetic standpoint. The clinical changes observed (tooth sensitivity, discomfort and gingival irritation) were limited to the period in which the bleaching agent was being used. The carbamide peroxide gel produced inflammatory changes in the epithelial cells of the gingiva, which were still present 30 days after the end of the treatment.

ASSUNTO(S)

clareamento de dente neoplasias bucais odontologia clareamento dental tooth bleaching oral cancer citologia esfoliativa cÃncer bucal perÃxido de carbamida a 10% 10% carbamide peroxide gel perÃxidos exfoliative cytology tÃcnicas citolÃgicas

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