Restricted accessReview articleFirst published online 2022-03
Photobiomodulation Reduces Pain-Related Symptoms Without Interfering in the Efficacy of In-Office Tooth Bleaching: A Systematic Review and Meta-Analysis of Placebo-Controlled Clinical Trials
This systematic review aimed to determine whether the use of photobiomodulation (PBM) with low-level laser therapy prevents tooth sensitivity induced by in-office tooth bleaching with hydrogen.
Methods:
Placebo-controlled clinical trials were included to evaluate the efficacy of PBM with low-level laser therapy in the prevention of tooth sensitivity after in-office tooth bleaching. Searches were conducted on the Medline database via PubMed, Scopus, Web of Science, EBSCO, SciELO, LILACS, Cochrane, DOSS, and Google Scholar until July 2020, and fixed-effects meta-analysis was performed for tooth sensitivity [standardized mean differences (MDs)] and color changes (MDs).
Results:
Five studies were included in this systematic review and meta-analysis, with a total of 288 patients, 123 patients in the PBM group and 165 patients in the placebo group. In the meta-analysis, despite high heterogeneity, PBM significantly reduced the tooth sensitivity after the first [p < 0.001; Cohen's d = −0.32, 95% confidence interval (CI) = −0.46 to −0.18], second (p < 0.001; Cohen's d = −0.30, 95% CI = −0.46 to −0.15), and third (p < 0.001; Cohen's d = −0.82, 95% CI = −1.06 to −0.58) sessions of in-office tooth bleaching, without impairing the ΔE (p = 0.300).
Conclusions:
The results of this systematic review and meta-analysis suggest that PBM significantly prevents pain-related symptoms after the first three weekly sessions of in-office tooth bleaching with hydrogen.
Get full access to this article
View all access options for this article.
References
1.
WangJV, RiederEA, SchoenbergE, ZacharyCB, SaediN. Patient perception of beauty on social media: professional and bioethical obligations in esthetics. J Cosmet Dermatol, 2020; 19:1129–1130.
2.
De FreitasPM, MenezesAN, Da MotaAC, et al.Does the hybrid light source (led/laser) influence temperature variation on the enamel surface during 35% hydrogen peroxide bleaching? A randomized clinical trial. Quintessence Int, 2016; 47:61–73.
3.
MaranBM, BureyA, de ParisMT, LoguercioAD, ReisA. In-office dental bleaching with light vs.without light: a systematic review and meta-analysis. J Dent, 2018; 70:1–13.
4.
KershawS, NewtonJT, WilliamsDM. The influence of tooth colour on the perceptions of personal characteristics among female dental patients: comparisons of unmodified, decayed and ‘whitened’ teeth. Br Dent J, 2008; 204:256–257.
5.
American Dental Association (ADA) Council on Scientific Affairs. Tooth whitening/bleaching: treatment considerations for dentists and their patients. ADA Council on Scientific Affairs, 2009; 1–13.
6.
PontesM, GomesJ, LemosC, et al.Effect of bleaching gel concentration on tooth color and sensitivity: a systematic review and meta-analysis. Oper Dent, 2020; 45:265–275.
7.
LlenaC, VillanuevaA, MejiasE, FornerL. Bleaching efficacy of at home 16% carbamide peroxide. A long-term clinical follow-up study. J Esthet Rest Dent, 2020; 32:12–18.
8.
KawamotoK, TsujimotoY. Effects of the hydroxyl radical and hydrogen peroxide on tooth bleaching. J Endod, 2004; 30:45–50.
9.
KwonSR, WertzPW. Review of the mechanism of tooth whitening. J Esthet Restor Dent, 2015; 27:240–257.
10.
BalladaresL, Alegría-AcevedoLF, Montenegro-AranaA, et al.Effects of pH and application technique of in-office bleaching gels on hydrogen peroxide penetration into the pulp chamber. Oper Dent, 2019; 44:659–667.
11.
VazMM, LopesLG, CardosoPC, et al.Inflammatory response of human dental pulp to at-home and in-office tooth bleaching. J Appl Oral Sci, 2016; 24:509–517.
12.
de PaulaEA, KossatzS, FernandesD, LoguercioAD, ReisA. Administration of ascorbic acid to prevent bleaching-induced tooth sensitivity: a randomized triple-blind clinical trial. Oper Dent, 2014; 39:128–135.
13.
de SilvaCC, Alencar CM de PaulaBLF, JasséFFA, AraújoJLN, SilvaCM. Photobiomodulation vs. placebo on post-bleaching sensitivity and color change: a split-mouth clinical study. Open Dent J, 2020; 14:267–274.
14.
HamblinMR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys, 2017; 4:337–361.
15.
TsaiSR, HamblinMR. Biological effects and medical applications of infrared radiation. J Photochem Photobiol B, 2017; 170:197–207.
16.
ZupinL, OttavianiG, RupelK, et al.Analgesic effect of photobiomodulation therapy: an in vitro and in vivo study. J Biophotonics, 2019; 12:e201900043.
17.
MoosaviH, ArjmandN, AhrariF, ZakeriM, MaleknejadF. Effect of low-level laser therapy on tooth sensitivity induced by in-office bleaching. Lasers Med Sci, 2016; 31:713–739.
18.
CalheirosAPC, MoreiraMS, GonçalvesF, et al.Photobiomodulation in the prevention of tooth sensitivity caused by in-office dental bleaching. A randomized placebo preliminary study. Photomed Laser Surg, 2017; 35:415–420.
19.
AlencarCM, de PaulaBLF, AraújoJLM, AlvesEB, JasséFFA, SilvaCM. Effect of low-level laser therapy combined with 5000 parts per million fluoride dentifrice on postbleaching sensitivity: a clinical, randomized, and double-blind study. J Esthet Restor Dent 2018;30:352–359.
20.
de PaulaB, AlencarC, OrtizM, CoutoR, AraújoJ, SilvaC. Effect of photobiomodulation with low-level laser therapy combined with potassium nitrate on controlling post-bleaching tooth sensitivity: clinical, randomized, controlled, double-blind, and split-mouth study. Clin Oral Investig, 2019; 23:2723–2732.
21.
OuzzaniM, HammadyH, FedorowiczZ, ElmagarmidA. Rayyan—a web and mobile app for systematic reviews. Syst Rev, 2016; 5:210.
22.
TufanaruC, MunnZ, AromatarisE, CampbellJ, HoppL. Chapter 3: systematic reviews of effectiveness. In: Joanna Briggs Institute Reviewer's Manual. Aromataris E, Munn Z (eds.). Adelaide, Australia: The Joanna Briggs Institute, 2017.
23.
HaasLF, DutraK, PorporattiAL, et al.Anatomical variations of mandibular canal detected by panoramic radiography and CT: a systematic review and meta-analysis. Dentomaxillofac Radiol, 2016; 45:20150310.
24.
WanX, WangW, LiuJ, TongT. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol, 2014; 14:135.
25.
SchünemannHJ, OxmanAD, BrozekJ, et al.Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ, 2008; 336:1106–1110.
26.
AuschillTM, HellwigE, SchmidaleS, SculeanA, ArweilerNB. Efficacy, side-effects and patients' acceptance of different bleaching techniques (OTC, in-office, at-home). Oper Dent, 2005; 30:156–163.
27.
BastingRT, AmaralFLB, FrançaFMG, FlórioFM. Clinical comparative study of the effectiveness of and tooth sensitivity to 10% and 20% carbamide peroxide home-use and 35% and 38% hydrogen peroxide in-office bleaching materials containing desensitizing agents. Oper Dent, 2012; 37:464–473.
28.
de PaulaEA, NavaJA, RossoC, et al.In-office bleaching with a two- and seven-day intervals between clinical sessions: a randomized clinical trial on tooth sensitivity. J Den, 2015; 43:424–429.
29.
Pintado-PalominoK, Peitl FilhoO, ZanottoED, TirapelliC. A clinical, randomized, controlled study on the use of desensitizing agents during tooth bleaching. J Den, 2015; 43:1099–1105.
30.
OliveiraSN, AssunçãoIV, BorgesBCD. Efficacy of ibuprofen and codeine + paracetamol to reduce immediate bleaching sensitivity caused by in-office tooth bleaching: a randomized, controlled, double-blind clinical trial. Am J Dent, 2018; 31:195–198.
31.
CopplaFM, RezendeM, de PaulaE, et al.Combination of acetaminophen/codeine analgesics does not avoid bleaching-induced tooth sensitivity: a randomized, triple-blind two-center clinical trial. Oper Dent, 2018; 43:e53–e63.
32.
ChenY, ChenXL, ZouXL, ChenSZ, ZouJ, WangY. Efficacy of low-level laser therapy in pain management after root canal treatment or retreatment: a systematic review. Lasers Med Sci, 2019; 34:1305–1316.
33.
HeWL, YuFY, LiCJ, PanJ, ZhuangR, DuanPJ. A systematic review and meta-analysis on the efficacy of low-level laser therapy in the management of complication after mandibular third molar surgery. Lasers Med Sci, 2015; 30:1779–1788.
34.
ZhaoH, HuJ, ZhaoL. The effect of low-level laser therapy as an adjunct to periodontal surgery in the management of postoperative pain and wound healing: a systematic review and meta-analysis. Lasers Med Sci, 2021; 36:175–187.
35.
KaraarslanES, ÖzmenZC, AytacF, et al.Evaluation of biochemical changes in dental tissues after different office bleaching methods. Hum Exp Toxicol, 2019; 38:389–397.
36.
YadavS, NawalRR, TalwarS, VermaM. Low-level laser therapy for management of large periapical lesions associated with open apex cases. Indian J Dent Res, 2020; 31:334–336.
37.
ArasMH, OmezliMM, GüngörmüşM. Does low-level laser therapy have an antianesthetic effect? A review. Photomed Laser Surg, 2010; 28:719–722.
38.
SoaresLES, Brugnera JuniorA, ZaninF, PachecoMTT, MartinAA. Molecular analysis of Er:YAG laser irradiation on dentin. Braz Dent J, 2006; 17:15–19.
39.
HawkerGA, MianS, KendzerskaT, FrenchM. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res (Hoboken), 2011; 63:S240–S252.
40.
SchünemannHJ. Interpreting GRADE's levels of certainty or quality of the evidence: GRADE for statisticians, considering review information size or less emphasis on imprecision?. Clin Epidemiol, 2016; 75:6–15.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
