Effect of Different Desensitizing Protocols on Pulp Inflammatory Responses in Whitened Teeth: A Randomized Clinical Trial

Abstract

Purpose

This randomized controlled, blind clinical trial evaluated the efficacy of different desensitizing protocols in preventing pulp inflammation after whitening treatment with hydrogen peroxide (HP) at 35% (Whiteness HP 35%).

Materials and Methods

Thirty healthy third human molars extracted by orthodontic indication were randomized and allocated into five groups (n=5): NC (negative control): without intervention; PC (positive control): HP; PBM: HP + photobiomodulation with a Watts LASER; CPP: HP + casein phosphopeptide amorphous calcium phosphopeptide (CPP-ACP); and NANO: HP + nano-hydroxyapatite. The in-office whitening was performed in two sessions with a single 45 minutes application at an interval of 48 hours. Pulp tissues were extirpated for immunohistochemical analysis. Immunoreaction for activated caspase-3 was observed, and images were acquired using an Axio Scope A1 microscope. The Kruskal-Wallis test was used to evaluate the immunoexpression of caspase-3.

Results

Comparisons between the PC and NC groups revealed a statistically significant difference (p<0.05) for the analysis of caspase-3 immunoexpression. A statistically significant difference (p<0.05) was also observed for the CPP and PBM groups in relation to the PC.

Conclusion

Photobiomodulation and CPP-ACP are promising alternatives to minimize pulpal inflammation induced by tooth whitening.

Clinical Trial Registration Number

NCT04548674.