Performance clínica de pincel aplicador para clareamento dental: uma revisão sistemática e metanálise

Abstract

To evaluate whether the method of applying the whitening gel with an applicator brush promotes better clinical performance in the in-office tooth whitening technique withhydrogen peroxide compared to not using it. Methodology: PubMed, Cochrane, Open-Grey and LILACS were searched by two independent investigators using search keys based on the PICOS strategy (P- patients with vital permanent teeth/human or bovine teeth; I- in-office whitening gel with applicator brush; C - in-office whitening gel without applicator brush; O concentration of hydrogen peroxide in the pulp chamber, mount of whitening gel used and color change; S- in vitro and clinical). The risk of bias was assessed according to the RoB2 tools for clinical studies and 7 parameters for laboratory studies. All studies were subjected to five meta-analyses according to the main outcome, assessed by the Revman software and the certainty of evidence by GRADE. Results: 7 studies were included in this systematic review. 5 were classified as “low”, 1 as “medium” and 1 as “high” risk of bias. The use of the applicator brush did not present statistical significance for all meta-analysis performed (p>0.05). Heterogeneity was considered high (84 and 87%), low (14%) and absent (0%). The quality of evidence was considered “low” and “very low”. Conclusion: Using an applicator brush generates the same concentration of hydrogen peroxide in the pulp chamber, uses an equal amount of whitening gel and promotes similar whitening efficacy compared to not using it, through in vitro and clinical studies with low certainty of evidence.