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Different light-activation systems associated with dental bleaching: a systematic review and a network meta-analysis

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Abstract

Objectives

A systematic review and a network meta-analysis were performed to answer the following research question: “Is there any light-activation protocol capable of improving color change efficacy when associated with an in-office bleaching gel in adults?”

Material and methods

A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE without date and/or language restrictions in April 23, 2017 (updated on March 30, 2018). IADR abstracts (1990–2018), unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials conducted in adults that included at least one group treated with in-office dental bleaching with light activation were included. The risk of bias (RoB) was evaluated using the Cochrane Collaboration tool. A random-effects Bayesian-mixed treatment comparison (MTC) model was used to combine light-activated versus light-free in-office bleaching with direct light-free comparison trials. A meta-analysis with independent analysis (high- and low-concentrate hydrogen peroxide [HP]) was conducted for color change (∆E*, ∆SGU).

Results

After the removal of duplicates, title, and abstract screening, 28 studies remained. Nine were considered to be at a low RoB, five were at a high RoB, and the remaining were at an unclear RoB. The MTC analysis showed no significant difference in color change (ΔE* and ΔSGU) between light-activation protocols and light-free in-office bleaching, regardless of the HP concentration in the efficacy of the bleaching.

Conclusion

No type of light-activated in-office bleaching was superior to light-free in-office bleaching for both high- and low-concentrate in-office bleaching gels (PROSPERO—CRD42017078743).

Clinical relevance

Although many times dental professionals use “laser whitening” as a form of marketing, this study confirmed that no type of light-activation for in-office bleaching can improve the bleaching efficacy.

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References

  1. Mehr K, Maciejewska-Szaniec Z, Stanglewicz T, Maciejewska B, Pilarska A, Lira J, Piotrowski P (2016) Temperament and perception of tooth bleaching results. J Family Med Prim Care 3:294–297. https://doi.org/10.5114/fmpcr/63667

    Article  Google Scholar 

  2. Martin J, Rivas V, Vildósola P, Moncada L, Oliveira Junior OB, Saad JRC, Fernandez E, Moncada G (2016) Personality style in patients looking for tooth bleaching and its correlation with treatment satisfaction. Braz Dent J 27:60–65. https://doi.org/10.1590/0103-6440201600127

    Article  PubMed  Google Scholar 

  3. Dahl JE, Pallesen U (2003) Tooth bleaching - a critical review of the biological aspects. Crit Rev Oral Biol Med 14:292–304

    Article  PubMed  Google Scholar 

  4. De Geus JL, Wambier LM, Kossatz S, Loguercio AD, Reis A (2016) At-home vs in-office bleaching: a systematic review and meta-analysis. Oper Dent 41:341–356. https://doi.org/10.2341/15-287-lit

    Article  PubMed  Google Scholar 

  5. Almeida LCA, Riehl H, Dos Santos PH, Sundfeld MLMM, Briso ALF (2012) Clinical evaluation of the effectiveness of different bleaching therapies in vital teeth. Int J Periodont Rest 32:302–309. https://doi.org/10.1038/sj.bdj.2012.587

    Article  Google Scholar 

  6. Charakorn P, Cabanilla L, Wagner W, Foong W, Shaheen J, Pregitzer R, Schneider D (2009) The effect of preoperative ibuprofen on tooth sensitivity caused by in-office bleaching. Oper Dent 34:131–135. https://doi.org/10.2341/08-33

    Article  PubMed  Google Scholar 

  7. Gallagher A, Maggio B, Bowman J, Borden L, Mason S, Felix H (2002) Clinical study to compare two in-office (chairside) whitening systems. J Clin Dent 13:219–224

    PubMed  Google Scholar 

  8. Giachetti L, Bertini F, Bambi C, Nieri M, Russo DS (2010) A randomized clinical trial comparing at-home and in-office tooth whitening techniques a nine-month follow-up. J Am Dent Assoc 141:1357–1364. https://doi.org/10.14219/jada.archive.2010.0081

    Article  PubMed  Google Scholar 

  9. Tay LY, Kose C, Herrera DR, Reis A, Loguercio AD (2012) Long-term efficacy of in-office and at-home bleaching: a 2-year double-blind randomized clinical trial. Am J Dent 25:199–204

    PubMed  Google Scholar 

  10. Joiner A (2006) The bleaching of teeth: a review of the literature. J Dent 34:412–419. https://doi.org/10.1016/j.jdent.2006.02.002

    Article  PubMed  Google Scholar 

  11. Gurgan S, Cakir FY, Yazici E (2010) Different light-activated in-office bleaching systems: a clinical evaluation. Lasers Med Sci 25:817–822. https://doi.org/10.1007/s10103-009-0688-x

    Article  PubMed  Google Scholar 

  12. Sulieman M, Macdonald E, Rees J, Addy M (2005) Comparison of three in-office bleaching systems based on 35% hydrogen peroxide with different light activators. Am J Dent 18:194–197

    PubMed  Google Scholar 

  13. Kashima-Tanaka M, Tsujimoto Y, Kawamoto K, Senda N, Ito K, Yamazaki M (2003) Generation of free radicals and/or active oxygen by light or laser irradiation of hydrogen peroxide or sodium hypochlorite. J Endod 29:141–143. https://doi.org/10.1097/00004770-200302000-00013

    Article  PubMed  Google Scholar 

  14. Buchalla W, Attin T (2007) External bleaching therapy with activation by heat, light or laser - a systematic review. Dent Mater J 23:586–596. https://doi.org/10.1016/j.dental.2006.03.018

    Article  Google Scholar 

  15. De Almeida Farhat PB, Santos FA, Gomes JC, Gomes OM (2014) Evaluation of the efficacy of led-laser treatment and control of tooth sensitivity during in-office bleaching procedures. Photomed Laser Surg 32:422–426. https://doi.org/10.1089/pho.2014.3729

    Article  PubMed  Google Scholar 

  16. Alomari Q, El Daraa E (2010) A randomized clinical trial of in-office dental bleaching with or without light activation. J Contemp Dent Pract 11:e17–e24

    Article  Google Scholar 

  17. Henry RK, Bauchmoyer SM, Moore W, Rashid RG (2013) The effect of light on tooth whitening: a split-mouth design. Int J Dent Hyg 11:151–154. https://doi.org/10.1111/j.1601-5037.2012.00568.x

    Article  PubMed  Google Scholar 

  18. Kugel G, Papathanasiou A, Williams AJ, Anderson C, Ferreira S (2006) Clinical evaluation of chemical and light-activated tooth whitening systems. Compend Contin Educ Dent 27:54–62

    PubMed  Google Scholar 

  19. Tavares M, Stultz J, Newman M, Smith V, Kent R, Carpino E, Goodson JM (2003) Light augments tooth whitening with peroxide. J Am Dent Assoc 134:167–175. https://doi.org/10.14219/jada.archive.2003.0130

    Article  PubMed  Google Scholar 

  20. Posso Moreno SL, Ramírez Ramírez DX, Rosas Jaimes JA, Güiza Cristancho EH (2010) Comparación del blanqueamiento dental con peróxido de hidrógeno al 25 percent en consultorio, utilizando o no activación con lámpara de luz halógena. Univ Odontol 29:19–25

    Google Scholar 

  21. De Freitas PM, Menezes AN, Da Mota AC, Simoes A, Mendes FM, Lago AD, Ferreira LS, Ramos-Oliveira TM (2016) 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 47:61–73. https://doi.org/10.3290/j.qi.a34454

    Article  PubMed  Google Scholar 

  22. Bortolatto JF, Trevisan TC, Bernardi PSI, Fernandez E, Dovigo LN, Loguercio AD, Batista De Oliveira Junior O, Pretel H (2016) A novel approach for in-office tooth bleaching with 6% H2O2/TiO_N and LED/laser system—a controlled, triple-blinded, randomized clinical trial. Lasers Med Sci 31:437–444. https://doi.org/10.1007/s10103-016-1866-2

    Article  PubMed  Google Scholar 

  23. Calatayud JO, Calatayud CO, Zaccagnini AO, Box M (2010) Clinical efficacy of a bleaching system based on hydrogen peroxide with or without light activation. Eur J Esthet Dent 5:216–224

    PubMed  Google Scholar 

  24. Maran BM, Burey A, De Paris Matos T, Loguercio AD, Reis A (2018) In-office dental bleaching with light vs. without light: a systematic review and meta-analysis. J Dent 70:1–13. https://doi.org/10.1016/j.jdent.2017.11.007

    Article  PubMed  Google Scholar 

  25. Lu G, Ades A (2004) Combination of direct and indirect evidence in mixed treatment comparisons. Stat Med 23:3105–3124. https://doi.org/10.1002/sim.1875

    Article  PubMed  Google Scholar 

  26. Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, Ioannidis JP, Straus S, Thorlund K, Jansen JP (2015) The prisma extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 162:777–784. https://doi.org/10.7326/M14-2385

    Article  PubMed  Google Scholar 

  27. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savović J, Schulz KF, Weeks L, Sterne JA (2011) The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928. https://doi.org/10.1136/bmj.d5928

    Article  PubMed  PubMed Central  Google Scholar 

  28. Dias S, Welton N, Caldwell D, Ades A (2010) Checking consistency in mixed treatment comparison meta-analysis. Stat Med 29:932–944. https://doi.org/10.1002/sim.3767

    Article  PubMed  Google Scholar 

  29. Bortolatto JF, Pretel H, Neto CS, Andrade MF, Moncada G, Junior OBO (2013) Effects of led–laser hybrid light on bleaching effectiveness and tooth sensitivity: a randomized clinical study. Laser Phys Lett 10:085601

    Article  Google Scholar 

  30. Kossatz S, Dalanhol AP, Cunha T, Loguercio A, Reis A (2011) Effect of light activation on tooth sensitivity after in-office bleaching. Oper Dent 36:251–257. https://doi.org/10.2341/10-289-C

    Article  PubMed  Google Scholar 

  31. Kugel G, Ferreira S, Sharma S, Barker ML, Gerlach RW (2009) Clinical trial assessing light enhancement of in-office tooth whitening: Masters of esthetic dentistry. J Esthet Restor Dent 21:336–347. https://doi.org/10.1111/j.1708-8240.2009.00287.x

    Article  PubMed  Google Scholar 

  32. Lo Giudice R, Pantaleo G, Lizio A, Romeo U, Castiello G, Spagnuolo G, Lo Giudice G (2016) Clinical and spectrophotometric evaluation of led and laser activated teeth bleaching. Open Dent J 10:242–250. https://doi.org/10.2174/1874210601610010242

    Article  PubMed  PubMed Central  Google Scholar 

  33. Marson FC, Sensi LG, Vieira LCC, Araujo E (2008) Clinical evaluation of in-office dental bleaching treatments with and without the use of light-activation sources. Oper Dent 33:15–22. https://doi.org/10.2341/07-57

    Article  PubMed  Google Scholar 

  34. Martín J, Ovies N, Cisternas P, Fernández E, Junior OO, De Andrade M, Moncada G, Vildósola P (2015) Can an led-laser hybrid light help to decrease hydrogen peroxide concentration while maintaining effectiveness in teeth bleaching? Laser Phys 25:025608. https://doi.org/10.1088/1054-660X/25/2/025608

    Article  Google Scholar 

  35. Mena-Serrano A, Garcia E, Luque-Martinez I, Grande R, Loguercio A, Reis A (2016) A single-blind randomized trial about the effect of hydrogen peroxide concentration on light-activated bleaching. Oper Dent 41:455–464. https://doi.org/10.2341/15-077-C

    Article  PubMed  Google Scholar 

  36. Polydorou O, Wirsching M, Wokewitz M, Hahn P (2013) Three-month evaluation of vital tooth bleaching using light units-a randomized clinical study. Oper Dent 38:21–32. https://doi.org/10.2341/12-041-C

    Article  PubMed  Google Scholar 

  37. Ziemba SL, Felix H, Macdonald J, Ward M (2005) Clinical evaluation of a novel dental whitening lamp and light-catalyzed peroxide gel. J Clin Dent 16:123–127

    PubMed  Google Scholar 

  38. Bernardon JK, Sartori N, Ballarin A, Perdigao J, Lopes G, Baratieri LN (2010) Clinical performance of vital bleaching techniques. Oper Dent 35:3–10. https://doi.org/10.2341/09-008cr

    Article  PubMed  Google Scholar 

  39. Mondelli RFL, De Azevedo JFDG, Francisconi AC, De Almeida CM, Ishikiriama SK (2012) Comparative clinical study of the effectiveness of different dental bleaching methods - two year follow-up. J Appl Oral Sci 20:435–443. https://doi.org/10.1590/S1678-77572012000400008

    Article  PubMed  PubMed Central  Google Scholar 

  40. Ontiveros JC, Paravina RD (2009) Color change of vital teeth exposed to bleaching performed with and without supplementary light. J Dent 37:840–847. https://doi.org/10.1016/j.jdent.2009.06.015

    Article  PubMed  Google Scholar 

  41. Strobl A, Gutknecht N, Franzen R, Hilgers RD, Lampert F, Meister J (2010) Laser-assisted in-office bleaching using a neodymium:yttrium-aluminum-garnet laser: an in vivo study. Lasers Med Sci 25:503–509. https://doi.org/10.1007/s10103-009-0675-2

    Article  PubMed  Google Scholar 

  42. Papathanasiou A, Kastali S, Perry RD, Kugel G (2002) Clinical evaluation of a 35% hydrogen peroxide in-office whitening system. Compend Contin Educ Dent 23:335–338

    PubMed  Google Scholar 

  43. Ward M, Felix H (2012) A clinical evaluation comparing two H2O2 concentrations used with a light-assisted chairside tooth whitening system. Compend Contin Educ Dent 33:286–291

    PubMed  Google Scholar 

  44. Gomes RS, Souza FBD, Lacerda CM, Brambilla CFF, Pascotto RC (2008) Avaliação clínica da eficiência do uso do sistema led-laser, led e luz halógena na ativação do agente clareador em dentes vitalizados. Rev Dental Press Estét 5:62–77

    Google Scholar 

  45. Martin J, Vildosola P, Bersezio C, Herrera A, Bortolatto J, Saad JR, Oliveira OB Jr, Fernandez E (2015) Effectiveness of 6% hydrogen peroxide concentration for tooth bleaching-a double-blind, randomized clinical trial. J Dent 43:965–972. https://doi.org/10.1016/j.jdent.2015.05.011

    Article  PubMed  Google Scholar 

  46. Ma J, Liu W, Hunter A, Zhang W (2008) Performing meta-analysis with incomplete statistical information in clinical trials. BMC Med Res Methodol 8(56). https://doi.org/10.1186/1471-2288-8-5

  47. He LB, Shao MY, Tan K, Xu X, Li JY (2012) The effects of light on bleaching and tooth sensitivity during in-office vital bleaching: a systematic review and meta-analysis. J Dent 40:644–653. https://doi.org/10.1016/j.jdent.2012.04.010

    Article  PubMed  Google Scholar 

  48. Sekine L, Morais VD, Lima KM, Onsten TG, Ziegelmann PK, Ribeiro RA (2015) Conventional and high-dose daunorubicin and idarubicin in acute myeloid leukaemia remission induction treatment: a mixed treatment comparison meta-analysis of 7258 patients. Hematol Oncol 33:212–219. https://doi.org/10.1002/hon.2173

    Article  PubMed  Google Scholar 

  49. Rheinheimer J, Ziegelmann PK, Carlessi R, Reck LR, Bauer AC, Leitao CB, Crispim D (2014) Different digestion enzymes used for human pancreatic islet isolation: a mixed treatment comparison (mtc) meta-analysis. Islets 6:e977118. https://doi.org/10.4161/19382014.2014.977118

    Article  PubMed  PubMed Central  Google Scholar 

  50. Ribeiro RA, Ziegelmann PK, Duncan BB, Stella SF, Da Costa Vieira JL, Restelatto LMF, Moriguchi EH, Polanczyk CA (2013) Impact of statin dose on major cardiovascular events: a mixed treatment comparison meta-analysis involving more than 175,000 patients. Int J Cardiol 166:431–439. https://doi.org/10.1016/j.ijcard.2011.10.128

    Article  PubMed  Google Scholar 

  51. Bangalore S, Toklu B, Amoroso N, Fusaro M, Kumar S, Hannan EL, Faxon DP, Feit F (2013) Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysis. BMJ 347:f6625. https://doi.org/10.1136/bmj.f6625

    Article  PubMed  PubMed Central  Google Scholar 

  52. Faggion CM Jr, Chambrone L, Listl S, Tu YK (2013) Network meta-analysis for evaluating interventions in implant dentistry: the case of peri-implantitis treatment. Clin Implant Dent Relat Res 15:576–588. https://doi.org/10.1111/j.1708-8208.2011.00384.x

    Article  PubMed  Google Scholar 

  53. Pires CW, Pedrotti D, Lenzi TL, Soares FZM, Ziegelmann PK, Rocha RDO (2018) Is there a best conventional material for restoring posterior primary teeth? A network meta-analysis. Braz Oral Res 32. https://doi.org/10.1590/1807-3107bor-2018.vol32.0010

  54. Pulikkotil S, Nagendrababu V, Veettil S, **atongthai P, Setzer F (2018) Effect of oral premedication on the anaesthetic efficacy of inferior alveolar nerve block in patients with irreversible pulpitis–a systematic review and network meta-analysis of randomized controlled trials. Int Endod J 51:989–1004. https://doi.org/10.1111/iej.12912

    Article  PubMed  Google Scholar 

  55. Joseph A, Ayyagari R, **e M, Cai S, **e J, Huss M, Sikirica V (2017) Comparative efficacy and safety of attention-deficit/hyperactivity disorder pharmacotherapies, including guanfacine extended release: a mixed treatment comparison. Eur Child Adolesc Psychiatry 26:875–897. https://doi.org/10.1007/s00787-017-0962-6

    Article  PubMed  PubMed Central  Google Scholar 

  56. Jansen JP, Crawford B, Bergman G, Stam W (2008) Bayesian meta-analysis of multiple treatment comparisons: an introduction to mixed treatment comparisons. Value Health 11:956–964. https://doi.org/10.1111/j.1524-4733.2008.00347.x

    Article  PubMed  Google Scholar 

  57. Rezende M, Loguercio AD, Kossatz S, Reis A (2016) Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: a multi regression and logistic analysis. J Dent 45:1–6. https://doi.org/10.1016/j.jdent.2015.11.003

    Article  PubMed  Google Scholar 

  58. Rezende M, Coppla F, Chemin K, Chibinski AC, Loguercio AD, Reis A (2018) Tooth sensitivity after dental bleaching with a desensitizing-containing and a desensitizing-free bleaching gel: a systematic review and meta-analysis. Oper Dent. https://doi.org/10.2341/17-253-L

  59. De Geus JL, Wambier LM, Boing TF, Loguercio AD, Reis A (2018) At-home bleaching with 10% vs. more concentrated carbamide peroxide gels: a systematic review and meta-analysis. Oper Dent 43:E210–E222. https://doi.org/10.2341/17-222-L

    Article  PubMed  Google Scholar 

  60. Jüni P, Altman DG, Egger M (2001) Assessing the quality of controlled clinical trials. BMJ 323:42–46. https://doi.org/10.1136/bmj.323.7303.42

    Article  PubMed  PubMed Central  Google Scholar 

  61. Higgins J, Sterne J, Savović J, Page M, Hróbjartsson A, Boutron I, Reeves B, Eldridge S (2016) A revised tool for assessing risk of bias in randomized trials. Cochrane Methods Cochrane Database of Systematic Reviews 10:29–31. https://doi.org/10.1002/14651858.CD201601

    Article  Google Scholar 

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Acknowledgments

The authors of this study would like to thank the following authors who kindly provided information not available in their full texts: Fabiano Marson, Gustavo Moncada, Jesus O. Calatayud, Alexandra Mena-Serrano, Jo M. Goodson, Joe C. Ontiveros, Jussara K. Bernardon, Letícia C. A. G de Almeida, Patricia M. de Freitas, Rafael F. L. Mondelli, Sevil Gurgan.

Funding

This study was partially supported by the National Council for Scientific and Technological Development from the Brazilian Government, under grants 303332/2017-4 and 305588/2014-1 and the Coordination of Improvement of Higher Level Personnel (CAPES) from the Brazilian Ministry of Education.

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Authors and Affiliations

  1. Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Rua Engenharia, 464 – Universitário, Cascavel, Paraná, 85819-190, Brazil

    Bianca Medeiros Maran

  2. Statistics Department and Post-Graduation Program in Epidemiology, Federal University of Rio Grande do Sul, Rua Paulo Gama, 110 – Farroupilha, Porto Alegre, Rio Grande do Sul, 90040-060, Brazil

    Patrícia K. Ziegelmann

  3. Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, BlocoM, Sala 64-A, Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil

    Adrieli Burey & Thalita de Paris Matos

  4. Department of Restorative Dentistry, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M, Sala 64-A, Uvaranas, Ponta Grossa, Paraná, 84030-900, Brazil

    Alessandro D. Loguercio & Alessandra Reis

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  1. Bianca Medeiros Maran
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Maran, B.M., Ziegelmann, P.K., Burey, A. et al. Different light-activation systems associated with dental bleaching: a systematic review and a network meta-analysis. Clin Oral Invest 23, 1499–1512 (2019). https://doi.org/10.1007/s00784-019-02835-x

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