Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research

ObjectivesThis study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.Materials and MethodsElectronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of differe...

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Main Authors: Letícia Aparecida Silva Batista, Alexandre Henrique dos Reis-Prado, Hebertt Gonzaga dos Santos Chaves, Lara Cancella de Arantes, Luís Fernando Santos Alves Morgan, Carolina Bosso André, Thaís Yumi Suzuki, Francine Benetti
Format: Article
Language:English
Published: Korean Academy of Conservative Dentistry 2023-11-01
Series:Restorative Dentistry & Endodontics
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Online Access:http://www.rde.ac/upload/pdf/rde-48-e39.pdf
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author Letícia Aparecida Silva Batista
Alexandre Henrique dos Reis-Prado
Hebertt Gonzaga dos Santos Chaves
Lara Cancella de Arantes
Luís Fernando Santos Alves Morgan
Carolina Bosso André
Thaís Yumi Suzuki
Francine Benetti
author_facet Letícia Aparecida Silva Batista
Alexandre Henrique dos Reis-Prado
Hebertt Gonzaga dos Santos Chaves
Lara Cancella de Arantes
Luís Fernando Santos Alves Morgan
Carolina Bosso André
Thaís Yumi Suzuki
Francine Benetti
author_sort Letícia Aparecida Silva Batista
collection DOAJ
description ObjectivesThis study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.Materials and MethodsElectronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed.ResultsOut of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%–38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (n = 3). However, orally administered drugs did not reduce pulp inflammation (n = 4). Cytotoxicity (n = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies.ConclusionsFew in vivo studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings.Trial RegistrationPROSPERO Identifier: CRD42022337192
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institution Kabale University
issn 2234-7658
2234-7666
language English
publishDate 2023-11-01
publisher Korean Academy of Conservative Dentistry
record_format Article
series Restorative Dentistry & Endodontics
spelling doaj-art-c8a5305ab25e411a91585bdba6daa7ba2025-08-20T03:31:10ZengKorean Academy of Conservative DentistryRestorative Dentistry & Endodontics2234-76582234-76662023-11-01484e3910.5395/rde.2023.48.e391082Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic researchLetícia Aparecida Silva BatistaAlexandre Henrique dos Reis-PradoHebertt Gonzaga dos Santos ChavesLara Cancella de ArantesLuís Fernando Santos Alves MorganCarolina Bosso AndréThaís Yumi SuzukiFrancine BenettiObjectivesThis study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.Materials and MethodsElectronic searches were performed in July 2023. In vivo and in vitro studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed.ResultsOut of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%–38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment (n = 3). However, orally administered drugs did not reduce pulp inflammation (n = 4). Cytotoxicity (n = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies.ConclusionsFew in vivo studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings.Trial RegistrationPROSPERO Identifier: CRD42022337192http://www.rde.ac/upload/pdf/rde-48-e39.pdfcell survivaldental pulphydrogen peroxideinflammationtooth bleachingsystematic review
spellingShingle Letícia Aparecida Silva Batista
Alexandre Henrique dos Reis-Prado
Hebertt Gonzaga dos Santos Chaves
Lara Cancella de Arantes
Luís Fernando Santos Alves Morgan
Carolina Bosso André
Thaís Yumi Suzuki
Francine Benetti
Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research
Restorative Dentistry & Endodontics
cell survival
dental pulp
hydrogen peroxide
inflammation
tooth bleaching
systematic review
title Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research
title_full Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research
title_fullStr Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research
title_full_unstemmed Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research
title_short Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research
title_sort can different agents reduce the damage caused by bleaching gel to pulp tissue a systematic review of basic research
topic cell survival
dental pulp
hydrogen peroxide
inflammation
tooth bleaching
systematic review
url http://www.rde.ac/upload/pdf/rde-48-e39.pdf
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