Efeito do ozônio medicinal sobre a eficácia clareadora e a sensibilidade dentária no clareamento de consultório: ensaio clínico cego e randomizado

Abstract

Post-bleaching dental sensitivity (DS) following tooth whitening with high-concentration hydrogen peroxide (HP) is a common adverse effect that can be modulated by adjuvant therapies, such as ozone therapy, due to its anti-inflammatory and analgesic properties. The aim of this parallel, blinded randomized clinical trial was to evaluate the whitening efficacy and dental sensitivity following the use of 35% HP or ozonized gas. Methodology: In the control group (HP), 35% HP was applied for 45 minutes, preceded by the application of a desensitizing agent containing 5% Potassium Nitrate and 2% Sodium Fluoride for 10 minutes. In the ozone group (OZ), ozonized gas at a concentration of 55 µg was applied for 30 minutes using a custom-made silicone tray. In both groups, the upper arch received the respective clinical protocols, while the lower arch underwent bleaching with 16% carbamide peroxide for 14 days. Results: The HP group showed a significant increase in sensitivity over time across all sessions (p < 0.05), with greater intensity during the intermediate periods of the procedure and persistence at 24 hours. The OZ group presented values consistently close to zero, with no significant variation over time. Intergroup differences were observed from the intermediate time points through 24 hours (p < 0.05), with higher values in the HP group. Regarding color, both groups showed significant change between baseline and final assessments (p < 0.05); however, the HP group demonstrated a greater magnitude of whitening (median ΔC = 7 [7–10]) compared to the OZ group (median ΔC = 1.5 [0–3]) (p < 0.001; r = 0.73). Conclusion: 35% hydrogen peroxide demonstrated superior whitening efficacy, but was associated with greater dental sensitivity. Ozone therapy alone did not show a clinically relevant whitening effect, but it resulted in the absence of tooth sensitivity during and after the procedure.