Concordância na avaliação da mudança de cor entre o guia de cores VITA Classical e o espectrofotômetro VITA Easyshade após o clareamento dental em consultório: uma revisão sistemática e meta análise

Abstract

Introduction: Accurate assessment of tooth color change is essential for evaluating the effectiveness of in-office bleaching procedures. Although visual and instrumental methods are widely used, the agreement between the VITA Classical shade guide and the VITA Easyshade spectrophotometer remains unclear. Objective: To systematically review the literature and perform a meta-analysis to evaluate agreement and systematic differences in color change assessment between the VITA Classical shade guide and the VITA Easyshade spectrophotometer following in-office tooth bleaching with 35% hydrogen peroxide. Methodology: The protocol was registered in PROSPERO (CRD42024476136). Searches were conducted in MEDLINE, Cochrane Library, Embase, LILACS/BBO, Scopus, Web of Science, grey literature and clinical trial registries. Randomized clinical trials (RCTs) evaluating both methods in the same participants were included. Risk of bias was assessed using the Cochrane (RoB 2.0). Agreement was evaluated using Bland Risk of Bias 2.0 Altman analysis. Differences between methods were analyzed using standardized mean differ ences (SMD) with a random-effects model. Subgroup, meta-regression and equivalence testing (TOST; ±0.30 SMD) were performed. Results: Twenty-two RCTs were included. The VITA Easyshade spectrophotometer detected significantly greater color change than the VITA Classical shade guide (SMD = 1.05; 95% confidence interval [CI]: 0.79–1.30; p < 0.00001). Bland–Altman analysis showed systematic positive bias (+3.8 ΔE*) and wide limits of agreement, indicating low agreement. No significant subgroup or meta-regression effects were observed. Sensitivity analyses confirmed robustness. Equivalence testing confirmed non equivalence. Conclusions: The VITA Classical shade guide and the VITA Easyshade spectrophotometer are not equivalent and should not be used interchangeably for assessing color change after in-office bleaching.