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A meta-analysis of ozone effect on tooth bleaching
Lia Dietrich1, Marcelo Dias Moreira de Assis Costa1, Cauane Blumenberg2
1School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil.
Scientific Reports
|June 24, 2021
Summary
Ozone (O3) is not superior to hydrogen peroxide (HP) for in-office tooth bleaching color change. Ozone alone did not cause sensitivity, and when combined with HP, sensitivity only occurred if ozone was applied before HP.
Area of Science:
- Dental materials science
- Clinical dentistry
- Biomedical engineering
Background:
- In-office tooth bleaching is a common cosmetic dental procedure.
- Hydrogen peroxide (HP) is the conventional agent used, but concerns about tooth sensitivity exist.
- Ozone (O3) has been proposed as an alternative or adjunct agent for tooth bleaching.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of ozone (O3) in tooth bleaching (TB) and its impact on tooth sensitivity.
- To compare O3-based bleaching with conventional HP bleaching using randomized controlled trials (RCTs).
Main Methods:
- Systematic review of RCTs from seven databases and grey literature.
- Assessed risk of bias using the JBI tool.
- Meta-analysis of ΔELab color change and standardized mean difference (SMD) using random-effect models.
- Assessed evidence certainty using the GRADE approach.
Main Results:
- Ozone (O3) alone resulted in a ΔELab of 1.28.
- O3 combined with hydrogen peroxide (HP) yielded a ΔELab of 6.93.
- No significant difference in TB effectiveness between O3 + HP and HP alone (SMD = 0.38; 95% CI: -0.04; 0.81).
- O3 alone did not cause tooth sensitivity.
- Hypersensitivity occurred with O3 + HP only when O3 was applied before HP.
Conclusions:
- Ozone (O3) is not more effective than conventional hydrogen peroxide (HP) for in-office tooth bleaching color change.
- Ozone (O3) can be used without causing sensitivity when applied alone.
- The sequence of application matters when combining O3 and HP to minimize tooth sensitivity.
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