Efecto de la activación del blanqueamiento dental mediante laser diodo vs luz led sobre la pulpa. Una revisión sistemática

Abstract

Dental whitening is an oxide-reduction technique that seeks to whiten pigmentations in tooth enamel. Hydrogen peroxide can alter the pulp by releasing reactive oxygen species. Objective: To analyze the effects of the activation of tooth whitening by means of diode laser vs LED light on the pulp, reported in the literature. Methodology: Electronic searches were carried out in Pubmed, Medline, Web of Science, Scielo, Lilacs, and Cochrane Library databases for the last fifteen years, for in vitro studies, in English, Spanish and Portuguese. Assessment of methodological quality, risk of bias and data extraction were performed independently and in duplicate. Results: Twelve articles were included, two of penetration, one of cytotoxicity and nine of increased intrapulpal temperature. There are no statistically significant differences regarding the penetration of 35-45% hydrogen peroxide in the pulp chamber with or without activation. The wavelength of the laser had a significant effect, and the substances released by the 35% gel are cytotoxic to fibroblasts. Nine studies documented that the temperature rise was below the critical value of 5.6 ° C, and three studies reported that light activation of the bleaching materials caused temperature increases considered critical.