Topical application of a desensitizing agent containing potassium nitrate before dental bleaching: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#dentin-sensitivity #humans #hydrogen-peroxide #nitrates #potassium-compounds

Topical application of a desensitizing agent containing potassium nitrate before dental bleaching: a systematic review and meta-analysis

Martini et al., 2021 | Clin Oral Investig | Meta Analysis

Citation

Martini E C, Favoreto M W, ... Reis A. Topical application of a desensitizing agent containing potassium nitrate before dental bleaching: a systematic review and meta-analysis. Clin Oral Investig. 2021-Jul;25(7):4311-4327. doi:10.1007/s00784-021-03994-6

Abstract

OBJECTIVES: To conduct a systematic review and meta-analysis to evaluate the risk and intensity of tooth sensitivity (TS) after topical application of desensitizers containing potassium nitrate before dental bleaching. METHODS: We searched PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE. We also surveyed gray literature without restrictions. We meta-analyzed the data using the random-effects model to compare potassium nitrate and placebo in terms of risk and intensity of TS and color change (∆SGU or ∆E). The quality of the evidence was rated using the GRADE approach. The risk of bias (RoB) of the included studies was analyzed using the Cochrane RoB tool. RESULTS: After the database screening, 24 articles remained. A significant 12% lower risk for the groups where desensitizing agents were applied (p = 0.02), with a risk ratio of 0.88 (95% CI 0.78 to 0.98). About the intensity of TS, a significant average mean difference of - 0.77 units of VAS units (95%CI - 1.34 to - 0.19; p = 0.01) in favor of the desensitizer group. In the NRS scale, a significant average mean difference of - 0.36 (95% CI - 0.61 to - 0.12; p value = 0.004) in favor of the desensitizer group. No significant difference was observed in color change (p > 0.28) in ∆SGU and ∆E. CONCLUSIONS: Although a significant reduction in the risk and intensity of TS was observed in groups treated with a potassium nitrate at some point during the bleaching, the clinical significance of this reduction is subtle and clinically questionable. Color change is not affected by the use of agents. CLINICAL RELEVANCE: The reduction in the risk and intensity of TS with the topical application of potassium nitrate-based desensitizing agents in dental bleaching is subtle and maybe clinically questionable.

Key Findings

After the database screening, 24 articles remained. A significant 12% lower risk for the groups where desensitizing agents were applied (p = 0.02), with a risk ratio of 0.88 (95% CI 0.78 to 0.98). About the intensity of TS, a significant average mean difference of - 0.77 units of VAS units (95%CI - 1.34 to - 0.19; p = 0.01) in favor of the desensitizer group. In the NRS scale, a significant average mean difference of - 0.36 (95% CI - 0.61 to - 0.12; p value = 0.004) in favor of the desensitizer

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Dentin Sensitivity
  • Humans
  • Hydrogen Peroxide
  • Nitrates
  • Potassium Compounds
  • Tooth Bleaching
  • Tooth Bleaching Agents

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09