Introduction
inflammation, orthodontic
INFLAMMATION, TOOTH SENSITIVITY, ADVERSE EFFECTS
Aesthetics are one of the main demands of patients seeking dental treatment. Therefore, among the most common complaints are the changes in dental color, shape, and teeth alignment [According to Slack et al. [However, similar clinical trials have demonstrated the effectiveness of at-home bleaching performed on teeth with orthodontic brackets [However, no attention has been paid to the inflammatory processes that can occur when both therapies are indicated together. For instance, it is well known that the fixed orthodontic appliance (FOA) is composed of accessories and wires that can facilitate the accumulation of biofilm and cause inflammation of periodontal tissues [Regarding the adverse effects that occur during bleaching procedures, the concerns mainly related to tooth sensitivity and gingival irritation. However, the evidence gathered to date regarding the inflammatory aspects of dental bleaching remains controversial. Despite not detecting any inflammatory changes post dental bleaching, recent randomized clinical trials [Therefore, considering that previous studies have demonstrated changes in inflammatory activity using FOAs [Thus, the primary objective of this clinical trial was to investigate the alterations in inflammatory activity in patients undergoing both dental bleaching and orthodontic treatment in comparison with that in patients who underwent either dental bleaching or orthodontic treatment. In addition, the efficacy of dental bleaching in teeth with and without orthodontic appliances was also evaluated. The null hypotheses tested were: (1) there was no difference in inflammatory activity when dental bleaching or orthodontic treatment was used alone; and (2) dental bleaching performed during the orthodontic treatment would not result in different degrees of color changes when compared to dental bleaching performed alone.