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Santana et al. BMC Oral Health (2024) 24:139
https://doi.org/10.1186/s12903-024-03900-y BMC Oral Health
*Correspondence:
André Luis Faria-e-Silva
fariaesilva.andre@gmail.com
Full list of author information is available at the end of the article
Abstract
Background Light-cured resins are widely used as gingival barriers to protect the gums from highly concentrated
peroxides used in tooth bleaching. The impact of barrier brand on clinical outcomes is typically considered negligible.
However, there is limited evidence on the eects of dierent brands on operator experience, barrier adaptation, and
patient comfort.
Objective This clinical trial assessed the impact of four commercial gingival barrier brands (Opaldam, Topdam,
Lysadam, and Maxdam) on operator perception, adaptation quality, and patient comfort.
Methods Twenty-one undergraduate students placed gingival barriers in a randomized sequence using blinded
syringes. Photographs of the barriers were taken from frontal and incisal perspectives. After bleaching procedures,
operators rated handling features and safety using Likert scale forms. Two experienced evaluators independently
assessed barrier adaptation quality on a scale from 1 (perfect) to 5 (unacceptable). The absolute risk of barrier-induced
discomfort was recorded. Data were analyzed using Friedman and Chi-square tests (α = 0.05).
Results Opaldam and Topdam received the highest scores in most handling features, except for removal, which was
similar among all brands. No signicant dierence was observed in barrier adaptation quality between the evaluated
brands. Discomforts were mainly reported in the upper dental arch, with Maxdam having the highest absolute risk
(35% for this arch and 24% overall).
Conclusions This study suggests that gingival barrier brands can inuence operator perception and patient comfort.
Opaldam and Topdam were preferred by operators, but all brands demonstrated comparable adaptation quality.
Eect of gingival barrier brands on operator
perception, cervical adaptation, and patient
comfort during in-oce tooth bleaching:
a randomized clinical trial
Tauan RosaSantana1, Paula Fernanda DamascenoSilva1, Márcia Luciana CarregosaSantana1,
Clara Lemos Leal BaratadeMattos1, Michael WillianFavoreto2, TaynaradeSouza Carneiro2, AlessandraReis2,
Alessandro DouradoLoguércio2, Larissa Maria AssadCavalcante3, Luis Felipe JochimsSchneider3,4 and
André LuisFaria-e-Silva1,5*
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Santana et al. BMC Oral Health (2024) 24:139
Background
Tooth bleaching is a popular cosmetic dentistry pro-
cedure that eectively brightens discolored teeth and
enhances the overall appearance of your smile. Its suc-
cess in clinical trials is well-documented, with numerous
studies demonstrating its ecacy and safety [1–5]. While
the exact mechanism behind tooth bleaching is still being
unraveled, it’s believed to work by increasing the opacity
of tooth enamel and oxidizing phosphoproteins within
the dentin, which contribute to tooth discoloration [6–8].
Among various whitening techniques, in-oce bleach-
ing using highly concentrated hydrogen peroxide gels has
gained favor due to its controlled application and faster
results [9–11]. However, the high peroxide concentra-
tion raises concerns about potential irritation or burns
to the sensitive gingival tissues if direct contact occurs
[2, 12–15]. To address this safety concern, dentists com-
monly utilize light-cured resin-based materials known as
gingival barriers. ese are applied to the gum margins
around the teeth before bleaching, creating a physical
barrier that prevents the bleaching agent from touching
the soft tissues [16, 17]. is ensures a safe and comfort-
able bleaching experience while optimizing whitening
results.
Colored and owable light-cured resins are used to
construct gingival barriers, and these features aim to
make their application easy. e gingival barriers are
frequently placed on the gum following the cervical
contouring of the clinical crown of teeth submitted to
bleaching procedures [16]. Another approach is to cover
the cervical third of teeth without impacting the eec-
tiveness of bleaching [17]. erefore, the most important
matter regarding the gingival barrier application is to
avoid gaps permitting the passage of hydrogen peroxide
from the tooth surface to reach the gum. In this context,
the handling characteristics of the resin used as a gingi-
val barrier should favor its correct application. Another
point is that the light-curing tip is placed very close to
the gingival tissues during the barrier light-curing, which
can result in some heat in the gum and a burn sensation
[18–21]. Hence, the resins used as barriers should be
able to dissipate part of this heat to increase the patient’s
comfort.
In clinical trials assessing tooth bleaching protocols,
the primary adverse eect studied is post-bleaching tooth
sensitivity caused by whitening products. However, one
crucial aspect that often gets overlooked is the role of
gingival barriers in ensuring the procedure’s safety. It’s
worth perceiving that there are signicant variations
in prices among several gingival barrier products, and
their thixotropic characteristics also dier across brands.
Although the cost of these barriers may only slightly
impact the overall in-oce tooth bleaching expenses,
some clinicians might decide on cheaper brands with-
out fully considering potential variations in handling and
clinical performance. is oversight could have implica-
tions for the success and safety of the tooth-bleaching
process.
erefore, the purpose of this study was to evaluate
how dierent brands of gingival barriers impact the oper-
ator’s perception of their safety and ease of use, the qual-
ity of their adaptation to the cervical tooth margins, and
the reported comfort experienced by patients. We tested
the hypotheses that the gingival barrier brand would not
inuence (1) the operator’s perceptions, (2) the quality of
the cervical adaptation, and (3) the comfort reported by
patients.
Materials and methods
Study design, ethics approval, and participant selection
is study was nested within a randomized controlled
trial to evaluate the impact of enamel moistening on the
eectiveness of tooth bleaching using a 37% carbamide
peroxide solution. e trial was registered at https://
ensaiosclinicos.gov.br with the identier RBR-9gtr9sc on
July 14, 2023.
We employed a split-mouth design to evaluate four
light-activated resin-based gingival barriers (Table1). All
participants provided their informed consent by signing
a participation agreement for the study. e reporting
of this study adheres to the protocol established by the
CONSORT statement [22].
e sample size calculation was conducted in advance
for the primary outcome, which focused on the “qual-
ity of barriers adaptation.” For this calculation, the out-
come was dened as continuous, and the F-test Repeated
Measures ANOVA was chosen as the statistical test. e
Clinical trial registration The study was nested in a randomized clinical trial registered in the Brazilian Clinical Trials
Registry under identication number RBR-9gtr9sc.
Keywords Clinical trial, Gingival barrier, Patient-related outcome, Tooth bleaching
Table 1 Evaluated gingival barriers in the study
Name Manufacturer Price*
Opaldam Ultradent Products Inc., South
Jardan, UT, USA
5.40
Topdam FGM, Joinvile, SC, Brazil 4.20
Lysdam Lysanda, São Paulo, SP, Brazil 1.00
Maxdam Maquira dental group, Londrina,
PR, Brazil
2.10
* Price of resin -based gingival bar riers in Brazil (per g ram of resin), converted to
US Dollars as o f July 2023
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Santana et al. BMC Oral Health (2024) 24:139
calculation considered an eect size (F) of 0.3, a type I
error rate of 0.05, a power of 0.80, a single intervention,
and four measurements (number of barriers per partici-
pant). A correlation of 0.5 among the repeated measures
was assumed, and a spherical correction (ε) of 1.0 was
applied. We utilized the statistical power analysis pro-
gram G*Power 3.1.9.6, developed by Franz Faul at the
University of Kiel, Germany, to perform the sample size
calculation. Our calculations determined a minimum of
17 participants as necessary to meet the predetermined
parameters.
e study included patients over 18 years of age who
were referred to the Restorative Dentistry and Integrated
Clinic disciplines at the Dental School of the Federal
University of Sergipe. We excluded patients with caries,
existing restorations, severe discoloration (such as stains
caused by tetracycline), enamel hypoplasia on any of
their six upper anterior teeth, and those using xed orth-
odontic appliances. e interventions were carried out
between July and August 2023.
Interventions
To maintain blinding, the syringes containing each gin-
gival barrier were disguised by covering them with black
tape. Neither the operators nor the participants could
discern which barrier was applied to each dental hemi-
arch. Each participant received all four barriers during
the study, but only one barrier was randomly assigned to
each hemi-arch. is randomization was performed by
an investigator uninvolved in the interventions or evalua-
tions, using a pre-generated list of 21 blocks (equal to the
number of participants). Each block contained a random
sequence of the four interventions. is list was created
and kept condential within an opaque envelope until the
intervention commenced.
Before applying the gingival barriers, dental prophy-
laxis was conducted using a rubber cup, pumice, and
water. Next, a lip and cheek retractor were placed, and the
barriers were applied by third-year undergraduate dental
students. ese students had received instructions on the
procedures but had no prior experience in tooth bleach-
ing. e barriers were applied to the dried gingival tis-
sue, following the contour of the cervical margins of the
teeth’s clinical crowns. An LED-based light unit (Radii-
Cal, SDI, Victoria, Australia) was utilized for light-curing
the barriers, providing an irradiance of approximately
800 mW/cm². e light activation involved positioning
the LED’s tip over groups of three teeth for 25s, ensuring
thorough curing with a fully charged battery. Each par-
ticipant was attended by a dierent operator.
Photographs of the applied barriers were taken from a
frontal and incisal perspective to evaluate their adapta-
tion to the tooth cervical margins later. e images were
captured using a DSLR camera (Canon EOS Rebel T5,
Canon, Taiwan) equipped with a macro lens (Canon EF
100mm f/2.8L Macro IS USM, Canon, Taiwan). A whit-
ening agent containing 37% carbamide peroxide (Power
Bleaching, BM4, Palhoça, SC, Brazil) was applied over the
buccal surfaces of teeth and left undisturbed for 40min.
After this, the agent was removed with moist gauze, and
the teeth were washed with water-stream. Afterward,
a skilled clinician, who was part of the study, carefully
separated the barriers in the same dental arch by cutting
the interface between them using a scalpel blade. Subse-
quently, the operators removed the gingival barriers.
Evaluations
After completing the interventions, the undergraduate
students who applied the gingival barriers answered a
questionnaire to assess their experience. e self-admin-
istered questionnaire consisted of ve statements, four of
which indicated optimal handling features of the materi-
als, while one armed the operator’s condence in the
protection provided by the gingival barrier during the
tooth bleaching procedure. e students used a Likert
scale to score each statement, ranging from 1 (completely
disagree) to 5 (completely agree).
Furthermore, the patients who underwent the bleach-
ing procedure were asked about an eventual discomfort
caused by the gingival barriers. To evaluate the quality of
the barriers, images of the same barriers taken from fron-
tal and incisal perspectives were presented to two evalu-
ators who were not involved in any clinical procedures
(Fig. 1). ese blinded evaluators assessed the barrier
adaptation to the cervical tooth areas and assigned scores
based on the following scale: 1 (perfect), 2 (very good), 3
(good), 4 (poor), and 5 (unacceptable). Furthermore, the
barrier adaptation was categorized as adequate (scores 1
to 3) or inadequate (scores 4 or 5).
Data analysis
Data on the operators’ perception of the handling fea-
tures of resin-based gingival barriers were analyzed using
Friedman Repeated Measures Analysis of Variance on
Ranks. e scores assigned independently by the two
evaluators were averaged and then analyzed using the
same method. Data on the acceptable adaptation rate and
absolute risk of discomfort reported by patients with gin-
gival barriers were analyzed using the Chi-square test. A
signicance level of 95% was pre-set for all data analyses.
Results
e owchart of the study is presented in Fig.2. Twenty-
one participants between the ages of 21 to 28 years were
enrolled in the study and received all four interventions.
Out of the participants, 14 (66.7%) were female. No inter-
vention was discontinued, and data of all participants and
dental hemi-arches were analyzed.
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Santana et al. BMC Oral Health (2024) 24:139
e operators’ perception regarding the handling fea-
tures of resin-based gingival barriers is summarized in
Table 2. Opaldam and Topdam received higher median
scores than the other evaluated barriers, except for the
question concerning removal ease (no dierence among
the materials).
e quality of gingival barriers achieved with the dier-
ent evaluated materials is presented in Table3. Although
Maxdam received the lowest median score, no signicant
association was observed between the quality of the bar-
riers, as assessed by the evaluators, and the type of light-
cured resins used for their construction. Notably, barriers
made with Maxdam exhibited the lowest rate of adequate
adaptation (66.7%), while other materials showed compa-
rable rates (ranging from 81.0 to 85.7%), with no statisti-
cally signicant dierence.
Table 4 displays the results of patient-reported dis-
comfort attributed to the gingival barrier. Participants
exclusively reported experiencing some level of discom-
fort in the upper dental arch. Out of the evaluated barri-
ers, Maxdam had the highest absolute risk of discomfort
(23.81%), while no patients reported any discomfort with
Topdam.
Fig. 2 Flowchart of the split-mouth designed study
Fig. 1 Images captured from frontal (A) and incisal (B) perspectives showcasing a barrier and utilized to assess its adaptation quality to the cervical areas
of the teeth
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Santana et al. BMC Oral Health (2024) 24:139
Discussion
e results of this study revealed signicant variations
in the ratings that operators gave regarding the handling
features of dierent brands of gingival barriers, with the
more expensive barriers receiving higher scores (except
for the removal facility). Additionally, operators attrib-
uted the highest level of protection to the more expen-
sive barriers, leading us not to accept the study’s initial
hypothesis.
To mitigate biases associated with operator experi-
ence and ensure a blinded procedure, undergraduate
students with no prior experience in the evaluated pro-
cedures applied the gingival barriers. is approach
aimed to prevent experienced clinicians from recogniz-
ing the brand based on the syringe and applicator tip,
which could potentially introduce bias into the evalua-
tion and compromise blinding [23, 24]. By standardizing
the syringes and applicator tips for all barriers, the opera-
tor’s ability to recognize the brand would be minimized,
and the study could be conducted by experienced opera-
tors. However, it is important to consider that besides
the gingival barriers’ physicochemical characteristics,
each brand’s applicator tip can also inuence the opera-
tor’s perception. Hence, the barriers were kept in their
original syringes provided by the manufacturers, and the
application was made using the respective applicator tips.
Indeed, a comprehensive comparison should consider
both the physicochemical characteristics and the presen-
tation (syringe and applicator tip) of the gingival barriers
provided by the manufacturers. Besides, involving inex-
perienced operators in the evaluation allows for a more
objective assessment of the ease of use and condence
achieved when utilizing the evaluated materials during
bleaching procedures.
It is essential to highlight that all evaluated gingival
barriers received high scores regarding handling features,
application, and removal facility. Even for the brands
Lysdam and Maxdam, which received the lowest scores,
more than half of the operators agreed, at least partially,
Table 2 Medians (1st / 3rd quartiles) of scores reported by operators` perception regarding the handling features of gingival barriers
evaluated (n = 21)
Questions Gingival barriers p-value
Opaldam Topdam Lysdam Maxdam
It was easy for me to apply the gingival barrier. 5.00
(4.00/5.00)
5.00
(4.00/5.00)
4.00
(2.00/5.00)
4.00
(2.00/5.00)
0.031
I felt safe with the barrier’s protection to the whitening process. 5.00
(4.50/5.00)
5.00
(4.00/5.00)
4.00
(2.50/5.00)
4.00
(4.00/5.00)
0.015
The barrier removal was easy. 5.00
(4.50/5.00)
5.00
(4.00/5.00)
5.00
(4.00/5.00)
5.00
(4.00/5.00)
0.909
The syringe and tip facilitated the barrier`s application. 5.00
(4.50/5.00)
5.00
(4.50/5.00)
4.00
(2.00/5.00)
4.00
(2.00/4.50)
0.017
The barrier`s viscosity facilitated its application. 5.00
(3.00/5.00
5.00
(4.00/5.00)
4.00
(2.00/5.00)
4.00
(2.00/4.00)
0.036
The follow ing scores were used: 1 – Compl etely disagree, 2 – Par tially disagree, 3 – No opi nion, 4 – Partially agre e, and 5 – Completely agree. P-values calculated by
Friedman Repeated Measures Analysis of Variance on Ranks
Table 3 Results of evaluators’ scores for gingival barrier
adaptation quality
Gingival barriers Median
(1st / 3rd quartiles)
Rate of adequate
adaptation (%)
Opaldam 1.50 (1.00/ 2.25) 17/21 (81.0)
Topdam 1.50 (1.25/ 2.50) 18/21 (85.7)
Lysdam 1.50 (1.50/ 3.00) 17/21 (81.0)
Maxdam 3.00 (1.50/ 3.50) 14/21 (66.7)
Overall 1.50 (1.38/ 3.00) 66/84 (78.6)
p-value 0.094* 0.467**
The following scores were used: 1 – Perfect, 2 – Very good, 3 – Good, 4 – Poor,
and 5 – unacceptable. Scores 1 to 3 were dened as “adequate”, while 4 or 5
were inadeq uate. * P-value calculated by Friedman Repeated Measures Analysis
of Variance on Ran ks. ** P-value calculated Chi-square test
Table 4 Number (percentage) of participants reporting any gingival discomfort during the bleaching procedure according to the
gingival barrier used (n = 21)
Dental arch Gingival barriers p-value*
Opaldam Topdam Lysdam Maxdam
Upper 1/12
8.33%
0/8
0.00%
1/8
12.50%
5/14
35.71%
0.114
Lower 0/9
0.00%
0/13
0.00%
0/13
0.00%
0/7
0.00%
Not calculated
Overall 1/21
4.85%
0/21
0.00%
1/21
4.85%
5/21
23.81%
0.027
*Chi-square test
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Santana et al. BMC Oral Health (2024) 24:139
that the gingival barriers had features that facilitated clin-
ical procedures. Similar results were observed regarding
the safety provided by the barriers during the bleaching
procedures. ese ndings indicate that all evaluated
gingival barriers possess favorable characteristics, and
the procedures related to teeth isolation before tooth
bleaching are considered easy, even for undergraduate
students with no prior experience. However, it is impor-
tant to note that the high scores might not have been
observed if the study had involved more experienced
operators. is is because prior experience with similar
materials could have inuenced their perception, poten-
tially leading to more strict evaluations [25–27]. Further
studies are needed to validate this assertion.
e operators’ positive perception of the gingival bar-
riers can be conrmed by the quality of adaptation
achieved with these materials at the cervical tooth areas.
Apart from Maxdam, the median scores given to the bar-
riers were 1.5 for the other brands, indicating that at least
half of the gingival barriers constructed by the under-
graduate students had an adaptation classied between
very good and perfect. Despite the lowest scores received
by the barriers that used Maxdam, it is important to note
that at least half of them achieved a score of 3 (good
adaptation) or lower (very good or perfect). When the
adaptation quality was dichotomized, a high overall rate
(78.6) of adequate adaptation was observed, even for the
worst-scored gingival barrier Maxdam (66.7%). Impor-
tantly, no statistical dierence was observed in the “adap-
tation quality” outcome among the evaluated brands, not
rejecting the study’s second hypothesis. It’s important to
note that employing a larger sample size might uncover
lower scores for Maxdam. However, determining whether
the dierences observed in the scores would have any
clinically signicant implications is challenging. e most
signicant observation from this outcome is that even
undergraduate students with no prior experience could
create gingival barriers with good to perfect adaptation
in the cervical tooth area. is nding underscores that
using light-cured resins to protect gingival tissues during
in-oce tooth bleaching is a reliable and straightforward
procedure.
e last outcome analyzed in this study was the occur-
rence of discomfort among patients using gingival barri-
ers. Notably, patients reported experiencing discomfort
only in the upper dental arch. Among the various brands
of gingival barriers, Maxdam had the highest absolute
risk of discomfort, with approximately one-fourth of
participants reporting some discomfort (one-third in
the upper arch). Although the specic type of discom-
fort was not specied, it was predominantly described
as a mild heating sensation in the gingival tissue during
the light-curing process. Since the light-curing unit tip is
positioned close to the gingival tissue, the resin used as a
gingival barrier is expected to absorb some heat gener-
ated during the light-curing procedure [18–21]. It’s worth
noting that despite the relatively high overall occurrence
of discomfort in the upper dental arch (16.7%), this issue
remains largely unexplored. Besides, it is possible that
a higher absolute risk of discomfort could be reported
when light-curing units with high irradiance are used
[19]. Additionally, the light-curing resins used for gingival
barriers contain methacrylate monomers, which have the
potential for genotoxic eects [13]. Since the light-curing
process may not fully polymerize the barriers, there is a
possibility of residual monomers causing damage to the
gingival tissues. However, the exact composition of the
evaluated resin is unknown, and any explanations for the
observed dierences among the brands are purely specu-
lative. Further investigation is required to understand
better and assess this potential harm.
It is crucial to highlight that our study employed a
bleaching agent characterized by high viscosity and a
relatively low peroxide concentration. Notably, the prod-
uct’s manufacturer asserts its safe application even in the
absence of a gingival barrier. is precautionary measure
was adopted to prioritize participant safety during the
tooth bleaching procedures conducted by inexperienced
undergraduate students. Importantly, our study observed
no instances of gingival burns caused by the bleach-
ing agent, and there were no signicant reports of post-
bleaching tooth sensitivity.
To the best of our knowledge, no previous studies
have investigated the clinical aspects of gingival barriers,
including the perceptions of operators and the absolute
risk of discomfort reported by patients. Numerous gingi-
val barrier options are available in the dental market, and
clinicians might choose based on price or brand loyalty
[28]. Considering the lack of studies in this area, clini-
cians and researchers evaluating tooth bleaching have
assumed that gingival barriers are a minor concern in in-
oce tooth bleaching procedures. Although the pricier
barriers exhibited greater consistency in the results, this
study’s ndings indicated that inexpensive materials do
not necessarily possess inferior handling characteristics
or compromise the barrier’s adaptation to the cervical
tooth structure. e least expensive barrier evaluated
received high operator ratings, indicating adequate adap-
tation and a discomfort comparable to the most expen-
sive material. We believe that the results reported in this
study can also benet the manufacturer of the lowest-
rated brand, which had a high absolute risk of discom-
fort, by prompting improvements to their material.
It’s important to emphasize that the results of this study
cannot be generalized to experienced clinicians, but they
underscore the importance of further research on gingi-
val barriers to support their clinical use in in-oce tooth
bleaching. Finally, it is crucial to underscore that, despite
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Santana et al. BMC Oral Health (2024) 24:139
the evaluators not having access to information about the
specic brand employed in each hemi-arch, one of the
evaluated materials (Opaldam) was distinguished by its
green color, contrasting with the others that were blue.
As a result, ensuring a completely blinded evaluation
cannot be guaranteed, and there exists a potential for
some bias in the assessment.
Conclusion
In conclusion, our study revealed that the pricier gingival
barriers, Opaldam and Topdam, received higher scores
from operators for their superior handling features and
safety during the bleaching procedures. However, no sig-
nicant dierence was observed among the evaluated
brands concerning the adaptation quality to the cervi-
cal areas of teeth. Notably, using the barrier Maxdam
was associated with a higher absolute risk of discom-
fort reported by the patients. ese ndings emphasize
the importance of considering operator preferences and
patient comfort when selecting gingival barriers for tooth
bleaching procedures.
Author contributions
T.R., P.F.D, M.L.C., and C.L.L. were responsible for the methodology. M.W., T.S.,
and L.M.A. scored the quality of barrier adaptation. A.L. was responsible for
data analysis. A.R., A.D., L.F.S., and A.L. were responsible for formal analysis.
All authors wrote the original draft and revised the nal version of the
manuscript.
Funding
This study was nanced in part by the Coordenação de Aperfeiçoamento de
Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.
Data availability
The raw data from the study is accessible and can be requested directly from
the authors by contacting Dr. Tauan Rosa Santana via email at tauanrosas@
gmail.com.
Declarations
Ethics approval and consent to participate
The study protocol was approved by the scientic review committee and
the committee for the protection of human study participants of the Federal
University of Sergipe (protocol CAAE 16843819.9.0000.5546). All participants
enrolled signed the informed consent agreeing with their participation in the
study and data usage for the publication.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Author details
1Graduate Program in Dentistry, Federal University of Sergipe, Rua Cláudio
Batista, s/n, Sanatório, Aracaju, SE 49060-100, Brazil
2Department of Restorative Dentistry, State University of Ponta Grossa,
Avenida Carlos Cavalcanti, 4748, Bloco M, Sala 04, Ponta Grossa,
PR 84030-900, Brazil
3School of Dentistry, Federal Fluminense University, R. Mario Santos Braga,
28, Centro, Niterói, RJ 24020-140, Brazil
4School of Dentistry, Veiga de Almeida University, Praça da Bandeira, 149,
Tijuca, Rio de Janeiro, RJ 20270-150, Brazil
5Departamento de Odontologia, Universidade Federal de Sergipe,
Campus da Saúde, Rua Cláudio Batista, s/n – Sanatório, Aracaju,
SE 49060-100, Brazil
Received: 18 September 2023 / Accepted: 15 January 2024
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