Evaluation of desensitizing efficacy of nanohydroxyapatite on the treatment of dentine hypersensitivity following ultrasonic scaling: a randomized controlled trial / Avaliação da eficácia dessensibilizante da nanoidroxiapatita no tratamento da hipersensibilidade dentinária após raspagem ultrassônica: um ensaio clínico randomizado

Objective: This randomized controlled trial aimed to compare nanohydroxyapatite with fluoride on managing post ultrasonic scaling Dentine hypersensitivity (DH). Material and Methods: Thirty patients (aged 20-50 years) with post ultrasonic-scaling DH were included in this study. The sample was randomly divided into three equal groups of 60 teeth each: the first group received nanohydroxyapatite material, the second group received fluoride material and the third group received sterile water as a placebo (controls). The materials were applied once for each patient. All patients were instructed to rate the level of pain before treatment, and after 1 hour, 24 hours, 2 weeks and 1 month on the numerical rating scale (NRS). The Kruskal-Wallis test, Mann-Whitney tests, linear regression analysis were used for the statistical analysis. Significance level was set at 0.05. Results: Both nanohydroxyapatite and fluoride were successful in reducing pain associated with DH when compared with the placebo in subsequent follow-ups (p < 0.05). However, one-hour and one-day post application, nanohydroxyapatite could reduce hypersensitivity pain moreeffectively than fluoride (p < 0.05). Conclusion: Nanohydroxyapatite material was found to besignificantly more effective in reducing the DH that followed ultrasonic scaling one-hour and one-day post application as compared to fluoride and sterile water. Both fluoride and nanohydroxyapatite had similar effect on DH after two-weeks and one-month after application. (AU)

Objetivo: Este ensaio clínico randomizado teve como objetivo comparar a nano-hidroxiapatita com o flúor no manejo da hipersensibilidade dentinária (HD) pós-raspagem ultrassônica. Material e Métodos: Trinta pacientes (com idades entre 20-50 anos) com HD pós-raspagem ultrassônica foram incluídos neste estudo. A amostra foi dividida aleatoriamente em três grupos iguais com 60 dentes cada: o primeiro grupo recebeu material de nano-hidroxiapatita, o segundo grupo recebeu material de flúor e o terceiro grupo recebeu água esterilizada como placebo (controle). Os materiais foram aplicados uma vez para cada paciente. Todos os pacientes foram instruídos a avaliar o nível de dor antes do tratamento, e após 1 hora, 24 horas, 2 semanas e 1 mês na escala de avaliação numérica (NRS). Os testes de Kruskal-Wallis, Mann-Whitney e análise de regressão linear foram usados para a análise estatística. O nível de significância foi estabelecido em 0,05. Resultados: Tanto a nano- hidroxiapatita quanto o flúor foram bem-sucedidos na redução da dor associada à HD quando comparados ao placebo em acompanhamentos subsequentes (p <0,05). No entanto, 1 hora e 1 dia após a aplicação, a nano-hidroxiapatita pode reduzir a dor de hipersensibilidade de forma mais eficaz do que o flúor (p <0,05). Conclusão: O material da nano-hidroxiapatita foi significativamente mais eficaz na redução da HD que se seguiu à raspagem ultrassônica, 1 hora e 1 dia após a aplicação, em comparação com o flúor e a água estéril. Tanto o flúor, quanto a nano-hidroxiapatita apresentou efeito semelhante na HD após 2 semanas e 1 mês após a aplicação (AU)

Treatment of dentinal hypersensitivity using propolis varnish: A scanning electron microscope study

Background: Dentin hypersensitivity (DH) affects all age groups in a population and is perceived as pain to any stimuli. From time immemorial, researchers have sought herbal or natural solutions to treat hypersensitivity. Propolis is one such natural, nontoxic resinous substance produced by honey bees, which is useful in various applications in dentistry and effective in treating dentinal hypersensitivity. Aim: The aim of this in vitro study is to assess the effect of propolis varnish on occlusion of dentinal tubules thus aiding in the treatment of dentinal hypersensitivity. The objective is to evaluate the effectiveness of the proposed treatment using scanning electron microscope (SEM) imaging. Materials and Methods: Twenty naturally extracted teeth were collected and stored until in vitro assessment. Discs obtained from each tooth were divided into two groups of 20 each – I (test) and II (control), with each tooth acting as its own control. Propolis varnish was applied only to the acid-etched surface of the exposed dentin of discs in the test group, whereas all the discs were subjected to SEM imaging. Results: Statistical analysis showed a significant reduction in open tubules (P < 0.001) from 160 ± 6.97 before treatment to 61.20 ± 9.10 after propolis varnish application in the test group. Conclusion: This study showed the promise of propolis varnish as a natural treatment modality for DH.

Characterization of Fluorotic Enamel After Microabrasion and Desensitizing Agent

ntroduction. Enamel microabrasion is a procedure used for removing a superficial layer of enamel that has some alteration of color and/or texture caused by dental fluorosis. The purpose of this study was to compare the microhardness and micromorphology of the fluorotic enamel surface after microabrasion with 6.6% hydrochloric acid and silica or 18% hydrochloric acid and evaluate the effect of desensitizing agent exposure on the treated enamel. Materials and Methods. Twenty anterior teeth with moderate fluorosis were divided into two groups: 1) Perla-Dent® group and 2) Opalustre® group. Each buccal surface of incisors was sectioned to obtain samples 3x3 mm. The samples were then mounted in acrylic blocks. The enamel surface of the blocks was polished, after the microabrasion materials and desensitizing agent were applied according to the manufacturer's instructions. All samples were analyzed by Vickers microhardness tester and scanning electron microscopy (SEM). Results. Both experimental groups presented a decrease in the microhardness values, with statistically significant differences (p<0.0001) when comparing the baseline and after treatments values. To compare the microhardness values after both microabrasion and desensitizing treatment in the study groups, it was observed that the Perla-Dent® group obtained lower values than the Opalescence® group with a statistically significant difference (p<0.0001). The representative images of study groups in SEM showed the enamel surface morphology after Perla-Dent® treatment more irregular and a very marked relief than that observed in enamel surface morphology after Opalustre® treatment. Conclusion. The surface of the enamel was more affected with Perla-Dent® treatment than with Opalustre® treatment and the placement of UltraEz® agent does not recover its baseline microhardness.

ntroducción. La microabrasión del esmalte es un procedimiento usado para remover la capa superficial de esmalte que tiene alguna alteración de color y / o textura causada por la fluorosis dental. El objetivo de este estudio fue comparar la microdureza y micromorfología de la superficie del esmalte fluorado después de microabrasión con ácido clorhídrico al 6,6% y sílice ó 18% de ácido clorhídrico y evaluar el efecto de la exposición del agente desensibilizante sobre el esmalte tratado. Materiales y métodos. 20 dientes anteriores con fluorosis moderada se dividieron en dos grupos: 1) grupo PerlaDent® y 2) grupo Opalustre®. La superficie bucal se seccionó para obtener muestras de 3x3 mm. Las muestras se montaron luego en bloques acrílicos. La superficie del esmalte de los bloques fue pulida, y posteriormente los materiales de microabrasión y el agente desensibilizante se aplicaron de acuerdo con las instrucciones del fabricante. Todas las muestras fueron analizadas por medio de microdureza Vickers y Microscopía electrónica de barrido (MEB). Resultados. Ambos grupos experimentales presentaron disminución de los valores de microdureza con diferencias estadísticamente significativas (p<0.0001) al comparar los valores de antes y después de los tratamientos. Al comparar los valores de microdureza después del tratamiento de microabrasión y desensibilizante en los grupos de estudio, se observó que el grupo Perla-Dent® obtuvo valores más bajos que el grupo Opalustre® con diferencia estadísticamente significativa (p<0.0001). Las imágenes representativas de los grupos de estudio en MEB mostraron la morfología de la superficie del esmalte después del tratamiento con Perla-Dent® más irregular y con un relieve más marcado que el observado en la superficie del esmalte después del tratamiento con Opalustre®. Conclusión. La superficie del esmalte se presentó más afectada posterior al tratamiento con Perla-Dent® que con Opalustre® y la colocación del agente UltraEz® no logró recuperar el grado de microdureza basal.

Effect of Erosion/Abrasion Challenge on the Dentin Tubule Occlusion Using Different Desensitizing Agents

The aim of the study was to evaluate dentinal tubule occlusion, measuring the dentin permeability (Lp) and using different desensitizing agents before and after abrasive/erosive challenge. Dentin discs from 42 healthy human third molars were obtained. Minimum Lp was measured after a smear layer simulation using #600 SiC paper and maximum Lp after an immersion in 0.5 M EDTA. The specimens were treated with different desensitizers: two varnishes (Clinpro XT Varnish-CV, Fluor Protector-FP), a paste (Desensibilize Nano P-NP) and a gel (Oxa Gel-OG). The Lp of each specimen was measured immediately after the desensitizers’ application. The discs were subjected to erosion/abrasion cycles for 7 days, with 0.5% citric acid solution (6x/day) and tooth brushing (3x/day). Lp was measured after the first, fourth and seventh day of the challenge. The data were analyzed by 3-way ANOVA with repeated measurements and by a Games-Howell test (α=5%). FP and CV did not show significant differences in Lp immediately after application until the 7th day (p<0.05). OG showed a significant increase in Lp after the 4th and 7th days. NP resulted in a significantly higher permeability compared to the other materials immediately after the application and after the 1st day of challenge. All the desensitizers reduced the dentin permeability immediately after application. However, only the varnishes were able to maintain the occlusive effect after the erosion/abrasion challenge.

Resumo O objetivo do estudo foi avaliar a permeabilidade da dentina (Lp) usando diferentes agentes dessensibilizantes antes e depois de um desafio abrasivo/erosivo. Discos de dentina foram obtidos a partir 42 terceiros molares humanos. Lp mínima foi medida após uma simulação de smear layer usando lixa de SiC # 600 e a Lp máxima foi medida após imersão em EDTA 0,5 M. As amostras foram tratadas com diferentes dessensibilizantes: dois vernizes (Fluor Protector-FP, Clinpro XT Varnish-CV), uma pasta (Desensibilize Nano P-NP) e um gel (Oxa Gel-OG). A Lp de cada amostra foi medida imediatamente após a aplicação dos dessensibilizantes. Os discos foram submetidos a um ciclo de erosão/abrasão durante 7 dias, com uma solução de 0,5% de ácido cítrico (6x/dia) e escovação (3x/dia). Lp foi medida do primeiro ao sétimo dia do desafio. Os dados foram analisados por ANOVA a 3 critérios com medidas repetidas e teste de Games-Howell (α=5%). FP e CV demonstraram Lp semelhante imediatamente depois da aplicação até 7 dias (p<0,05). OG apresentou um aumento significativo na Lp depois do 4º e 7º dias. NP resultou numa permeabilidade significativamente mais elevada comparada com a dos outros materiais imediatamente após a aplicação e após o primeiro dia de desafio. Todos os dessensibilizantes reduziram a permeabilidade da dentina imediatamente após a aplicação. No entanto, apenas os vernizes foram capazes de manter o efeito oclusivo após o desafio da erosão/abrasão.

Comparing the effect of a desensitizing material and a self-etch adhesive on dentin sensitivity after periodontal surgery: a randomized clinical trial

OBJECTIVES: This double-blind randomized placebo-controlled clinical trial evaluated the ability of a desensitizing agent and a self-etch adhesive on cervical dentin sensitivity (CDS) after periodontal surgery. MATERIALS AND METHODS: Ninety hypersensitive teeth of 13 subjects were included in the study. After periodontal surgery, the teeth of each posterior sextant treated with one of the following materials: G1: Clearfil S³ Bond (Kuraray Dental), G2: Gluma Desensitizer (Heraeus Kulzer), and G3: placebo (water). The sensitivity was assessed using evaporative stimuli before treatment (baseline, T0), 1 day after treatment (T1), after 1 week (T2), and after 1 month (T3) according to visual analog scale (VAS). RESULTS: Following the treatment, all the 3 groups showed significant reduction of CDS in T1 compared to T0. Reduction of CDS between T1 and T2 was observed only in G1 but there was no significant difference between T2 and T3 in this group. Although we observed a significant difference in T3 compared to T1 and T2 in G2 and G3, comparison of treatment groups in each assessment time showed a significant difference only in T3. According to paired comparison, this was due to the difference between G2 and G3. CONCLUSIONS: Dentin sensitivity following periodontal surgery will decrease spontaneously over time, but treating the sensitive teeth with Gluma Desensitizer and Clearfil S³ Bond can have some benefits.

Efeito de agentes dessensibilizantes na obliteração dos túbulos dentinários - estudo in vitro / Effect of desensitizing agents for dentinal tubules obliteration - in vitro study

Objetivo: avaliar o número de aplicações necessárias para a completa obliteração dos túbulos dentinários utilizando diferentes agentes dessensibilizantes. Material e Métodos: a porção do esmalte coronário da face vestibular de 40 incisivos bovinos foi removida com auxílio de lixas para expor a dentina superficial da junção amelo-cementária. Em seguida, as raízes e a porção coronária referente ao terço médio-incisal dos dentes foram removidas. A seguir foi realizada a completa remoção de smear layer, evidenciando os túbulos dentinários. As amostras foram divididas em quatro grupos experimentais conforme o agente dessensibilizante utilizado: verniz fluoretado, adesivo dentinário, dessensibilizante dentinário e creme dental. Os produtos foram aplicados de acordo com as recomendações do fabricante. As amostras foram avaliadas previamente e após o uso dos agentes por microscopia eletrônica de varredura de baixo vácuo. A aplicação do agente e a análise foram realizadas até a completa obliteração dos túbulos dentinários. Os dados foram avaliados estatisticamente em relação ao número de aplicações necessárias utilizando os testes de Kruskal-Wallis e Mann-Whitney (p < 0,05). Resultados: o verniz fluoretado foi o mais eficaz dos agentes avaliados, sendo necessária uma aplicação para a completa obliteração dos túbulos. Para o adesivo dentinário foram necessárias duas aplicações e para o dessensibilizante e o creme dental foram necessárias cinco aplicações. Conclusão: os agentes dessensibilizantes testados necessitam de um número variado de aplicações, sendo o mais eficaz o verniz fluoretado, onde apenas uma aplicação possibilitou a completa obliteração dos túbulos.

Objective: The aim of this study was to evaluate the number of applications necessary for the complete obliteration of dentinal tubules using different desensitizing agents. Materials and Methods: A portion of coronary enamel of the buccal surface of 40 bovine incisors was removed with the aid of sandpaper in order to expose the superficial dentin at the dentin-enamel junction. The roots and the coronary portions of the mesial-incisal third of the teeth were also removed. Complete smear-layer removal was performed, exposing the dentinal tubules. Samples were divided into four experimental groups according to the desensitizing agents used: fluoride varnish; dentin adhesive; dentin desensitizing; and toothpaste. The products were applied in accordance with the manufacturer's recommendations. Samples were evaluated before and after the application of different agents by scanning electronic microscopy of low vacuum. The application of the products and analyses were carried out until complete obliteration of dentinal tubules. Data were evaluated statistically in relation to the required number of applications, using Kruskal-Wallis and Mann-Whitney tests (p < 0.05). Results: The results showed that fluoride varnish was the most efficient of the tested agents, requiring a single application for the complete obliteration of the dentinal tubule. For the dentin adhesive, two applications were necessary and for the dentin desensitizing and toothpaste, five applications were required. Conclusion: The desensitizing agents tested required a distinct number of applications, and the fluoride varnish was the most effective agent, with a single application resulting in the complete obliteration of the dentin tubule.

Effects of a whitening strip combined with a desensitizing primer on tooth color / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to evaluate the efficacy of a 2.9% hydrogen peroxide (HP) whitening strip with a desensitizing agent as a primer. METHODS: This study was approved by the Institutional Review Board of Kyungpook National University Hospital. A total of 144 subjects (mean age: 21.7 years) were recruited after they provided informed consent for participation in the study. All participants used the whitening strip and primer for 1.5 h a day for 14 days. ShadeEye-NCC and Vita classical shade guide were used to determine the color changes, with respect to baseline, after 1, 3, 5, 7, and 14 days. A self-administered questionnaire was used to collect data on satisfaction after bleaching and irritating symptoms during the 14 days. All collected data were analyzed with repeated measures ANOVA and one-way ANOVA using SPSS 20.0 for windows. RESULTS: Brightness (ΔL*) was significantly higher in groups 2 and 3 than in the control group after 3 days of the experiment. Chroma (Δb*) started to decrease in groups 2 and 3, compared to control, after 1 day. Perceived symptoms of irritation were significantly lower in groups using the strip combined with the desensitizing primer than in the control group. Satisfaction after bleaching was higher in the experimental groups than in control. CONCLUSIONS: The HP whitening strip with a desensitizing agent as a primer is clinically effective in bleaching human enamel after 3 days of use. It also reduces the prevalence of gingival irritation.

Real-time measurement of dentinal fluid flow during desensitizing agent application / 대한치과보존학회지

OBJECTIVES: The aim of this study was to examine changes in the dentinal fluid flow (DFF) during desensitizing agent application and to compare permeability after application among the agents. MATERIALS AND METHODS: A Class 5 cavity was prepared to exposure cervical dentin on an extracted human premolar which was connected to a sub-nanoliter fluid flow measuring device (NFMD) under 20 cm water pressure. DFF was measured from before application of desensitizing agent (Seal&Protect, SP; SuperSeal, SS; BisBlock, BB; Gluma desensitizer, GL; Bi-Fluoride 12, BF) through application procedure to 5 min after application. RESULTS: DFF rate after each desensitizing agent application was significantly reduced when compared to initial DFF rate before application (p < 0.05). SP showed a greater reduction in DFF rate than GL and BF did (p < 0.05). SS and BB showed a greater reduction in DFF rate than BF did (p < 0.05). CONCLUSIONS: Characteristic DFF aspect of each desensitizing agent was shown in NFMD during the application procedure.

Effect of desensitizing agent on shear bond strength of an adhesive system

Desensitization of teeth after cavity preparation has been recommended in an attempt to avoid post-operative sensitivity. However, there is concern regarding application effect of desensitizing agent on shear bond strength of the adhesive system used. The purpose of our study was to compare the shear bond strength of adhesive system in two different dentin surface treatments, with and without desensitizing agent. Sixteen extracted human premolars were sectioned off at the coronal portion to expose the flat dentin surfaces. The surfaces were finished using 600 Grit Wet Silicon Carbide abrasive papers. The premolars were randomly assigned to two groups: control and treated with MS Coat desensitizing agent. The desensitizer was applied according to manufacturer’s instruction. Resin composite was bonded to each dentin surface using Prime & Bond® adhesive system. The composite resin was debonded by shear stress. Mann-Whitney Test was used in statistical analysis. Our result showed that application of MS Coat desensitizing agent on dentin surface had significantly reduced the shear bond strength of the adhesive system used (z = - 0.14, p < 0.05). Thus, we conclude that shear bond strength of Prime & Bond® NT (Dentsply, USA) adhesive system will be reduced if dentin surface is treated with MS Coat (Sun Medical, Japan) desensitizing agent.

A SEM study of dentinal tubule sealing effect of desensitizing agent applicated after root planning / 대한치주과학회지

The purpose of this study was to observe the degree of surface obliteration of dentinal tubule using Gluma(R) desensitizer and MS coat(R) with 15 specimens made out of 15 extracted lower incisors. They were divided into Root planning group(control), Gluma(R) desensitizer group(testI) and MS coat(R) group(testII). Degree of obliteration was examined under the scanning electron microscope(x2000). The following results were obtained : 1. In the root planning group(control), the complete open of dentinal tubule surface was accounted for 73.8%, the partial obliteration for 17.2% and the complete obliteration for 9.0%. 2. In the Gluma(R) desensitizer group (test I), the complete open of dentinal tubule surface was accounted for 23.6%, the partial obliteration for 42.8% and the complete obliteration for 33.6%. 3. In the MS coat(R) group (test II), the complete open of dentinal tubule surface was accounted for 19.2%, the partial obliteration for 45.6% and the complete obliteration for 35.2%. 4. The average number of open dentinal tubules in the control was significantly higher than in the testI and II(P<0.05), but there were no statistically significant differences between the test I and II. 5. The average number of the partially obliterated and the completely blocked dentinal tubules in the control was significantly lower than the testI and II(P<0.05), but there were no statistically significant differences between the test I and II. The results of this study suggest that Gluma(R) desensitizer and MS coat(R) is significantly effective on dentinal tubule obliteration, therefore they were effective on hypersensitivity caused by periodontal treatment