The 100 Most-Cited Papers in Dentin Hypersensitivity: A Bibliometric Analysis

ABSTRACT Objective: To identify the 100 most-cited articles in DH and analyze their characteristics. Material and Methods: A search was performed on the Web of Science (WoS) and the 100 most-cited articles were selected. The following data were extracted: citations, year of publication, authorship, institution, country, journal, language, study design, topic of interest, conflict of interest (COI), and sponsorship. The VOSviewer software was used to visualize bibliometric networks. Poisson regression analysis was performed to measure associations between several citations and the characteristics of the studies. Results: The number of citations ranged from 346 to 48. The most-cited article was published in 1997 by Holland in the Journal of Clinical Periodontology. This journal published the most papers, followed by the Journal of Oral Rehabilitation and Journal of Dentistry. Laboratory research, review, and clinical trial were the study designs most prevalent. Reviews (p<0.05; PR= 1.853) and method development studies (p<0.05; PR= 1.853) had a more chance to present more citations. The main topics of interest were the clinical effectiveness of desensitizers and in vitro analysis of dentin morphology. Sponsorship and COI were underreported. England and USA presented the greatest number of citations and connections in the coauthorship network map. Conclusion: Most of the articles were original research, and their topics of interest were mainly the clinical effectiveness of desensitizing agents and dentin morphology.

Effect of different toothpastes on permeability and roughness of eroded dentin / Efeito de diferentes cremes dentais na permeabilidade e rugosidade da dentina erodida

ABSTRACT Dentin hypersensitivity (DH) is characterized by rapid, acute pain arising from exposed dental tubules. Aim: the aim of this study was to evaluate the roughness, tubule occlusion, and permeability of eroded dentin brushed with different toothpastes. Materials and Method: ninety bovine teeth were cut into blocks. Thirty hemifaces were protected with varnish and the other sixty were submitted to permeability tests. Specimens were divided into groups according to the dentifrices: without fluoride (WF), sodium fluoride (NaF), and stannous fluoride (SnF2). The blocks were subjected to a 5-day erosive-abrasive protocol. Surface roughness and dentinal tubule occlusion (n=10) were assessed for both control and test hemifaces of the same sample along with permeability analysis (n=20). Two-way RM ANOVA and Tukey's post-hoc test were performed (p≤0.05). Results: NaF and SnF2 presented higher roughness than WF. The number of open tubules was higher in WF. Permeability was higher in SnF2, but there was no significant difference between WF and NaF. Conclusions: both fluoride toothpastes occluded dentinal tubules and increased roughness. NaF toothpaste promoted greater decrease in dentin permeability.

RESUMO A hipersensibilidade dentinária (HD) é caracterizada por dor rápida e aguda decorrente de túbulos dentais expostos. Objetivo: este estudo teve como objetivo avaliar a rugosidade, oclusão tubular e permeabilidade da dentina erodida escovada com diferentes dentifrícios. Materiais e Método: noventa dentes bovinos foram seccionados em blocos. Trinta hemifaces foram protegidas com verniz e outras sessenta foram submetidas à permeabilidade. Os espécimes foram divididos em grupos de acordo com os dentifrícios: sem flúor (SF), fluoreto de sódio (NaF) e fluoreto estanoso (SnF2). Em seguida, os blocos foram submetidos a um protocolo erosivo-abrasivo de 5 dias. A rugosidade da superfície e a oclusão do túbulo dentinário (n = 10) foram avaliadas para ambas as hemifaces de controle e teste da mesma amostra, também realizou-se a análise de permeabilidade (n = 20). Two-way RM ANOVA e pós-teste de Tukey foram realizados (p≤0,05). Resultados: NaF e SnF2 apresentaram rugosidade superior ao SF. O número de túbulos abertos foi maior em SF. Não encontramos diferenças significativas entre SF e NaF em relação à permeabilidade; entretanto, SnF2 apresentou maior permeabilidade. Conclusão: ambos os dentifrícios fluoretados foram capazes de ocluir os túbulos dentinários e aumentar a rugosidade. No entanto, o dentifrício NaF promoveu uma maior diminuição da permeabilidade dentinária.

Obliteration of Dentinal Tubules by Desensitizing Agents Based on Silver Fluoride/Potassium Iodide or Pre-Reacted Glass Particles: An in Vitro Study

Abstract Objective: To evaluate the efficacy of desensitizing agents for the obliteration of dentinal tubules subjected or not to a simulated oral environment. Material and Methods: Dentinal discs (n=8) treated with Riva-Star (RS) or PRG-Barrier-Coat (PRG) were submitted (cycled) or not submitted (control) to erosive-abrasive-thermal cycles and evaluated using scanning electron microscopy/energy dispersive spectroscopic analysis. The variables analyzed were tubule obliteration and dentin surface chemical composition. Data were analyzed by non-parametric tests (p<0.05). Results: The cycled and control groups did not differ significantly for the responses in each material. The PRG control and cycled groups had fewer visible tubules and a higher proportion of totally obliterated tubules than the RS groups. The percentages of silver coverage were higher in the RS-control than in the RS-cycled. There was a significant inverse correlation between the presence of silver and non-obliterated tubules (R=-0.791; p<0.001). The percentages of carbon, aluminum, strontium, and potassium were significantly higher in the PRG-control and PRG-cycled compared to the RS control. The percentages of calcium, phosphorus, and silver were significantly higher in the RS compared to the PRG groups. PRG-control showed a higher percentage of boron than RS-control. Conclusion: PRG promoted greater tubule obliteration than SR. Simulated stress did not affect the obliterating effect of each agent. Greater silver coverage corresponded to a lower proportion of non-obliterated tubules in RS. Carbon, aluminum, strontium, boron, and potassium predominated in the dentin surface treated with PRG, while calcium, phosphorus, and silver prevailed in RS groups (AU).

Barniz polimerizable de vidrio ionómero modificado con resina "clinpro xt": una alternativa de tratamiento para la sensibilidad dentaria. Revisión sistemática de la literatura

Resumen Introducción: En respuesta a la sensibilidad dentinaria, se han desarrollado múltiples productos, entre ellos, Clinpro XT, barniz de vidrio ionómero modificado con resina fotopolimerizable con flúor, calcio y fosfato. Metodología: Se realizó una revisión sistemática de la literatura. La selección fue en base a título, resumen y texto completo de acuerdo a los criterios de inclusión y exclusión. Resultados: De 299 artículos, fueron seleccionados revisiones sistemáticas, metaanálisis, estudios in vivo e in vitro y 2 encuestas. Discusión: Clinpro XT reduce la permeabilidad dentinaria, ocluye túbulos dentinarios e inhibe su reapertura, aumenta la biodisponibilidad de minerales en saliva y promueve la remineralización del esmalte. Significando una mayor protección del esmalte y dentina de forma inmediata y a largo plazo. Conclusiones: Clinpro XT demostró disminuir la hipersensibilidad dentinaria incluso después 6 meses posterior a su aplicación.

Resumo Introdução: Em resposta à sensibilidade dentinária, foram desenvolvidos múltiplos produtos, incluindo Clinpro XT, um verniz de vidro de ionómero modificado com resina fotopolimerizável com flúor, cálcio, e fosfato. Metodologia: Foi realizada uma revisão sistemática da literatura. A selecção foi baseada no título, resumo e texto completo de acordo com os critérios de inclusão e exclusão. Resultados: De 299 artigos, revisões sistemáticas, meta-análises, estudos in vivo e in vitro e 2 inquéritos foram seleccionados. Discussão: Clinpro XT reduz a permeabilidade da dentina, oclui os túbulos dentinários e inibe a sua reabertura, aumenta a biodisponibilidade dos minerais na saliva e promove a remineralização do esmalte. O que significa uma maior protecção do esmalte e da dentina imediatamente e a longo prazo. Conclusões: Foi demonstrado que o Clinpro XT diminui a hipersensibilidade da dentina mesmo 6 meses após a aplicação.

Abstract Introduction: Multiple products have been developed to treat dentin sensitivity, including Clinpro XT, a lightcuring resinmodified ionomer glass varnish with fluoride, calcium, and phosphate. Methodology: A systematic literature review was conducted. The articles were selected based on title, abstract, and full text according to the inclusion and exclusion criteria. Results: Of 299 articles, systematic reviews, metaanalysis, in vivo and in vitro studies, and 2 surveys were selected. Discussion Clinpro XT reduces dentin permeability, occludes dentin tubules, inhibits their reopening, increases mineral bioavailability in saliva, and promotes enamel remineralization. This entails greater protection of enamel and dentin immediately and in the long term. Conclusions: Clinpro XT was shown to decrease dentin hypersensitivity even six months after application.

Treatment of dentin hypersensitivity with laser: systematic review / Tratamento da hipersensibilidade dentinária com laser: revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: Dentin hypersensitivity is an exacerbated response to a stimulus, causing acute and short-term pain. Over the years, several treatments for dentin hypersensitivity have emerged, including laser therapy. Thus, the objective of this work was to carry out a review about the available devices and the existing procedures of laser therapy in the treatment of dentin hypersensitivity. CONTENTS: A systematic review of studies published from 2016 to 2020 was carried out through bibliographic search in the electronic databases Pubmed and the Biblioteca Virtual em Saúde - (Virtual Health Library), using the following descriptors: "Laser" And "Dentin Hypersensitivity". Of the total of 51 articles found in the search, 14 were eligible for a review. There was an evaluation of the possible risks of bias for each of the articles included. CONCLUSION: As a result, a variety of devices available on the market and different protocols that prove to be effective for the treatment of dentin hypersensitivity when compared to the initial pain situation (baseline) were found. When laser treatment is compared with other existing therapies, it's not so clear which would be the most effective, due to the wide variety of study methodologies. However, an association of therapies that act in the two mechanisms of pain interception (neural and blocker) seems to be an appropriate conduct in the control of dentin hypersensitivity, and this combination can happen through physical methods (High and low intensity laser) and chemical (neural and blocker agents).

RESUMO JUSTIFICATIVA E OBJETIVOS: A hipersensibilidade dentinária é uma resposta exacerbada a um estímulo, causando dor aguda e de curta duração. Ao longo dos anos, diversos tratamentos para a hipersensibilidade dentinária têm surgido, incluindo a laserterapia. O objetivo foi realizar uma revisão acerca dos aparelhos disponíveis e dos protocolos do tratamento da hipersensibilidade dentinária com laser. CONTEÚDO: Foi realizada uma revisão sistemática de estudos publicados de 2016 a 2020, por meio da busca bibliográfica nas bases de dados eletrônicos Pubmed e da Biblioteca Virtual em Saúde, utilizando os seguintes descritores: "Laser" e "Dentin Hypersensitivity". Do total de 51 artigos encontrados na busca, 14 foram elegíveis para a revisão. Foram analisados os possíveis riscos de viés para cada um dos artigos incluídos. CONCLUSÃO: Diante da variedade de protocolos existentes quanto ao uso do laser, tanto alta (LAP) quanto de baixa potência (LBP), nadiminuição do desconforto causado pela HD, pode-se concluir de maneira geral que o emprego do laser tem se mostrado efetivo na grande maioria dos protocolos utilizados nos estudos, porém, ainda não é claro qual seria a estratégia mais efetiva a longo prazo. A associação de intervenções que atuem nos dois mecanismos de interceptação da dor (neural e obliterador) parece ser uma conduta apropriada no controle da HD, podendo essa combinação acontecer por meio de métodos físicos (laser de alta e baixa intensidade) e químicos (agentes neurais e obliteradores). A terapia mais adequada para HD depende de criteriosa anamnese e exame físico, enquanto o sucesso do tratamento dependerá da remoção dos fatores causais e de um plano de tratamento feito individualmente para cada paciente.

In vitro dentin permeability and tubule occlusion of in-office desensitizing materials / Permeabilidade da dentina e oclusão tubular in vitro de materiais dessensibilizantes de consultório

Objetivo: O objetivo desse estudo foi investigar a permeabilidade dentinária e a oclusão tubular de materiais dessensibilizantes de uso em consultório. Métodos: Blocos de dentina bovina foram obtidos e imersos em EDTA 0,5 M para promover a abertura dos túbulos dentinários. Os materiais testados foram: verniz placebo (PLA); verniz fluoretado (FLU); verniz de NaF 5% + 5% trimetafosfato de sódio nanoparticulado (TMP); sistema adesivo universal (SBU); verniz contendo partículas S-PRG (SPRG); solução de Biosilicato (BIOS) e solução de amelotina (AMTN). Os materiais foram aplicados e os espécimes submetidos ao desafio erosivo-abrasivo. A permeabilidade dentinária foi avaliada em T0 (inicial), T1 (após a aplicação dos materiais) e T2 (após o desafio erosivo-abrasivo). As imagens confocais foram usadas para avaliar o comprimento e o número dos túbulos ocluídos e as imagens de microscopia eletrônica de varredura (MEV) para avaliar o número de tubulos abertos. Os dados de permeabilidade e MEV foram analisadas pelo teste ANOVA duas medidas repetidas e pós teste de Tukey. O comprimento e número de túbulos dentinários ocluídos foram analisadas pelo teste ANOVA um critério e pós teste de Tukey, Kruskal-Wallis e pós teste de Dunn's, respectivamente. Os testes de correlação de Spearman e Pearson também foram realizados. O nível de significância foi de 5%. Resultados: O grupo AMTN mostrou os menores valores de permeabilidade em T1 e a seguinte ordem decrescente ocorreu em T2: AMTN=SBU>BIOS=SPRG>TMP>FLU>PLA. O grupo SBU teve o maior comprimento médio de túbulos dentinários ocluídos. O grupo AMTN teve maior número de túbulos dentinários ocluídos do que PLA e FLU e os menores valores de túbulos dentinários abertos foram observados para os grupos AMTN e SBU. Uma correlação significativa foi encontrada entre as análises realizadas. Significância: O sistema adesivo universal e a proteína amelotina foram mais efetivos em reduzir a permeabilidade dentinária através da oclusão dos túbulos dentinários(AU)

Objectives: The aim of this study was to investigate the dentin permeability and tubule occlusion of in-office desensitizing materials. Methods: Bovine dentin blocks were obtained and immersed in 0.5 M EDTA to open dentinal tubules. The materials tested were: placebo varnish (PLA); fluoride varnish (FLU); NaF 5% + 5% nanoparticulate sodium trimetaphosphate varnish (TMP); universal adhesive system (SBU); S-PRG filler-containing varnish (SPRG); Biosilicate solution (BIOS) and amelotin solution (AMTN). The materials were applied, and specimens were submitted to an erosive-abrasive challenge. Dentin permeability was evaluated at T0 (initial), T1 (after application of materials) and T2 (after erosive-abrasive challenge). Confocal images were used to evaluate length and number of dentinal tubules occluded and images from scanning electron microscopy (SEM) to evaluate opened dentinal tubules. Permeability and SEM data were evaluated by two-way repeated measures ANOVA and Tukey tests. The length and number of dentinal tubules occluded were evaluated by one-way ANOVA and Tukey, Kruskal-Wallis and Dunn's tests, respectively. Spearman and Pearson correlation tests were also used. The significance level was 5%. Results: AMTN group showed the lowest permeability value in T1 and the following decreasing order occurred in T2: AMTN=SBU>BIOS=SPRG>TMP>FLU>PLA. SBU group had the highest mean value of dentinal tubules occluded lengths. AMTN group had greater number of dentinal tubules occluded than PLA and FLU and the lowest values of opened dentin tubules were observed for AMTN and SBU groups. A significant negative correlation was found between the analysis. Significance: Universal adhesive system and the AMTN solution were more effective to reduce dentin permeability by occluding dentin tubules(AU)

Effect of prior application of desensitizing agent on the teeth submitted to in-office bleaching

Abstract This study aimed to quantify the penetration of hydrogen peroxide, color change evaluation, surface morphology, and composition after application of desensitizing agents before in-office bleaching. Fifty premolars were sectioned, an acetate buffer was placed in the pulp chamber and divided into five groups (n=10). In the positive control group, only the in-office bleaching gel was used, and in the negative control group, no treatment was used. Three different desensitizing agents were applied: Desensibilize KF2%® group; Mi Paste® group, and Desensibilize Nano-P® group. The bleaching procedure was carried out with 35% HP. The absorbance of the resulting solution was determined in a spectrophotometer. Color change was assessed by using a digital spectrophotometer. Four additional premolars were assigned to the same groups above for analysis under scanning electron microscope, as well as to evaluate the elemental composition with X-ray dispersive energy spectrometry. Data were subjected to ANOVA and Tukey's test (α=0.05). All products reduced the penetration of HP in the pulp chamber. Mi Paste and Nano P were the products that yielded the lowest HP penetration, which was similar to the negative control group (p<0.001). No significant difference was detected in color change (p<0.001). Concerning enamel morphology, the groups that were analyzed after bleaching were observed a greater deposition of desensitizing agents on the surface. The use of desensitizing agents before tooth bleaching seems to be an alternative to reduce adverse effects of the tooth.

Resumo Este estudo teve como objetivo quantificar a permeabilidade do peróxido de hidrogênio (PH), avaliação da mudança de cor, morfologia da superfície e composição de elementos após a aplicação de agentes dessensibilizantes antes do clareamento em consultório. Cinquenta pré-molares foram seccionados, um tampão de acetato foi colocado na câmara pulpar e divididos em cinco grupos (n=10). No grupo controle positivo, apenas o gel clareador em consultório foi utilizado e no grupo controle negativo nenhum tratamento foi realizado. Foram aplicados três agentes dessensibilizantes diferentes: grupo KF2%®; grupo Mi Paste® e Desensibilize Nano-P®. O procedimento de clareamento foi realizado com PH a 35%. A absorbância da solução resultante foi determinada em um espectrofotômetro. A mudança de cor foi avaliada utilizando um espectrofotômetro digital. Quatro pré-molares adicionais foram atribuídos aos mesmos grupos acima para análise em microscópio eletrônico de varredura, bem como para avaliar a composição elementar com espectrometria de energia dispersiva por raios-X. Os dados foram submetidos ao teste ANOVA e Tukey (a=0,05). Todos os produtos reduziram a penetração de PH na câmara pulpar. Mi Paste e Nano P foram os produtos que apresentaram a menor penetração de PH, semelhante ao grupo controle negativo (p<0,001). Nenhuma diferença significativa foi detectada na mudança de cor (p<0,001). Em relação à morfologia do esmalte, os grupos analisados após o clareamento apresentou maior deposição de agentes dessensibilizantes na superfície. O uso de agentes dessensibilizantes antes do clareamento dental parece ser uma alternativa para reduzir os efeitos adversos no dente.

Efeitos de diferentes dentifrícios na permeabilidade e rugosidade de dentina erodida / Effect of different toothpastes on permeability and roughness of eroded dentin

O objetivo deste estudo foi avaliar a rugosidade, a obliteração dos túbulos dentinários e a permeabilidade da dentina erodida e escovada com diferentes dentifrícios. Noventa dentes bovinos foram seccionadas em blocos, sendo que em trinta a hemiface foi protegida com verniz ácido resistente e sessenta foram submetidos ao teste de permeabilidade. Os espécimes foram divididos de acordo com os dentifrícios: sem flúor (SF), com fluoreto de sódio (NaF) e com fluoreto de estanho (SnF2). Em seguida, os blocos foram submetidos a um protocolo erosivo-abrasivo por 5 dias. As análises de rugosidade superficial e obliteração dos túbulos dentinários (n=10) foram realizadas nas hemifaces controle e teste do mesmo espécime e a análise da permeabilidade (n=20) foi realizada novamente. Os dados foram submetidos aos testes de ANOVA a dois critérios medidas repetidas e pós teste de Tukey (p≤0,05). Os grupos NaF e SnF2 apresentaram maior rugosidade comparando-se ao SF. O grupo SF apresentou a maior quantidade de túbulos abertos quanto comparado aos demais. Não houve diferença significativa na permeabilidade pós-ciclagem entre os dentifrícios SF e NaF, contudo o dentifrício SnF2 apresentou maior permeabilidade comparando-se aos demais. Ambos os dentifrícios contendo flúor tiveram oclusão efetiva dos túbulos dentinários; contudo, os efeitos da presença de fluoreto de estanho na permeabilidade podem ser neutralizados pela abrasão deste dentifrício(AU)

The aim of this study was to evaluate the roughness, dentin tubule occlusion and permeability of eroded dentin brushed with different toothpastes. Ninety bovine teeth were sectioned in blocks. The hemiface of thirty specimens was protect with acid resistant varnish and sixty were submitted to permeability test. The specimens were divided according to the dentifrices: without fluoride (WF), sodium fluoride (NaF) and stannous fluoride (SnF2). Then, the blocks were submitted to erosive-abrasive protocol for 5 days. The analysis of surface roughness and dentin tubule occlusion (n=10) were performed on control and test hemifaces of the same sample and permeability analysis (n=20) was again performed. Data were analyzed by two-way RM ANOVA and Tukey tests (p≤0.05). NaF and SnF2 groups presented higher roughness when compared with WF. WF group presented larger number of opened tubules compared to the others. No significant differences were found between WF and NaF for permeability; however, SnF2 presented higher hydraulic conductance compared to other dentifrices. In conclusion, both fluoride-containing toothpastes had promising tubule occlusion; however, the effects on permeability of stannous formulation may be counteracted by the effects of abrasion from this dentifrice(AU)

Terapias para disminuir la sensibilidad por blanqueamiento dental / Therapies to decrease tooth whitening sensitivity

La complicación más comun del tratamiento de blanqueamiento dental es la sensibilidad dental, ésta ocurre por la los radicales libres que se liberan a partir del peróxido de hidrógeno, principal agente de los productos blanqueadores, atraviesan el esmalte, la dentina y llegan a la pulpa dental produciendo el dolor. Existen diferentes terapias utilizadas antes, durante y después para disminuir esta sensibilidad dental, como el uso de agentes que actúan inhibiendo la repolarización del nervio como el nitrato de potasio y los que obliteran los túbulos entre ellos como el fosfato de calcio amorfo, silicato de calcio y sodio, gluconato de calcio, hidroxiapatita, GLUMA y flúor; existen otras terapias alternativas como el uso de antiinflamatorios, antioxidantes y aplicación de láser, las cuales también han sido revisadas en la literatura. La siguiente revisión tiene como objetivo mostrar la evidencia científica sobre los diferentes métodos para disminuir la sensibilidad por blanqueamiento dental.

The most common side effect in tooth bleaching is tooth sensitivity because of the pulp reaction to free radicals produced by the hydrogen peroxide used in bleaching products. Different therapies have been used before, during and after to reduce tooth sensitivity, agents that block nerve repolarization such as potassium nitrate and agents that block dentinal tubules: amorphous calcium phosphate, calcium sodium phosilicate, calcium gluconate, hydroxyapatite, GLUMA and fluor; alternative therapies such as the use of anti-inflammatory, antioxidants and laser application which have also been mentioned in the literature. The aim of this review is to show the scientific evidence on the different methods to decrease the sensitivity on tooth bleaching.

Hiperestesia dentinária: aspectos de interesse / Dentinal hyperesthesia: aspects of interest

A hiperestesia dentinária cervical se caracteriza como uma manifestação com sintomatologia dolorosa aguda, repentina, localizada e de curta duração, provocada por um estímulo tátil, químico, térmico ou osmótico. Cessa após a remoção e não é provocada em dentes saudáveis por estímulos considerados fisiológicos. Acomete geralmente o terço cervical dos elementos dentários como pré-molares e molares, com exposição da dentina e abertura dos túbulos dentinários após recessão gengival, perda de estrutura cementária ou adamantina, lesões não cariosas, hábitos deletérios, entre outros. Devido à alta prevalência dessa condição na população mundial e queixas frequentes no consultório odontológico, a hiperestesia tem sido exaustivamente estudada. O objetivo deste trabalho, por meio de revisão de literatura, é elucidar a etiologia, diagnóstico diferencial, terapias e efetividade no controle desse problema de saúde pública

The cervical dentinal hyperesthesia is characterized as a manifestation with sharp, sudden, located painful symptomatology and of short duration, provoked by a stimulus tactile, chemical, thermal or osmotic. It ceases after the removal and it isn´t provoked in healthy teeth by stimulus considered physiologic. It usually attacks the cervical third of the dental elements as premolar and molars, with exhibition of the dentine and opening of the dentinal tubules after gingival recession, loss of cementery or adamantine structures, non-carious lesions, harmful habits, among others. Due to the high prevalence of that condition in the world population and frequent complaints in the dentistry clinic, the hyperesthesia has been exhaustively studied. The aim of this paper, through review of literature, was to elucidate the aetiology, differential diagnosis,therapies and effectiveness in the control of that problem of public health

A novel application of nano eggshell/titanium dioxide composite on occluding dentine tubules: an in vitro study

Abstract To synthesize Nano eggshell-titanium-dioxide (EB@TiO2) biocomposite and to evaluate its effectiveness in occluding opened dentine tubules. EB@TiO2 was synthesized and characterized using X-ray diffraction (XRD), and Transmission Electron Microscope (TEM). Sixteen simulated bovine dentine discs were prepared and randomly assigned into four groups according to the following treatment (n = 4): Group 1: No treatment; Group 2: eggshell powder; Group 3: EB@TiO2; Group 4: Sensodyne. These were then agitated in a solution of 1g powder and 40mL water for 3hours. Thereafter, each dentine discs from the respective groups were post-treated for 5 min with 2wt% citric acid to test their acid resistant characteristics. Scanning Electron Microscope (SEM) was used to observe the effectiveness of occluded dentine pre-and post-treatment. The cytotoxicity of the synthesized EB@TiO2 was tested using NIH 3T3 assay. ANOVA was used to evaluate the mean values of the occluded area ratio and the data of MTS assay. This was followed by a multi-comparison test with Bonferroni correction (α = .05). The XRD confirmed that EB@TiO2 was successfully modified through ball-milling. The TEM revealed the presence of both spherical and irregular particle shape powders. The SEM result showed that EB@TiO2 could effectively occlude open dentine tubules. Equally, the result demonstrated that EB@TiO2 exhibited the highest acid resistant stability post-treatment. NIH 3T3 assay identified that EB@TiO2 had little effect on the NIH 3T3 cell line even at the highest concentration of 100µg/ml. This study suggests that the application of EB@TiO2 effectively occluded dentine tubules and the occlusion showed a high acid resistant stability.

Randomized clinical trial of the effect of NovaMin and CPP-ACPF in combination with dental bleaching

Abstract Objective This randomized, controlled, double-blind clinical study evaluated the effect of calcium sodium phosphosilicate (NovaMin) and casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) on the prevention of post-operative sensitivity and on the effects of clinical bleaching treatment. Material and Methods Sixty volunteers were selected according to inclusion and exclusion criteria and were randomly assigned into three groups (n=20): CG (control group) patients, who were treated with 35% hydrogen peroxide; NOVAG (NovaMin group) patients, who were treated with 35% hydrogen peroxide followed by the application of NovaMin; and CPPG (CPP group) patients, who were treated with 35% hydrogen peroxide followed by the application of CPP-ACPF. Both bioactive agents were applied for five minutes. An evaporative stimulus associated with a modified visual scale was used to analyze sensitivity 24 hours after each bleaching session. The color evaluation was performed on the maxillary central incisors using a spectrophotometer. Associations between the intervention group, bleaching session, and reported sensitivity were tested using Chi-square partitioning. Results Color change values (ΔE) were analyzed using analysis of variance (ANOVA). The significance level used for both tests was 5%. In the intragroup assessment, the Friedman test showed that only the CPP-ACPF group showed no statistically significant difference (p<0.05) between baseline and first bleaching session. In the intergroup assessment, the Kruskal-Wallis test showed that the CPPG had less postoperative sensitivity after the first session, when compared to the other groups (p<0.05). Color change analysis (ΔE) showed a significant difference between the means obtained in the different bleaching sessions in all groups (p<0.05). Conclusions This study showed that the combination of CPP-ACPF with 35% hydrogen peroxide significantly reduced post-operative sensitivity in the first session, compared with the other evaluated treatments. The association of CPP-ACPF and NovaMin did not affect the color change induced by tooth bleaching.

Adhesión después del uso de dentífricos: Una revisión de la literatura / Bonding after the use of toothpastes: A literature review

La adhesión representa uno de los procedimientos de mayor empleo en la odontología restauradora, para ello el sistema adhesivo debe contar con propiedades mecánicas ideales, pues su técnica es muy sensible. Muchos reportes indican que el uso de dentífricos puede afectar el proceso de adhesión al sustrato dental, sea esmalte o dentina, y puede variar de acuerdo a su composición. Algunos pueden afectar obliterando los túbulos dentinarios, así también las pastas blanqueadoras liberan radicales libres por un tiempo determinado y pueden afectar la fotopolimerización del material. En la literatura existe controversia del efecto de estos productos sobre la adhesión, es por eso que el objetivo de la presente revisión es mostrar la evidencia científica del efecto de los dentífricos con diferentes principios activos en la resistencia de los sistemas adhesivos a la estructura dental.

Bonding represents one of the largest employment procedures in restorative dentistry, for which the adhesive system should have ideal mechanical properties because their technique is very sensitive. Many reports indicate that the use of toothpaste can affect the process of bonding of the dental substrate, either enamel or dentin, and may vary according to its composition. Some may affect obliterating the dentinal tubules, so whitening toothpaste free radicals released by a certain time and can affect the ligthtcuring of the material. There is controversy in the literature about the effect of these products on bonding, the purpose of this review is to show the scientific evidence of the effect of toothpastes with different active principles in the strength of bonding systems to the dental structure.

Effect of two desensitizing agents on dentin permeability in vitro

Abstract Objective The aim of this in vitro study was to investigate the effect of two desensitizing agents and water on hydraulic conductance in human dentin. Material and Methods GLUMA Desensitizer PowerGel (GLU) contains glutaraldehyde (GA) and 2-hydroxyethyl methacrylate (HEMA), and Teethmate Desensitizer (TD) is a powder comprising tetracalcium phosphate (TTCP) and dicalcium phosphate anhydrous (DCPA) that is mixed with water. Deionized water was used as a negative control (CTR). Thirty discs with a thickness of 1.2 mm were cut from the coronal dentin of the third molars and cleaned with 0.5 M EDTA (pH 7.4). After being mounted in a split-chamber device, the discs were pressurized with water at 1 kPa and 3 kPa in order to measure flow rates with a highly sensitive micro-flow sensor and to calculate hydraulic conductance as a baseline value (BL). Following the application of GLU, TD, and CTR (n=10), hydraulic conductance was remeasured with intermittent storage in water after 15 min, 1 d, 1 w, and 1 m. Reduction in permeability (PR%) was calculated from hydraulic conductance. Data were statistically analyzed using nonparametric methods (α<0.05). Representative discs were inspected by SEM. Results PR% for GLU and TD were 30-50% 15 min and 1 m after their application. Post hoc tests indicated that PR% of CTR was significantly greater than those of GLU and TD at all time points tested. The PR% of GLU and TD were not significantly different. SEM examinations showed noncollapsed collagen meshes at the tubular entrances after GLU, and crystalline precipitates occluding the tubular orifices after TD, whereas CTR specimens showed typical patterns of etched dentin. Conclusions The present study on hydraulic conductance in dentin discs treated with two chemically different desensitizing agents and water as a control demonstrated that both products may be characterized as effective.

Evaluation of dentin hypersensitivity treatment with glass ionomer cements: A randomized clinical trial

Abstract A randomized, double-blind, split-mouth clinical trial was performed compared the desensitizing efficacy of the resin-modified glass ionomer cement (GIC) ClinproTM XT (3M ESPE, Minnesota, USA) and the conventional GIC Vidrion R (SS White, Gloucester, UK) in a 6-month follow-up. Subjects were required to have at least two teeth with dentin hypersensitivity. Teeth were divided at random into 2 groups, one group received Clinpro XT and the other conventional GIC Vidrion R. Treatments were assessed by tactile and air blast tests using Visual Analogue Scale (VAS) at baseline, after 20 minutes, and at 7, 15, 21, 30, 90 and 180 days post-treatment. Twenty subjects (152 teeth) were included. Both tests (tactile and air blast) showed a significant reduction of dentin hypersensitivity immediately after the application of Vidrion R and Clinpro XT (20 min). VAS scores obtained along the 6-month follow-up were statistically lower when compared to initial rates (p < 0.05). Both GIC were able to reduce dentin hypersensitivity up to 6-month post-treatment period without statistically significant differences among them (p > 0.05). Both cements provided satisfactory results in long-term dental sensitivity reduction.

Estudo do uso e eficácia de substâncias para redução de sensibilidade durante o tratamento clareador caseiro / Study of the use and effectiveness of substances to reduce sensitivity during the whitening home treatment

A sensibilidade nos dentes é o principal sintoma apresentado durante o tratamento clareador, é desagradável e de curto prazo, porém intenso e se manifesta quando há exposição de parte do dente a fatores como frio e calor não associados a qualquer tipo de doença ou má formação. Assim, este trabalho tem como objetivo descrever os variados métodos e produtos dessensibilizantes utilizados durante o tratamento clareador caseiro relatados nos bancos de dados da literatura científica, entre as quais Scielo, Pubmed, Google Acadêmico, no período de 1989 a 2015. O método de estudo foi a pesquisa descritiva e exploratória, por meio de uma revisão de literatu¬ra narrativa, com análise qualitativa dos achados. Há diversas formas de dessensibilização dos dentes afetados, como o uso de anti-inflamatórios, substâncias dessensibilizantes como o Gluma®, arginina, nitrato de potássio, nano-hidroxiapatita, caseína, flúor tópico, entre outros. O uso de LED e LASER para o clareamento, a concen¬tração dos géis clareadores e até mesmo a forma de escovação dentária podem interferir na sensibilidade. Os métodos de tratamento citados na literatura parecem efetivos. Diante das possibilidades de tratamento e das influências dos diversos fatores para o aparecimento da sensibilidade, mais ensaios clínicos randomizados e controlados são necessários para que revisões sistemáticas desses trabalhos possam mensurar o nível de reso¬lução da sensibilidade e confirmar a eficiência dos produtos disponíveis com alto nível de evidência científica

Sensitivity on teeth is the principal symptom during the whitening treatment, nasty and short-term, however it is intense when there is part of the teeth exposure to factors like cold and heat associates to anyone kind of disease. This paper aims to describe various methods of desensitizing products used in the home bleaching treatment reported in the databases of the scientific literature, including Scielo, Pubmed, Google Scholar, from 1989 to 2015. The method of study was descriptive and exploratory research, through a narrative review of the literature and a qualitative analysis of the findings. There are several forms of desensitization of teeth affected, such as the use of anti-inflammatory, desensitizing substances such as Gluma®, arginine, potassium nitrate, nano-hydroxyapatite, casein, topical fluoride, among others. The use of LED and laser for whitening, the con¬centration of the bleaching gels and even the form of tooth brushing can interfere with the onset of sensitivity. Treatment methods cited in the literature seem effective. Before the treatment possibilities and influences of the various factors to the onset of sensitivity, more randomized controlled trials are needed for systematic reviews of these studies can measure the resolution level of sensitivity and confirm the effectiveness of products avail¬able with high-level scientific evidence

Efficacy of a bioactive material and nanostructured desensitizing on dentin hypersensitivity treatment / Eficácia de um material bioativo e dessensibilizante nanoestruturado no tratamento da hipersensibilidade dentinária

Introduction: Dentin hypersensitivity is a frequent occurrence in dental practice. It is clinically characterized by acute, short, and temporary pain in response to mechanical, chemical, thermal, or osmotic stimuli resulting from dentin exposure. Objective: To compare in vivo the effect of an experimental crystalline bioactive material and nanostructured desensitizing on the pain assessment among patients with cervical dentin hypersensitivity. Material and method: Thirty patients were selected for this study, who were randomly assigned to two groups (n=15) in a split-mouth design. Each patient received two treatments: group 1 (fluoride gel and bioactive material) and group 2 (fluoride gel and nanostructured desensitizing). Pain analyses were performed using a visual analogue scale, ranging 0-10. Baseline pain measurement was performed prior to initial treatment (T0) and new measurements were carried out weekly for 3 weeks (T1, T2, and T3) before materials were reapplied. Final pain analysis was performed 3 months after initial treatment (T4). Degree of pain reduction was calculated using the formula T0 - Tperiod after treatment. The data of the pain measurements were analyzed using 2-way repeated measure ANOVA and Tukey’s test (α=0.05). Result: Regardless of evaluation period, there was no statistical difference on pain reduction between the treatments (p>0.05). The degree of pain was reduced significantly in each evaluated period for all tested treatments (p<0.05), by approximately three degrees after 3 months. Conclusion: The tested desensitizing materials were effective on dentin hypersensitivity reduction.

Introdução: A hipersensibilidade dentinária é uma ocorrência frequente na prática clínica; clinicamente caracterizada por dor aguda, curta e temporária, em resposta ao estímulo mecânico, químico, térmico ou osmótico causada pela exposição dentinária. Objetivo: Comparar in vivo o efeito de um material bioativo cristalino experimental e um dessensibilizante nanoestruturado na avaliação da dor de pacientes com hipersensibilidade dentinária cervical. Material e método: Trinta pacientes foram selecionados para este estudo, que foram randomicamente divididos em dois grupos (n=15) em um desenho experimental de boca dividida. Cada paciente recebeu dois tratamentos: grupo 1 (flúor gel e material bioativo) e grupo 2 (flúor gel e dessensibilizante nanoestruturado). As análises de dor foram realizadas usando uma escala visual analógica, variando de 0-10. A mensuração da dor inicial foi realizada previamente ao tratamento inicial (T0) e novas análises foram realizadas semanalmente durante 3 semanas (T1, T2 e T3) antes da reaplicação dos materiais. A análise final da dor foi realizada 3 meses após o início do tratamento (T4). O grau de redução de dor foi mensurado pela fórmula: T0 - Tperíodo após tratamento. Os dados das mensurações de dor foram analisados pela ANOVA para medidas repetidas 2 critérios e teste de Tukey (α=0,05). Resultado: Independente do período de avaliação, não houve diferença estatística entre todos os tratamentos na redução da dor (p>0,05). O grau de dor reduziu significativamente em cada período avaliado para todos os tratamentos testados (p<0,05), aproximadamente três graus após 3 meses. Conclusão: Os materiais dessensibilizantes testados foram efetivos na redução da hipersensibilidade dentinária.

Influence of prolonged use of desensitizing dentifrices on dentin bond strength of self-etching adhesive system / Influencia del uso prolongado de pasta dentífrica desensibilizante en la fuerza de unión de la dentina de un sistema adhesivo autocondicionante

Dentin hypersensitivity is a relatively common clinical condition, which affects a large part of the world's population. The objective of this study was to evaluate the influence of previous and prolonged treatment with desensitizing dentifrices (DD) on bond strength to dentin, promoted by a self-etching adhesive system. Seventy non-carious bovine incisors were used, and divided into five groups (n= 14), according to the desensitizing toothpaste used, such as, G1: distilled water (WATER) (control); G2: Colgate Total 12 (CT12) (control); G3: Colgate Sensitive Pro-Relief (CSPR); G4: Sensodyne Rapid Relief (SRR); G5: Sensodyne Repair & Protect (SRP). Teeth had their buccal surfaces flattened until the exposure of dentin, and fragments of 4x4x2 mm were obtained. Fragments were included in polyvinyl chloride (PVC) cylinders and exposed to 17 % EDTA for 1 min. Subsequently, specimens were submitted to 20 000 cycles of simulated dental toothbrushing. After 24 h in artificial saliva, specimens were hybridized (Clearfil SE Bond ­ Kuraray), as well as resin composite cylinders built on dentin surfaces. Samples were stored in distilled water, at 37 C for 24 h, and the shear bond strength was determined. The highest bond strength (MPa) value was seen in CT12 group (4.39), and the lowest one in CSPR group (3.34). Data were statistically analyzed by 1-way ANOVA (ð= 0.05), and results showed that there were no significant differences (p= 0.5986) considering the DD factor. The predominant fracture pattern was cohesive on dentin. The previous and prolonged use of different DD did not affect dentin bond strength promoted by a self-etching adhesive system.

La hipersensibilidad dentinaria es una condición clínica relativamente común, que afecta a una gran parte de la población mundial. El objetivo fue evaluar la influencia del tratamiento previo y prolongado con dentífricos desensibilizantes (DD) en fuerza de adhesión a la dentina, que promueve un sistema adhesivo de autograbado. Se utilizaron 70 incisivos bovinos no cariados, y se dividieron en cinco grupos (n= 14), de acuerdo con la pasta de dientes desensibilizante utilizada: G1: agua destilada (agua) (control), G2: Colgate Total 12 (CT12) (control), G3: Colgate Sensitive Pro-Alivio (CSPR), G4: Sensodyne Rápido Alivio (SRR) y G5: Sensodyne Repair & Protect (SRP). Los dientes tenían sus superficies bucales aplanadas hasta la exposición de la dentina, y se obtuvieron fragmentos de 4x4x2 mm. Los fragmentos se incluyeron en cilindros de cloruro de polivinilo y se expusieron a 17 % de EDTA durante un 1 min. Después, las muestras se sometieron a 20 000 ciclos de cepillado dental simulado. Después de 24 h en saliva artificial, las muestras se hibridaron (Clearfil SE Bond - Kuraray), y cilindros de resina compuesta fueron construidos sobre superficies de dentina. Las muestras se almacenaron en agua destilada, a 37 °C durante 24 h y luego se determinó la resistencia al cizallamiento. El mayor valor de resistencia a la unión (MPa) se observó en el grupo CT12 (4,39), y el menor en el grupo CSPR (3,34). Los datos fueron analizados estadísticamente mediante ANOVA de un factor 1 (ð= 0,05), y los resultados no mostraron diferencias significativas (p= 0,5986) teniendo en cuenta el factor de los DD. El patrón de fractura predominante sobre la dentina fue el cohesivo. El uso previo y prolongado de diferente DD no afectó resistencia de unión a la dentina promovido por un sistema adhesivo de autograbado.

Occluding Effect of the Application of Fluoride Compounds and Desensitizers on Dentinal Tubules / 치위생과학회지

This study compared and analyzed the occluding effects of fluoride compounds and desensitizers, which are commonly used in dental clinics, on dentinal tubules. This study also evaluated the persistence of the active ingredients over time by performing toothbrushing with an electric toothbrush. Thirty-five molar teeth, which had been extracted within the past 3 months from healthy people without tooth decays, amalgam fillings, or dental crowns, were divided into 4 pieces each. Of these, 135 teeth pieces were used as study specimens. These specimens were divided into a control group, an untreated group, and 5 experimental groups (acidulated fluoride gel, fluoride varnish, Gluma, Super Seal, and SE-Bond). The specimens were then subjected to toothbrushing equivalent to 1 week (140 times), 2 weeks (280 times), and 4 weeks (560 times), and the occluding effects on dentinal tubules in 3 regions of each specimen were examined under a scanning electron microscope. The fluoride varnish treated group showed the highest degree of dentinal tubule occlusion effects during the first, second, and fourth weeks of toothbrushing, with the SE-Bond treated group showing the second highest degree and the Gluma treated group showing the lowest degree. After 4 weeks of toothbrushing, the Gluma treated group and the Super Seal treated group showed the lowest degrees of dentinal tubule occlusion effects. In summary, the fluoride varnish treated group and the SE-Bond treated group displayed higher occlusion effects even after 4 weeks of treatment than did the other experimental groups. Therefore, it is the authors' belief that fluoride varnish and SE-Bond are effective for treating dentinal hyperesthesia.

Effect of dentin desensitizers on resin cement bond strengths

Introduction: The crown preparation promotes the exposure of dentin tubules. Thus, to avoid post-operative sensitivity, the first approach involves the use of dentin adhesives, and the second one the use of dentin desensitizers. Objective: This study evaluated the effect of dentin desensitizers on microtensile bond strengths (μTBSs) of a resin cement to dentin. Material and methods: Twenty bovine teeth were prepared until obtaining flat dentin surfaces. A standardized smear layer was created (#600-grit SiC paper). The samples were randomly divided into the following four groups (n = 5): no treatment (Control), treatment with Gluma Desensitizer (Heraeus Kulzer), Super Seal (Phoenix Dental) and Teethmate Desensitizer (Kuraray Noritake Dental). The dentin surfaces were then treated with ED Primer II (Kuraray Noritake Dental). Twenty composite blocks, 4 mm thick (Estenia CeB, Kuraray Noritake Dental) were used. The composite surfaces were abraded with aluminum oxide (50 μm), and then silanized. The composite block was bonded to the dentin surface with a resin cement (Panavia F 2.0, Kuraray Noritake Dental) according to the manufacturer's instructions. After 24-hour storage (37ºC, 100% RH), the bonded samples were cut into beam-shaped microtensile specimens and loaded in tension until failure. Data were analyzed with one-way ANOVA and the Dunnett's test (α = 0.05). An SEM was used to examine the failure modes. Results: The μTBSs (MPa ± SD) were: 24.4 ± 3.2 (Control), 14.0 ± 5.6 (Gluma Desensitizer), 8.6 ± 4.7 (Super Seal), and 34.7 ± 4.6 (Teethmate Desensitizer), in which there were significant differences among the four groups (p < 0.05). The Teethmate Desensitizer group showed the highest μTBS, while the Super Seal group showed the lowest mean of μTBS to dentin. Conclusion: The efficacy of the desensitizers is material-dependent; Gluma Desensitizer and Super Seal decreased the μTBSs, however, Teethmate Desensitizer improved it.