Abstract
BackgroundMany studies have demonstrated efficacy of casein phosphopeptide (CPP) containing products for dentin tubule occlusion for treatment of dentin sensitivity, but their effectiveness under dynamic erosive challenges remains to be elucidated. The purpose of the present study was to investigate the effectiveness of a desensitizing dentifrice containing CPP in occluding dentin tubules and resisting erosive challenges in comparison to that containing polyvinyl methyl ether/maleic acid (PVM/MA) copolymers.Methods A total of 33 dentin discs were prepared from coronal sections of human third molars and divided into 3 groups: a toothpaste containing CPP; a toothpaste containing PVM/MA and submicron silica; and a regular toothpaste (Controls). A soft-bristle toothbrush was used to brush the dentin discs with the dentifrices for 45 strokes in 30 s at a force of approximately 200 g. The brushing cycle was repeated after immersion of the dentin discs in artificial saliva overnight. The dentin discs were then challenged in orange juice for 10 min in an incubator rocking at 120 rpm. Three fields were randomly selected on each dentin disk surface to assess dentin tubule occlusions after each brushing cycle and after orange juice challenge with a 3D laser scanning microscope. Specimen cross sections were examined with a scanning electron microscope equipped with energy dispersive spectroscopy (SEM/EDS).ResultsAfter the first and second cycles of brushing, dentin tubules were occluded on average by 56.3% and 85.7% in CPP group, 66.2% and 88.1% in PVM/MA group, and 0.0 and 13.0% in the controls, respectively. There were no statistically significant differences in dentin tubule occlusions between the CPP and PVM/MA groups after two cycles of brushing (p>0.05). After dynamic erosive challenges with orange juice, 20.3% of the dentin tubules in the CPP group, 79.1% in the PVM/MA group and none in the control remained occluded (P<0.05). SEM/EDS imaging showed that dentin tubules were blocked with plugs containing dentifrice substances in CPP and PVM/MA groups after treatments, but none in the controls.ConclusionsDesensitizing dentifrices containing CPP or PVM/MA could effectively occlude dentin tubules after two cycles of brushing. PVM/MA in combination with submicron silicon dioxide exhibited stronger resistance to dynamic erosive challenges by acidic beverages. Inorganic fillers that can enter dentin tubules and resist erosive challenges may be key for desensitizing dentifrices.
Highlights
Many studies have demonstrated efficacy of casein phosphopeptide (CPP) containing products for dentin tubule occlusion for treatment of dentin sensitivity, but their effectiveness under dynamic erosive challenges remains to be elucidated
A parallel cut was made above the cementoenamel junction to produce a dentin disc that was Baseline sample measurements An anti-acid nail polish was used to mark the dentin disc to identify the orientation landmarks for repeated imaging measurements of the samples before and after dentifrice treatments. 3D images of the dentin discs were obtained adjacent to the indentation marks using the 3D laser scanning microscope at magnifications of ×1000 and ×3000
The findings of the present study indicate that the dentifrice containing CPP can form intra-tubular plugs and occlude the dentin tubule openings comparable to the dentifrice containing polyvinyl methyl ether/maleic acid (PVM/MA) and submicron silica fillers, and provide some protection to exposed dentin surfaces against erosive challenges by orange juice
Summary
Many studies have demonstrated efficacy of casein phosphopeptide (CPP) containing products for dentin tubule occlusion for treatment of dentin sensitivity, but their effectiveness under dynamic erosive challenges remains to be elucidated. The purpose of the present study was to investigate the effectiveness of a desensitizing dentifrice containing CPP in occluding dentin tubules and resisting erosive challenges in comparison to that contain‐ ing polyvinyl methyl ether/maleic acid (PVM/MA) copolymers. When subjected to external stimuli, dentin tubule fluids moves rapidly under hydrodynamic pressure, and activates the sensory receptors located in the dental pulp, causing transient pain [5]. Several therapeutic strategies have been developed to treat DS based on the hydrodynamic theory, including physically occluding the exposed dentin tubules to form a barrier and isolate the tubule contents from the external stimulation, or chemically desensitizing the sensory nerves in the dental pulp and prevent the transmission of sensory impulses. Dentin tubule occlusion by dentifrices, directly or indirectly, has been shown to be an effective treatment for dentin sensitivity [1, 9]
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