Reducing Dentine Hypersensitivity Research Articles

Comparative Evaluation of Dentin Hypersensitivity Reduction Over One Month after a Single Topical Application of Three Different Materials: A Prospective Experimental Study

ABSTRACT Background: Dentinal hypersensitivity (DH) is a prevalent condition characterized by sharp, transient pain arising from exposed dentine in response to various stimuli. It is common among patients with gingival recession, tooth abrasion, and erosion. Materials and Methods: A prospective experimental study was conducted in the Department of Periodontology at the Chhattisgarh Dental College and Research Institute. A total of 45 patients with DH were randomly assigned to three groups: Test Group I (5% potassium nitrate gel), Test Group II (Tetric-N-Bond self-etch adhesive), and Test Group III (fluoride varnish). Clinical assessments of DH were conducted immediately after treatment, at one week, and at one month, using tactile sensation, cold stimuli, and air blast tests. Pain levels were measured using a 10-point visual analog scale (VAS). Results: Tetric-N-Bond demonstrated the most significant reduction in DH at all follow-up intervals. Immediately after application, VAS scores (tactile) were potassium nitrate (1.33 ± 0.48), Tetric-N-Bond (1.53 ± 0.74), and fluoride varnish (3.06 ± 0.88). After one month, the scores were: Tetric-N-Bond (2.53 ± 1.12), potassium nitrate (3.20 ± 0.41), and fluoride varnish (4.73 ± 1.57). Significant differences were observed between all groups (P < 0.05). The Schiff cold air score also supported these findings, showing Tetric-N-Bond as the most effective treatment, followed by potassium nitrate and fluoride varnish. Conclusion: The study concluded that Tetric-N-Bond is the most effective treatment for reducing DH immediately and over a one-month period, followed by potassium nitrate and fluoride varnish.

Effect of Low- and High-Level Laser Therapy on the Treatment of Dentin Hypersensitivity: An Umbrella Review.

Introduction: Dentin hypersensitivity (DH) is a prevalent unpleasant condition which might affect quality of life. Laser therapy is one of the non-invasive treatments for dentin hypersensitivity. The aim of this umbrella review was to assess the effect of lasers on the treatment of dentin hypersensitivity by analyzing the previously published systematic reviews and meta-analyses. Methods: Electronic databases (PubMed, Embase, Scopus, Cochrane, and ISI) were searched to identify relevant systematic reviews and meta-analyses based on the keyword search strategy. Two independent reviewers carried out the selection of studies, extraction of data, and assessment of methodological quality. The actual overlap of primary studies was measured through the visual tool known as the citation matrix and three indices of % overlaps, covered area (CA), and corrected covered area (CCA). The reviews were appraised for methodological quality through A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2, and the risk of bias was evaluated using the Risk of Bias in Systematic Reviews (ROBIS) tool. Results: Following eliminating duplicates, a total of 2,768 articles were found, and of them, 9 systematic reviews met the inclusion criteria. Six of them included a meta-analysis as well. The actual overlap of primary studies was low. The AMSTAR 2 tool classified one systematic review as high quality, three as moderate quality, three as low quality, and the remaining two as critically low quality. The results of the included reviews generally showed that all types of lasers reduced dentin hypersensitivity compared to placebo/no treatment. Conclusion: Lasers are effective in treating dentin hypersensitivity.

Comparison of efficacy of commercially available desensitizing Toothpastes in reducing Dentin Hypersensitivity

Dentine hypersensitivity is characterized by a short sharp pain arising from exposed dentine in response to thermal, evaporative, tactile, osmotic or chemical stimuli that cannot be ascribed to any other form of dental defect. Today, multiple desensitizing toothpastes that claim superiority over each other in reducing dentin hypersensitivity are commercially available. The present study was undertaken to evaluate and compare the efficacy of three commercially available desensitizing toothpastes in reducing dentine hypersensitivity (herbal desensitizing toothpaste, desensitizing toothpaste and desensitizing toothpaste containing 8% arginine). After ethical clearance and informed consent, a total of 45 participants were recruited equally into 3 groups (Group 1: Herbal desensitizing toothpaste; Group 2: Desensitizing paste containing potassium salt; Group 3: Desensitizing toothpaste containing 8% Arginine) by a simple random sampling method. Dentine hypersensitivity was evaluated at the baseline, immediately, at 4th week and 8th week after using the assigned toothpaste. Dentine hypersensitivity was evaluated using the Schiff sensitivity score. In this study, the comparison of the efficacy of desensitizing toothpaste within group 1 at different time intervals was found to be statistically significant (p=0.004). Comparison of the efficacy of desensitizing toothpaste within group 2 and group 3 at different time intervals was found to be statistically highly significant (p=0.000). However, the comparison of the efficacy of desensitizing toothpaste between 3 groups at baseline (p=0.659), immediately (p=0.366), at the 4th week (p=0.388) and the 8th week (p=0.583) was found to be statistically nonsignificant. The present study can be useful, as it is important to assess the efficacy of various commercially available desensitizing toothpastes, since the use of desensitizing toothpastes is considered to be the primary strategy in the management of non-carious dentinal exposure causing dentinal hypersensitivity. Key Words - Dentine hypersensitivity, Herbal toothpaste, Sensitivity, Stimuli

A Comparative Study on the Safety and Efficacy of Erbium Laser Therapy Versus Traditional Treatments in Managing Dentin Hypersensitivity: An Observational Study.

Background This study aimed to explore the potential efficacy and safety of laser therapy compared with traditional desensitizing treatments in the management of dentin hypersensitivity. Methodology A comprehensive observational study was conducted on 138 adult individuals aged 18-65 diagnosed with dentin hypersensitivity. Participants were allocated to either the laser therapy or traditional treatment group. The laser therapy group received treatment using the Fotona LightWalker® Erbium laser at 2,940 nm. The energy density was set at 20 J/cm² using continuous and contact modes, with the laser tip held perpendicularly to the irradiated site. Each session lasted five minutes, conducted bi-weekly for three months. Traditional treatment included the in-office application of 5% sodium fluoride varnish application once every 15 days for three months and the use of desensitizing toothpaste as part of regular oral hygiene routines. Follow-up assessments were conducted 6 and 12 months post-treatment to evaluate the longevity and stability of the treatment effects. Primary outcomes were assessed by dentin hypersensitivity reduction measured using Visual Analog Scale (VAS) scores and tactile hypersensitivity assessments. Results Laser therapy consistently surpassed traditional treatment in reducing dentin hypersensitivity, as reflected by the significantly lower VAS scores. Notably, at 3, 6, and 12 months, laser therapy demonstrated mean VAS scores of 2.5 (±1.5), 1.2 (±0.9), and 0.6 (±0.5), respectively, while the traditional treatment group exhibited higher scores (3.8 ± 1.2, 4.5 ± 1.0, and 4.0 ± 0.7, respectively). Statistical analysis revealed that these differences were highly significant (p < 0.001). Tactile hypersensitivity assessments echoed these findings, with laser therapy consistently maintaining lower scores (0.8 ± 0.7 at 6 months, 0.4 ± 0.3 at 12 months) compared to traditional treatment (3.5 ± 1.0 at 6 months, 4.0 ± 0.7 at 12 months) with statistical significance at all time points (p < 0.001). Conclusions Although this study lacks a randomized controlled design, the observed substantial reduction in VAS scores and tactile hypersensitivity assessments, along with the favorable safety profile of laser therapy, suggest its potential as an effective alternative for managing dentin hypersensitivity.

Treatment of Dentine Hypersensitivity with Diode Laser

Patient discomfort due to dentin hypersensitivity DH is one of the major challenges faced by dentists in daily practice. Difficulties in DH treatment have resulted in the many regimens currently used. This clinical study aimed to evaluate the effectiveness of a new protocol in reducing dentin hypersensitivity using a 980 nm diode laser. 50 cases of DH were enrolled in the study, and the pain level was assessed using the Visual Analog Scale (VAS) Apply a 980 nm diode laser with continuous mode, backward motion, tangential incidence of the beam in non-contact mode and 0.7 W delivered output with a total exposure time of 60 s per tooth. Postoperative pain was significantly reduced immediately after treatment. Means remained stable until the 2-week follow-up.

Desensitizing efficacy of a universal dentin adhesive containing mesoporous bioactive glass on dentin hypersensitivity: a randomized clinical trial with a split-mouth model

This split-mouth blinded randomized controlled study compared the efficacy of a desensitizing agent with oxalate/resin polymer and a universal adhesive containing mesoporous bioactive glass (MBG) for dentin hypersensitivity (DH) relief, using Schiff sensitivity score (SSS) and visual analog scale (VAS). Split quadrants containing teeth with DH were treated with either MS Coat ONE or Hi-Bond Universal with MBG as the functional additive. Assessments at baseline, immediately post-application, and at 1- and 2-week follow-ups used standardized stimulus protocols (air, cold, and acid). The SSS difference was the primary outcome, while the VAS difference was the secondary outcome. A mixed linear effect model performed statistical analysis. Immediate DH reduction occurred in response to air stimuli, with a significant decrease in Group HB than in Group MS (p = 0.0178). Cold stimulus reduction exhibited a gradual cumulative effect, with consistently greater reductions in Group HB than in Group MS (p ≤ 0.0377). Both groups effectively managed acidic stimuli, with no significant differences (p > 0.05). The VAS scores decreased gradually over the follow-up period (p < 0.0001). This study highlights the differential efficacy of treatments for various DH triggers and recommends specific approaches based on different stimulus types. The universal adhesive containing MBG demonstrated DH relief potential, promising efficacy identical to or superior to that of a dedicated desensitizing agent. Further research exploring the long-term efficacy and underlying mechanisms is warranted. The universal adhesive containing MBG can be adopted as an in-office desensitizing agent for DH relief. The desensitizing efficacy of universal adhesive matches or surpasses dedicated agents for air and cold stimuli.

Biomineralization reaction from nanosized calcium silicate: A new method for reducing dentin hypersensitivity

Background/purposeThis study assessed the ability of experimental materials consisting of dicalcium silicate (DCS) and tricalcium silicate (TCS) with nanosized particles to form intratubular crystals under phosphate-buffered saline (PBS) and the effect on dentin permeability reduction. Materials and methodsBy isolating the cervical part of the extracted premolars, 195 specimens were obtained. Two experimental materials (DCS/TCS and TCS) were applied to the dentin surface by brushing and stored in PBS (n = 65). Another 65 specimens were not treated. Each group was randomly divided into five subgroups based on the PBS immersion period (1, 15, 30, 60, and 90 days, n = 10). The dentin permeability was measured, and the hydraulic conductance, Lp (%), was calculated. After acid challenge with 1 M acetic acid, Lp (%) was remeasured. Data were analyzed using two-way analysis of variance and Fisher's least significant difference test (α = 0.05). Three specimens of each subgroup were longitudinally sectioned and examined using scanning electron microscopy and a field emission-electron probe micro analyzer. ResultsThe Lp (%) of the experimental groups gradually decreased over time (P < 0.05). The hydroxyapatite-like crystals that grew were observed and found to have a Ca/P ratio similar to that of hydroxyapatite. The crystals remained after the acid challenge, and the Lp (%) was not significantly different from that before acid treatment. ConclusionIntratubular crystals formed from the experimental materials consisted of DCS and TCS and were resistant to acid. These crystals significantly reduced dentin permeability.

Efficacy of seventh generation bonding agents as desensitizers in patients with dentin hypersensitivity: a randomized clinical trial

BackgroundDentin hypersensitivity (DH) is one of the most challenging and persistent dental complaints characterized by transient, intense pain triggered by various stimuli. It affects a significant portion of the global population, predominantly those aged 20–40. This study aims to evaluate the desensitizing efficacy of seventh-generation dentin bonding agents (Single Bond Universal by 3 M ESPE and Xeno-V + by Dentsply) against a control group using Bifluorid 12 by Voco in mitigating DH within a month of the follow-up period.MethodsThis was a single-center, parallel-group, double-blind, controlled randomized clinical trial conducted at Dow University of Health Sciences, Karachi, Pakistan. A total of 105 patients with DH were allocated into three groups for this study. The patients were divided into three groups (Single Bond Universal by 3 M ESPE and Xeno-V + by Dentsply) and the control group containing fluoride varnish (Bifluorid 12 by Voco). Discomfort Interval Scale scores and Schiff Cold Air Sensitivity Scale scores were recorded at baseline, immediately after the intervention, after 01 weeks, and after 01 month.ResultsAll the materials demonstrated a statistically significant reduction in discomfort and sensitivity (DIS scores p-value 0.01) immediately after 01 week and over a period of 01 month after treatment compared with the baseline scores before application, with no single material proving superior over the one-month observation period. The study also provided insights into dental hygiene practices, with a significant majority using a toothbrush and sensitivity patterns, with cold stimuli being the most common cause of sensitivity.ConclusionThe study demonstrates that Single Bond Universal, Xeno V+, and Bifluorid 12 are equally effective in reducing dentin hypersensitivity, with no distinct superiority observed over a one-month period. The findings highlight the potential of fluoride varnishes as a less technique-sensitive and cost-effective option for treating DH, offering valuable insights for future research and clinical practice.Trial registrationNCT04225247 (https://clinicaltrials.gov/study/NCT04225247), Date of Registration: 13/01/2020. (Retrospectively registered).

Efficacy of Biosilicate Glass-ceramic and Fluoride Varnish in the Treatment of Dentin Hypersensitivity-A Randomized Controlled Clinical Trial.

The objective of this study was to compare the efficacy of Biosilicate and Duraphat in the treatment of dentin hypersensitivity (DH). This clinical trial was conducted with young adults presenting DH. A visual analogue scale (VAS) was used to assess the level of pain, using volatile and tactile tests. Forty participants presenting two teeth with DH were included, and these teeth were divided into two groups according to the treatment: Biosilicate or Duraphat. Each product was randomly applied on one tooth per participant once a week for 4 weeks and evaluated every 15 days for 60 days after the last application. The mean and standard deviation (SD) of VAS values for the initial volatile sensitivity evaluation were 6.18 (1.99) and 6.08 (1.98) for the Biosilicate and Duraphat groups, respectively, and at the fourth week 0.48 (1.5) and 0.83 (1.58). After 60 days, the volatile sensitivity showed the following values: 0.63 (1.19) for Biosilicate and 1.03 (1.07) for Duraphat. The intragroup comparison showed a significant reduction of mean VAS values for DH-related pain assessed by volatile testing for both groups (p<0.001), and the assessment at the 60-day follow-up showed mean values statistically similar to those obtained at the end of treatment. Initial tactile sensitivity observed was 1.48 (2.39) for the Biosilicate and 1.4 (2.2) for the Duraphat group and at the 60-day follow-up 0.23 (0.73) and 0.15 (0.36), respectively, with significant statistical difference (p<0.002). When the reduction in tactile and volatile sensitivities between both groups was compared, no statistically significant difference was observed. This study indicated that both products were able to promote an important reduction in dentin hypersensitivity with similar results within a 60-day follow-up.

Effectiveness of Bioactive Toothpastes against Dentin Hypersensitivity Using Evaporative and Tactile Analyses: A Randomized Clinical Trial

The objective of this study was to investigate and compare the effectiveness of toothpastes containing bioactives to relieve dentin hypersensitivity with that of a commercial desensitizing toothpaste containing REFIX technology, associated or not with a calcium booster. In this double-blind, randomized, parallel-group, multi-center clinical trial, thirty-two volunteers diagnosed with dentin hypersensitivity and qualified to participate were randomized into four groups: (1) Colgate Sensitive Pro-Relief; (2) Sensodyne Repair &amp; Relief; (3) Regenerador Sensitive; and (4) Regenerador Sensitive, associated with a calcium booster. Evaporative and tactile tests were used to check for dentin hypersensitivity in the test subjects. The participants brushed their teeth with one of the toothpastes, and dentin hypersensitivity was immediately tested using a visual analogue scale (VAS), in which the pain was rated on a scale of 0 to 10. Dentin hypersensitivity was measured after one week and after one month of the subjects continuing to use the toothpaste three times per day. Data were statistically analyzed with a non-parametric Friedman test for dependent data (α = 0.05). All toothpastes reduced dentin hypersensitivity. In the evaporative test, Sensodyne Protect &amp; Repair and Regenerador Sensitive, associated with the calcium booster, exhibited faster and more effective results in reducing pain caused by dentin hypersensitivity, even after the first use. Colgate Sensitive Pro-Relief was effective only after one week of use. All toothpastes performed well in the tactile test for treating dentin hypersensitivity, and their performance improved over time. Sensodyne Repair &amp; Protect presented the highest overall pain remission after one month (84.6%). The bioactive toothpastes reduced, to a different extent, the tooth hypersensitivity reported by the volunteers. Sensodyne Repair &amp; Relief and Regenerador Sensitive, associated or not with a calcium booster, presented faster and more effective results in reducing pain caused by dentin hypersensitivity.

Efficacy of different in-office treatments for dentin hypersensitivity: randomized and parallel clinical trial.

The aim of this clinical, prospective, randomized, and parallel study was to evaluate different in-office treatments for dentin hypersensitivity (DH). One hundred ninety-two teeth with non-cavitated root exposures were treated using different desensitizers: fluoride varnish (Duraphat - FLU); bioactive ceramic solution (Biosilicate - BIOS); universal self-etching adhesive (Single Bond Universal - SBU); bioactive photoactivated varnish (PRG filler - SPRG). The degree of DH was analyzed using a visual analog scale (VAS) and computerized visual scale (CoVAS), before treatments and after 7, 15, and 30 days from the first session. Comparisons among desensitizers were performed using the Kruskal-Wallis and Dunn's tests. Friedman test was used to compare between times (p ≤ 0.05). Comparing desensitizers FLU presented a higher value of DH than BIOS using VAS at 7 days, however, no differences were found using CoVAS analysis. Comparing times, BIOS and SBU showed a reduction in DH after 7 days and SBU showed a reduction at 30 days compared to 7 days using VAS. FLU and SPRG groups reduced DH from 15 days to 30 days using VAS. There was a reduction in DH for FLU, BIOS, and SBU after 7 days and for BIOS this reduction also occurred at 30 days when compared to 15 days using CoVAS. SPRG group showed a reduction from 15 to 30 days. All desensitizers tested were able to reduce the initial sensitivity. The bioactive ceramic solution reduced the DH gradually after 30 days using computerized analysis.

Efficacy of Experimental Propolis‐Based Toothpastes on Dentin Hypersensitivity: A Randomized Clinical Trial

Background. Propolis is a natural bee product that has garnered attention due to its harmlessness and numerous beneficial biological properties. This randomized, double‐blinded, placebo‐controlled clinical trial aimed to assess the effect of toothpastes containing different concentrations of propolis (10% and 15%) on the control of dentin hypersensitivity (DH). Methods. From adults aged 18–40 years with DH, 66 teeth were randomly divided into 3 treatment groups as follows (n = 22): control (toothpaste without active ingredient), 10% propolis toothpaste, and 15% propolis toothpaste. DH was assessed thrice (baseline and 15 and 30 days after treatment) by tactile and evaporative stimuli using the visual analog scale. Data were analyzed using Friedman and Kruskal–Wallis tests. A significance level of 5% was used in all analyses. Results. All the groups showed a reduction in DH during the study (p &lt; 0.05). The experimental groups (10% and 15% propolis) showed significantly greater reduction in DH than the control group (p &lt; 0.05) after 30 days of treatment; however, the experimental groups displayed similar results (p &gt; 0.05). Conclusion. Toothpastes containing propolis at concentrations of 10% and 15% were equally effective in controlling DH, regardless of their concentration. Trial Registration. This trial is registered with NCT05083052. Date of registration: 19/10/2021.

Bioactive silicon-based dental gel associated with a calcium booster for dentin hypersensitivity treatment: A randomized clinical study.

Dentin hypersensitivity affects a significant portion of the world's population, causing pain and negatively impacting oral health and quality of life This clinical study investigated the effectiveness of a desensitizing fluoride silicon-rich dental gel associated with a calcium booster. In this single-blind, randomized, parallel-group clinical trial, forty-eight volunteers diagnosed with dentin hypersensitivity and qualified to participate were randomized into 2 groups: (1) fluoride silicon-rich dental gel (REFX Technology)/calcium booster (Si/Ca protocol); (2) Pumice stone diluted in saline. A draw was carried out between the right and left sides of the patients so that either a prophylaxis with the dental gel associated with calcium or with fine pumice stone diluted in saline was carried out. An evaporative test was used to check for dentin hypersensitivity in the subjects before and immediately after treatment and scored using the Schiff scale, rated 0 to 3. Data were statistically analyzed (ANOVA/Tukey test, α=5%). The treatment with Si/Ca protocol drastically reduced dentin hypersensitivity (from 2.58 to 0.67) immediately after the use. In the control group (Pumice stone), similar results were observed before and after treatment (2.67 and 2.82, respectively). The Si/Ca protocol was fast and effective in reducing pain caused by dentin hypersensitivity. Key words:Clinical trial, dentin hypersensitivity, desensitizing, toothpaste.

Effect of Iontophoresis on the Effectiveness of Nano-Hydroxyapatite and Pro-argin in In-Office Treatment of Dentin Hypersensitivity: A Split-Mouth Randomized Clinical Trial.

Background and objectives Dentin hypersensitivity (DH) treatment is one of the main challenges dentists facein their daily clinical practice. Current therapies provide only temporary relief and require multiple applications to exhibit results, and there is a lack of evidence related to the long-term effects of these agents. Nano-hydroxyapatite (n-HA) and pro-argin (8.0% arginine-calcium carbonate) have recently been used fordentin desensitization with a one-time in-office application, but the effects are interim. However, a standard treatment protocol demandsdefinitive or enduring results. Since iontophoresis amplifiesthe transportof neutral and ionized drugsacross a membrane, the use of these desensitizing agents with iontophoresis may be beneficial to accomplish satisfactory results.This study was conducted to evaluate whether iontophoresis could enable better penetration of nano-hydroxyapatite and pro-argin into the dentin, enhancing and prolonging their therapeutic effect. Materials and methods Forty-five participants with dentin hypersensitivity in the age group of 20 to 60 years were included. In each individual, four teeth with cervical lesions (one from each quadrant) were selected and divided randomly into four groups: group I: desensitizing paste containing nano-hydroxyapatite, group II: desensitizing paste containing nano-hydroxyapatite with iontophoresis, group III: desensitizing paste containing pro-argin, and group IV: desensitizing paste containing pro-argin with iontophoresis; followed by one-time application of the agents. Sensitivity was assessed by tactile, air blast, and cold-graded thermal tests(CGTTs) before and immediately after application, after one week, and at the end of the first, third, and sixth months. Statistical analysis Statistical analysis was done by repeated measures ANOVA for within-group comparison. Intergroup comparison was done using one-way ANOVA and Tukey's post-hoc test. Results All the groups showed a statistically significant reduction in dentin hypersensitivity (p<0.001). The reduction inhypersensitivity in various groups can be graded as group II (3.578/1.800/1.556) > group IV (3.367/1.755/1.555) > group I (2.3781/1.022/0.822) > group III (2.222/0.911/0.778) as evaluated by tactile, air blast, and cold-graded thermal tests, respectively. Group II and group IV presented a significant reduction in sensitivity levels consistent for up to six months. Conclusion Nano-hydroxyapatite and pro-argin can be used effectively for reducing dentin hypersensitivity. Iontophoresis can be a valuable adjunct for their improved delivery, enhancing and prolonging their effectiveness.

Prospects of silver diamine fluoride (SDF) in reducing dentin hypersensitivity: An updated review

Dental Hypersensitivity (DH) is a common clinical condition yet an annoying disease. Most of the time, clinicians fail to diagnose, leading to improper management and unsatisfied patients, negatively impacting their quality of life. The management involves various self-applied and in-office management modalities. This review briefly discusses several treatment options available for dentinal hypersensitivity and recommends Silver Diamine Fluoride (SDF) as a newer and more effective treatment option for dentinal hypersensitivity based on the available literature.

Comparative clinical evaluation of two different formulated in-office newer desensitizing agents (Clinpro XT and Tokuyama Shield Force Plus) in reducing dentin hypersensitivity - A randomized clinical trial.

The aim of this study was to assess the effectiveness of two various in-office newer desensitizing agents in reducing dentinal hypersensitivity in patients with mild-to-moderate sensitivity for a 1-month follow-up. Forty subjects with cervical dentin hypersensitivity (otherwise healthy patients) were included. A split-mouth, randomized clinical trial was conducted. A Visual Analog Scale (VAS) was used to record the initial sensitivity levels at the baseline visit. Each individual has been exposed to thermal (ethyl chloride spray) and evaporative (air blast) stimuli to elicit sensitivity. A single application of two different in-office desensitizing agents, Clinpro XT Varnish (3M ESPE, Minnesota, USA) and Shield Force Plus (Tokuyama Dental, Tokyo, Japan), was done. The sensitivity scores were recorded after the application of the desensitizing agent immediately, after 1 week, and after 1 month using both air and cold stimuli in the same manner as initially. Mean VAS scores represent teeth that were more sensitive to cold stimuli compared to air blasts in both groups. For both stimuli at all-time intervals except baseline, there is a significant difference between CXT and SFP, with low mean VAS scores for CXT. Post hoc analysis revealed that in the CXT group, there is a significant difference in mean VAS score between pre-and postintervention at all-time intervals except between immediate and 1-week time intervals (P < 0.001) but only at immediate and 1-week time intervals in SFP. Clinpro XT Varnish is more efficient compared to Shield Force Plus at all-time points irrespective of the stimuli after a 1-month follow-up.

Intratubular crystal formation in the exposed dentin from nano-sized calcium silicate for dentin hypersensitivity treatment

The aim of this study is to evaluate intratubular crystal formation from the experimental material consisting of dicalcium silicate (C2S) and tricalcium silicate (C3S) with nano-scaled particle size. A total of twenty-four specimens were made by isolating 8 mm of the cervical part centered at the cementoenamel junction of extracted premolars. Twelve specimens were not treated and considered as control. The experimental material was applied to the other twelve specimens by brushing for 10,000 strokes. Each group was randomly divided into four subgroups according to the period of immersion in phosphate buffer saline (PBS) for 1, 30, 60, and 90 days each. The specimens were sectioned longitudinally and examined with scanning electron microscopy and energy dispersion X-ray spectroscopy. The intratubular crystal were formed in PBS and densely filled the dentinal tubules over time. The crystal formation occurred at a depth of more than 50 μm from the dentin surface. The Ca/P ratio of formed intratubular crystals was 1.68 after 3 months. The experimental material consisting of C2S and C3S with a nanoscale particle size can form hydroxyapatite-like crystals in dentinal tubules in PBS, and there is a possibility of reducing dentin hypersensitivity by blocking the dentinal fluid flow.

Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence.

As the demand for clinically effective fluoride-free oral care products for consumers increases, it is important to document which types of toothpastes have been shown in clinical studies to be effective in improving oral health. In this review, we included different indications, i.e., caries prevention, improving periodontal health, reducing dentin hypersensitivity, protecting against dental erosion, and safely improving tooth whitening in defining what constitutes improvement in oral health. While there are several professional and consumer fluoride-containing formulations fortified with calcium-phosphate-based ingredients, this review focuses on fluoride-free toothpastes containing biomimetic calcium-phosphate-based molecules as the primary active ingredients. Several databases were searched, and only clinical trials in human subjects were included; in vitro and animal studies were excluded. There were 62 oral health clinical trials on biomimetic hydroxyapatite (HAP), 57 on casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), 26 on calcium sodium phosphosilicate (CSPS, or so called Bioglass), and 2 on β-tricalcium phosphate (β-TCP). HAP formulations were tested the most in clinical trials for benefits in preventing caries, dentin hypersensitivity, improving periodontal health, and tooth whitening. Based on the current clinical evidence to date, fluoride-free HAP toothpaste formulations are the most versatile of the calcium phosphate active ingredients in toothpastes for improving oral health.

Is silver diamine fluoride effective in reducing dentin hypersensitivity? A systematic review.

The purpose of this systematic review was to assess the clinical efficacy (sensitivity reduction) and safety (gum damage) of silver diamine fluoride (SDF) as a tooth desensitizer for adults. The search strategy was developed and adapted from 12 databases. Two independent reviewers selected the studies in consensus with a third reviewer. Randomized clinical trials with adult volunteers affected by dentin hypersensitivity (DH), and receiving treatment with SDF were included. Studies with volunteers testing tooth whitening products, using some type of desensitizer, or taking analgesic or anti-inflammatory medication were excluded. The risk of bias was assessed according to the RoB 2 tool, and confidence in cumulative evidence, according to GRADE. Only 3 articles were included. The average pain assessed using the visual analog scale was lower in the SDF groups than in the short-term control groups (24h to 7 days) (P=0.0134 and P=0.0015) of the two studies. The third study evaluated a combination of SDF and a CO2 laser, compared to using only SDF, and found no statistical difference between the two (P=0.74). Inflammation and gingival staining were also evaluated in two of the three studies. No adverse effects were reported. All the included studies had a high risk of bias, and the certainty of the evidence was very low. SDF can be used as a safe and effective tooth desensitizer in adults, with good results, as was achieved in a short-term follow-up. However, more studies with longer evaluation periods are required.

Root coverage surgery for dentin hypersensitivity reduction: a systematic review and meta-analysis of randomized controlled trials.

To evaluate the effectiveness of root coverage surgery in reducing dentin hypersensitivity (DH) through a systematic review and meta-analysis. Unrestricted search of four indexed databases up to September 2022 was performed to identify randomized controlled trials (RCTs) evaluating the effect of root coverage surgery on DH frequency and/or intensity presurgically (baseline) and at least 3 months postsurgically. Two authors independently conducted study screening and data extraction. Subgroup meta-analyses were performed separately for stimulated and unstimulated DH frequency and intensity at different timepoints. The risk of bias and quality of the available evidence were assessed. Nineteen RCTs presenting data from 7 days to 30 months after root coverage surgery with various treatment modalities were included from the 662 identified studies. A total of 486 patients contributed 784 recession defects. Results from the subgroup meta-analyses showed that, overall, root coverage surgery reduced the risk for DH by 67% (RR, 0.33; 95% CI, 0.21 to 0.53) and 53% (RR, 0.47; 95% CI, 0.38 to 0.58) upon unstimulated and stimulated DH assessment, respectively. The DH intensity was also significantly reduced (mean visual analog score difference, 2.37; 95% CI, 2.02 to 2.71) upon stimulated DH assessment. No significant changes in DH intensity were observed upon unstimulated DH assessment. The included studies did not have high risk of bias and the quality of evidence was low to high. Existing evidence suggests that root coverage surgery may effectively reduce the DH frequency and intensity.