Desensitizing Agents Research Articles

Meta-Analysis the Effect of a Potassium Nitrate Desensitizing Agent and Casein Phosphopeptide Amorphous Calcium Phosphate on Tooth Sensitivity after Office Bleaching Treatment

Background: Office bleaching is a treatment used to treat tooth discoloration, but it often results in tooth sensitivity. The desensitizing agent potassium nitrate and casein phosphopeptide amorphous calcium phosphate (CPP-ACP) can reduce tooth sensitivity because they work to inhibit nerve transmission, thereby preventing the sensation of pain. This study aimed to investigate the effect of potassium nitrate desensitization agents and CPP-ACP on tooth sensitivity after bleaching treatment.Subjects and Method: This was a meta-analysis with the following PICO format. Population= Patients who have undergone office bleaching treatment. Intervention= desensitizing agents potas-sium nitrate and CPP-ACP. Comparison: without desensitizing agent. Outcome: tooth sensitivity. Keywords used "Office bleaching" AND "Tooth sensitivity" OR "Dentine hypersensitivity" AND "Potassium nitrate" AND Casein Phosphopeptide Amorphous Calcium Phosphate" OR "CPP-ACP" AND "Randomized Controlled Trial" OR “RCT”. Studies published at PubMed, Springerlink, Cochrane Database, Hindawi, Elsevier, Google Scholar and Wiley Online Library databases, from 2013 to 2023. The selected articles were critically reviewed using the PRISMA checklist and analyzed using the Review Manager 5.4.1. The effect size used is the Standardized Mean Difference (SMD).Results: A total of 13 RCTs from Brazil, Spain, India, Pakistan, Turkey, Jordan, Iran, and the United States was selected for meta-analysis. Meta-analysis of 7 articles shows that the use of potassium nitrate desensitization agents can reduce tooth sensitivity by 0.20 units lower than without the use of desensitization agents (SMD= - 0.20; 95% CI= -0.37 to -0.03; p=0.020). Meanwhile, 7 articles show that the use of CPP-ACP desensitization agents can reduce tooth sensitivity by 0.46 units lower than without the use of desensitization agents (SMD= -0.46; 95% CI= -0.67 to - 0.24; p<0.001).Conclusion: The use of potassium nitrate desensitization agents and CPP-ACP reduces tooth sensitivity compared to without the use of potassium nitrate desensitization agents and CPP-ACP and is statistically significant. Keywords: desensitizing agent, potassium nitrat, casein phosphopeptide amorphous calcium phosphate, tooth sensitivity, office bleaching

The Effect of Dentine Desensitizing Agents on the Retention of Cemented Fixed Dental Prostheses: A Systematic Review

Background and Objectives: The use of desensitizing agents (DA) after tooth preparation to prevent hypersensitivity is well documented in the literature. A fixed dental prosthesis (FDP) should have good retention to be successful. Inadequate retention may result in microleakage, secondary caries, and, eventually, dislodgement of the FDP. The effect of DAs on the retention of FDPs has been widely studied in the literature, but the results are conflicting. Thus, this study aimed to conduct a systematic review to assess the effect of dentine desensitizing agents, used to prevent post-cementation hypersensitivity, on the retention of cemented FDPs. The null hypothesis framed was that there is no effect of dentine desensitizing agents on the retention of cemented FDPs. The focused PICO question was as follows: "Does the application of dentine desensitizing agents (I) affect the retention (O) of cemented fixed dental prosthesis (P) when compared to non-dentine desensitizing groups (C)"? Materials and Methods: Four electronic databases were systematically searched and, on the basis of the predefined inclusion and exclusion criteria, 23 articles were included in this systematic review. A modified CONSORT scale for in vitro studies was used to assess the quality of the selected studies, as all included studies were in vitro studies. Results: Most of the studies compared the effect of more than one type of DA on retention. The results of the selected studies varied due to differences in the composition of tested dentine DAs and types of luting cements. Conclusions: Within the limitations of this study, it can be concluded that the retention values of FDPs cemented using zinc phosphate cement were reduced with most of the DAs, whereas retention values increased when GIC, resin-modified GIC, and resin cements were used with the majority of DAs. These findings are important, as they can guide dentists in selecting the DA before cementing the crowns with the luting agent of their choice, without compromising the retention of the crowns.

Bonding properties of mild universal adhesives to dentin pretreated with hydroxyapatite-based desensitizing agents.

The purpose of the study was to evaluate the effect of hydroxyapatite (HA)-based desensiti-zing agents and determine their influence on the bonding performance of mild universal adhesives. Mid-coronal dentin samples were sectioned from human third molars and prepared for a dentin-sensitive model. According to desensitizing applications, they were randomly divided into four groups for the following treatments: no desensitizing treatment (control), Biorepair toothpaste (HA-based desensitizing toothpaste) treatment, Dontodent toothpaste (HA-based desensitizing toothpaste) treatment, and HA paste treatment. Dentin tubular occlusion and occluded area ratios were evaluated by scanning electron microscopy (SEM). Furthermore, All-Bond Universal, Single Bond Universal, and Clearfil Universal Bond were applied to the desensitized dentin in self-etch mode. The wettability and surface free energy (SFE) of desensitized dentin were evaluated by contact angle measurements. Bonded specimens were sectioned into beams and tested for micro-tensile bond strength to analyze the effect of desensitizing treatment on the bond strength to dentin of universal adhesives. SEM revealed that the dentin tubule was occluded by HA-based desensitizing agents, and the area ratios for the occluded dentin tubules were in the following order: HA group>Biorepair group>Dontodent group (P<0.05). Contact angle analysis demonstrated that HA-based desensitizing agents had no statistically significant influence on the wettability of the universal adhesives (P>0.05). The SFE of dentin significantly increased after treatment by HA-based desensitizing agents (P<0.05). The micro-tensile bond strength test showed that HA-based desensitizing toothpastes always decreased the μTBS values (P<0.05), whereas the HA paste group presented similar bond strength to the control group (P>0.05), irrespective of universal adhesive types. HA-based desensitizing agents can occlude the exposed dentinal tubules on sensitive dentin. When mild and ultra-mild universal adhesives were used for subsequent resin restoration, the bond strength was reduced by HA-based desensitizing toothpastes, whereas the pure HA paste had no adverse effect on bond strength.

Phototherapy Using Er,Cr:YSGG Laser as a Definitive Treatment for Dentin Hypersensitivity: A Systematic Review

PurposeTo assess the efficacy of Er,Cr:YSGG lasers in reducing dentine hypersensitivity (DH).MethodsElectronic literature were searched through various databases (MEDLINE, SCOPUS, ProQuest, LILACS and EBSCO) up to March 2022 for articles addressing the following focused question: “In patients with dentine hypersensitivity, does an Er,Cr:YSGG laser provide a better outcome in terms of pain reduction than other dentine desensitizer agents?”. The literature was searched using combinations of the following medical subject heading (MeSH) terms and keywords: (laser OR phototherapy OR Er,Cr:YSGG laser) AND (dentine hypersensitivity OR dentine sensitivity OR dental sensitivity).ResultsA total of 486 studies were found, of which 7 randomized controlled trials were included in the review. The Er,Cr:YSGG laser wavelengths, power density and duration of irradiation used in the studies were 2780 nanometers, 0.25–0.5 watts and 20–60 seconds, respectively. The follow-up assessments were conducted ranging from immediately to 3 months after treatment. All studies showed that the Er,Cr:YSGG laser was effective in alleviating DH.ConclusionThis systematic review suggests that the application of an Er,Cr:YSSG laser is effective in alleviating DH and may have limited adverse effects if adequate parameters are followed.

Post-Operative Sensitivity and Color Change Due to In-Office Bleaching With the Prior Use of Different Desensitizing Agents: A Systematic Review.

Bleaching agents can cause certain surface alterations on the enamel, such as depressions, surface porosity, and surface irregularities; this makes the dentin more susceptible to post-operative tooth sensitivity (PoS). In addition, the presence of flawed or leaky restorations, gingival recession, or defects in the cementoenamel junction can also cause severe tooth sensitivity post tooth bleaching.Hence, the current study aimed to perform a systematic review to determine the efficacy of various desensitizing agents (DA) in managing post-operative tooth sensitivity and color alteration when applied before in-office bleaching procedures. Randomized clinical trials were searched to conduct an SR where the post-operative tooth sensitivity was evaluated after in-office bleaching with various desensitizing agents used before the procedure. Post-operative pain assessment was measured using the Visual Analogue Scale (VAS). Outcomes were evaluated up to an hour and 24 hours post the procedure. Out of 163 articles, only 13 titles were selected that met the eligibility criteria. Eight hundred and forty-one adult patients with vital pulp status were included. The participants receiving prior desensitizing agent applications reported significantly lower pain scores in the VAS reports. The most significant reduction of post-operative sensitivity was observed in the immediate (up to an hour) and 24 hours after the in-office bleaching. The popular desensitizing agent that could manage post-operative tooth sensitivity (TS) is 5% potassium nitrate and 2% sodium fluoride used before the in-office bleaching procedure.

Treatment of dentin hypersensitivity by association of chemical desensitizing agents: a case report

Background: Dentin hypersensitivity is an increasingly common complaint, especially among young people. It manifests as painful symptoms in areas of exposed dentinal tubules and is related to the patients' lifestyle. Aim: The present work aimed to address a protocol with chemical desensitizing agents in treatment of Dentin Hypersensitivity. Case report: The treatment was performed in a 22-year-old female patient who presented as the main complaint a moderate to intense degree sensitivity in anterior and posterior teeth. In the 1st and 2nd week, a neural action desensitizer based on potassium nitrate (Ultra EZ™ - Ultradent Products Inc) was used, while in the 3rd and 4th week, a desensitizer with an obliterating action based on calcium phosphates (Nano P™ - FGM Dental Products) was chosen. In the 5th week, another chemical occlusal desensitizer agent was applied, the 5% sodium fluoride varnish (Enamelast™ - Ultradent Products Inc). Results: The patient was successfully treated by the associative technique through neural and blocker desensitizers obtaining effective pain control in a18-month follow-up. Conclusion: The associative technique of different chemical desensitizers has shown extremely satisfactory results, which can be confirmed in the present case report.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity.

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry “Dentin Hypersensitivity,” based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

Comparing the Effectiveness of Different Dentinal Desensitizing Agents: In Vitro Study.

Objectives To evaluate the in vitro effectiveness of desensitizing agents in reducing dentine permeability. Methods The efficacy of desensitizing agents in reducing dentine permeability by occluding dentine tubules was evaluated using a fluid filtration device that conducts at 100 cmH2O (1.4 psi) pressure, and SEM/EDX analyses were evaluated and compared. Forty-two dentine discs (n = 42) of 1 ± 0.2 mm width were obtained from caries-free permanent human molars. Thirty dentine discs (n = 30) were randomly divided into 3 groups (n = 10): Group 1: 2.7% wt. monopotassium-monohydrogen oxalate (Mp-Mh oxalate), Group 2: RMGI XT VAR, and Group 3: LIQ SiO2. Dentine permeability was measured following treatment application after 10 minutes, storage in artificial saliva after 10 minutes and 7 days, and citric acid challenge for 3 minutes. Data were analysed with a repeated measures ANOVA test. Dentine discs (n = 12) were used for SEM/EDX analyses to acquire data on morphological changes on dentine surface and its mineral content after different stages of treatment. Results Desensitizing agents' application on the demineralized dentine discs exhibited significant reduction of permeability compared to its maximum acid permeability values. Mp-Mh oxalate showed a significant reduction in dentine permeability (p < 0.05) when compared to RMGI XT VAR and LIQ SiO2. On SEM/EDX analysis, all the agents formed mineral precipitates that occluded the dentine tubules. Conclusions 2.7% wt. monopotassium-monohydrogen oxalate was significantly effective in reducing dentine permeability compared to RMGI XT VAR and LIQ SiO2.

Novel Management of Hypersensitive Dentin Using Propolis-based Herbal Desensitizing Agents: An In Vitro Scanning Electron Microscopic Study

The objective of this in vitro study was to assess the efficacy of novel propolis-based varnish against the two conventional varnishes on quantitative and qualitative assessments of occlusion of dentin tubules and resistance to erosive and abrasive wears employing scanning electron microscope (SEM). Thirty human premolars free from caries extracted due to orthodontic reasons were included in the study. Experimental group was done based on treatment received and divided into three groups. Group A: ClinProXT Varnish (n = 10), Group B: MI Varnish (n = 10), and Group C: Propolis Varnish (n = 10) were applied. Teeth were cleaned and decoronation of crown was done with dentin disks. Dentin specimens of dimension 4 × 4 × 2 mm were prepared and subjected to finishing and polishing. The sample specimens were submersed in EDTA solution for a period of five minutes to open up the dentinal tubules. This was followed by treatment with varnishes and subjection to acidic-abrasive challenge. The specimens were analyzed with an image analyzer connected to SEM for the verification of the number of opened dentin tubules. The parameter assessed in SEM includes size, topography and surface characteristics of dentinal tubule were assessed. The obliteration potential of dentinal tubules was assessed with SEM images. Additionally, the dentin surface loss and resistance to acidic and abrasive wear were also evaluated with SEM. Data were analyzed with two-way analysis of variance (ANOVA) with post hoc Tukey's test. MI Varnish caused higher obliteration of dentin tubules followed by ClinproXT Varnish. Propolis Varnish showed the least obliteration of dentinal tubules among tested experimental groups. After acidic-abrasive challenge, Propolis Varnish was found to be more efficient with less material loss among the experimental groups tested. There was an insignificant difference among the MI Varnish and ClinProXT Varnish groups. Simulation of hypersensitive lesions mimicking the clinical scenario was a challenging task in this in vitro study. All varnishes tested in the study had good efficacy in the management of dentin hypersensitivity (DH). Propolis-based varnish had good resistance to material loss after subjection to acidic-abrasive challenge among the tested materials. The casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP)-based MI Varnish had good efficacy to obliterate the dentinal tubules among the tested materials. It was prudent to select the varnishes with good long-term efficacy to survive in the clinical scenario which still remains a challenging task for the clinicians. The stability of the varnish plays a vital role in maintenance of its long-term efficacy. The chemical nature along with the ability of the material to interact with the substrate plays a major role in management of DH.

Comparative Evaluation of the Effects of Diode Laser and Desensitizing Agents on the Treatment of Dentin Hypersensitivity: a Clinical Study.

Background:Dentine hypersensitivity (DH) is a frequent clinical problem that represents a long-term painful discomfort for the patients, and for the dentists, it represents a diagnostic and therapeutic challenge.Objective:The aim of the research is to verify the effect of the treatment with diode laser SiroLaser Blue (660nm) of DH alone or in combination with different impregnating agents.Methods:Fifty patients were included in this research, separated into five groups. All the patients have been asked to define the level of dentine hypersensitivity using VAS (0-10). The first group was treated with Fluor Protector, the second group after the application of Fluor Protector has undergone irradiation with SiroLaser Blue (660nm), the third group was treated with impregnating agent Vivasens, the fourth group, after the application of impregnating agent Vivasens, has had SiroLaser Blue (660nm) irradiation. The fifth group has just been treated with SiroLaser Blue (660nm). The efficiency of the treatment was checked using VAS for every group immediately after the conducted treatment, after 7 days and 1 month.Results:Our results showed that all of the desensitizing agents used in the research alone or in combination with a diode laser (660nm) have shown a reduction of DH. The difference has been proven statistically significant in mean values by groups and examinations. Vivasens and diode laser irradiation have provided the best results in the review of mean values after the first examination and one month after the treatment of DH (p<0,05). In our research, the application of diode laser alone has not proven superior to other treatment methods that have been used in the research.Conclusion:Vivasens plus diode laser irradiation has provided the best results even after one month since the treatment of DH.

Assessment of the acid resistance behaviour of dentin tubules occluded by different desensitizers

Aim: To evaluate the efficacy of in-office and home-based products in the prevention of dentinal hypersensitivity on dentin discs.&#x0D; Methodology: Ninety-six dentin disc samples of 1 mm were divided equally into six groups as follows: TeethmateTM, Smartprotect®, novamin®, Arginine calcium carbonate, potassium oxalate with rinse and saline (control). After acid etching, test agents were applied, and eight samples in each group were subjected to citric acid. SEM examination (3000x) and statistical analysis were carried out.&#x0D; Results: Before citric acid challenge, novamin® and teethmate had superiority when compared to others (p&lt;0.001), but there was no a statistical difference between novamin® and teethmate. After citric acid challenge, teethmate and smartprotect showed resistance on occluded tubules. The decreasing in the level of occluded tubules in novamin® group was statistically significant (p&lt;0.05). In-office products including teethmate and smartprotect were found more successful compared to home-based products. Smartprotect resisted against to citric acid (0.506).&#x0D; Conclusion: Novamin® showed a successful occlusion in all tubules before acid challenge whereas; it was the most unsuccessful group after acid challenge when compared to other agents. In-office agents were found to be more successful in reducing dentine permeability than home-care products. In-office agents showed more resistance to acid attacks. Further studies are needed to assess the efficacy of desensitizer agents.&#x0D; How to cite this article:&#x0D; Karayürek F, Arpağ OF. Assessment of the acid resistance behaviour of dentin tubules occluded by different desensitizers. Int Dent Res 2020;10(3):80-9. https://doi.org/10.5577/intdentres.2020.vol10.no3.3&#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Influence of desensitizers agents on the dentin bond strength after one-year water storage

Aim: Evaluate the effect of adhesives systems combined with desensitizer agents on the microtensile bond strength (μTBS) of a composite resin to dentin. Methods: Cervical dentin of thirty-two human molars were used to simulate hypersensitivity areas. The teeth were divided into four groups (n=8), according to the type of adhesive system and desensitizer agents. No desensitizer was used in the control (Clearfil SE Bond – CS). Two experimental groups were pretreated with either MS Coat Bond (MS) or Biofluorid 12 (BF) immediately prior to bonding with CS. The last group corresponded to Gluma Comfort Bond + Desensitizer (GC) application. After dentin treatments, a composite block was built-up on dentin surface and after 24 hours teeth were serially sectioned to obtain bonded bean specimens. Beams were stored in water for 24 hours or one year. Subsequently, the specimens were submitted to the μTBS test. Data were analyzed by two-way mixed ANOVA and Bonferroni’s test (α = 0.05). Results: At 24 hours, there was no significant difference in μTBS among groups. However, at one year, dentin treated with MS or BF demonstrated significantly lower μTBS of CS to dentin compared to control and GC, which kept their μTBS stable. Conclusion: The effect of MS and BF desensitizer agents on the μTBS of CS to dentin did not reduce the μTBS at 24 hours, but it decreases significantly after one year.

The effects of different desensitizer agents on shear bond strength of orthodontic brackets after home bleaching: an in vitro study.

The aim of this study was to test the null hypothesis that no difference exists between shear bond strength values of control and bleaching plus desensitizer applied groups. A hundred freshly extracted human premolar teeth were randomly divided into five groups. Group I served as the control group with no bleaching application, while only bleaching was achieved in Group II. Desensitizer containing potassium nitrate-fluoride and casein phosphopeptide amorphous calcium phosphate were applied in Groups III and IV, after bleaching respectively. A bleaching agent containing amorphous calcium phosphate was used in Group V. Shear bond strength tests were carried out using a universal testing machine (Instron Corp., Norwood, MA, USA). Remnant adhesive on the teeth and brackets was examined to score the adhesive remnant index. Kruskal-Wallis and Chi-Square tests were used for statistical analysis of the data. Statistically significant differences were found among the groups for shear bond strength values (p<.001). The shear bond strength of Group III (8.0±2.2 MPa) was significantly lower than the other groups (p<.05). The highest shear bond strength values were found for Group I (13.6±3.7 MPa) and Group IV (12.8±4.0 MPa). No statistically significant difference was observed between Group II (10.0±2.7 MPa) and Group V (10.8±2.9 MPa). The differences between adhesive remnant index scores of the groups were not statistically significant. Casein phosphopeptide amorphous calcium phosphate gel application showed a similar shear bond strength value to the control group, while shear bond strength values decreased after using other desensitizers.

Long-Term In Vitro Effectiveness of A Bioglass Desensitizing Agent Investigated Using Electrochemical Impedance Spectroscopy, Atomic Force Microscopy and Scanning Electron Microscopy

Objectives: To compare the long-term in vitro effectiveness of a newer desensitizing agent containing bioactive glass and two other commercial products employed for dentin hypersensitivity. Methods: Fifty occlusal dentin disks from extracted sound human third molars were treated with 0.5M ethylenediaminetetraacetic acid for 2 min then randomly divided into five groups (n=10). Specimens were brushed for 2 min twice daily with Actimins Paste (Group1), Lesening Super Desensitizing Toothpaste (Group2), Colgate Sensitive Pro-Relief Desensitising Polishing Paste (Group3) and distilled water (Group4) at 9:00 am and at 5:00 pm. Specimens in Group5 had no brushings. All specimens were immersed sequentially for 5 min into coffee (pH=5.4) at 10:00 am and undiluted cola (pH=2.5) at 6:00 pm. Dentin permeability was measured weekly over one month using electrochemical impedance spectroscopy (EIS). Data were analyzed using two-way repeated measures ANOVA and post hoc LSD tests. Dentin microstructures were observed at one month by atomic force microscopy and scanning electron microscopy. Results: The three desensitizing agents significantly reduced dentin permeability over one month. Post hoc LSD tests of the EIS values indicated that brushing with Actimins showed no significant difference from Colgate Sensitive (P=0.32), and that both agents had significantly less permeability than Lesening (P<0.05). Conclusions: The three desensitizing agents were effective in occluding dentinal tubules and reducing permeability to varying extents over one month, with Actimins and Colgate Sensitive being the most effective. Actimins might be initially, a faster-working desensitizing agent. Clinical significance: Actimins, a newer desensitizing agent containing bioactive glass, has the potential to relieve dentin hypersensitivity in the presence of long-term daily acidic beverage ingestion.

Influence of desensitizing procedures on adhesion of resin cements to dentin

This study evaluated the effect of two desensitizer agents with different contents and Nd:YAG laser irradiation on the shear bond strength (SBS) of adhesive resin cements to dentin. New treatment options of Nd:YAG laser irradiation and tetracalcium phosphate-containing agent applications were compared with routinely used glutaraldehyde-containing agents. One hundred and twenty human, caries-free premolars were embedded in acrylic resin blocks 2 mm below the cementoenamel junction. Buccal surfaces of the teeth were ground to expose dentin. The specimens were randomly assigned into three different surface treatments (desensitizing agents, Nd:YAG laser) and the control, then into three different adhesive resin cement applications (n = 10). Resin cements (Panavia SA cement (PA), Panavia SA cement with Clearfil Universal Bond (PACU), and Multilink N (MN)) were applied to the conditioned teeth surfaces using Teflon tubes. The specimens were thermocycled (5000 cycles, 5–55 ± 1 °C, dwell time 30 s). The SBS test was performed in all groups. The results were submitted to two-way ANOVA and Tukey HSD tests (p < .05). Further, SEM analysis was performed on the dentin surfaces. SBS values were significantly difference among the surface treatment groups and also among adhesive resin cement groups (p < .05). The specimen cemented with PA showed lower SBS values than PACU- and MN-applied specimens. The highest SBS value was obtained in the Nd:YAG laser group which was cemented with PACU cement. The lowest SBS value was obtained in the control group which was cemented with PA cement. In addition, SEM evaluation revealed that desensitizing agents and Nd:YAG laser occluded dentin tubules.

Analysis of bleaching products associated with desensitizing agents in experimental whitening gel –randomized clinical trial

The objective of this clinical study was to determine the effect of adding desensitizing agents in homemade experimental whitening gel Carbamide peroxide 16%. 60 young patients were selected (between 18-28 years), who used randomly (by lottery) the whitening gel DA (with desensitizing agent) or whitening gel CO (without desensitizing agent) characterized as control of a double-blind study, ie the patient and the evaluator did not know the product that was being used. Teeth 15, 14, 13, 12, 11, 21, 22, 23, 24 and 25 were bleached. The guidelines of how to apply the bleaching agents were performed by an experienced and calibrated team, and the application accompanied by examiners in several phases. To measure the color we used a Visual Range Vita Classical through visual inspection by the evaluators and patient information. A comparative test regarding each individual stimulation caused by mechanical attrition and thermal probe with clinical test was done (air syringe) in order to verify the presence of sensitivity in three phases: before treatment, after 7 and 14 days. Data were collected using Visual Analogue Scale (VAS) adapted to four criteria: no pain, mild pain, moderate pain and severe pain. The correlation of the data x teeth sensitivity were obtained separately, and tabulated for further comparative analysis. The results showed that there was no difference between the groups in terms of bleaching effect. In the post-operative sensitivity test, the subjects who used the product without desensitizing showed higher levels of sensitivity in different types of teeth, regardless of sex or age. It was concluded that the addition of desensitizing agent in the carbamide peroxide 16% whitening gel produced less post-bleaching sensitivity index. We emphasize that from the teeth evaluated, the premolars showed higher sensitivity index, followed by the canines and incisors. There was no difference in the bleaching capacity of the products used, demonstrating that the addition of desensitizing did not affect the efficacy of the treatment.

Effect of Dentın Desensitizing Agents on Dentin-Adhesive Cement Bonding: An In-Vıtro Study

Effect of Dentın Desensitizing Agents on Dentin-Adhesive Cement Bonding: An In-Vıtro Study

The immune-modulator AS101 reduces anti-HLA antibodies in sera of sensitized patients: A structural approach

BackgroundSignificant efforts are dedicated to identification of agents that eliminate anti-HLA antibodies (Ab) from sera of transplant candidates. Antibody titer following in vitro incubation of sera with desensitizing agents has shown to reflect the probability that a patient would benefit from clinical de-sensitization protocols. AS101 is a non-toxic, synthetic, organic tellurium compound. The aim of this research was to assess the ability of AS101 to reduce anti-HLA Abs and to identify patients likely to benefit from this effect. MethodsSera of sensitized patients awaiting transplant were incubated in the presence of AS101. Measured mean fluorescence intensity (MFI) represents reactivity of anti HLA Abs in the serum, as detected by the Luminex platform. The repertoire of HLA antigen epitopes was recognized using HLA Matchmaker software. ResultsAS101 Incubation caused a significant Ab titer decrease in approximately two thirds of the samples. The median Class I and II MFI decrease among the responding samples was 16.7% and 14%, respectively (p<0.05). HLA Matchmaker analysis of the patients' class I epitope sequences revealed apparent amino-acid differences between the patterns of the responding and non-responding patients. ConclusionIn vitro incubation of sera in the presence of AS101 causes a decrease in the anti-HLA Ab's reactivity in several patient samples. Sera most likely to demonstrate this effect are characterized by a moderate MFI level and a distinct antibody reactivity pattern specific for defined HLA antigen epitopes. These results support further investigation of AS101 as a potential agent for desensitization of humoral reactivity prior to transplantation.

Influence of Two Desensitizer Agents on the Microleakage of Adhesively Luted Ceramic Inlays

The purpose of this study was to evaluate the effects of two different desensitizers (Hemaseal & Cide and Aqua Prep F) on the microleakage of ceramic inlay restorations luted with adhesive resin cement. Cylindrical Class V cavities were prepared on the buccal surfaces of thirty extracted human third molars. One of the desensitizers (either Hemaseal&Cide, Advantage Dental Products Inc. or Aqua-Prep F, Bisco) was applied to the cavities. Ten samples were used as controls. Ceramic inlays were fabricated using the heat-pressed glass ceramic technique (IPS Empress II). Inlay restorations were luted using adhesive cement (Variolink II, Ivoclar-Vivadent). The restorations were properly finished, stored in distilled water at 37°C for 24 h and subjected to 1000 thermal cycles. The microleakage scores were examined using a stereomicroscope at the 30x magnification after each sample was stained with 0.5% basic fuchsin. The data were analyzed using Kruskall Wallis and Mann Whitney U tests (P=0.05). Aqua-Prep F samples showed significantly higher microleakage scores at the enamel margins than did the Hemaseal & Cide and control groups (P<.05). Hemaseal & Cide application led to less microleakage than the other groups both at the enamel and dentin margins (P<.05). Hemaseal & Cide desensitizer decreased the microleakage process at the enamel and dentin margins of inlay restorations luted with adhesive luting cement, while Aqua-Prep F increased the leakage scores at the enamel margins.

Effects of Potassium Nitrate and Oxalate Desensitizer Agents on Shear Bond Strengths of Orthodontic Brackets

To evaluate the effects of potassium nitrate and oxalate desensitizer agents on shear bond strengths of orthodontic brackets. Forty-five extracted human premolar teeth were randomly assigned to three groups of 15 each. UltraEZ potassium nitrate desensitizer was applied on teeth in the first group, while BisBlock oxalate desensitizer was applied on teeth in the second group. The third group served as a control. Orthodontic brackets were bonded with a light cure composite resin and cured with a halogen light. After bonding, the shear bond strength of the brackets was tested with a universal testing machine. The highest shear bond strengths were measured in Group III. The shear bond strength in Groups I and II was significantly lower than in Group III (P < .001). Significant difference was also found between Group I and Group II (P < .01). Orthodontic brackets bonded to enamel treated with potassium nitrate and oxalate desensitizers showed significantly lower bond strengths than did brackets bonded to untreated enamel.