Treatment Of Dentin Hypersensitivity Research Articles

Novel calcium encapsulated mesocellular siliceous foams for crystal growth in dentinal tubules

ObjectivesThe aim of this study was to investigate the novel mesocellular siliceous foams (MCF) containing CaCO3 nanoparticles (denoted as CMCF) combined with phosphoric acid could occlude dentinal tubules through the formation of biomimetic crystal barrier. MethodsUltrastructures of MCF and CMCF were examined by transmission electron microscopy (TEM). Elemental components were analyzed with energy dispersive X-ray spectrometry (EDX). CMCF was mixed with distilled water, 10%, 20% and 30% phosphoric acid then applied on dentine discs. Crystals were characterized by X-ray powder diffractometry (XRD). The sealing efficacy of the dentinal tubules was examined by scanning electron microscopy. ResultsTEM images showed MCF presented a pore size of approximately 30.0 nm and CMCF contained abundant nano-CaCO3. Sealing efficacy showed that CMCF, when reacted with 30% phosphoric acid, would form crystals in the dentinal tubules to a depth of 83.2 ± 17.6 μm at an occlusion percentage of 75.6 ± 12.8% on average; both occlusion percentage and depth were higher than those obtained with 10% or 20% phosphoric acid (p < 0.05). The results of XRD and EDS indicated that the crystal growth in the dentinal tubules could be transformed into the biomimetic crystals. ConclusionThis study showed that the CMCF with 30% phosphoric acid could effectively occlude the dentinal tubules through the formation of biomimetic crystal barrier. Clinical significanceThe novel CMCF combined with phosphoric acid may have potential for the treatment of dentine hypersensitivity.

Comparison of Er,Cr:YSGG and diode laser effects on dentin hypersensitivity: a split-mouth randomized clinical trial.

The aim of the present study was to compare the clinical efficacy of diode laser and Er,Cr:YSGG lasers in the treatment of dentin hypersensitivity. Thirty-four teeth from 17 patients with dentin hypersensitivity were divided into two groups. In group D, the teeth were irradiated with diode laser beams with a wavelength of 940nm for 1min, and in group E, the teeth were irradiated with Er,Cr:YSGG laser beams with a wavelength of 2780nm and a pulse width of 140-200μs. Treatments with laser beams were carried out in 1 session. Sensitivity was assessed with air spray and a dental explorer. Pain severity was measured with the use of visual analog scale (VAS) before and after laser application. A decrease in dentin hypersensitivity was observed in both groups immediately, 1week, and 1month after laser irradiation. Statistically significant differences were found between the two groups in dentin hypersensitivity severity only 1month after laser application. The decrease in dentin hypersensitivity by Er,Cr:YSGG laser was significantly higher than that by diode laser at this time interval. The decrease in dentin hypersensitivity after application of Er,Cr:YSGG laser was significantly higher than that after the application of diode laser at 1-month postoperative interval. Er,Cr:YSGG laser is a better choice than diode laser for the treatment of dentin hypersensitivity in the short term.

Dentinal Hypersensitivity Treatment Using Diode Laser 980 nm: In Vivo Study.

The discomfort of patients due to dentinal hypersensitivity (DH) is one of the main challenges that dentists face in daily practice. Difficulties in DH treatment gave rise to many protocols which are currently used. The aim of this clinical study is to evaluate the effectiveness of a new protocol on the reduction of dentinal hypersensitivity with diode laser 980 nm and the application of a graphite paste. 184 patients enrolled in the study, the degree of pain was evaluated by visual analog scale (VAS), graphite paste was applied on the exposed dentine before irradiation, the application of diode laser 980 nm with continuous mode, backward motion, tangential incidence of the beam in non-contact mode and a delivery output of 1 W. Fiber’s diameter was 320 μm and total exposure time depended on the time necessary to remove the graphite paste from the teeth. Statistical analyses were performed with Prism 5® software. Pain in post-operative significantly decreased immediately after the treatment. Mean values stayed stable until a 6-month follow-up. The application is considered to be safe with long-term effectiveness.

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

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

Comparative evaluation of neodymium-doped yttrium aluminum garnet laser with nanocrystalline hydroxyapatite dentifrices and herbal dentifrices in the treatment of dentinal hypersensitivity.

Background:The aim of this study was to compare and evaluate the efficacy of neodymium-doped yttrium aluminum garnet laser with and without herbal and nanohydroxyapatite dentifrices in management of dentinal hypersensitivity (DH).Materials and Methods:A total of 180 patients who responded to air-blast test and cold-water test using verbal rating scale (VRS) were included in this study. The patients were randomly assigned to six groups (n = 30): control group (CG), scaling and root planning (SRP) + nanocrystalline hydroxyapatite dentifrices, SRP + nanocrystalline hydroxyapatite dentifrices + laser, SRP + herbal dentifrices, SRP + herbal dentifrices + laser, and SRP + laser. Each group was evaluated at baseline, 1 week, 1 month, and 6 months. In every visit of each patient, their clinical examination was done.Results:Among all groups’, repeated ANOVA measures and Kruskal–Wallis test was performed in which laser groups showed maximum reduction in DH in all indices while the CG showed minimum reduction in DH. The VRS values showed maximum reduction in SRP + nanocrystalline hydroxyapatite dentifrices + laser group with mean of 0.3 ± 0.5 and minimum reduction in CG with mean of 3.0 ± 0.5 (P < 0.001).Conclusion:Among all the groups, SRP + Nanocrystalline hydroxyapatite + Laser can be an effective treatment modality for DH.

Comparative assessment of effectiveness of Biomin, NovaMin, herbal, and potassium nitrate desensitizing agents in the treatment of hypersensitive teeth: A clinical study

Aim and Objectives: To compare the efficacy of four commercially available toothpastes in the treatment of dentinal hypersensitivity (DH). Materials and Methods: In a single-centered clinical trial, a total of 160 subjects were divided equally into four groups: group 1 – a toothpaste containing 5% fluoro calcium sodium phosphosilicate with fused silica (Biomin); group 2 – a toothpaste containing 5% CSPS (NovaMin); group 3 – herbal formulation; and group 4 – a toothpaste containing 5% potassium nitrate. The patient's DH scores for tactile, evaporative stimuli were recorded on a visual analog scale at baseline, 2 weeks, and at the end of 4 weeks. Results: All the four desensitizing toothpastes containing different active agents were effective in relieving DH. However, the Biomin group showed a better clinical response at the end of 4 weeks when compared with others. Conclusion: The Biomin group showed significantly better results compared with either NovaMin, herbal, and potassium nitrate toothpastes in the treatment of dental hypersensitivity symptoms.

Comparative evaluation of treatment of noncarious cervical hypersensitivity by a fluoride varnish, a dentin bonding agent, and Er, Cr:YSGG laser: An in vivo study.

Context:Dentin hypersensitivity is one of the most common dental problems encountered regularly. This commonly appearing condition is quite difficult to treat satisfactorily, and so, a large number of techniques and therapeutic alternatives constantly are being proposed to relieve it. However, till date, the search for an ideal agent is on. Various laser systems have been discussed as a new treatment option for dentin hypersensitivity. Researchers are claiming good prognosis with lasers. Treatment with soft tissue lasers is being practiced for some time and is well documented. However, the use of Er, Cr:YSGG laser for desensitization purpose is new, and the available data on clinical outcome are limited.Aims:The purpose of this study was to test and compare the efficacy of a fluoride varnish, a dentin bonding agent, and Er, Cr: YSGG laser in treating noncarious cervical hypersensitivity, in vivo.Settings and Design:Fifty patients aged between 25 and 55 years complaining of dentinal hypersensitivity who reported to the Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, participated in this study.Subjects and Methods:Sensitive teeth in each patient were randomly divided into three treatment groups: Group 1 treated with fluoride varnishGroup 2 treated with dentin bonding agentGroup 3 treated with Er, Cr: YSGG laser. Hypersensitivity assessment was done pretreatment, immediately posttreatment, and 1 day, 1, 2, 3, and 4 weeks postoperatively.Statistical Analysis Used:The data obtained were tabulated and subjected to statistical analysis using the paired and unpaired t-test.Results:In all the treatment groups, there was significant decrease in mean hypersensitivity scores from pretreatment values after 4 weeks. The posttreatment hypersensitivity scores of Group 3 were minimum for all three test stimuli followed by Group 2 and Group 1, respectively.Conclusions:All the three treatment agents, namely fluoride varnish, dentin bonding agent, and Er, Cr:YSGG laser, were effective in treating dentin hypersensitivity. Least recurrence in hypersensitivity occurred in the laser-treated group. Even where recurrences did occur, hypersensitivity did not return to pretreatment value and occurred more in those cases exhibiting high pretreatment sensitivity.

The effectiveness of home-use photobiomodulation toothbrush for treating dentin hypersensitivity: A pilot study.

Dentin hypersensitivity is a frequent oral condition among patients suffering from gingival recession. Recent studies have suggested that photobiomodulation has the potential to reduce inflammation and relieve pain. The present study aims to assess the effectiveness of a new design of photobiomodulation toothbrush with specific irradiation parameters as a homecare device in treating dentin hypersensitivity and to compare its therapeutic effect with that of fluoride varnish. Thirty patients with gingival recession and dentin hypersensitivity were selected and randomly assigned to three groups of equal size: fluoride varnish, photobiomodulation, and the combination. Dentin pain and hypersensitivity were measured using visual analog scale (VAS) by two distinct tests: the contact test with a periodontal probe and the air blast test on the areas of gingival recession and denuded root; once at baseline and again one month after the initial application of treatments. Laser irradiation was carried out at the wavelength of 660 nm in CW with an output power of 40 mW for 30 seconds per spot (1.2 J per spot, 6 J/cm2 energy density, and 200 mW/cm2 power density), perpendicularly to denuded root surfaces in non-contact mode. A significant reduction in dentin pain and hypersensitivity was observed in all three groups. However, the reduction was significantly greater in the combination group. At-home treatment of dentin hypersensitivity with photobiomodulation toothbrush is a convenient, safe, and effective method for the management of dentin hypersensitivity.

Brazilian dentists' perception of dentin hypersensitivity management.

The aim of this study was to investigate how Brazilian dentists perceive and manage dentin hypersensitivity (DH) in their clinical routine. A 13-item questionnaire-based survey was developed and sent electronically to a convenience sample of dentists. The questionnaire assessed the personal and dental practice characteristics of the sample, the occurrence of DH in their daily clinical practice, and management strategies. The data were analyzed descriptively and together with the chi-square test (a = 0.05). A total of 353 responses were obtained from September 2017 to March 2018. Of all the respondents, 62% were females, 49.9% reported fewer than five years of dental practice, and 70.5% were self-identified as private practitioners. Most of the dentists reported an estimated frequency (30-60%) of patients with DH in their practice. The most frequently cited (91.79%) trigger of DH was air blast and/or scratching with a probe. The first-choice strategy to manage DH was a dentin desensitizer (48.16%). The number of years in clinical practice did not influence DH relapse frequency (p = 0.76) significantly, or consider DH treatment as a problem (p = 0.22). The present findings indicate that, regardless of clinical experience, dentists in Brazil still consider DH management a challenge in their daily dental practice. In addition, the results suggest that guidelines should be developed to disseminate the available knowledge regarding this condition in ways that may influence decision-making processes among practitioners.

Comparison of Clinical Efficacy of Pro-Argin and NovaMin Toothpastes in Relieving Dentin Hypersensitivity: A Systematic Review and Meta-analysis.

To compare the clinical efficacy of toothpastes containing Pro-Argin and NovaMin as dentin hypersensitivity (DH) treatment. A systematic review and meta-analysis based on PRISMA was conducted (PROSPERO registration CRD42018095367). Electronic searches were performed in Pubmed, Scopus, Cochrane Library, Web of Science, Virtual Health Library and Open Grey until June 2018, with the terms [pro-argin OR arginine] AND [novamin OR calcium sodium phosphosilicate OR calcium sodium phospho silicate]. Randomised and non-randomised clinical trials comparing DH reduction in adults given Pro-argin-containing toothpastes and NovaMin-containing toothpastes were included. Study selection and quality assessment with Cochrane tool were performed. In the meta-analysis, the comparison between desensitising toothpastes was assessed by standardised mean difference (SMD) with 95% confidence intervals (CI). Certainty of evidence was evaluated with GRADE. Five studies fulfilled the inclusion criteria. In four included studies, a reduction in the DH under tactile stimulus between baseline and post-application times for both toothpastes was demonstrated. Three studies were suitable for meta-analysis. No statistically significant difference between the two toothpastes for DH reduction was observed at immediate (SMD = -1.05, CI = -3.52;1.41), 2-week (SMD = -0.55, CI = -2.59;1.48) and 4-week (SMD = -0.49, CI = -2.78;1.81) follow-up. Certainty of the evidence was very low. Included studies presented a high risk of bias. Pro-argin-containing and NovaMin-containing toothpastes showed effectiveness for DH reduction. No statistically significant difference between the two toothpastes was found. Thus, both can be prescribed to treat DH in adults with equivalent effectiveness up to four weeks.

Assessment of efficiency of treatment of dentin hypersensitivity after preparation

Assessment of efficiency of treatment of dentin hypersensitivity after preparation

A Comparative Evaluation of the Effectiveness of Three Different Modalities in Occluding Dentinal Tubules: An In Vitro Study

This in vitro study was designed to evaluate and compare the effectiveness of a dentifrice containing 8% arginine and calcium carbonate, diode laser (810 nm) and the combined use of diode laser (810 nm) and the same dentifrice in occluding dentinal tubules. Forty sectioned dentine discs were observed in this study. The Samples were randomly divided into 4 groups. In group A, a dentifrice containing arginine and calcium carbonate was applied. In group B, the specimens were subjected to diode laser (810 nm) irradiation. In group C, the same dentifrice was applied and the specimens were subjected to diode laser (810 nm) treatment. Group D was left untreated and served as the control. The specimens were observed under the scanning electron microscope. Then the photomicrographs of each specimen were taken which were uploaded into Photoshop 7®, and the diameters of the dentinal tubules of each specimen were measured and the data were analyzed statistically. The overall comparison between different treatment modalities using one-way analysis of variance (ANOVA) and multiple comparisons of two modalities assessed using post hoc Tukey method revealed that there is a highly significant difference (p value = 0.0001) in the dentinal tubule diameter and rate of occlusion in different treatment modalities. The study concluded that all three treatment modalities caused significant occlusion of dentinal tubules. The combined use of desensitizing toothpaste and diode laser (810 nm) is the most effective, then comes the diode laser (810 nm) alone and finally the desensitizing toothpaste alone. This study suggests an effective treatment of dentinal hypersensitivity using diode laser and desensitizing toothpaste.

Comparative evaluation of fluoro calcium phosphosilicate, calcium sodium phosphosilicate, and strontium chloride hexahydrate containing dentifrice for the treatment of dentin hypersensitivity: A randomized single-blind study

Aims and Objectives: This study aimed to evaluate and compare the clinical effectiveness of dentifrices containing fluoro calcium phosphosilicate, calcium sodium phosphosilicate, and strontium chloride hexahydrate for the treatment of dentin hypersensitivity (DH) when applied twice daily. Materials and Methods: Participants with a history of DH and with visual analog scale (VAS) score of ≥5 to a painful test stimuli response (dental explorer) in at least one tooth at the qualifying baseline visit were enrolled in this four-week randomized study. Participants (n = 93) were randomly allocated to one of the following groups: Group 1––fluoro calcium phosphosilicate (BioMin™), Group 2––calcium sodium phosphosilicate (NovaMin®), and Group 3––strontium chloride hexahydrate. Clinical effectiveness (VAS), perceived sensation score (verbal rating scale [VRS]), participants’ subjective assessment (four-item questionnaire) and oral health-related quality of life (Oral Health Impact Profile-14 [OHIP-14]) questionnaire) were assessed. Results: A significant (P < 0.0001) reduction in symptoms over a period of four weeks (from baseline) was noted in all groups; however, the intergroup difference was not statistically significant. At week 2, the percentage reductions in VAS (Group 1: 58.19%; Group 2: 49.18%; Group 3: 52.69%) and VRS (Group 1: 58.19%; Group 2: 47.16%; Group 3: 49.05%) scores were higher in Group 1 as compared with other groups. Subjective assessment results and oral health-related quality of life were comparable in all the three groups at the end of four weeks. Conclusion: Fluoro calcium phosphosilicate bioactive glass containing desensitizing dentifrice treatment may provide better treatment response for the treatment of DH because of its early onset of action in relieving hypersensitivity symptoms as compared with other dentifrices (CTRI/2018/04/013481).

Effects of oligopeptide simulating DMP-1/mineral trioxide aggregate/agarose hydrogel biomimetic mineralisation model for the treatment of dentine hypersensitivity.

Dentine hypersensitivity (DH) occurs when dentine is exposed to stimuli from the oral environment due to a lack of enamel or cementum. The use of biomimetic mineralisation in occluding exposed dentinal tubules and regenerating enamel-like tissues on dentine surfaces is preferred for a long-lasting treatment. In this study, we established a biomimetic mineralisation model composed of oligopeptide stimulating dentine matrix protein 1 (DMP-1), mineral trioxide aggregate (MTA) and an agarose hydrogel biomimetic mineralisation model (AHBMM); the proposed model is thus referred to as DMP-1@MTA@AHBMM. The effectiveness of DMP-1@MTA@AHBMM for the management of DH was analysed with scanning electron microscopy, energy dispersive X-ray spectroscopy, X-ray diffraction, Fourier transform infrared spectroscopy and a microhardness test. The use of DMP-1@MTA@AHBMM on a demineralised dentine surface occluded the dentinal tubules and regenerated an enamel-like tissue containing well-defined fluoridated hydroxyapatite crystals on the dentine surface. The microhardness of the regenerated enamel-like tissue was greater than that of the demineralised dentine. Therefore, DMP-1@MTA@AHBMM can be a promising method for the management of DH.

The effectiveness of Sensodyne Instant effect toothpaste for dentin hypersensitivity treatment

The article presents an analysis of the clinical efficacy of Sensodyne Instant Effect toothpaste containing sodium fluoride and tin fluoride for the treatment of increased sensitivity of hard dental tissues. The study proved long-term efficiency of Sensodyne Instant Effect toothpaste designed to reduce tooth hyperesthesia. Toothpaste Sensodyne Instant Effect can be widely recommended to reduce the hypersensitivity of dentin.

Efficacy Comparison of Nd:YAG laser, diode laser and dentine bonding agent in dentine hypersensitivity reduction: a clinical trial.

Dentin hypersensitivity is characterized by short, sharp pain arising from exposed dentin in response to external stimuli. Several modalities have been suggested for treatment of this condition such as low-level laser therapy (LLLT) and application of dentin bonding agents. The aim of this study was to compare the clinical efficacy of diode laser, Nd:YAG laser and dentin bonding agent for treatment of dentin hypersensitivity. In this study, 135 teeth of 22 patients diagnosed with dentin hypersensitivity were divided into three groups: In group 1, the teeth were irradiated by diode laser with 810 nm wavelength for 30 seconds and in group 2, the teeth were irradiated by Nd:YAG laser with 1064 nm wavelength for 40 seconds. CLEARFIL SE BOND was applied on teeth in group 3. LLLT was carried out in 3 sessions with 7-day intervals between sessions, during a period of 3 consecutive weeks. Hypersensitivity was assessed by cold test according to the criteria proposed by Uchida at baseline, immediately after treatment and at 1, 3 and 6 months, postoperatively. Reduction of dentin hypersensitivity was observed at 3 and 6 months following the use of Nd:YAG laser (p < 0.001). Reduction in dentin hypersensitivity was observed immediately after treatment in all groups. Statistically significant differences in level of dentin hypersensitivity were found between groups at 3 and at 6 months (p ≤ 0.001). The reduction in dentin hypersensitivity by Nd:YAG laser was significantly superior to that in other groups at this time. The efficacy of Nd:YAG laser in reduction of dentin hypersensitivity was significantly superior to that of other modalities at 3 and 6 months.

Clinical Assessment Of Bonding Agent v/s Fluoride Varnish In Dentinal Hypersensitivity

Objective: To compare the mean reduction in pain scores between Bonding agent (GLUMA® Comfort® Bond+ Desensitizer, and Fluoride varnish. Methodology: The study was conducted at Operative Dentistry, Department at Altamash Institute of Dental Medicine, Karachi from July 2015 to August 2016. Total 152 patients were selected. Patients were randomly allocated into two groups A and B. Gluma comfort bond plus desensitizer® was applied to the patients in group A and Duraphet® was applied to the patients in group B. Initial assessment was done after the application of the above products and thermal test was performed. The outcomes were based on a Visual Analogue Scale (VAS). Re-Evaluation was done again after 30 days of treatment in terms of mean reduction in pain from baseline by applying thermal test on visual analogue scale. Results: The average age of the patients was 37.4 ±8.38 years. After 30 days, mean Visual Analog Scale was significantly low in Group A i.e. 2.95±0.0.86 as compared to Group B i.e. 4.01±0.79(p=0.0005). Significant more reduction in mean pain score was observed in Bonding agent (Gluma desensitizer) as compared to Fluoride varnish Duraphat. Conclusion: In our study we found that bonding agent ( Gluma Desensitizer) is more effective in treating Dentine Hypersensitivity compared to fluoride varnish (Duraphat desensitizer group).

Laser Effects on the Prevention and Treatment of Dentinal Hypersensitivity: A Systematic Review.

Introduction: Dentinal hypersensitivity (DH) is an acute intensive tooth pain which can lead to dental annoyances during eating and drinking. Stimulating exposed dentinal tubules by either kind of thermal, tactile, chemical and/or osmotic stimuli is believed to be the cause of this pain. It is hypothesized that dentinal tubules' orifice occlusion (DOO) can help relieve such dental irritations. Thus, this systematic review was conducted to evaluate the effectiveness of laser application as a prevention and treatment modality on DH reduction. Methods: Electronic databases (MEDLINE, SCOPUS) were searched among randomized clinical trials from January 2007 to December 2016. The extraction of data and quality assessments were carried out by different independent observers. Results: A total of 499 items were found of which3 9 relevant articles were extracted. The profound findings proved lasers' effectiveness as a treatment of DH. Although some of the researches reported no significant difference between laser and other desensitizing agents, most of the studies suggested that better results (both rapid and long-lasting) were obtained in combined modalities. Furthermore, the preventive role of this new technology has been emphasized as well. Nd-YAG (neodymium-doped yttrium aluminum garnet) and diode lasers reduce DH after bleaching. Lasers can also protect cervical restorations from DH due to tubular occlusion. Moreover, it is suggested to apply lasers in relief of DH following scaling and root planning. Nevertheless, a few researchers dispute its beneficence as a result of placebo effect. Conclusion: The results obtained from several studies in the present review revealed that the application of lasers is effective not only in terms of treatment of DH, but also in the prevention of this intensive tooth pain. Among various types of lasers, the application of Nd:YAG laser has shown the best results in DH treatment.

O uso do diamino fluoreto de prata no controle de lesões cariosas: uma revisão integrativa

INTRODUÇÃO: a cárie dentária ainda é uma patologia presente na maioria da população mundial. Cariostáticos à base de diamino fluoreto de prata (DFP) são conhecidos pela sua capacidade de controlar a progressão de lesões de cárie, favorecendo a adequação do meio bucal de crianças. OBJETIVO: verificar o nível de evidência científica dos estudos que indicam a capacidade do DFP em controlar e/ou prevenir lesões de cárie em crianças e identificar outras indicações clínicas do material. MÉTODOS E MATERIAIS: esta revisão integrativa seguiu os seguintes passos idealizados por Cooper (1982): formulação do problema, coleta dos dados dos estudos selecionados, avaliação dos dados coletados, análise e interpretação dos dados coletados e apresentação pública. RESULTADOS: a partir dos critérios de inclusão e exclusão adotados, foram selecionadas 28 publicações. Entre aquelas que relatavam a eficácia da substância para controle e/ou prevenção de lesões cariosas em crianças, duas foram revisões sistemáticas e três foram ensaios clínicos randomizados. A principal indicação clínica do DFP encontrada foi na cariologia, seguida por endodontia e no tratamento de hipersensibilidade dentinária. CONCLUSÃO: existem poucos estudos com alto nível de evidência que indiquem a eficácia do DFP para controle e/ou prevenção das lesões de cárie em crianças. Outras indicações do material foram na prevenção de cárie radicular em idosos, na endodontia e no tratamento de hipersensibilidade dentinária, também com poucos estudos de alto nível de evidência.

Grit blasted aggregates of hydroxyl apatite functionalized calcium carbonate in occluding dentinal tubules

ObjectivesThis study aimed to investigate the effects of using hydroxyl apatite functionalized calcium carbonate (FCC) particles on occluding dentinal tubules. MethodsDentine specimens extracted from eighteen human molars with exposed dentinal tubules were divided into three groups (n = 6/group): a) Cut surface with smear layer; b) EDTA (smear layer removed with 17% EDTA for 1 min); and c) Grit blasted functionalized calcium carbonate (FCC) with and air pressure of 280 kPa. Microscopic dentinal tubule occlusion, tubule diameter and tubule area were evaluated using scanning electron microscopy (SEM) before and after grit blasting. Biomineralization of specimens was carried out in a simulated body fluid (SBF). Elemental analysis of occluding materials was carried out using energy-dispersive X-ray spectroscopy (EDX). X-ray diffraction (XRD) analysis was performed to demonstrate the crystal structure of the biomineralized layer on dentine. ResultsFCC particles showed penetration into the dentinal tubules by breakage of their original particle shape and size. EDTA treated surface had higher number and larger size tubules than those with smear layer or grit blasted (p < 0.005). SEM-EDX analysis revealed mineral precipitation of calcium phosphate on the SBF immersed dentin specimens. XRD analysis showed typical crystal structure of hydroxyl apatite for the biomineralized surface layer on dentine. ConclusionsGrit blasted FCC particles initially occluded effectively the opened dentinal tubules and biomineralization occurred in tubules primarily occluded by the FCC particles. However, in the optimal in vitro conditions in SBF, no difference between biomineralization was found between the grit blasted surface and the control surface. Clinical significanceSeveral materials and methods have been established for treatment of dentinal hypersensitivity although a golden standard treatment has not been discovered. Grit blasted functionalized calcium carbonate has a potential to occlude and remineralize exposed dentinal tubules. This could offer a more biological approach on treatment of dentin hypersensitivity.