ArticleLiterature Review

EFFECTIVENESS of arginine containing TOOTHPASTES in treating dentine hypersensitivity: A systematic Review.

January 2013
Journal of Dentistry 41(6)

DOI:10.1016/j.jdent.2013.01.009

Source
PubMed

Authors:

Mohammad Owaise Sharif

Glan Clwyd Hospital

Samina Iram

University of Leeds

Paul Brunton

Curtin University

OBJECTIVES: To evaluate by way of a systematic review the effectiveness of arginine-containing desensitising toothpastes in comparison to control agents in reducing dentine hypersensitivity. Data Sources: Electronic databases were searched including: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS (30/03/2012). Reference lists of eligible studies and systematic reviews were cross-checked in an attempt to identify additional studies. Strategies to identify grey literature were employed. Study Selection: Inclusion criteria: Controlled Clinical Trials (CCTs) and Randomized Controlled Trials (RCTs) comparing arginine-containing desensitising toothpastes to non-arginine-containing control toothpastes. Two review authors independently screened the titles and abstracts of studies identified. Data collection forms were completed for included studies. Outcomes: Changes in sensitivity to tactile and air-blast stimuli. A subjective assessment of sensitivity was also sought. CONCLUSION: Data identified indicates a potential role for arginine-containing toothpastes in managing dentine hypersensitivity. However, this conclusion is based on small sample sizes and the studies identified did not follow patients up in the medium to long term. The authors recommend that there is a need for well-designed RCTs to be conducted prior to any definitive recommendations being made. Clinical significance: Dentine hypersensitivity is a common condition. Its multi-factorial aetiology has led to several treatment modalities being advocated. The continued introduction of new desensitising agents suggests that no product has yet proven ultimately successful. Arginine-containing toothpastes have recently been introduced, this article systematically reviews the evidence relating to their effectiveness.

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

Article

Full-text available

Oct 2019

Purpose: To compare the clinical efficacy of toothpastes containing Pro-Argin and NovaMin as dentin hypersensitivity (DH) treatment. Materials and methods: 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. Results: 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. Conclusions: 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.

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

Article

Full-text available

Oct 2019
Oral Health Prev Dent

Uso de dentífricos y colutorios para el control de la hipersensibilidad dentinaria en adultos: una revisión narrativa.

Article

Dec 2018

Objectives: Describe the effectiveness of the use of different desensitizing agents contained in dentifrices and mouthwashes for the control of dentin hypersensitivity in adults. Method: An electronic search of the scientific evidence available was made in PubMed, Epistemónikos, EBSCO, BEIC and Cochrane Library; using a search strategy that included the key words. For each article found the level and quality of evidence, risk of bias and ethics were analyzed. Results: A total of 36 articles were included, 29 randomized controlled clinical trials and 7 systematic reviews. Of the clinical trials, five tested the efficacy of mouthwashes, two made a comparison using dentifrices and mouthwashes and 22 tested only the use of dentifrices. The desensitizing agents mainly found were potassium salts, arginine, nano-hydroxiapatite, calcium sodium phosphosilicate (CSPS) and strontium salts. Only the first two were tested in both presentations. All the clinical trials demonstrated a reduction in dentin hypersensitivity with the use of an agent in comparison to the initial measurement. Conclusions: The use of nitrate and citrate potassium, arginine, calcium sodium phosphosilicate and nano-hydroxyapatite in dentifrices for the treatment of hypersensitivity may be recommended.

Current and Novel Clinical Approaches for the Treatment of Dentin Hypersensitivity

Article

Jan 2015

The management of dentin hypersensitivity (DH) has been traditionally based on products or procedures (in-office [professionally-applied] and over-the-counter (OTC)/at-home) that may either block the dentin tubules on the exposed root surface or desensitise the nerves in the pulp. The clinician however is often faced with an array of products from the manufacturers all claiming to be effective in terms of both immediate and long-lasting relief from pain. Whether there is an ideal treatment or so-called gold standard for DH may be challenged. Furthermore several investigators have reported on the wide range of in-office and OTC products and procedures that have been used by clinicians in daily dental practice, and it was evident from these reports that there is considerable confusion for the clinician with regard to which of these products actually are effective in reducing DH. The aim of this chapter therefore is to review the various products and procedures that have been recommended for the treatment of DH and any novel products that have been recently introduced, together with some recommendations for future development of desensitising strategies.

Dentine Hypersensitivity: Review of a Common Oral Health Problem

Article

Full-text available

Dec 2017

Influence of the Extended Use of Desensitizing Toothpastes on Dentin Bonding, Microhardness and Roughness

Article

Full-text available

Jun 2017
Braz Dent J

The aim of this study was to evaluate the influence of an extended use of desensitizing toothpastes (DTs) on dentin bonding, microhardness and roughness. One hundred and twenty bovine incisor teeth were randomly divided into four groups: G1, distilled water (WATER); G2, Colgate Total 12 (CT12); G3, Colgate Sensitive Pro-Relief (CSPR); and G4, Sensodyne Repair ?αμπ; Protect (SRP). Dentin surfaces were etched with 17% EDTA and 2 years of simulated tooth brushing (20,000 cycles) was performed on their surfaces. Knoop microhardness, surface roughness and scanning electron microscopy (SEM) were performed before and after the simulated tooth brushing. For microshear bonding test, a 2-step self-etching adhesive system (Clearfil SE Bond) was used and 0.8 mm diameter composite resin (Filtek Z350 XT) cylinders were built. Microshear test was performed with an orthodontic wire and with a crosshead speed of 0.5 mm/min. The data were analyzed for: 1) bond strength (one-way ANOVA), 2) microhardness intra-group (Student’s test) and inter-group (one-way ANOVA/Tukey’s test) comparisons, 3) roughness intra-group (Student’s test/Wilcoxon’s test) and inter-group (Kruskal-Wallis/Student-Newman-Keuls test) comparisons. The extended use of both dentifrices (conventional and for sensitive teeth) did not affect the bond strength and produced a significant increase in microhardness and roughness of the dentin, except for the microhardness of the SRP group. The simulated tooth brushing technique with water produced an increase in roughness, without reducing significantly the dentin microhardness.

Evaluation of ex vivo effectiveness of commercial desensitizing dentifrices

Article

Full-text available

Apr 2017

Background: Dentin hypersensitivity is a short, severe pain with fast onset. Therapy aims to either prevent or decrease neural transmission or physically occlude the dentinal tubules. This study aimed to evaluate the effectiveness of commercial desensitizing dentifrice by means of an ex vivo method. Material and methods: Samples (n=8 lower human premolars for each group) were randomly allocated into: G1- brushing with Colgate®Sensitive Pro-Relief; G2- brushing with Sensodyne®Rapid Relief; G3- brushing with Sensodyne®Repair & Protect; and G4- brushing with Colgate®Maximum Cavity Protection. The test bodies were submitted to simulated toothbrushing and dentifrices were analyzed regarding their hydrodynamic size, polydispersity index (PI) and zeta potential. Specimens were evaluated using: scanning electron microscopy (SEM); spectroscopy energy dispersive X-ray (EDS); and profilometry. A qualitative analysis of the photomicrographs and topographies was performed. Results: The dentifrices showed statistical similar physical and chemical characteristics. They also demonstrated obliteration of dentinal tubules when micrographs were observed. Regarding the chemical elements present in the dentin samples, there was a statistically significant difference between the control and experimental surfaces in the four groups. Conclusions: Joint data analysis shows that the desensitizing dentifrice showed better results with regards to the obliteration of dentinal tubules compared to positive and negative controls. Key words:Dentin hypersensitivity, dentin desensitizing agents, toothpastes.

Influence of Prolonged use of Desensitizing Dentifrices on Dentin Bond Strength of Self-Etching Adhesive System

Article

Full-text available

Apr 2016

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

Effect of Arginine and nano-hydroxyapatite application on the hypersensitivity and color change of bleached enamel: A randomized controlled clinical trial

Article

Jun 2022

Background: To evaluate the effect of 2.5% Arginine and nano-hydroxyapatite (nHA) application on the post-bleaching hypersensitivity (HS) and color change in a randomized controlled trial. Material and methods: Sixty-four participants were randomly allocated to four groups (n=16) according to the investigated desensitizing agents (UltraEZ gel, experimental 2.5% Arginine, 2.5% nHA pastes and control (no treatment) groups). An in-office chemical bleaching agent (40% hydrogen peroxide) was used for vital bleaching of the anterior teeth. The desensitizing agents were applied to the assigned groups and left for 30 min then rinsed off the teeth. HS was evaluated using Visual Analogue Scale (VAS) from 0-10, immediate (after bleaching), first seven days, then every week for 3-w. Color change was evaluated using VITAPAN classical A1-D4 at baseline (before bleaching), immediate (after bleaching), and after 1,2, 3-w. Results: HS results showed statistically insignificant difference between the tested groups at day-1 and -2. All groups showed no HS (0) at/and after day-3. There was a statistically significant color change between immediate, 1-w and 2-w and baseline results for investigated materials. No statistically significant difference was recorded between the baseline and 3-w for the investigated materials. Both Arginine and nHA groups showed a higher color change compared to UltraEZ group. Conclusions: Arginine and nHA present a potential treatment modality for the post-bleaching HS without jeopardizing the bleaching efficiency. Key words:Arginine, nano-hydroxyapatite, bleached enamel, hypersensitivity, color change, clinical trial.

Molar Incisor Hypomineralization from Inception to Intervention–Evidence Based Review

Article

Full-text available

Nov 2021

Rana A. Alamoudi

Background: Molar Incisor Hypomineralization (MIH) is considered a highly prevalent clinical problem worldwide. The etiology of MIH involves a complex interaction between systemic and environmental insults with possible genetic contribution. Early diagnosis is facilitated by collaboration between clinicians responsible for oral health management of the patient and is the key for enhancing the long-term prognosis and quality of life of affected children. MIH management is a formidable oral health challenge due to the wide spectrum of clinical presentation with the need for tailored treatment for the child affected by MIH condition. Objective: To provide dental practitioners with an updated and evidence-based overview of MIH etiology, diagnosis, and treatments modalities available for its management. Conclusion: In this review, recent clinical evidence on MIH etiology, diagnosis and treatment is presented. Given recent availability of sophisticated technologies there is an increasing number of treatment modalities now at the fingertips of all oral health clinicians alike, ranging from preventive measures, management of hypersensitivity to advanced restorative techniques. The tailored treatment plan should encompass a short and long-term approach requiring more frequent dental check-ups in order to achieve better outcomes and prognosis. Future translational clinical research to best practice that will enhance our understanding of the exact causes of MIH and allow development of standardized diagnostic criteria as well as optimal treatment strategies are warranted.

An In Vitro Comparison of A Novel Self-Assembling Peptide Matrix Gel and Selected Desensitizing Toothpastes in Reducing Fluid Flow by Dentine Tubular Occlusion

Article

Full-text available

Feb 2020

Objectives: The objective of this explorative in vitro study was to evaluate the ability of a novel self-assembling peptide matrix gel with calcium phosphate in effectively occluding dentine tubules compared to selected desensitizing toothpastes. Methods: Mid-coronal dentine discs with a thickness of 1 mm were sectioned from caries-free human molars. The discs were etched with 6% citric acid for 2 minutes, halved and subjected to a 2-minute brushing with a novel gel (SAPM) and three selected desensitizing toothpastes ([SRP], [SRR] and [CSP]). The ability of the desensitizing gel and toothpastes to occlude the dentine tubules was assessed and compared before and after brushing using Scanning Electron Microscopy (SEM) on both etched and fractured dentine surfaces. The SEM observations were supplemented by hydraulic conductance measurements using a modified Pashley model before and after tooth brushing (n=5). Results: The results demonstrated that there was a reduction in both the number and the diameter of the open dentine tubules, which was evident for all the treated dentine discs. The particles that occluded the open dentine tubules, however had different morphologies and distribution. The selfassembling peptide matrix gel (SAPM) demonstrated greater reduction in the number of open tubules compared to the other desensitizing toothpastes. Reductions in the hydraulic conductance measurements were observed for all tested materials (mean [SD, %]: SAPM 55.1 [12.5], SRP 64.9 [18.5], SRR 39.1 [17.1] and CSP 27.6 [6.8]). No statistically differences were observed between the SAPM and SRP, SRR toothpastes (paired t-Test; ≤0.05) although a significant difference was noted between the SAPM and the CSP toothpastes. There was an overall trend for reduction for the SAPM compared to the SRR toothpaste. Conclusion: The results would suggest that a novel self-assembling peptide matrix gel (SAPM) was effective in blocking the dentine tubules and may therefore have the potential to be an effective desensitizing product for the treatment of Dentine Hypersensitivity.

A randomized clinical trial of dentin hypersensitivity reduction over one month after a single topical application of comparable materials

Article

Full-text available

Mar 2021

Dentinal hypersensitivity (DH) is a condition that causes patient discomfort. To evaluate the clinical efficacy of Gluma, fluoride varnish and Tetric N-Bond self-etch system in relieving DH immediately and over 30 days following a single topical application. The present randomized clinical trial was conducted on 55 patients with an age range 20–49 years. 70 teeth in total were incorporated and randomly assigned to the three groups. Parameters examined were: Tactile, air blast, and cold stimuli. VAS was used to assess tactile stimulus whereas the Schiff Cold Scale for air blast and cold stimuli. DH was evaluated immediately, at two weeks and 1 month follow up. Gluma showed a statistically significant reduction in DH scores over other materials. It was concluded that Gluma have statistically significant results over other materials in relieving DH immediately and over 30 days following a single topical application. Trial Registration: Clinical Trials.gov Identifier: NCT04351412, King Abdulaziz University Protocol Record 129-09-19. Registered 17 April 2020 – Retrospectively registered. http://ClinicalTrials.gov/NCT04351412 .

Effects of Desensitizers on Adhesive-Dentin Bond Strength: A Systematic Review and Meta-analysis

Article

Jan 2021
J ADHES DENT

Purpose: To systematically review in vitro studies that evaluated adhesive-dentin bond strength with or without the addition of desensitizers. Materials and methods: A search was conducted in four databases (PubMed, Embase, Web of Science, and Cochrane Library) without publication date or language limits in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA). Two reviewers selected the studies, extracted data, and assessed the risk of bias independently. The inclusion criterion was the evaluation of the effect of immediate or aged bond strength after applying desensitizer in the bonding step. The risk of bias was assessed following the method used by Sarkis-Onofre et al.41 Meta-analysis was conducted using Review Manager 5.3. Results: A total of 1636 articles were found using the search strategy above; 59 articles were selected for full-text analysis, and 32 were systematically reviewed, with 18 considered in the meta-analysis. Results showed a significant difference among various kinds of desensitizers. The subgroup comparison showed high heterogeneity among the different kinds of desensitizers. The use of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and arginine-CaCO3 showed no negative effect on the immediate bond strength, whereas other desensitizers showed some influence. Conclusion: Different desensitizers have various effects on microtensile bond strength. Desensitizers may be selected based on the bond strength and especially used to relieve tooth sensitivity after tooth preparation.

Molar Incisor Hypomineralization (MIH) in a Child with Congenital Chronic Intestinal Pseudo-obstruction (CIPO)

Article

Full-text available

Dec 2020

Molar incisor hypomineralization (MIH) is a qualitative enamel defect of systemic origin affecting 1–4 permanent first molars (PFMs) frequently in association with affected permanent incisors (PIs). The exact etiology of MIH is still unclear but considered to be multifactorial. This present case report to the best of our knowledge is the first case reported which acknowledges MIH in a patient with chronic intestinal pseudoobstruction (CIPO) with underlying neurological disease due to somatic mitochondrial disorder. It also elicits the availability of various contemporary treatment options and their proper selection and early intervention to manage the functional and aesthetic problems caused by enamel defects and to improve the quality of life in the patients.

Does a pretreatment with a dentine hypersensitivity mouth-rinse compensate the pain caused by professional mechanical plaque removal? A single-blind randomized controlled clinical trial

Article

Full-text available

May 2021
CLIN ORAL INVEST

Objectives Pain is affecting acceptance of supportive periodontal therapy and primary periodontitis prevention. Our objective was to evaluate the efficacy of a 1-week pre-treatment use of dentinal-hypersensitivity-reducing mouth-rinses (DHM) in periodontal maintenance (SPT) or dental prophylaxis patients. Material and methods One hundred fifty-five participants attending for professional mechanical plaque removal (PMPR) were randomly assigned to use a mouth-rinse twice daily for 1 week prior to their next PMPR. Rinses were containing either potassium oxalate (n = 52), arginine (n = 52), or herbal extracts (n = 51). At baseline and reassessment, procedural pain was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). Self-reported efficacy was documented. Results No inter-group differences were estimated between both test groups and the control for baseline and reassessment means (VAS, VRS). In the SPT group, VAS reduction and self-reported efficacy were found (p < 0.05). Conclusion The 1-week use of DHM failed to show a predictable effect on discomfort during PMPR overall. Around 20% of the patients showed a quantifiable benefit from both test mouth-rinses, whereas more than 50% reported a subjective pain reduction. Focusing patients undergoing supportive periodontal therapy, quantifiable effects were found for both test groups. From a patient’s point of view, DHM might be a suitable adjunct to enhance procedural comfort, especially in patients with a history of periodontitis. Clinical relevance The 1-week use of the dentinal-hypersensitivity-reducing mouth-rinses prior to professional-mechanical-plaque-removal showed to be a suitable adjunct to enhance procedural comfort during instrumentation, especially in patients undergoing supportive periodontal therapy. Registration number: DRKS00010811

Temporary Tooth Separation to Improve Assessment of Approximal Caries Lesions: A School-Based Study

Article

Full-text available

Jun 2020

Clinical Relevance Radiographic lesion depth should not be used as the single determinant of the restorative threshold for clinically inaccessible approximal caries lesions. Temporary tooth separation is a feasible and effective diagnostic aid for assessment and appropriate management of approximal lesions.

An in vitro comparison of a novel Self-Assembling Peptide Matrix Gel and selected desensitizing toothpastes in reducing fluid flow by dentine tubular occlusion

Preprint

Full-text available

Nov 2019

Background: The objective of the present in vitro study was to evaluate the ability of a novel self-assembling peptide matrix gel with calcium phosphate in effectively occluding dentine tubules compared to selected desensitizing toothpastes. Methods: Mid-coronal dentine discs with a thickness of 1 mm were sectioned from caries-free human molars. The discs were etched with 6% citric acid for 2 minutes, halved and subjected to a 2-minute brushing with a novel gel (SAPM) and three selected desensitizing toothpastes ([SRP], [SRR] and [CSP]). The ability of the desensitizing gel and toothpastes to occlude the dentine tubules was assessed and compared before and after brushing using Scanning Electron Microscopy (SEM) on both etched and fractured dentine surfaces. The SEM observations were supplemented by hydraulic conductance measurements using a modified Pashley model before and after tooth brushing (n=5). Results: The results demonstrated that there was a reduction in both the number and the diameter of the open dentine tubules, which was evident for all the treated dentine discs. The particles that occluded the open dentine tubules, however had different morphologies and distribution. The self-assembling peptide matrix gel (SAPM) demonstrated the greater reduction in the number of open tubules compared to the other desensitizing toothpastes. Reductions in the hydraulic conductance measurements were observed for all tested materials (mean [SD, %]: SAPM 55.1 [12.5], SRP 64.9 [18.5], SRR 39.1 [17.1] and CSP 27.6 [6.8]). No statistically differences were observed between the SAPM and SRP, SRR toothpastes (paired t-Test; ≤0.05) although a significant difference was noted between the SAPM and the CSP toothpastes. There was an overall trend for reduction for the SAPM compared to the SRR toothpaste. Conclusion: The results would suggest that a novel self-assembling peptide matrix gel (SAPM) was effective in blocking the dentine tubules and may therefore have the potential to be an effective desensitizing product for the treatment of Dentine Hypersensitivity.

An In Vitro Comparison of A Novel Self-Assembling Peptide Matrix Gel and Selected Desensitizing Toothpastes in Reducing Fluid Flow by Dentine Tubular Occlusion

Article

Full-text available

Jan 2020

Objectives: The objective of this explorative in vitro study was to evaluate the ability of a novel self-assembling peptide matrix gel with calcium phosphate in effectively occluding dentine tubules compared to selected desensitizing toothpastes. Methods: Mid-coronal dentine discs with a thickness of 1 mm were sectioned from caries-free human molars. The discs were etched with 6% citric acid for 2 minutes, halved and subjected to a 2-minute brushing with a novel gel (SAPM) and three selected desensitizing toothpastes ([SRP], [SRR] and [CSP]). The ability of the desensitizing gel and toothpastes to occlude the dentine tubules was assessed and compared before and after brushing using Scanning Electron Microscopy (SEM) on both etched and fractured dentine surfaces. The SEM observations were supplemented by hydraulic conductance measurements using a modified Pashley model before and after tooth brushing (n=5). Results: The results demonstrated that there was a reduction in both the number and the diameter of the open dentine tubules, which was evident for all the treated dentine discs. The particles that occluded the open dentine tubules, however had different morphologies and distribution. The self-assembling peptide matrix gel (SAPM) demonstrated greater reduction in the number of open tubules compared to the other desensitizing toothpastes. Reductions in the hydraulic conductance measurements were observed for all tested materials (mean [SD, %]: SAPM 55.1 [12.5], SRP 64.9 [18.5], SRR 39.1 [17.1] and CSP 27.6 [6.8]). No statistically differences were observed between the SAPM and SRP, SRR toothpastes (paired t-Test; ≤0.05) although a significant difference was noted between the SAPM and the CSP toothpastes. There was an overall trend for reduction for the SAPM compared to the SRR toothpaste. Conclusion: The results would suggest that a novel self-assembling peptide matrix gel (SAPM) was effective in blocking the dentine tubules and may therefore have the potential to be an effective desensitizing product for the treatment of Dentine Hypersensitivity.

Desensitizing Toothpastes for Dentin Hypersensitivity: A Network Meta-analysis

Article

Feb 2020

The goal of this systematic review and network meta-analysis was to compare the relative effects of toothpaste formulations for dentin hypersensitivity (DH), tested in randomized controlled trials (RCTs). We searched 7 databases to February 2019. Paired reviewers independently screened studies, extracted data, and performed risk of bias assessment. The outcome of interest was painful response measured through tactile, cold, and air stimuli. We conducted a random-effects Bayesian network meta-analysis using standardized mean difference (SMD) and their credible intervals (CIs) as the measure of effect for each pain stimuli. We assessed certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We included 125 RCTs (12,541 patients). For tactile stimulus, the following active ingredients showed large beneficial effects compared to fluoride with moderate certainty of evidence (SMD; 95% CI): potassium + stannous fluoride (SnF 2 ) (3.05; 1.69–4.41), calcium sodium phosphosilicate (CSP) (2.14; 0.75–3.53), SnF 2 (2.02; 1.06–2.99), potassium + hydroxyapatite (2.47; 0.3–4.64), strontium (1.43; 0.46–2.41), and potassium (1.23; 0.48–1.98). For cold stimulus, CSP showed large beneficial effects compared to fluoride (3.93; 0.34–7.53) with moderate certainty; for air stimulus, arginine (2.22; 1.45–2.99), potassium + hydroxyapatite (2.44; 0.33–4.55), potassium + SnF 2 (2.28; 0.87–3.69), CSP (1.98; 0.99–2.98), and SnF 2 (1.9; 1.03–2.77) showed large beneficial effects compared to fluoride with moderate to high certainty. Most toothpaste formulations showed evidence of superiority against placebo or fluorides (amine fluoride, sodium monofluorophosphate, or sodium fluoride). CSP was most beneficial for all 3 stimuli with high to moderate certainty. SnF 2 alone and potassium combined with SnF 2 or hydroxyapatite were beneficial for tactile and air stimulus with high to moderate certainty. Arginine was beneficial for air stimulus, and strontium and potassium were beneficial for tactile stimulus, with moderate certainty.

Brazilian dentists' perception of dentin hypersensitivity management

Article

Full-text available

Jan 2019
Braz Oral Res

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.

Evaluation of the efficacy of dentin hypersensitivity treatments-A systematic review and follow-up analysis

Article

Jun 2019
J ORAL REHABIL

Objectives To compare the treatments used to treat dentin hypersensitivity (DH), based on its efficacy and effect duration. Methods Medline/PubMed, Cochrane Library, EMBASE, and ClinicalTrials were searched for articles published between January 1st, 2008 and November 14th, 2018, in English, Portuguese or Spanish, reporting clinical trials, completed and with results. This systematic review protocol was registered in PROSPERO, number CRD42019121986. Results 74 randomized clinical trials were included in the systematic review, reporting patients from 16 to 65 years old, with a clinical diagnosis of DH, that evaluate the efficacy of a desensitizing product, compared to pre‐treatment, used the evaporative method stimulation and the visual analogue scale. These studies evaluated 5366 patients and at least 9167 teeth. Seven follow‐up periods were considered corresponding to an immediate, medium or long‐time effect. 66 studies were included in the quantitative synthesis. Glutaraldehyde with HEMA, glass ionomer cements and Laser present significant immediate (until 7 days) DH reduction. Medium term (until 1 month) reduction was observed in stannous fluoride, glutaraldehyde with HEMA, hydroxyapatite, glass ionomer cements and Laser groups. Finally, long term significant reduction was seen at potassium nitrate, arginine, glutaraldehyde with HEMA, hydroxyapatite, adhesive systems, glass ionomer cements, and LASER. Conclusions All active ingredients show efficacy in DH reduction in different follow‐up times. Only in‐office treatments are effective in immediate DH reduction, maintaining its efficacy over time. For long time effects, at home treatments can also be used. More standardized evaluation protocols should be implemented to increase the robustly of the results.

Clinical efficacy of nano-hydroxyapatite in dentin hypersensitivity: A systematic review and meta-analysis

Article

Mar 2019
J DENT

Objectives: To evaluate the desensitizing effect of nano-hydroxyapatite (n-HAP) on dentine hypersensitivity (DH). Sources: Seven electronic databases were searched on April 27, 2018. Study selection: Randomized clinical trials (RCTs) were included based on the PICO strategy: Participants - Humans with DH; Intervention - n-HAP-containing desensitizing; Comparison -n-HAP-free treatments or placebo/negative control; and Outcomes - relief of DH. The risk of bias was classified by the Cochrane guidelines. Five meta-analyses were performed to evaluate the efficacy of n-HAP with regard to pain assessment stimuli (primary outcome); comparison of n-HAP with other treatments or placebo/negative control, and effectiveness of at-home and in-office n-HAP use (secondary outcomes). The quality of the evidence was evaluated using the GRADE. Data: Six RCTs with 4 weeks of follow-up were included in the meta-analysis. For the primary outcome, n-HAP showed a better desensitizing effect for evaporative stimuli (SMD -1.09 [-1.24, -0.94], p < 0.00001) and tactile stimuli (SMD -0.93 [-1.42, -0.43]) than other treatments (p = 0.0002). However, there was no difference between n-HAP and other treatments for the cold stimuli (SMD -0.17 [-0.81, 0.48], p = 0.61). In an overall analysis, n-HAP-containing treatment showing the most significant desensitizing effect (SMD -0.93 [-1.19, -0.68], p < 0.00001) with a high quality of evidence for pooled results. In the secondary outcomes, n-HAP showed the best effect in the overall analysis (p < 0.05) with moderate quality evidence. Conclusions: The n-HAP-containing treatment showed better clinical performance than other treatments for DH relief. However, long-term follow-up RCTs are required in the future before definitive recommendations can be made. Clinical significance: Dentin hypersensitivity is a common global condition and its multifactorial etiology has led to the development of several treatments. The n-HAP-containing treatment showed greater DH relief when compared to other desensitizing agents, placebo or negative control.

Dental hypomineralization treatment: A systematic review

Article

Full-text available

Oct 2018
J ESTHET RESTOR DENT

Introduction: Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects. Objective: To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization. Materials and methods: PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews. Results: From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements. Conclusions: Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion). Clinical significance: Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.

Molhabilidade da dentina erodida sob ação de dentifrícios dessensibilizantes

Thesis

Full-text available

Jan 2017

DENTİN HASSASİYETİNİN TEDAVİSİ VE LAZERLER

Article

Full-text available

Apr 2018

A randomized clinical trial on the efficacy of a new oxalate‐containing sensitivity relief strip following professional vs self‐application

Article

Sep 2017
Int J Dent Hyg

Objectives: The purpose of this study was to determine the efficacy of 3.14% dipotassium oxalate monohydrate-containing strip on the relief of dentinal hypersensitivity (DH). A second objective was to determine whether there was a difference in DH levels when the strip was self-applied vs applied by a dental professional. Methods: Sixty subjects were randomized into self-applied, professionally applied or placebo-strip groups. Dentinal hypersensitivity was evaluated by a blinded examiner, using the Schiff Air Scale (SAS). A verbal rating scale (VRS) was also used to measure the subjects' perception of pain. Measures were taken at baseline, 30 minutes, 4 and 8 weeks post-treatment. Results: There was a significant reduction in DH in all three groups (P ≤ .05) at 30 minutes and 8 weeks post-treatment. At the 4-week follow-up, only the self- and professionally applied (active ingredient) groups had a significant reduction in DH compared to baseline. When comparing the reduction in DH levels between groups, the only significant difference occurred between the professionally applied treatment group and the placebo group at the 4-week follow-up. There were no significant differences in DH reduction levels achieved between the self- and professionally applied groups (P > .05). Conclusions: This study confirmed the short-term (4 weeks) effectiveness of a single application of 3.14% dipotassium oxalate monohydrate-containing strip. Self- and professional application were not shown to be different.

Noncarious Cervical Lesions as Abfraction: Etiology, Diagnosis, and Treatment Modalities of Lesions: A Review Article

Article

Full-text available

Jan 2017

Abfraction may be defined as V-shaped or wedge shaped defect at the cervical region of a tooth with different clinical appearances mostly seen as angular notch like depressions on the facial surface of tooth structure at the junction of tooth and gingiva, this may be due to flexure of the cusp leading to mechanical overloading and may also be accompanied by pathological wear such as regressive alterations of teeth. Recent research on non-carious cervical lesions (NCCL) suggests that abfraction is also due to multifactorial etiology. The different types of cervical lesions in the human population is determined by their biological, chemical and behavioural factors. There are two school of thoughts regarding the etiology of abfraction among the population. The first school of thought argues that tooth brushes with other artificial forces may be the causative factors and the second school considered that some internal physiological forces as the causative factors. The second school of thought even though do not provides complete explanation, yet provides a significant role of this cervical lesions. The present review focuses on the etiology and all available treatment plan strategies of non-carious cervical lesions.

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

Article

Full-text available

Jan 2017

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

Changes in the oral ecosystem induced by the use of 8% arginine toothpaste

Article

Sep 2016

Objective: Bacterial metabolism of arginine in the oral cavity has a pH-raising and thus, potential anti-caries effect. However, the influence of arginine on the oral microbial ecosystem remains largely unresolved. Design: In this pilot study, nine healthy individuals used toothpaste containing 8% arginine for eight weeks. Saliva was collected to determine arginolytic potential and sucrose metabolic activity at the Baseline, Week 4, Week 8 and after a two weeks Wash-out period. To follow the effects on microbial ecology, 16S rDNA sequencing on saliva and plaque samples at Baseline and Week 8 and metagenome sequencing on selected saliva samples of the same time-points was performed. Results: During the study period, the arginolytic potential of saliva increased, while the sucrose metabolism in saliva decreased. These effects were reversed during the Wash-out period. Although a few operational taxonomic units (OTUs) in plaque changed in abundance during the study period, there was no real shift in the plaque microbiome. In the saliva microbiome there was a significant compositional shift, specifically the genus Veillonella had increased significantly in abundance at Week 8. Conclusion: Indeed, the presence of arginine in toothpaste affects the arginolytic capacity of saliva and reduces its sucrose metabolic activity. Additionally, it leads to a shift in the salivary microbiome composition towards a healthy ecology from a caries point of view. Therefore, arginine can be regarded as a genuine oral prebiotic.

Abfraction lesions: Etiology, diagnosis, and treatment options

Article

Full-text available

May 2016

Abfraction is a type of noncarious cervical lesion (NCCL) characterized by loss of tooth tissues with different clinical appearances. Evidence supports that abfraction lesions, as any NCCLs, have a multifactorial etiology. Particularly, the cervical wear of abfraction can occur as a result of normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The interaction between chemical, biological, and behavioral factors is critical and helps to explain why some individuals exhibit more than one type of cervical wear mechanism than others. In an era of personalized dentistry, patient risk factors for NCCLs must be identified and addressed before any treatment is performed. Marked variations exist in dental practice concerning the diagnosis and management of these lesions. The lack of understanding about the prognosis of these lesions with or without intervention may be a major contributor to variations in dentists' management decisions. This review focuses on the current knowledge and available treatment strategies for abfraction lesions. By recognizing that progressive changes in the cervical area of the tooth are part of a physiologically dynamic process that occurs with aging, premature and unnecessary intervention can be avoided. In cases of asymptomatic teeth, where tooth vitality and function are not compromised, abfraction lesions should be monitored for at least 6 months before any invasive procedure is planned. In cases of abfraction associated with gingival recession, a combined restorative-surgical approach may be performed. Restorative intervention and occlusal adjustment are not indicated as treatment options to prevent further tooth loss or progression of abfraction. The clinical decision to restore abfraction lesions may be based on the need to replace form and function or to relieve hypersensitivity of severely compromised teeth or for esthetic reasons.

Evaluation of instant desensitization after a single topical application over 30 days: A randomized trial

Article

Jul 2015
AUST DENT J

The aim of this study was to evaluate the efficacy of ProArgin(™) (8% arginine), Gluma(®) and NovaMin(®) (5% calcium phosphosilicate) in relieving dentinal hypersensitivity immediately and over 30 days following a single topical application. A three-cell, parallel group randomized trial was conducted among 56 patients exhibiting dentinal hypersensitivity with tooth as the unit of study. ProArgin(™) paste, Gluma(®) Desensitizer and NovaMin(®) paste were applied on randomly assigned teeth in each participant. Three stimuli were tested: tactile stimulated by running an explorer and measured using VAS (1-10 scale); air blast and cold water stimulated hypersensitivity measured using the Schiff Sensitivity Scale at baseline, immediately, 15 days and 30 days after application. Friedman test and Wilcoxon test were used for within group comparisons. Kruskal-Wallis test and Mann-Whitney U test were used for between group comparisons. All three groups showed significant reductions in hypersensitivity from baseline at all time points (p < 0.05). ProArgin(™) paste elicited a significantly higher reduction in hypersensitivity (p < 0.016) compared to Gluma(®) and NovaMin(®) for all stimuli at the end of 30 days. A single topical application of ProArgin(™) paste is significantly more effective than both a single topical application of Gluma(®) and NovaMin(®) paste in relieving dentinal hypersensitivity immediately and over 30 days. © 2015 Australian Dental Association.

DENTİN AŞIRI HASSASİYETİ: TANI VE TEDAVİ YÖNTEMLERİ

Article

Full-text available

May 2015

Dentin hypersensitivity has been defined as the short, sharp and severe pain arising from exposed dentin in response to thermal, evaporative, tactile, electrical, chemical or osmotic stimuli. Various theories about pain mechanism of dentin hypersensitivity have been reported but none of the pain mechanisms has not been proved yet. The epidemiological research reported various prevelances about dentin hyper-sensitivity and day after day it is increasing. The aetiology of dentin hypersensitivity is multifactorial. Diagnosis is difficult. Different materials and methods have been used for the treatment of dentin hypersensitivity but a gold standart for treatment has not been found yet. The definition, theories about pain mechanisms, aetiology and risk factors, diagnosis and treatment of dentin hypersensitivity will be discussed in this review. Keywords: Pain Mechanism, Dentin Hypersensitivity, Aetiology, Treatment

Effectiveness of a desensitizing agent for topical and home use for dentin hypersensitivity: A randomized clinical trial

Article

Full-text available

Oct 2014
AM J DENT

To evaluate the effectiveness of a desensitizing gel for topical and home use for the treatment of dentin hypersensitivity (DH) by means of a 3-arm parallel, randomized, double blind clinical trial. 107 participants were allocated to three groups: placebo gel (PG), test gel (TG) (5% sodium fluoride, 5% potassium oxalate, 10% strontium chloride) and 2% sodium fluoride gel (FG). DH measurement was performed by a single blind examiner by means of the visual analog scale (VAS) after tactile (blunt tipped probe), thermal (air blast) and osmotic (water blast) stimulus at time intervals of baseline, 7, 15 and 30 days. The greatest reductions in DH were observed for the TG, with significant differences for FG in the thermal (Δ = -56 vs -30) and osmotic stimuli (Δ = -44 vs -18). Considering the percentage of participants with moderate/severe pain at 30 days, the TG demonstrated the lowest percentages, with significant differences in comparison with the other groups in thermal and osmotic stimuli. We can conclude that the test gel showed a greater reduction in DH than fluoride 2% and placebo gel, and maybe a treatment option for individuals with DH.

Arginine promotes fluoride uptake into artificial carious lesions in vitro

Article

Mar 2015
AUST DENT J

This study focused on the interaction of arginine and fluoride on the remineralization of artificial enamel carious lesions in vitro. Human enamel blocks with artificial carious lesions were prepared and randomly divided into six treatment groups (n = 30 for each group): deionized water, arginine solution, NaF solution, arginine/NaF solution, arginine-free fluoride toothpaste slurry and arginine-containing fluoride toothpaste slurry. After a pH-cycling regimen for 10 days, subsets of specimens from each group were subjected to independent analysis, including surface microhardness (n = 8/30), cross-sectional microhardness (n = 8/30), enamel fluoride uptake (n = 8/30) and polarized light microscopy (n = 6/30). The samples tested for surface microhardness were further subjected to simulated plaque acid challenge before surface microhardness was remeasured. Arginine solution promoted remineralization compared with deionized water control (p < 0.05). When used in combination with fluoride, arginine significantly increased fluoride uptake compared with fluoride alone (p < 0.05). In addition, lesions treated with arginine-containing toothpaste also showed superior fluoride uptake compared with those treated with conventional fluoride toothpaste (p < 0.05). Arginine promoted enamel fluoride uptake when used in combination with fluoride, thereby contributing to resistance of enamel to carious demineralization. © 2015 Australian Dental Association.

Management of Dentine Hypersensitivity: Efficacy of professionally and self administered agents

Article

Dec 2014
J CLIN PERIODONTOL

ContextThe gold standard treatment modality for dentine hypersensitivity has not yet been established. This review examines the effectiveness of self and professionally applied treatments for the reduction of pain from dentine hypersensitivity.Materials and Methods Electronic (3 databases) and hand searches were performed 14-21 July 2014 to identify randomised clinical trials for the treatment of dentine hypersensitivity.ResultsThis systematic review provided numerous treatment modalities for dentine hypersensitivity. Eleven agents and 105 Randomised Controlled Trials were robust enough to be included. The studies varied considerably in design, observation period, active agents, formulation of the whole agent, negative and positive controls and comparator products investigated. The stimuli used were always airblast and often airblast/tactile. Due to the heterogeneity between the studies and lack of direct comparison between agents there was insufficient data to undertake a meta-analysis to compare agents for meaningful conclusions. Best available evidence for each treatment agent has been documented as a narrative.Conclusions Treatments including stannous fluoride, arginine and calcium sodium phosphosilicate and strontium toothpaste appear to be clinically effective for the treatment of dentine hypersensitivity compared to comparators and controls. There is limited evidence to confirm the relative effectiveness of individual professionally applied agents.This article is protected by copyright. All rights reserved.

The study of toothpaste desensitizing properties

Article

Mar 2022

Relevance. Over the past decade, manufacturers of oral care products have expanded the possibilities of solving the problem of hypersensitivity of teeth due to a variety of new modern technologies, which provides an opportunity to increase the effectiveness of active oral care product components. The study aimed to investigate desensitizing, remineralizing and anti-caries effectiveness of Asepta Extra Sensitive toothpaste to confirm the toothpaste properties stated by the manufacturer. Material and methods. Forty-nine people, aged from 24 to 58 years, participated in the clinical testing of the toothpaste. The study used the Orekhova – Ulitovskiy tooth sensitivity index to evaluate the desensitizing toothpaste and determined the severity of dental hyperesthesia using diagnostic tests. We objectively assessed the functional state of the enamel using the Okushko – Kosareva enamel resistance test. The study evaluated the electrical conductivity of the dentin hypersensitivity to investigate the anti-caries effect. Result. The desensitizing effectiveness increased to 64.59 ± 5.72% by the end of the study, according to the Orekhova – Ulitovskiy sensitivity index. The dentin hypersensitivity hypersensitivity decreased, according to the diagnostic tests. The tooth sensitivity reduction effectiveness increased – 62.22 ± 6.84%, according to the tooth tactile sensitivity assessment by linear advancement of the probe along the tooth surface. The analysis of the remineralizing parameter showed positive changes in the enamel resistance test. The remineralizing parameter value amounted to 21.49 ± 1.91%, and the remineralizing effectiveness reached 61.05 ± 2.98%. The values of anti-caries action and anti-caries effectiveness were 3.31 ± 0.52 mA and 29.72 ± 1.92%, respectively, according to the method of dentin hypersensitivity electrical conductivity evaluation with Asepta Extra Sensitive toothpaste. The desensitizing, remineralizing and anti-caries results of Asepta Extra Sensitive toothpaste use were high. Conclusion. The development of dental health strengthening measures determines the significance of oral care products in tooth sensitivity prevention in the population, which plays a leading role in planning individual programs to prevent major dental diseases.

Not All Desensitizing Toothpastes Perform Equally Well.

Article

Jun 2020
J Evid Base Dent Pract

Ben Balevi

Article title and bibliographic information: Network Meta-Analysis on the Effect of Desensitizing Toothpastes on Dentine Hypersensitivity. Hu ML, Zheng G, Lin H, Yang M, Zhang YD, Han JM. J Dent 2019;88:103170. Source of funding: National Natural Science Foundation of China (81771119). Type of study/design: Systematic review with meta-analysis of data.

Avaliação ex vivoda obliteração de túbulos dentinários humanos pelo uso comparativo de agentes dessensibilizantes convencionais e dessensibilizantes contendo biovidro

Article

Full-text available

Aug 2017

O objetivo do presente estudo foi avaliar a eficácia ex vivo de um dentifrício dessensibilizante contendo biovidro (Sensodyne®Repair&Protect, GlaxoSmithKline Brasil Ltd., Rio de Janeiro, Brasil), quanto ao potencial de obliteração dos túbulos dentinários e compará-lo com os dentifrícios convencionais (Colgate® Sensitive Pro-Alívio™, Colgate-Palmolive, São Paulo, SP, Brasil eSensodyne® Rápido Alívio, GlaxoSmithKline Brasil Ltd., Rio de Janeiro, Brasil). Foram utilizados 12 pré-molares humanos divididos em: G1 (n=4) - escovação com Colgate®Sensitive Pró-Alívio; G2 (n=4) - escovação com Sensodyne® Rápido Alívio; e G3 (n=4) - escovação com Sensodyne®Repair&Protect. As amostras foram submetidas à simulação de escovação de um período de oito semanas, com duas escovações diárias e analisadas em microscopia eletrônica de varredura (MEV), quanto à presença e características dos túbulos dentinários; a espectroscopia de raios-X por dispersão em energia (EDS), a fim de avaliar os elementos químicos presentes nos túbulos dentinários. A análise qualitativa da obliteração dos túbulos dentinários foi avaliada por meio das fotomicrografias. Para verificar a distribuição normal dos dados da EDS, utilizou-se o teste de Shapiro-Wilk (p

Network meta-analysis on the effect of desensitizing toothpastes on dentine hypersensitivity

Article

Jul 2019
J DENT

Objectives: This network meta-analysis compares different desensitizing toothpastes and placebo in terms of their effects on dentine hypersensitivity (DH) at 2, 4, and 8 weeks. Materials and methods: A systematic electronic literature search of four databases, and a manual search, were performed to identify randomized controlled trials (RCTs) on different desensitizing toothpastes for the treatment of DH. Pair-wise and network meta-analyses were performed to analyze the desensitization effect at 2, 4, and 8 weeks. The risk of bias was assessed based on the Cochrane guidelines and funnel plots. Statistical heterogeneity, inconsistencies, and ranking probability were also evaluated. Results: A total of 30 RCTs were included in the network meta-analysis, which included eight desensitizing toothpastes. There was no significant difference in the effect among calcium sodium phosphosilicate-containing (CSPS), potassium-containing (K) and strontium-containing (Sr) toothpastes. In addition, there was no significant difference between fluoride (F) and placebo. The desensitizing toothpaste with the highest probability of being the most effective treatment for DH was nano-hydroxyapatite (n-HA) at 2 and 4 weeks (60% and 67%, respectively), and Ar at 8 weeks (54%). Conclusions: No significant difference was detected in desensitizing effects among CSPS, K and Sr toothpastes. In addition, there was no significant difference between F and placebo, K and placebo. Furthermore, a significant placebo effect on DH was found in this study. Moreover, n-HA toothpastes may be the best desensitizing toothpastes for treatment of DH, followed by Ar toothpaste. Clinical significance: Based on the results of present network meta-analysis, n-HA containing toothpastes might be a recommended desensitizing toothpastes considering the treatment of DH. PROSPERO registration number: CRD42019117710.

Repair of dentine-related lesions without a drill or injection

Article

Full-text available

May 2019

For covering the shortages of traditional treatments, a novel and non-invasive system was developed with the simple adaption of nature's own repair process, while an extrinsic electric field was introduced to improve its remineralization kinetics. In an in vivo study, acid-etched rabbit dentine was used to evaluate the remineralization efficacy and safety of the system. The exposed dentine tubules were fully occluded after 5 hours/1.0 mA and 8 hours/0.5 mA of remineralization. After 5 hours of remineralization (1.0 mA), the micro-hardness of the demineralized dentine was fully recovered, equal to native rabbit dentine. Haematoxylin-eosin staining demonstrated no obvious inflammatory reaction. This study provides a feasible solution to realize rapid repair of dentine.

A Clinical, Randomised, Double-Blind Study on the Use of Nano-Hydroxyapatite and Arginine During at-Home Tooth Bleaching

Article

Full-text available

Dec 2018

Introduction: Home bleaching is a popular cosmetic technique that delivers quick results, reduces chair time, and has a lower risk of side effects compared to office bleaching. Aim: To evaluate the effect of nano-hydroxyapatite (n-HAP) and arginine on Bleach-Sensitive Teeth (BST) and colour change after at-home bleaching treatment across three months of follow-up. Materials and Methods: Sixty subjects were randomly allocated into one of three groups (n=20): 1) CONTROL, treated with 22% carbamide peroxide (CP)+toothpaste without a desensitising agent; 2) NANO, treated with CP +n-HAP; and 3) ARGININE, treated with CP + arginine. An air jet was used to evaluate BST associated with a modified Visual Analog Scale (VAS). A spectrophotometer was used to measure the colour of the maxillary incisors. Results: The Friedman vs Kruskal-Wallis tests showed that the BST reported in the experimental groups was lower when compared with the control group one day after the end of treatment (p=0.05). However, no significant difference was observed at 30, 60 or 90 days of evaluation (p>0.05). ANOVA showed no significant difference between groups when comparing mean ?E (p>0.05). Conclusion: The subjects treated with n-HAP and arginine presented lower sensitivity when compared to the control group one day after the end of treatment. In addition, there was no impairment of the efficacy of the at-home bleaching treatment over the 90-day evaluation period.

SUSCEPTIBILITY OF COTTON LEAFHOPPER Jacobiella facialis (HEMIPTERA: CICADELLIDAE) TO PRINCIPAL CHEMICAL FAMILIES: IMPLICATIONS FOR COTTON PEST MANAGEMENT IN CÔTE D’IVOIRE

Article

Full-text available

Oct 2018

Jacobiella facialis is a sucking insect pest of cotton in Côte d’Ivoire. Heavy infestations on cotton resulted in shedding of leaves, squares, young bolls and subsequently lead to significant yield losses. In recent years, attacks of the jassid remain persistent throughout the entire crop cycle despite insecticide treatments. Susceptibility tests of ten (10) active ingredients (chlorpyrifos-ethyl, profenofos, acetamiprid, imidacloprid, alpha-cypermethrin, lambdacyhalothrin, spinoteram, sulfoxaflor, spinosad and chlorantraniliprole) were performed against pest populations collected in Bouaké by leaf-dip method n° 15 proposed by Insecticide Resistance Action Commitee (IRAC 15, version 3). Lethal concentrations LC50 and LC90 were determined for all active ingredients. To compare susceptibility between different field strains, discriminate concentrations (LC90) for the most toxic active ingredients were tested by the same method on jassid populations from five localities (Korhogo, Boundiali, Ferké, Ouangolo and Niakara). Five active ingredients, chlorpyrifos-ethyl, profenofos, acetamiprid, alpha-cypermethrin and imidacloprid, with respective lethal concentrations (LC50) of 0.0012, 0.011, 0.024, 0.057, 0.070 mg/ml, were the most toxic to jassid, while spinosad and chlorantraniliprole were the least toxic as LC50 values were 1.616 mg/ml and 5.4 mg/ml respectively. Data collected on discriminate concentrations (LC90) for four active ingredients did not revealed any significant difference between the susceptibility levels of jassid strains. However, it was noted that survival rates were consistently high in strain collected from Boundiali and Korhogo, indicating low heterogeneity within some field populations. The results have provided important information on active ingredients to consider when developing pest management programs.

Effect of desensitizing toothpastes on dentine hypersensitivity: A systematic review and meta-analysis

Article

May 2018
J DENT

Objectives: To evaluate the desensitizing effect of toothpastes that contain ingredients that act against dentine hypersensitivity (DH) and to compare this effect with negative controls. Sources: Five databases were searched to identify relevant articles published up to November 27, 2017. Study selection: Randomized controlled trials (RCTs) comparing desensitizing toothpastes with a toothpastes without desensitizing component in adult patients that suffer from DH were included. The risk of bias was assessed according to the Cochrane guidelines, and the quality of the evidence was evaluated using the GRADE tool. Inverse variance random-effects meta-analyses of standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated using RevMan 5.3 software. Data: 53 RCTs with 4,796 patients were finally included in the meta-analysis. The toothpastes that contain active desensitization ingredients showed a better desensitizing effect on DH than the negative control, except the strontium- and amorphous calcium phosphate-containing toothpastes. The amorphous calcium phosphate-containing toothpaste had very low-quality evidence, the strontium, potassium and strontium, and potassium and stannous fluoride-containing toothpastes had low-quality evidence, and the other five toothpastes had moderate quality evidence. Conclusions: Our result support the premise that toothpastes containing potassium, stannous fluoride, potassium and strontium, potassium and stannous fluoride, calcium sodium phosphosilicate, arginine, and nano-hydroxyapatite relieve the symptoms of DH, but does not advise the use of toothpastes that contain strontium and amorphous calcium phosphate. Furthermore, high-quality studies are needed to confirm our results. (PROSPERO CRD42018085639).

Dentinal tubules occluded by bioactive-glass containing toothpaste exhibit high resistance toward acidic soft drink challenge

Article

Full-text available

Nov 2016
AUST DENT J

Background: Dentine hypersensitivity is a common problem attributed by patent dentinal tubules. Ingredients incorporated in toothpastes aim to occlude patent dentinal tubules to minimise the dentine hypersensitivity. However, frequent consumption of acidic soft drinks may reverse the dentinal tubules occlusion. In this in vitro study, the efficacy of dentinal tubules occluded by commercially available toothpastes to withstand different duration of an acidic soft drink challenge was investigated. Methods: One hundred and twenty dentine discs were divided into three groups. The discs from each group were brushed with toothpaste containing bioactive glass, arginine and control toothpaste. Each group were then divided into four subgroups and exposed to acidic soft drink over four different time durations. Results: The scoring and the percentage of occluded dentinal tubules by Novamin containing toothpaste was significantly better compared to arginine or the control toothpaste. Acidic soft drink challenge reduced the extent of dentinal tubules occlusion along with time. Dentinal tubules occluded by Novamin containing toothpaste withstand the acidic challenge comparatively for longer period. Conclusions: The findings demonstrated that occlusion of dentinal tubules is more efficient by the bioactive-glass containing toothpaste and thus may contribute to its better resistance to acidic soft drink challenge. This article is protected by copyright. All rights reserved.

Investigation on the remineralization effect of arginine toothpaste for early enamel caries: Nanotribological and nanomechanical properties

Article

Oct 2016

Remineralization is confirmed as a feasible method to restore early enamel caries. While there is evidence that the 8% arginine toothpaste has a good remineralization effect by increasing surface microhardness, the repair effect on wear-resistance and nanomechanical properties still remains unclear. Therefore, this research was conducted to reveal the nanotribological and nanomechanical properties changes of early caries enamel after remineralized with arginine toothpaste. Early enamel caries were created in bovine enamel blocks, and divided into three groups according to the treatment solutions: distilled and deionized water (DDW group), arginine toothpaste slurry (arginine group) and fluoride toothpaste slurry (fluoride group). All of the samples were subjected to pH cycling for 12 d. The nanotribological and nanomechanical properties were evaluated via the nanoscratch and nanoindentation tests. The wear depth and scratch morphology were observed respectively by scanning probe microscopic (SPM) and scanning electron microscopy (SEM). Finally, x-ray photoelectron spectroscopy (XPS) was used for element analysis of remineralized surfaces. Results showed that the wear depth of early caries enamel decreased after remineralization treatment and both the nanohardness and elastic modulus increased. Compared with the fluoride group, the arginine group exhibited higher nanohardness and elastic modulus with higher levels of calcium, fluoride, nitrogen and phosphorus; this group also underwent less wear and related damage. Overall, the synergistic effect of arginine and fluoride in arginine toothpaste achieves better nanotribological and nanomechanical properties than the single fluoride toothpaste, which could have significant impact on fight against early enamel caries.

Dentinhypersensibilität Ursachen und Therapieoptionen

Article

Full-text available

Jan 2014

Michael J Noack

The effect of desensitizing dentifrices on dentin wear and tubule occlusion

Article

Full-text available

Oct 2015
AM J DENT

Purpose: To evaluate the effect of desensitizing dentifrices on dentin erosive wear, using a 5-day erosionabrasion-remineralization cycling model. The effect of the dentifrices on dentin's tubule occlusion was also investigated. Methods: 30 samples of root dentin were randomly divided into three groups (n=10): (1) Colgate Total 12 Clean Mint (control, 1,450 ppm F); (2) Colgate Sensitive Pro-Relief (1,450 ppm F, Pro-Argin); and (3) Sensodyne Repair&Protect (1,450 ppm F, Novamin). Erosion was performed with a cola drink, for 5 minutes, 4x/day. Toothbrushing with the slurry dentifrices (1:2) was performed 2x/day, with electric toothbrushes, using standard pressure for 15 seconds. Surface loss (SL) was determined with optical profilometry at baseline and after the first, third and fifth days of cycling. Before treatment and in the end of the cycling, the amount of opened dentin tubules per area was evaluated in three randomly selected specimens from each group, by environmental scanning electron microscopy. The relative dentin abrasitivity (RDA) of the dentifrices was also measured. Data were statistically analyzed (a = 0.05). Results: All the dentifrices showed a progressive increase in SL over time. However, no significant differences in SL among the dentifrices were observed at any time studied. Sensodyne Repair&Protect significantly reduced the number of opened dentin tubules when compared to the other groups. Colgate Total 12 Clean Mint showed the highest RDA, followed by Sensodyne Repair&Protect and Colgate Sensitive Pro-Relief. The desensitizing dentifrices tested produced a similar rate of erosive dentin wear to the conventional dentifrice; however, only Sensodyne Repair&Protect was able to promote tubule occlusion.

Treatment Approaches for Dentin Hypersensitivity

Book

Jan 2014

David Gillam

The aim of this chapter is to review the various treatment approaches used by clinicians to treat dentin hypersensitivity and evaluate their efficacy in reducing dentin hypersensitivity. Evidence from both in vitro and in vivo studies will be assessed to determine whether there is any support for these treatment products and procedures based on their proposed underlying mechanism of action.

Management of Dentin Hypersensitivity

Article

Jun 2015

David Gillam

A PubMed literature research was undertaken by the author using various MeSH terms: (“therapy”[Subheading] OR “therapy”[All Fields] OR “treatment”[All Fields] OR “therapeutics”[MeSH Terms] OR “therapeutics”[All Fields]) AND (“organization and administration”[MeSH Terms] OR (“organization”[All Fields] AND “administration”[All Fields]) OR “organization and administration”[All Fields] OR “management”[All Fields] OR “disease management”[MeSH Terms] OR (“disease”[All Fields] AND “management”[All Fields]) OR “disease management”[All Fields]) AND (“dentin sensitivity”[MeSH Terms] OR (“dentin”[All Fields] AND “sensitivity”[All Fields]) OR “dentin sensitivity”[All Fields] OR (“dentin”[All Fields] AND “hypersensitivity”[All Fields]) OR “dentin hypersensitivity”[All Fields]). This search strategy generated a large number of papers on the topic of dentin hypersensitivity (DH); however, there were limited data on management strategies that could be successfully implemented in clinical practice. Although there have been a number of treatment paradigms published in the literature, there is a need for simple pragmatic guidelines to be recommended to the clinician in order to successfully manage the condition in the clinical environment. Furthermore, despite the published claims of clinical efficacy for both in-office and over-the-counter products there does not appear to be one ideal desensitizing agent than can be recommended to be used for the condition. The importance of educating both the clinician and the patient in the identification, prevention, and management of DH is paramount if the condition is to be successfully monitored and treated.

Dentine Hypersensitivity: Advances in Diagnosis, Management, and Treatment

Book

Mar 2015

David Gillam

This book provides wide-ranging information on the progress achieved in the diagnosis, treatment and management of dentine hypersensitivity during the past few years. Recent advances in research, including innovations in the development of desensitizing agents, are fully described and detailed attention is paid to novel clinical approaches and potential future strategies in product development. Introductory chapters cover important aspects of physiology, prevalence and aetiology and advances in diagnosis and in vitro testing techniques for dentine hypersensitivity are discussed. Dentine hypersensitivity is a troublesome clinical condition that continues to perplex the clinician despite the vast array of available treatments that have been formulated to resolve the problem. There continues to be under-reporting of the condition by clinicians and uncertainty over aetiology, diagnosis and effective management. This book will hopefully contribute in combating these deficiencies and assist the clinician in delivering optimal patient care.

Evaluation of the efficacy of a 5% calcium sodium phosphosilicate (NovaMin) containing dentifrice for the relief of dentinal hypersensitivity: a clinical study

Article

Full-text available

May 2012

Context: Dentinal hypersensitivity (DH) is a commonly encountered problem. Several products are used in management of DH with varying results. Need is felt in dentistry for a material that chemically reacts, physically occludes and adheres intimately to dentinal tubules to reduce the possibility of its recurrence. One such material is calcium sodium phosphosilicate-Novamin ® . Aim: To evaluate an efficacy of a 5% calcium sodium phosphosilicate (Novamin ® SHY NM TM ) containing dentifrice compared to placebo for the relief of DH. Settings and Design: Outpatients visiting Dept of Periodontics, Yenepoya Dental College with DH were deemed eligible for this case-control clinical trial after an informed consent. Materials and Methods: 30 patients having at least 2 sensitive teeth with a VAS (Visual Analogue Scale) of >3 cm after air blast stimulation, qualified to participate in the study. Test (SHY NM TM toothpaste containing 5% calcium sodium phosphosilicate) and control (Pepsodent toothpaste without a desensitizing agent) groups, each containing 15 participants, were subjected to cold water and air blast stimulation for an assessment of DH at baseline, 6 th and 8 th week using VAS. Statistical analysis used: Unpaired t-test and repeated measures ANOVA. Results: 5% Novamin ® containing dentifrice significantly reduced DH within 6 th and 8 th week of usage when compared to a placebo dentifrice. Conclusions: A Novamin ® containing dentifrice significantly reduced DH when compared to a placebo dentifrice.

A double blind controlled trial comparing three treatment modalities for dentin hypersensitivity

Article

Full-text available

Dec 2011

This randomized, double blind, split mouth study was aimed to compare three dentin desensitizing treatment modalities. Two hundred sixty teeth of 25 patients; each having at least 2 hypersensitive teeth in each quadrant, were included. Teeth were randomized to 4 groups: Group A treated with 2% NaF solution, Group B received GLUMA®; an aqueous solution of Hydroxy-Ethyl-Methacrylate and Glutarldehyde, (HEMA-G), Group C received iontophoresis with distilled water (placebo) and Group D was treated with NaF-iontophoresis. Pain response was evaluated on a visual analogue scale (VAS), by using tactile, air blast and cold-water stimuli at 0-day, 15-day, 1-month and 3-months interval. All treatments were effective in reducing dentinal hypersensitivity significantly, Group D and Group B were more effective than Group A and Group C at all time intervals. Group D and Group B were equally effective in reducing dentinal hypersensitivity at 15-day and 1-month interval but Group D was more effective at 3-months. All treatment modalities were more effective in reducing hypersensitivity than placebo. 2% NaF-iontophoresis and HEMA-G were more effective than 2% NaF local application at all time intervals. But at 3-months, 2% NaF-iontophoresis was more effective than HEMA-G, while placebo produced no significant effect in reduction of hypersensitivity.

Laser therapy for dentine hypersensitivity

Article

Full-text available

Sep 2011

Joana Cunha-Cruz

Medline, Embase, the Cochrane Central database as well as the Cochrane Oral Health Group's Trials Register and the National Research Register. In addition relevant journals were hand searched from 2000 to 2010 (Lasers in Medical Sciences, Lasers in Surgery and Medicine, Photomedicine and Laser Surgery, Photodiagnosis and Photodynamic Therapy, Journal of Oral Rehabilitation, Journal of Periodontology, Journal of Clinical Periodontology, Journal of Endodontics, Clinical Oral Investigations, Journal of Dental Research, Journal of Oral Laser Applications, Journal of Periodontal Research and Periodontology 2000) together with the reference lists of relevant trials. Randomised controlled trials (RCT) that included patients with two or more hypersensitive teeth confirmed by evaporative stimulus or tactile hypersensitivity assessment, comparing laser therapy versus other topical desensitising agents, such as fluoride varnish, dentine bonding agents etc, that were published in English. Studies were assessed for quality by two reviewers independently and data were extracted using a standardised form. Because of heterogeneity of the studies meta-analysis was not performed, so a qualitative synthesis is presented. Eight trials (234 participants) met the inclusion criteria. Half of the included studies compared GaALAS laser with topical desensitising agents, but the findings were conflicting. The remaining studies involved Nd:YAG laser, Er:YAG laser and CO2 laser, and all showed that the three types of lasers were superior to topical desensitising agents, but the superiority was slight. The review suggests that laser therapy has a slight clinical advantage over topical medicaments in the treatment of dentine hypersensitivity. However more large sample-sized, long-term, high-quality randomised controlled clinical trials are needed before definitive conclusions can be made.

Comparison of Two Different Forms of Varnishes in the Treatment of Dentine Hypersensitivity: A Subject-Blind Randomised Clinical Study

Article

Full-text available

Jan 2011
Oral Health Prev Dent

Dentine hypersensitivity is one of the most frequently recorded complaints of dental discomfort. Current evidence implicates patent dentinal tubules in hypersensitive dentine, and it follows that one effective way to reduce dentine sensitivity is to occlude the dentinal tubules. The purpose of this study was to compare the efficacy of two different desensitising agents, Cervitec varnish and Gluma varnish. Two hundred fifty patients self-reporting dentine hypersensitivity completed the paired split mouth randomised, subject-blind study. Each participant had a minimum of two sensitive teeth in at least two different quadrants and displaying a response of ≥3 cm to an evaporative stimulus. The hypersensitivity levels were measured with a tactile stimulus (scratchometer), thermal stimulus (cold water test), and an evaporative stimulus (air blast test) using a visual analogue scale. The teeth were evaluated immediately after treatment, and at 4 and 12 weeks after application of the chlorhexidine-containing varnish Cervitec and the glutaraldehyde-containing varnish, Gluma Desensitizer. Statistical analysis indicated that both the desensitising varnishes were effective in alleviating dentine hypersensitivity at all time intervals compared to baseline. There was a highly statistically significantly greater reduction in dentine hypersensitivity to evaporative stimulus, cold stimulus, and tactile stimulus after application of Cervitec than after Gluma Desensitizer (P < 0.001). Both the varnishes have a therapeutic potential to alleviate dentine hypersensitivity at all time intervals compared to baseline. However, Cervitec varnish is more efficacious in reducing dentine hypersensitivity than Gluma varnish at both 4 weeks and 12 weeks post-treatment.

Effect of an 8.0% arginine and calcium carbonate in-office desensitizing paste on the shear bond strength of composites to human dental enamel

Article

Full-text available

Dec 2010
AM J DENT

To evaluate the effect of 8.0% arginine and calcium carbonate, in-office desensitizing paste (Colgate Sensitive Pro-Relief Desensitizing Paste) on the shear bond strength of composites to human dental enamel. Two resin composites (Filtek Supreme, Premise) and human dental enamel were used. 16 samples per composite were prepared. Caries-free extracted human molars, not older than 3 months, and stored in distilled water were used for this portion of the experiment. Buccal and lingual surfaces were polished with high polishing pastes to create a uniform flat surface area to which the cylindrical composite samples were bonded. After polishing, the samples were rinsed in tap water and stored at 100% relative humidity. The resin composites were used to form cylindrical samples 3 mm x 1.6 mm, which were light-cured with a Demetron curing light according to the manufacturers' instructions. For each composite, 32 surfaces were used; 16 were a control group with the enamel polished with a water slurry of flour of pumice. The experimental group had the enamel polished with the 8.0% arginine and calcium carbonate desensitizing paste, using disposable latex free prophy cups with a slow speed hand piece at 3,000 rpm using moderate to light pressure, according to manufacturer's instructions. The composite cylinders were bonded to the enamel with their respective etching agents and adhesives and left in distilled water for 48 hours, after which the samples were sheared with an Instron testing machine at 0.5 mm/minute. After shearing, all samples were analyzed with a stereo microscope to evaluate failure pattern (failure at the enamel surface, failure at the composite surface, or mixed failure, at both enamel and composite surfaces). SEM images of selected surfaces were made to depict the overall morphology of the surface of dental materials used after 8.0% arginine and calcium carbonate desensitizing paste, application and shear strength tests. ANOVA and Student-Newman-Keuls tests (P < 0.05) were used to evaluate the difference among the groups. The 8.0% arginine and calcium carbonate desensitizing paste did not have a significant effect on the shear bond strength of the composites tested to enamel.

Dentin hypersensitivity reduction of a new toothpaste containing 8.0% arginine and 1450 ppm fluoride: An 8-week clinical study on Chinese adults

Article

Full-text available

May 2010
AM J DENT

To present the results of an 8-week dentin hypersensitivity clinical study in which the efficacy of a new Pro-Argin formula toothpaste, with gentle whitening benefits, containing 8.0% arginine, a high cleaning calcium carbonate system, and 1450 ppm fluoride as sodium monofluorophosphate (MFP) was compared to that of a commercial Pro-Argin formula toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride as MFP and a negative control toothpaste containing calcium carbonate and 1450 ppm fluoride as MFP. An 8-week clinical study, with 121 subjects, was conducted in Chengdu, Sichuan, China, using a double-blind, stratified, three-treatment design. Tactile and air blast sensitivity assessments were used to compare the efficacy of the three products. This clinical study demonstrated that the new Pro-Argin formula toothpaste provided a significant reduction in dentin hypersensitivity when used over a period of 8 weeks. The study also showed that the new toothpaste provided significantly greater reductions (P < 0.05) in dentin hypersensitivity in response to tactile (64.4%, 71.1%, and 61.0%) and air blast (40.7%, 58.8%, and 74.4%) stimuli than the negative control toothpaste containing 1450 ppm fluoride after 2, 4, and 8 weeks of product use, respectively. The results for the new toothpaste did not differ significantly from those of the positive control toothpaste at all time points in the study.

Concise Review: Dentin Hypersensitivity and Oxalates: a Systematic Review

Article

Full-text available

Mar 2011
J DENT RES

Treatment of dentin hypersensitivity with oxalates is common, but oxalate efficacy remains unclear. Our objective was to systematically review clinical trials reporting an oxalate treatment compared with no treatment or placebo with a dentin hypersensitivity outcome. Risk-of-bias assessment and data extraction were performed independently by two reviewers. Standardized mean differences (SMD) were estimated by random-effects meta-analysis. Of 677 unique citations, 12 studies with high risk-of-bias were included. The summary SMD for 3% monohydrogen-monopotassium oxalate (n = 8 studies) was -0.71 [95% Confidence Interval: -1.48, 0.06]. Other treatments, including 30% dipotassium oxalate (n = 1), 30% dipotassium oxalate plus 3% monohydrogen monopotassium oxalate (n = 3), 6% monohydrogen monopotassium oxalate (n = 1), 6.8% ferric oxalate (n = 1), and oxalate-containing resin (n = 1), also were not statistically significantly different from placebo treatments. With the possible exception of 3% monohydrogen monopotassium oxalate, available evidence currently does not support the recommendation of dentin hypersensitivity treatment with oxalates.

A comparative clinical study investigating the efficacy of a test dentifrice containing 8% strontium acetate and 1040 ppm sodium fluoride versus a marketed control dentifrice containing 8% arginine, calcium carbonate, and 1450 ppm sodium monofluorophosphate in reducing dentinal hypersensitivity

Article

Full-text available

Jan 2010
J Clin Dent

The objective of this clinical study was to evaluate and compare the efficacy in reducing dentin hypersensitivity of an 8% strontium acetate, 1040 ppm sodium fluoride dentifrice to a marketed control 8% arginine, calcium carbonate, 1450 ppm sodium monofluorophosphate dentifrice after twice-daily brushing for two, four, and eight weeks. This was a randomized, examiner-blind, two-arm parallel group, eight-week longitudinal clinical study with seventy-nine subjects, stratified based on baseline tooth sensitivity (Schiff score, Yeaple). Subjects brushed with either an 8% strontium acetate-based dentifrice or a marketed 8% arginine calcium carbonate dentifrice twice daily for approximately one minute. At screening, baseline, weeks two, four, and eight, subjects' tooth sensitivity was determined through both evaporative (Schiff and Visual Analogue Scale [VAS]) and tactile stimuli (Yeaple probe). Subject assessments using each stimulus were performed by the same examiner throughout the study. Seventy-seven subjects completed this clinical study. Both subject groups exhibited significant cumulative reductions from baseline to Days 14, 28, and 56 in dentin hypersensitivity as measured by Schiff, Yeaple, and VAS (for the 8% strontium acetate group, p < or = 0.0001 for all time points; for the 8% arginine calcium carbonate group, p = 0.0031 for Yeaple at Day 14, p = 0.0015 for VAS at Day 14, and p < 0.0001 for all remaining measures and time points). No significant differences (p > 0.05) were observed between treatments for any of the time points and measures except for tactile sensitivity at Day 56, for which the 8% strontium acetate-based dentifrice was statistically superior (p = 0.0391) to the control 8% arginine calcium carbonate dentifrice. The 8% strontium acetate, 1040 ppm sodium fluoride dentifrice provided significant reductions in dentin hypersensitivity (p < 0.0001) after two, four, and eight weeks of product use. Comparisons to a control 8% arginine calcium carbonate dentifrice showed no significant differences (p > 0.05) apart from tactile (Yeaple) sensitivity at week 8, where the 8% strontium acetate-based dentifrice showed significant improvement over the control (p = 0.0391).

Comparing the efficacy in reducing dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a benchmark commercial desensitizing toothpaste containing 2% potassium ion: An eight-week clinical study in Rome, Italy

Article

Full-text available

Jan 2009
J Clin Dent

The objective of this double-blind dentin hypersensitivity clinical study was to investigate the effectiveness of a new desensitizing toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate (MFP), compared to that of a benchmark commercially available desensitizing toothpaste containing 2% potassium ion, dosed as 5.0% potassium nitrate, and 1450 ppm fluoride as sodium fluoride (NaF). A total of 80 subjects were entered into the study, and stratified into two balanced groups according to their baseline mean tactile and mean air blast sensitivity scores. The two groups were randomly assigned to use either the new arginine toothpaste or the benchmark commercially available desensitizing toothpaste containing 2% potassium ion. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned toothpaste and a commercially available soft-bristled toothbrush. Dentin hypersensitivity examinations, which included tactile and air blast sensitivity measures, were conducted at baseline, one week, two weeks, four weeks, and eight weeks. Subject examinations were conducted by the same dental examiner at each examination period. This clinical study demonstrated that the new toothpaste, containing 8.0% arginine and 1450 ppm fluoride as MFP in a calcium carbonate base, provided a significant reduction in dentin hypersensitivity when used over a period of eight weeks. The study also showed that the new arginine toothpaste provided significantly greater reductions (p < 0.05) in dentin hypersensitivity in response to tactile (38.9%, 28.8%, and 11.6%) and air blast (16.8%, 26.4%, and 33.8%) stimuli than the benchmark commercial desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride as NaF in a silica base, after two weeks, four weeks, and eight weeks of product use, respectively. A new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride as MFP provides significantly increased hypersensitivity relief (p < 0.05) as compared to a benchmark commercial desensitizing toothpaste containing 2% potassium ion, dosed as potassium nitrate, after two weeks, four weeks, and eight weeks of product use.

A breakthrough therapy for dentin hypersensitivity: How dental products containing 8% arginine and calcium carbonate work to deliver effective relief of sensitive teeth

Article

Full-text available

Feb 2009
J Clin Dent

These studies have utilized a range of state-of-the-art surface techniques to gain insight into the mechanism of action of a new technology for dentin hypersensitivity relief based upon arginine and calcium carbonate and, in particular, to address important questions regarding the nature and extent of dentin tubule occlusion. Confocal laser scanning microscopy (CLSM), scanning electron microscopy (SEM), and atomic force microscopy (AFM) have been used to assess tubule occlusion. Energy dispersive x-ray (EDX) and electron spectroscopy for chemical analysis (ESCA) have been used to identify the composition of the dentin plug. CLSM has also been used to compare the mechanism of action of the toothpaste and the desensitizing prophylaxis paste, to address whether both the arginine and the calcium carbonate components are essential to occlusion, to identify the location of the arginine within the occluded dentin, and to demonstrate resistance of the occlusion to acid challenge. Hydraulic conductance has been used to assess the effectiveness of the arginine-calcium carbonate technology in arresting dentin fluid movement, to evaluate the effects of pulpal pressure on the robustness of the occlusion, and to confirm the resistance of the occlusion to an acid challenge. The CLSM, SEM, and AFM studies demonstrate that the arginine-calcium carbonate technology is highly effective in rapidly and completely occluding dentin tubules. The EDX and ESCA studies show that the dentin surface deposit and occluded tubule plug contain high levels of calcium and phosphate, as well as carbonate. CLSM has confirmed that the toothpaste and the desensitizing prophylaxis paste have the same mechanism of action, that the arginine and calcium carbonate components are both essential to the effectiveness of these products, and that the arginine becomes incorporated into the dentin plug. The hydraulic conductance studies demonstrate that the occlusion provided by the arginine-calcium carbonate technology results in highly significant reductions in dentin fluid flow, and that the tubule plug is resistant to normal pulpal pressure and acid challenge. A breakthrough technology based upon arginine and calcium carbonate provides clinically proven benefits with respect to rapid and lasting relief of dentin hypersensitivity. It is unique in that two of its key components, arginine and calcium, are found naturally in saliva, and that the arginine and calcium carbonate work together to accelerate the natural mechanisms of occlusion to deposit a dentin-like mineral, containing calcium and phosphate, within the dentin tubules and in a protective layer on the dentin surface.

Comparing the efficacy in reducing dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a commercial sensitive toothpaste containing 2% potassium ion: An eight-week clinical study in Rome, Italy

Article

Full-text available

Jun 2009
J Clin Dent

This paper presents the results of one of two eight-week dentin hypersensitivity clinical studies in which the efficacy of a novel toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate (MFP) was compared to that of a benchmark commercial toothpaste containing 2% potassium ion, dosed as 3.75% potassium chloride, and 1450 ppm fluoride as sodium fluoride (NaF). An eight-week clinical study, with eighty patients, was conducted in Rome, Italy using a double-blind, stratified, two-treatment design. Tactile sensitivity assessments, as well as air blast sensitivity assessments, were used to compare the efficacy of the two products. This clinical study showed that the new toothpaste containing 8.0% arginine and 1450 ppm fluoride as MFP in a calcium carbonate base provided a significant reduction in dentin hypersensitivity when used over a period of eight weeks. The study also showed that this new arginine toothpaste provided significantly greater reductions (p < 0.05) in dentin hypersensitivity in response to tactile (37.0%, 30.0%, and 12.2%) and air blast (23.9%, 32.0%, and 29.3%) stimuli than the commercial sensitive toothpaste containing 2% potassium ion and 1450 ppm fluoride as NaF in a silica base, after two weeks, four weeks, and eight weeks of product use, respectively. A new toothpaste containing 8.0% arginine calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate (MFP) provides significantly increased dentin hypersensitivity relief (p < 0.05) compared to a commercial sensitive toothpaste containing 2% potassium ion after two weeks, four weeks, and eight weeks of product use.

Cochrane handbook for systematic reviews of interventions. Cochrane Collaboration

Article

Jan 2011

J.P.T. Higgins

Laser therapy for dentinal hypersensitivity

Chapter

Nov 2011

Prevalence of cervical dentine sensitivity in a population of patients referred to a specialist Periodontology Department

Article

Nov 1996
J CLIN PERIODONTOL

Abstract The reported prevalence of cervical dentine sensitivity (CDS) ranges from 8 to 35%. Detailed epidemiology of the condition, particularly with regard to possible causal factors, is lacking. In particular, no published data appear to exist on its prevalence in periodontal patients. The aim of the present study was therefore to determine the prevalence, distribution and severity of CDS in a population of patients referred to a Periodontology Department of a specialist postgraduate hospital. 507 patients (181 M: 326F, mean age 44.2 (SD 10.31) years) attending a periodontal clinic were assessed for CDS by a questionnaire. The results demonstrated a prevalence of CDS of 84% with no significant gender difference. 71.1% of patients perceived cold as the most common cause of discomfort. A higher prevalence of self-reported discomfort was observed between 40 and 49 years. Of the patients with a reported history of periodontal surgery (34.7%), those treated within 6 months prior to assessment appeared to be more at risk to CDS. Of the patients who received hygienist treatment (88.2%). only 10.5% reported discomfort persisting ≥3 days after treatment. Generally, patients who complained of varying degrees of discomfort over time (84.5%) did not perceive the condition as severe and consequently did not seek treatment. The prevalence of CDS in these referred patients was very high, suggesting that periodontal diseases and/or treatment effects play a role in its aetiology.

Efficacy of a Commercial Dentifrice Containing 2% Strontium Chloride and 5% Potassium Nitrate for Dentin Hypersensitivity: A 3-Day Clinical Study in Adults in China

Article

Feb 2012

Studies of dentifrices containing strontium chloride or potassium nitrate have documented the clinical efficacy of these formulations for dentin hypersensitivity (DH), but few studies have evaluated dentifrices containing both active ingredients. The objective of this study was to compare the effects on DH of a dentifrice containing 2% strontium chloride and 5% potassium nitrate in a silica base (experimental dentifrice) with those of a dentifrice containing the same silica base without any active ingredient (control dentifrice). Male and female patients aged 20 to 65 years with DH were eligible to participate in this randomized, double-blind, placebo-controlled study in China. Patients were assigned to receive the experimental or control dentifrice. At baseline, immediately after topical dentifrice use, and after 3 days, patients received an oral examination of their hard and soft tissues, followed by an evaluation of DH that used the Yeaple Probe to measure tactile hypersensitivity and the Schiff Cold Air Scale to measure the perception of pain from an air blast stimulus. Adverse events (in particular, discomfort while brushing or alteration in taste) in the oral hard or soft tissues were monitored throughout the study. A total of 81 patients were enrolled (40 in the experimental group; 41 in the control group), of whom 79 (55 women; 24 men) completed the study. After topical use, the experimental group had a significantly higher mean (SD) tactile hypersensitivity score (19.47 [14.69] vs 14.27 [5.76]; P = 0.047) and a significantly lower mean air blast hypersensitivity score (1.93 [0.51] vs 2.22 [0.60]; P = 0.026) than did the control group. After 3 days, the experimental group had a significantly higher mean tactile hypersensitivity score (19.87 [14.95] vs 14.51 [6.00]; P = 0.045) and a significantly lower air blast hypersensitivity score (1.80 [0.56] and 2.13 [0.60]; P = 0.014) than the control group. After topical use and after 3 days, the experimental group had increases from baseline in tactile scores of 54.04% and 56.67%, respectively (both, P = 0.001) and reductions from baseline in air blast scores of 18.51% and 24.21% (both, P < 0.001); the control group had increases in tactile scores of 21.14% and 21.54% (P = 0.022 and P = 0.007) and reductions in air blast scores of 10.24% and 13.41% (P = 0.001 and P < 0.001). No adverse events were reported throughout the study. In these patients with DH in China, the dentifrice containing 2% strontium chloride and 5% potassium nitrate was efficacious in reducing DH when used instantly after topical dentifrice use and after 3 days of use.

Clinical evaluation of the fast onset and sustained sensitivity relief of a 0.454% stannous fluoride dentifrice compared to an 8.0% arginine-calcium carbonate-sodium monofluorophosphate dentifrice

Article

Dec 2011
AM J DENT

To evaluate the efficacy of a dentifrice containing 0.454% stannous fluoride (SnF2) in the reduction of dentin hypersensitivity immediately after use, after 3 days and after a 2-week use period as compared to a positive control dentifrice containing 8.0% arginine, calcium carbonate and 1450 ppm fluoride as sodium monofluorophosphate. 80 healthy adult subjects with moderate dentin hypersensitivity were enrolled in this clinical study, which had a controlled, randomized, examiner-blind, two-treatment (40 subjects per treatment group), parallel group design. For each subject, two sensitive bicuspid or cuspid teeth in different quadrants demonstrating reproducible sensitivity to thermal stimuli (Schiff air sensitivity score of > 1) were chosen for evaluation. Subjects were randomized to treatment with either the SnF2 dentifrice or the positive control dentifrice. At the baseline visit, subjects were assessed for sensitivity to thermal stimuli, received an oral soft tissue examination, and were instructed to brush with their assigned dentifrice according to manufacturers' usage instructions. Immediately after brushing, sensitivity to thermal stimuli for each enrolled tooth was assessed by an experienced dental examiner using the Schiff air sensitivity index and by study subjects based on air visual analog scale (VAS). After using their assigned dentifrice for 3 days and for 2 weeks, thermal sensitivity was re-assessed by both examiner and subject, and each subject received an oral soft tissue examination. 40 subjects in the SnF2 dentifrice group and 38 subjects in the control group completed all study procedures. Both dentifrice groups showed significant sensitivity relief relative to baseline (P < 0.01). The SnF2 dentifrice provided a statistically significant (P = 0.005) 7.4% reduction in sensitivity relative to the positive control dentifrice immediately after first use and an even more significant (P = 0.001) 20% reduction at Week 2 based on the Schiff air sensitivity scale. Based on the VAS, the SnF2 dentifrice provided statistically significant (P < 0.0001) reduction in sensitivity relative to the positive control dentifrice immediately after first use, at Day 3, and Week 2, with percent reductions of 7.2%, 15.8% and 28.2%, respectively. No adverse events were reported with either dentifrice.

Rapid desensitizing efficacy of a stannous-containing sodium fluoride dentifrice

Article

Jan 2011
J Clin Dent

To evaluate the efficacy of an experimental stannous-containing sodium fluoride dentifrice (1450 ppm fluoride) in the reduction of dentinal hypersensitivity over a three-day period as compared to a positive control dentifrice containing 8% arginine, calcium carbonate, and 1450 ppm fluoride as sodium monofluorophosphate. This study, conducted in China, had a controlled, randomized, examiner-blind, two-treatment, parallel-group design. Eighy-one healthy adult subjects with moderate dentinal hypersensitivity were enrolled, two bicuspid or cuspid teeth in different quadrants demonstrating reproducible thermal (cold air) sensitivity with a score of > 1 on the SchiffAir Sensitivity Scale were chosen for each subject. Subjects also assessed their own level of pain on a Visual Analog Scale (VAS). Subjects were randomized to treatment with either the experimental or positive control dentifrice. At the baseline visit, sensitivity to thermal stimuli was assessed by both the examiner (Schiff Air Sensitivity) and the subject (pain VAS), and subjects were instructed to brush with their assigned study dentifrice according to the manufacturer's instructions provided. Immediately after brushing, thermal sensitivity for each enrolled tooth was reassessed by both examiner and subject. Subjects used their assigned dentifrices at home for three days, after which thermal sensitivity was reassessed by both examiner and subject. Subjects received an oral soft tissue examination at baseline and on Day 3. Forty subjects in the experimental group and 41 subjects in the positive control group completed all study procedures. On the Schiff Air Sensitivity Scale, the experimental dentifrice provided statistically significant (p < 0.001) reductions of 14.8% and 54.1% in sensitivity relative to the positive control dentifrice immediately after first use and at Day 3, respectively. On the pain VAS, the experimental dentifrice provided statistically significant (p < 0.001) reductions of 22.3% and 74.1% in sensitivity relative to the positive control dentifrice immediately after first use and at Day 3, respectively. No adverse events were reported for any subject. An experimental stannous-containing sodium fluoride dentifrice provided significantly better dentin hypersensitivity relief relative to a positive control dentifrice both immediately and after three days of product use.

Extrinsic stain removal efficacy of a new desensitizing dentifrice containing 8.0% arginine, calcium carbonate and 1450 ppm fluoride

Article

May 2010
AM J DENT

To evaluate the extrinsic stain removal efficacy of a new Pro-Argin formula whitening dentifrice containing 8.0% arginine, a high cleaning calcium carbonate and 1450 ppm fluoride, as monofluorophosphate, after brushing twice daily for 4 and 8 weeks. At the baseline visit, 92 adult subjects were stratified based on their Lobene Stain Index scores and randomized into two treatment groups; one using the new Pro-Argin formula whitening dentifrice (test group) and the other using the original Pro-Argin formula dentifrice (control group). Subjects were instructed to brush twice daily for the duration of the study. Tooth stain evaluations were conducted as stain area and stain intensity according to the Lobene Stain Index. All 92 enrolled subjects complied with the protocol and completed the 8-week study. Baseline scores demonstrated no significant differences between the two treatment groups for the evaluated area and intensity parameters of stain (P > 0.05). At both the 4- and 8-week post-use evaluations, subjects brushing with the test dentifrice demonstrated significant reductions for all stain parameters versus the control (P < 0.05). Relative to the control group, the test group demonstrated reductions in mean stain intensity scores of 9.7% and 17.9% at the 4- and 8-week evaluations, respectively. Corresponding reductions in mean stain area scores for the test group relative to the control were 11.7% and 20.8% at the 4- and 8-week evaluations, respectively. (Am JDent 2010;23 Sp Is A:36A-40A).

Instant dentin hypersensitivity relief of a new desensitizing dentifrice containing 8.0% arginine, a high cleaning calcium carbonate system and 1450 ppm fluoride: A 3-day clinical study in Chengdu, China

Article

May 2010
AM J DENT

To compare, with a double-blind, randomized, parallel-design clinical study, the hypersensitivity efficacy of a new Pro-Argin formula dentifrice containing 8.0% arginine, a high cleaning calcium carbonate system and 1450 ppm fluoride to a previously validated Pro-Argin formula dentifrice containing 8.0% arginine, calcium carbonate and 1450 ppm fluoride, and to a control toothpaste containing calcium carbonate and 1450 ppm fluoride, instantly after a single direct topical self-application using a fingertip, and after subsequent brushing for 3 days. Qualifying subjects from the Chengdu, China area who presented two hypersensitive teeth with a tactile score of 10 to 50 grams, and an air blast score of 2 or 3, participated in this study. The first phase of the study consisted of a single topical application of the assigned product directly onto the hypersensitive surface of each of the two hypersensitive teeth. Study subjects applied a pea-size amount of their toothpaste onto the hypersensitive surface and massaged for 1 minute. The second phase of the study consisted of twice-daily at-home brushing with the toothpaste for 3 days. All one hundred and twenty-two (122) subjects complied with the study protocol and completed the study. There was good balance among the three groups at baseline. The mean tactile sensitivity scores for the new Pro-Argin formula dentifrice, the previously validated Pro-Argin formula dentifrice, and the control dentifrice were at baseline 14.88, 14.76 and 14.38, and after direct application were 28.90, 29.02 and 15.88, and after 3 days of brushing were 34.51, 33.41 and 16.00, respectively. The mean air blast scores at baseline were 2.11, 2.12 and 2.15, and after direct application were 1.21, 1.18 and 2.06, and after 3 days of brushing were 0.80, 0.83 and 1.93, respectively. Immediately after direct application and after 3 days of brushing, for both the tactile and air blast sensitivity scores, the differences between the two dentifrices containing 8.0% arginine and the control were statistically significant. There were no statistically significant differences between the two 8.0% arginine dentifrices immediately after direct application and after 3 days of brushing.

Effectiveness of laser therapy and topical desensitising agents in treating dentine hypersensitivity: a systematic review

Article

May 2011
J ORAL REHABIL

The aim of this systematic review was to compare the effectiveness of laser therapy with that of topical desensitising agents in treating dentine hypersensitivity. A secondary objective was to determine the safety of laser application according to the relevant studies. A systematic search was performed in the MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the National Research Register, the Cochrane Oral Health Group's Trials Register database to retrieve all articles that were about randomised controlled trials involving the application of laser desensitising procedures and topical desensitising agents in the treatment of dentine hypersensitivity. A total of eight trials that met all inclusion criteria involving 234 participants were reviewed. Based upon the 'quality' of evidence, one study was classified as A level, five as B level and two as C level. Owing to the heterogeneity of the studies, a meta-analysis was not performed. Half of the included studies compared GaALAS laser with topical desensitising agents, but the findings were conflicting. The remaining studies involved Nd:YAG laser, Er:YAG laser and CO2 laser, and all showed that the three types of lasers were superior to topical desensitising agents, but the superiority was slight. A systematic review of the literature indicates the likelihood that laser therapy has a slight clinical advantage over topical medicaments in the treatment of dentine hypersensitivity. More large sample-sized, long-term, high-quality randomised controlled clinical trials are needed before definitive conclusions were made.

The Effectiveness of a Calcium Sodium Phosphosilicate Desensitizer in Reducing Cervical Dentin Hypersensitivity

Article

Aug 2010

NovaMin (NovaMin Technology, Alachua, Fla.) was introduced into the dental market as a desensitizer in December 2004. However, to the authors' knowledge, no researchers yet have evaluated the effectiveness of 100 percent NovaMin powder with NovaMin-containing toothpaste in reducing dentin hypersensitivity compared with the effectiveness of NovaMin-containing toothpaste only and a desensitizing toothpaste containing potassium nitrate as a control. The authors divided 60 participants randomly into three groups: NovaMin powder with NovaMin-containing toothpaste (group 1), a placebo powder with NovaMin-containing toothpaste (group 2) and a placebo powder with the control toothpaste (group 3). The authors used tactile and cold stimuli and a visual analog scale to evaluate participants' pain at baseline, immediately after powder application and at one week, two weeks and four weeks after powder application. They analyzed data by using Friedman and Wilcoxon signed-rank tests for within-group comparison. They used Kruskal-Wallis and Mann-Whitney U tests for between-group comparison. They considered P < .05 to be statistically significant. Groups 1 and 2 showed significant hypersensitivity reduction over baseline at all time points. Group 3 showed significant hypersensitivity reduction at one week onward. Group 1 showed significant improvement compared with groups 2 and 3, except for response to tactile stimulus at four weeks with group 2. Between groups 2 and 3, there were significant differences at two and four weeks. and The use of NovaMin powder and NovaMin-containing toothpaste for hypersensitivity reduction is more effective than the use of a desensitizing toothpaste containing potassium nitrate and fluoride.

Comparative In Vivo Study on the Desensitizing Efficacy of Dentin Desensitizers and One-bottle Self-etching Adhesives

Article

May 2010

This in vivo study evaluated the desensitizing efficacy of two one-bottle self-etching adhesives, two dentin desensitizers and a placebo (water). Thirty-one volunteers with 55 hypersensitive teeth were recruited into this clinical investigation. The sensitive teeth were randomly assigned into five groups and treated with one of the following materials: iBond, Heraeus; Xeno V, Dentsply; Gluma desensitizer, Heraeus; Bifluorid 12, Voco; placebo (water). Mechanical and thermal stimuli were used to assess the tooth sensitivity response. Discomfort interval scale (DIS) scores of the sensitive teeth were recorded at three different investigation times (baseline, immediately and one month after treatment). Impressions were taken from the sensitive teeth at all three different investigation times, and replica models were made for the evaluation of the dentin surfaces by scanning electron microscopy. The Friedman test and the Mann Whitney U-test were used to analyze the data. All dental materials significantly reduced the dentin hypersensitivity immediately (p < 0.05) and one month after treatment (p < 0.05), with the exception of Bifluorid 12 for mechanical tooth sensitivity. The placebo (water) only caused a short-term effect on the thermal dentin hypersensitivity (p < 0.05). Topical application of the dentin adhesives/desensitizers on sensitive dentinal areas resulted in occlusion of the patent tubules. The one-bottle self-etching adhesives and dentin desensitizers involved in the current clinical investigation could significantly relieve dentin hypersensitivity immediately and over the course of a month after treatment (except for Bifluorid 12 for tooth mechanical sensitivity). The placebo (water) had an immediate effect on thermal dentin hypersensitivity.

Comparing the efficacy in providing instant relief of dentin hypersensitivity of a new toothpaste containing 8.0% Arginine, Calcium carbonate, and 1450 ppm fluoride relative to a benchmark desensitizing toothpaste containing 2% Potassium ion and 1450 ppm fluoride, and to a control toothpaste with 1450 ppm fluoride: A three-day clinical study in new Jersey, USA

Article

Oct 2009
J Clin Dent

The objective of this double-blind, randomized, parallel-design clinical study was to compare the efficacy in reducing dentin hypersensitivity of a novel toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste containing 1450 ppm fluoride, instantly after a single direct topical self-application using a fingertip, and after subsequent brushing twice daily for three days. Qualifying subjects from the Mississauga, Canada area who presented two hypersensitive teeth with a tactile hypersensitivity score (Yeaple Probe) between 10 and 50 grams of force, and an air blast hypersensitivity score of 2 or 3 (Schiff Sensitivity Scale) participated in this study. The first phase of the study consisted of a single topical application of the assigned product directly onto the hypersensitive surface of each of the two baseline-designated hypersensitive teeth. Study subjects applied a pea-size amount of their assigned toothpaste onto the hypersensitive surface of each tooth, and massaged each surface for one minute. The second phase of the study consisted of twice-daily at-home brushing with the assigned toothpaste for three days. Dentin hypersensitivity assessments, as well as examinations of oral hard and soft tissues, were conducted at baseline, immediately after direct topical application, and after three days of product use. One-hundred and twenty subjects complied with the protocol and completed the study. Relative to the desensitizing toothpaste and the control toothpaste groups, the 8.0% arginine toothpaste group exhibited statistically significant (p < 0.05) reductions in dentin hypersensitivity on both tactile and air blast measures immediately after completion of the first phase of the study. Reductions in sensitivity for the 8.0% arginine toothpaste, compared to the benchmark desensitizing toothpaste and the control toothpaste, were 130.7% and 139.5% (tactile), and 43.8.0% and 49.6% (air blast), respectively. Relative to the benchmark desensitizing toothpaste and control toothpaste groups, the 8.0% arginine group also exhibited statistically significantly (p < 0.05) reductions in sensitivity after completion of the second phase of the study, of 104.9% and 136.1% (tactile), and 44.5% and 53.2% (air blast), respectively. There was no loss of the instant relief effects in the 8.0% arginine group after the brushing period. A single fingertip topical self-application of the 8.0% arginine-calcium carbonate toothpaste directly onto the hypersensitive surface of teeth provides significant immediate improvements in dentin hypersensitivity relative to an identical application of the control toothpaste and to the benchmark potassium-based desensitizing toothpaste. Significant improvements in dentin hypersensitivity were also demonstrated after three days of brushing with the 8.0% arginine-calcium carbonate toothpaste, subsequent to the single topical self-application of the product, relative to an identical application of the control toothpaste and to the benchmark potassium-based desensitizing toothpaste. The improvement demonstrated by the 8.0% arginine toothpaste after direct application was maintained after three days of twice-daily brushing.

Dentin Hypersensitivity: A Randomized Clinical Comparison of Three Different Agents in a Short-term Treatment Period

Article

Jan 2010

Dentin hypersensitivity, or what patients may describe as "sensitive teeth," is defined as a short, sharp pain arising from exposed dentin in response to thermal, evaporative, tactile, electrical, osmotic or chemical stimuli. It is widely accepted that dentin hypersensitivity is an uncomfortable condition that also affects function and quality of life. This study determines the differences in efficiency of three desensitizing products when compared with a placebo. A randomized controlled clinical trial was conducted to compare three different professional dentin desensitizer agents in 52 patients. The age and sex of the patients was recorded. Gluma Desensitizer (Heraeus Kulzer), UltraEZ (Ultradent Products, Inc) and Duraphat (Colgate Oral Pharmaceuticals, Inc, New York, NY, USA) were used as desensitizer agents and distilled water was used as the placebo. The baseline measurement of the dentin hypersensitivity was made by using a visual analog scale (VAS). Twenty-four hours and seven days after application of the desensitizer agents and placebo, a new VAS analysis was conducted for patients' sensitivity level. The desensitizer agents were compared in terms of mean values, and ANOVA was used for testing differences among the groups (p<0.05). The results showed that the mean pain scores of the placebo group were significantly higher than that of the study groups (p<0.05). The VAS analysis revealed a significant decrease in dentin hypersensitivity over time with the use of agents (p<0.05). No statistically significant difference was found among the three desensitizing agents (p>0.05). These three desensitizing agents, which contain different active ingredients, were effective in relieving dentin hypersensitivity. However, no superiority was found in dentin sensitivity relief among the agents.

In-Office Treatment of Dentinal Hypersensitivity

Article

Feb 2009

Dentinal hypersensitivity is a common dental complaint, especially in periodontal patients. It is believed to be mediated by a hydrodynamic mechanism in which various stimuli result in increased fluid flow in dentinal tubules, thereby generating action potentials in associated nerve fibers. Although it is often perceived as mild discomfort by the patient, it can be severe. A variety of interventions has been used, although few have been subjected to rigorous study. This article surveys those in-office treatments that are available, and suggests directions for research so that clinicians may treat patients based on best evidence. Until such evidence is available, it seems prudent to employ therapies that are least likely to cause harm and are reversible.

Clinical effectiveness of a strontium chloride-containing desensitizing agent over 6 months: A randomized, double-blind, placebo-controlled study

Article

Apr 2008

The aim of this multicenter study was to evaluate the clinical efficacy of a strontium chloride-containing desensitizer, Hyposen (Lege Artis), over 6 months. A total of 142 patients with hypersensitivity in 9 dental practices and 2 clinical departments were included in the double-blind, randomized, placebo-controlled study. Each patient exhibited at least 2 hypersensitive and caries-free teeth with exposed dentin surfaces. One tooth was treated with strontium chloride (SR) as recommended by the manufacturer, another with a placebo. Levels of hypersensitivity were assessed after 2, 8, 12, and 24 weeks by cold air and tactile stimuli. After 6 months 132 patients could be reexamined. A reduction of discomfort and pain was observed in 95 patients (72%) after treatment with SR. Statistical analysis showed a significant positive effect of SR compared to the placebo group (P < .05, McNemar test). Use of SR for desensitizing hypersensitive dentin is an effective alternative to existing desensitizing agents.

Prevalence and distribution of cervical dentine hypersensitivity in a population in Rio de Janeiro, Brazil

Article

Nov 1992
J DENT

The prevalence, distribution and possible causal factors of cervical dentine hypersensitivity were studied in a population from a Marine Dental Clinic in the city of Rio de Janeiro, Brazil. A total of 635 patients were examined for the presence of cervical dentine hypersensitivity by means of a questionnaire and intraoral tests (air and probe stimuli). There were 157 patients (25%) reporting to have hypersensitive teeth, but only 108 patients (17%) were diagnosed as having cervical dentine hypersensitivity. The prevalence of hypersensitivity was higher among females than males, but this difference was not statistically significant. Most females with hypersensitivity were aged 20-49 and most males were aged 40-59. Incisors and premolars had the highest prevalence of dentine hypersensitivity to air and probe stimuli, while molars had the lowest. The presence and history of dentine hypersensitivity were positively correlated with previous exposure to periodontal treatment. Only a few of the patients who claimed to have dentine hypersensitivity had tried treatment with desensitizing toothpastes or sought professional help.

Incidence of hypersensitive teeth in the West of Scotland

Article

Oct 1985
J DENT

The incidence of ‘hypersensitive’ teeth was investigated in 369 patients by means of a questionnaire and intraoral testing with a cold-water mouthrinse (CWMR) and a sharp probe. Patients' subjective evaluations were found to be unreliable. Of the 103 patients who thought they had ‘sensitive’ teeth, only 62 responded positively to the intraoral tests. Around 29 per cent of patients reported discomfort with the CWMR, but when those with obvious causes for the pain (e.g., caries, cracked enamel) were excluded, the incidence of sensitivity to the CWMR was found to be 18 per cent. The incidence of sensitivity to CWMR and probing was 8·7 per cent. More females than males had sensitive teeth, but the differences were not statistically significant.

The effect of stannous fluoride on dentinal hypersensitivity

Article

Mar 1994

Many agents have shown varying degrees of effectiveness on pain resulting from exposed dentine. One which has shown some promising results is stannous fluoride (SnF2). The purpose of the following paper is twofold: to review and summarise the clinical literature pertaining to the relative effectiveness of solutions or gels containing SnF2 in controlling pain associated with dentinal hypersensitivity; and to statistically re-evaluate these studies in combination, in order to develop recommendations for the optimal use of SnF2 for hypersensitivity. Seven blinded clinical studies were identified and reviewed. Five of these compared 0.4 per cent SnF2 gel solution to an identical placebo. One compared a 0.4 per cent SnF2 gel solution and a 0.717 per cent F solution to an aqueous placebo. The final study compared a 0.717 per cent F solution to an aqueous placebo. Statistical power analysis and a combined meta-analysis were used to ensure adequate internal consistency and to contribute to an overall consensus of the efficacy across time. It was concluded that the 0.717 per cent F solution provides a virtually immediate and definable effect, which seems to continue for several months. This effect was present in all subjects used in the study. This solution was applied directly to the sensitive area for one minute and allowed to remain for 3-5 minutes. An additional one minute application was applied if needed. The effect of the 0.4 per cent SnF2 gel appears to be more gradual, perhaps involving a different mechanism of action. This solution requires approximately two to four weeks of continuous treatment to be effective. It was concluded that an effective strategy involving the use of stannous fluoride gel includes the application of the

EFFECTIVENESS of arginine containing TOOTHPASTES in treating dentine hypersensitivity: A systematic Review.

Abstract

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