Evaluation and comparison of the effects of a new paste containing 8% L-Arginine and CaCO3 plus KNO3 on dentinal tubules occlusion and dental sensitivity: a randomized, triple blinded clinical trial study.

BACKGROUND: Dentin hypersensitivity, often occurring after dental treatments or from erosive lesions, is a prevalent patient complaint. This study introduces a paste combining 8% L-arginine, calcium carbonate, and potassium nitrate to evaluate its impact on dentinal tubules occlusion, dentin permeability, and tooth sensitivity. METHODS: Dentin surfaces from 24 third molars (thickness: 2 mm) were divided into two groups of 12. One received the experimental paste, while the other received a placebo without desensitizer. Permeability and sealing ability were assessed through scanning electron microscopy (SEM) and dentin permeability measurement. The pastes' effects on hypersensitivity were then examined in a triple-blind, randomized parallel-armed clinical trial with 16 eligible patients. Sensitivity to cold, touch, and spontaneous stimuli was recorded using the VAS scale at various intervals post-treatment. Statistical analysis was conducted using Shapiro-Wilk, Mann-Whitney U, Friedman, and Wilcoxon tests (α = 0.05). RESULTS: The permeability test demonstrated a significant reduction in dentin permeability in the experimental group (P = 0.002) compared to the control (P = 0.178). SEM images revealed most dentinal tubules in the intervention samples to be occluded. Clinically, both groups showed a significant decrease in the three types of evaluated sensitivity throughout the study. However, no significant difference in sensitivities between the two groups was observed, with the exception of cold sensitivity at three months post-treatment (P = 0.054). CONCLUSION: The innovative desensitizing paste featuring 8% L-arginine, calcium carbonate, and potassium nitrate effectively occluded dentinal tubules and reduced dentin permeability. It mitigated immediate and prolonged dentin hypersensitivity to various stimuli, supporting its potential role in managing dentin hypersensitivity. TRIAL REGISTRATION: http://irct.ir : IRCT20220829055822N1, September 9th, 2022.

The effect of sodium hexametaphosphate on sensitivity and whitening effectiveness of an at-home bleaching gel: a randomized, triple-blinded clinical trial.

OBJECTIVE: Bleaching sensitivity (BS) is the most common adverse effect of tooth bleaching treatments. This study evaluated the effect of adding 1% sodium hexametaphosphate (SHMP) on BS and the whitening effectiveness of a bleaching gel. METHOD AND MATERIALS: Two maxillary quadrants from 26 patients were randomly assigned to the experimental and control groups in a split-mouth design. In the control group the at-home bleaching gel containing 3% hydrogen peroxide, and in the experimental quadrant the same gel with 1% SHMP, were applied in individual trays for 6 hours per night for 2 weeks. The patients' sensitivity to cold and touch as well as spontaneous sensitivity were recorded based on a visual analog scale (VAS). Changes in shade guide units (ΔSGU) and ΔE were measured using a spectrophotometer. Data were analyzed using the Kolmogorov-Smirnov, Mann-Whitney U, Wilcoxon signed-rank test, and independent sample t test. RESULTS: Twenty-four patients completed the study. After 2 weeks, the sensitivity to cold and touch was significantly lower in the intervention group compared to the control (P = .015 and P = .039, respectively). The spontaneous sensitivity revealed no significant alteration between these two groups and during the bleaching period in each group (P > .050). Regarding both color measurements, the bleaching effectiveness in both groups was comparable, with no noticeable difference (P > .050). CONCLUSION: The application of 1% SHMP was able to reduce the BS with no detrimental effect on the at-home bleaching effectiveness. (Quintessence Int 2021;52:596-605; doi: 10.3290/j.qi.b1098303).