Uso do fluoreto de sódio como dessensibilizante no clareamento dental: uma revisão de literatura / Use of sodium fluoride as a desensibilizer in dental bleaching: a literature review

Objetivo: Verificar, por meio de uma revisão de literatura, a efetividade do uso do fluoreto de sódio como dessensibilizante para casos de sensibilidade induzida por clareamento dental. Resultados: O clareamento dentário tornou-se um dos procedimentos estéticos mais procurados na odontologia. Atualmente, existem duas técnicas supervisionadas por dentistas: o clareamento caseiro e o de consultório. Os materiais mais utilizados são o peróxido de carbamida e o de hidrogênio, respectivamente. O clareamento dental baseia-se na premissa de que o peróxido de hidrogênio penetra na estrutura dentária para interagir com os cromóforos orgânicos. Embora o protocolo de clareamento exija o uso de agentes oxidantes de baixa concentração, a sensibilidade dentária ainda está presente e pode ser considerado o principal efeito adverso da técnica de clareamento. Para minimizar este problema, a aplicação tópica de dessensibilizantes antes e após o clareamento dentário tem mostrado bons resultados na redução da intensidade de sensibilidade. Considerações finais: Mediante revisão apresentada, constatou-se que fluoreto de sódio quando utilizado após o protocolo clareador, como dessensibilizante, não elimina a sensibilidade, mas diminui a intensidade da dor. Quando utilizado antes do clareamento dental, não apresenta resultados positivos. Ademais, salienta-se que quando o fluoreto é incorporado no gel clareador, resulta em menor desmineralização do esmalte dentário.(AU)

Objective: To verify, through a literature review, the effectiveness of using sodium fluoride as a desensitizer for cases of sensitivity induced by tooth whitening. Literature review: Teeth whitening has become one of the most desired aesthetic procedures in dentistry. Currently, there are two techniques supervised by dentists: home whitening and office whitening. The most used materials are carbamide peroxide and hydrogen peroxide, respectively. Teeth whitening is based on the premise that hydrogen peroxide penetrates the tooth structure to interact with organic chromophores. Although the whitening protocol requires the use of low concentration oxidizing agents, tooth sensitivity is still present and can be considered the main adverse effect of the whitening technique. To minimize this problem, the topical application of desensitizers before and after tooth whitening has shown good results in reducing the intensity of sensitivity. Final considerations: Upon the review presented, it was found that sodium fluoride, when used after the whitening protocol, as a desensitizer, does not eliminate sensitivity, but reduces the intensity of pain. When used before tooth whitening, it has no positive results. Furthermore, it should be noted that when fluoride is incorporated into the whitening gel, less enamel demineralization is induced.(AU)

Treatment of multiple recessions with collagen matrix versus connective tissue: a randomized clinical trial

Abstract The objective of this study was to determine whether collagen matrix (CM) is an alternative to connective tissue graft technique (CTG) in the treatment of multiple gingival recessions (GR). The indication of CM for the treatment of multiple GR is not yet clear. More studies are needed to better understand this treatment modality, as an alternative to CTG. In this single-blind, split-mouth randomized clinical trial, fifteen patients with multiple Miller class I upper GR were selected and randomly assigned to control group (CTG) or test group (CM). Root coverage (RC) and patient-centered outcomes were evaluated at baseline and after 3, 6, and 12 months. A total of 82 GRs were treated. There was no significant difference regarding GR depth (GRD, primary outcome) between CTG (0.5 ± 0.9 mm) and CM groups (0.6 ± 1.0 mm) (p = 0.225). Percentage of RC was 82.14% in CTG and 77.7% in CM. Both groups demonstrated a gain in keratinized tissue width at 12 months (p < 0.05). Dentine hypersensitivity was effectively reduced in both groups. Postoperative pain was significantly higher in the CTG (p = 0.001). Esthetic satisfaction was high for both groups, with no significant difference (p > 0.05) between groups. After 12 months, both surgical treatments were able to promote RC, and GRD was similar in both CTG and CM groups.

Effect of dental bleaching on pulp oxygen saturation in maxillary central incisors - a randomized clinical trial

Abstract Objective To assess pulp oxygen saturation levels (SaO2) in maxillary central incisors after dental bleaching. Materials and Methods 80 participants (160 teeth) were randomly allocated to four groups: G1 In-office bleaching with two applications of 35% hydrogen peroxide (HP) (20 minutes), followed by at-home bleaching with 10% carbamide peroxide (CP) (2 hours/day for 16 days); G2 - Same protocol as G1, plus desensitizing toothpaste; G3 - In-office bleaching with 35% HP and one application of placebo gel (20 minutes), followed by at-home bleaching with 10% CP (2 hours/day for 16 days); and G4 - Same protocol as G3, plus desensitizing toothpaste. Pulp SaO2 levels were measured before (T0) and immediately after (T1) in-office bleaching; on the 5th (T2), 8th (T3), 12th (T4), and 16th days of at-home bleaching (T5); and on the 7th (T6) and 30th (T7) days. Mean (SD) pulp SaO2 levels were compared within groups by generalized estimating equations (GEE) and Student's t-test (P<0.05). Results Mean pulp SaO2 at T0 was 84.29% in G1, 84.38% in G2, 84.79% in G3, and 85.83% in G4. At T1, these values decreased to 81.96%, 82.06%, 82.19%, and 81.15% in G1, G2, G3, and G4 respectively, with significant difference in G4 (P<0.05). During home bleaching, pulp SaO2 levels varied in all groups, with 86.55%, 86.60%, 85.71%, and 87.15% means at T7 for G1, G2, G3, and G4, respectively; G2 presented significant difference (P<0.05). Conclusions Pulp SaO2 level in maxillary central incisors was similar at baseline, reducing immediately after in-office bleaching, regardless of using desensitizing toothpaste and increasing at 30 days after dental bleaching.

High-concentration carbamide peroxide can reduce the sensitivity caused by in-office tooth bleaching: a single-blinded randomized controlled trial

Abstract Objectives A single-blinded, randomized, parallel clinical trial evaluated the use of 37% carbamide peroxide (CP) on bleaching effectiveness and tooth sensitivity reported by patients undergoing in-office tooth bleaching, in comparison with the results of using 35% hydrogen peroxide. Material and Methods Forty patients were allocated to receive two sessions of in-office tooth bleaching using either 35% hydrogen peroxide (HP) or 37% CP. Each patient's sensitivity level was evaluated during and up to 24 h after bleaching. The effectiveness of the bleaching procedures was evaluated with a spectrophotometer one week after each session and 30 days after the last session. The impact of tooth bleaching on the patients' perceptions regarding smile changes, in addition to the bleaching procedures and their results, were also recorded. Absolute and relative sensitivity risks were calculated. Data on sensitivity level were analyzed using the Mann-Whitney or T-test, and data from the color evaluation were subjected to 2-way repeated measures ANOVA. Results The use of CP reduced the risk and level of tooth sensitivity to values close to zero, whereas the difference between the bleaching agents disappeared after 24 h. An increased bleaching effect was observed for HP, mainly due to an improved reduction of redness and yellowness. Participants perceived improved tooth bleaching for HP and reduced sensitivity for CP, but no differences regarding the comfort of the techniques were noted. Conclusions In our study, 37% CP resulted in reduced tooth sensitivity but decreased the tooth bleaching effectiveness. However, both bleaching agents resulted in high levels of patient satisfaction.

Preemptive use of etodolac on tooth sensitivity after in-office bleaching: a randomized clinical trial

Abstract Purpose: This study determined the effectiveness of the preemptive administration of etodolac on risk and intensity of tooth sensitivity and the bleaching effect caused by in-office bleaching using 35% hydrogen peroxide. Material and methods: Fifty patients were selected for this tripleblind, randomized, crossover, and placebo-controlled clinical trial. Etodolac (400 mg) or placebo was administrated in a single-dose 1 hour prior to the bleaching procedure. The whitening treatment with 35% hydrogen peroxide was carried out in two sessions with a 7-day interval. Tooth sensitivity was assessed before, during, and 24 hours after the procedure using the analog visual scale and the verbal rating scale. Color alteration was assessed by a bleach guide scale, 7 days after each session. Relative risk of sensitivity was calculated and adjusted by session, while overall risk was compared by the McNemar's test. Data on the sensitivity level of both scales and color shade were subjected to Friedman, Wilcoxon, and Mann-Whitney tests, respectively (α=0.05). Results: The preemptive administration of etodolac did not affect the risk of tooth sensitivity and the level of sensitivity reported, regardless of the time of evaluation and scale used. The sequence of treatment allocation did not affect bleaching effectiveness, while the second session resulted in additional color modification. The preemptive administration of etodolac in a single dose 1 hour prior to in-office tooth bleaching did not alter tooth color, and the risk and intensity of tooth sensitivity reported by patients. Conclusion: A single-dose preemptive administration of 400 mg of etodolac did not affect either risk of tooth sensitivity or level of sensitivity reported by patients, during or after the in-office tooth bleaching procedure.

Randomized clinical trial of the effect of NovaMin and CPP-ACPF in combination with dental bleaching

Abstract Objective This randomized, controlled, double-blind clinical study evaluated the effect of calcium sodium phosphosilicate (NovaMin) and casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) on the prevention of post-operative sensitivity and on the effects of clinical bleaching treatment. Material and Methods Sixty volunteers were selected according to inclusion and exclusion criteria and were randomly assigned into three groups (n=20): CG (control group) patients, who were treated with 35% hydrogen peroxide; NOVAG (NovaMin group) patients, who were treated with 35% hydrogen peroxide followed by the application of NovaMin; and CPPG (CPP group) patients, who were treated with 35% hydrogen peroxide followed by the application of CPP-ACPF. Both bioactive agents were applied for five minutes. An evaporative stimulus associated with a modified visual scale was used to analyze sensitivity 24 hours after each bleaching session. The color evaluation was performed on the maxillary central incisors using a spectrophotometer. Associations between the intervention group, bleaching session, and reported sensitivity were tested using Chi-square partitioning. Results Color change values (ΔE) were analyzed using analysis of variance (ANOVA). The significance level used for both tests was 5%. In the intragroup assessment, the Friedman test showed that only the CPP-ACPF group showed no statistically significant difference (p<0.05) between baseline and first bleaching session. In the intergroup assessment, the Kruskal-Wallis test showed that the CPPG had less postoperative sensitivity after the first session, when compared to the other groups (p<0.05). Color change analysis (ΔE) showed a significant difference between the means obtained in the different bleaching sessions in all groups (p<0.05). Conclusions This study showed that the combination of CPP-ACPF with 35% hydrogen peroxide significantly reduced post-operative sensitivity in the first session, compared with the other evaluated treatments. The association of CPP-ACPF and NovaMin did not affect the color change induced by tooth bleaching.

Os pricipais efeitos colaterais do clareamento dentário: como amenizá-los / Tooth whitening: main T collateral effects and how to smooth them

Introdução: em busca de uma perfeita harmonia na forma e nas cores dos dentes, a dentística desenvolveu diversas alternativas para a melhoria da estética dentária, sendo que para o tratamento das alterações cromáticas, o procedimento mais utilizado atualmente é o clareamento dental. Objetivo: realizar uma revisão de literatura a cerca dos possíveis efeitos colaterais advindos das técnicas de clareamento dental e como minimizá-los. Material e Métodos: revisão de literatura por meio de busca bibliográfica nas bases de pesquisa online: PubMED, Medline, Lilacs, Scielo e Scopus, através do rastreio de artigos relevantes publicados entre o período de 2010 a 2016. Resultados: dentre os efeitos colaterais apresentados pelo clareamento dental, a sensibilidade durante e após o clareamento tem sido um dos efeitos adversos mais apontados na literatura, fato que pode ser resultado do aumento da permeabilidade do esmalte, com uma possível difusão do peróxido até a polpa, os tratamentos mais eficazes no controle da sensibilidade são: nitrato de potássio a 5%, fluoreto de sódio neutro a 2%, a terapia a laser e o uso de analgésicos e anti-inflamatórios. O gel clareador deve ser removido totalmente ao final do clareamento, porém se alguma quantidade do mesmo é deixada para trás, o paciente pode eventual deglutir, o que pode levar a irritação na mucosa gastrointestinal, dessa forma é importante que seja evitado o excesso de produto e de aplicações, atentando com a remoção cuidadosa dos excessos, para evitar sua ingestão e contato com tecidos moles. Conclusão: independentemente da técnica de clareamento a ser utilizada é necessária a supervisão e acompanhamento de um cirurgião-dentista, pois com o seu criterioso diagnóstico e adequado tratamento é que os resultados satisfatórios serão alcançados e os efeitos colaterais evitados e/ou minimizados. (AU)

Introduction: in order to achieve a perfect harmony in the shape and colors of the teeth, the dentistry has developed several alternatives for the improvement of dental aesthetics, and for the treatment of chromatic alterations, the most commonly used procedure is tooth whitening. Objective: to carry out a literature review about the possible side effects of dental bleaching techniques and how to minimize them. Material and Methods: a review of the literature was carried out through a bibliographic search in the following online databases: PubMED, Medline, Lilacs, Scielo and Scopus, through the screening of relevant articles published between 2010 and 2016. Results: among the side effects of tooth whitening, sensitivity during and after bleaching has been one of the most commonly reported adverse effects in the literature, a fact that may be a result of increased permeability of the enamel, with a possible diffusion of the peroxide to the pulp. The most effective treatments for sensitivity control are: 5% potassium nitrate, 2% neutral sodium fluoride, laser therapy and the use of analgesics and anti-inflammatories. The bleaching gel should be removed completely at the end of bleaching, but if any amount is left behind, the patient may eventually swallow, which may lead to irritation in the gastrointestinal mucosa, so it is important to avoid excess product And applications, with the careful removal of excess, to avoid its ingestion and contact with soft tissues. Conclusion: regardless of the technique of whitening to be used, it is necessary the supervision and follow-up of a dental surgeon, because with his careful diagnosis and appropriate treatment, satisfactory results will be achieved and the side effects avoided and/or minimized. (AU)

Toxicidade do peróxido de carbamida 16% adicionado de nanopartículas de hidroxiapatita / Carbamide peroxide toxicity added 16% hydroxyapatite nanoparticles

O clareamento dental é um dos tratamentos mais realizados nos consultórios odontológicos a fim de melhorar a aparência do sorriso. O procedimento consiste na aplicação de um gel clareador, a base de peróxido de carbamida ou de hidrogênio, sobre os dentes a serem clareados. A sensibilidade dentária é o efeito adverso mais frequentemente relatado no clareamento dentário e é a principal causa de desmotivação dos pacientes. O mecanismo pelo qual se produz a sensibilidade após clareamento dentário ainda não foi completamente elucidado; no entanto, parece estar associado à rápida difusão dos agentes clareadores através do esmalte e dentina que, devido ao seu grau de citotoxicidade, podem agir agredindo as células pulpares, causando sensibilidade. O objetivo deste estudo foi avaliar a biocompatibilidade de nanopartícula de hidroxiapatita adicionada ao gel clareador peróxido de carbamida 16% com flúor e sem flúor e, para tanto, foram realizados testes de citotoxidade empregando MTT. Como resultados verificou-se que as nanopartículas de hidroxiapatita, quando comparadas aos géis de peróxido de carbamida a 16% com e sem flúor, foram as menos citotóxicas (p< 0.05). As diluições citotóxicas convertidas para 70% das amostras testadas também foram comparadas através do teste de Anova com tukey. Foi possível observar que as partículas de nanoHap quando adicionadas nos géis de clareamento com e sem flúor reduziu significativamento a citotoxidade. Concluímos que o novo material proposto nesta investigação apresenta melhor biocompatibilidade do que o gel sem hidroxiapatita, acompanhado da redução da citotoxidade, tais aspectos sugerem que as nanopartículas de hidroxiapatita podem ter aplicações clínicas futuras em tecidos mineralizados em procedimentos de clareamento dental, contribuindo para a redução da sensibilidade dentária.

The dental bleaching is one of the most procedures performed at dental offices to improve the appearance of the smile. The procedure consists of the application of a bleching gel, based on carbamide peroxide or hydrogen over the teeth to be whitened. Tooth sensibility is the frequently reported adverse effect on tooth whitening and is the leading cause of demotivation by the patients. The mechanism that provides the sensibility after tooth whitening has not already been fully elucidated; however, it appears to be associated with the rapid diffusion of bleaching agents through the enamel and dentin that, because of their degree of cytotoxicity, may act attacking pulp cells, causing the sensibility. The aim of this study was to evaluate the biocompatibility of hydroxyapatite nanoparticles added to whitening gel of 16% carbamide peroxide with and without fluoride and, therefore, cytotoxicity tests were performed using MTT. As a result, it was found that the hydroxyapatite nanoparticles, compared to the gels of 16 % carbamide peroxide with and without fluoride, were less cytotoxic (p <0.05). Cytotoxic dilutions converted to 70 % of the tested samples were compared using ANOVA test with Tukey. We concluded that the new material proposed in this research has a better biocompatibility in comparison with the gel without hydroxyapatite, followed by a reduction of cytotoxicity. These aspects suggest that the hydroxyapatite nanoparticles may have clinical future applications in mineralized tissues when dental bleaching procedures are performed, contributing to the reduction of tooth sensitivity. We conclude that the new material proposed in this research has a better biocompatibility of the gel without hydroxyapatite, accompanied by a reduction of cytotoxicity, these aspects suggest that the hydroxyapatite nanoparticles may have future clinical applications in mineralized tissues in dental bleaching procedures, contributing to a reduction tooth sensitivity.

Características bucais da perimólise e episódios recorrentes de vômitos: relato de caso / Features Oral of Perimolysis Recurrent Vomiting: Case Report

O presente trabalho teve o propósito de abordar, por meio de relato de caso clínico, aspectos relevantes sobre o diagnóstico, tratamento e acompanhamento de uma criança de 10 anos de idade portadora de perimólise. Ao exame clínico, a paciente apresentou IHO-S igual a 0,16 e ISG de 26,0%. Foram verificadas alterações do esmalte em vários elementos dentários (superfície palatina dos dentes anteriores superiores). O tratamento consistiu de 08 aplicações em intervalos semanais de verniz fluoretado a 5% NaF. Orientações de higiene e dieta também foram condutas adotadas. Após a realização das intervenções, foi constatada a redução da sensibilidade dentária.

This paper aims to address, through clinical case, the relevant aspects on the diagnosis, treatment and monitoring of a 10 year old carrier perimolysis. On clinical examination, the patient had OHI-S equal to 0.16 and 26.0% of ISG. Enamel alterations were noted in several dental elements (palatal surface of maxillary anterior teeth). Treatment consisted of 08 weekly applications at intervals of 5% NaF fluoride varnish. Guidelines hygiene and diet behaviors were also adopted. After completion of the interventions, was found to reduce tooth sensitivity.

Efecto de la arginina 8 por ciento-carbonato de calcio y del fluoruro de sodio al 5 por ciento en la reducción de la hipersensibilidad dentinaria post terapia periodontal: ensayo clínico / Effect of 8 percent arginine, calcium carbonate and 5 percent sodium fluoride on the reduction of the dentine hipersensitivity post periodontal therapy: clinical trial

Objetivo: El objetivo de este estudio clínico fue evaluar y comparar la eficacia en la reducción de la hipersensibilidad dentinaria de la arginina al 8 por ciento-carbonato de calcio, monofluorfosfato (1.450 ppm) en comparación con un grupo control tratado en base a un barniz de flúor (22.600 ppm) y un dentífrico fluorado (1.450 ppm), 3 veces al día durante un minuto, en pacientes con hipersensibilidad radicular en forma inmediata a la terapia periodontal mecánica (medición basal) y a las 4 semanas respectivamente. Materiales y Método: Estudio clínico aleatorizado de grupos paralelos, con 4 semanas de seguimiento, en el cual se reclutaron 20 pacientes con diagnóstico de periodontitis crónica leve a moderada, en tratamiento periodontal mecánico con presencia de recesiones gingivales a nivel de incisivos, caninos o premolares. A todos ellos, previa firma de consentimiento informado y en forma inmediata a los pulidos radiculares, se les aplicó el test térmico de chorro de aire con la jeringa de aire de la unidad dental a nivel de las recesiones gingivales con hipersensibilidad. La molestia o dolor fue determinado mediante la utilización de una escala visual análoga, realizada en forma inmediata a los pulidos radiculares (medición basal). Los pacientes fueron aleatoriamente asignados a uno de los siguientes grupos: grupo control, se les aplicó barniz de flúor (22.600 ppm) en todas las recesiones gingivales y se les indicó un dentífrico fluorado (1.450 ppm); grupo experimental, a quienes se les aplicó pasta tópica de arginina y carbonato de calcio (8 por ciento) a nivel de las recesiones gingivales, complementado con el uso de un dentífrico cuyo componente activo es la arginina al 8 por ciento-carbonato de calcio. Todos los pacientes fueron evaluados 4 semanas posterior a la aplicación y utilización domestica de los agentes des-sensibilizantes por un único examinador. Resultados: Ambos grupos experimentaron una disminución en la sensibilidad dentinaria, sin...

Aim: The aim of this clinical study was to evaluate and to compare the efficacy in reducing the dentine hypersensitivity of an 8 percent arginine, calcium carbonate, 1.450 ppm sodium monofluorophosphate dentifrice with topical application and twice-daily brushing, with a negative control toothpaste containing calcium carbonate and 1.450 ppm fluoride as MFP, after periodontal treatment (baseline) and four weeks respectively. Methods: A four-week clinical study with 20 subjects with diagnosis of slight to moderate chronic periodontitis under mechanical periodontal treatment and presence of gingival recessions in incisors, canines or premolars, stratified based on baseline tooth sensitivity. Subjects brushed with either a 1.450 ppm fluoride dentifrice or a marketed 8 percent arginine calcium carbonate dentifrice twice daily for approximately one minute. At screening, baseline and weeks four, subjects' tooth sensitivity was determined through both evaporative (Schiff and Visual Analogue Scale [VAS]). The same examiner throughout the study performed subject assessments using each stimulus. Results: Both subject groups exhibited significant reductions from baseline to four weeks in dentine hypersensitivity. However, patients who received 8 percent arginine calcium carbonate therapy, exhibited a greater reduction, with a 60 percent of individuals lacking of pain and with a final median of 0 in comparison with the 5 percent fluoride varnish and fluoride toothpaste group in which a 100 percent of subjects felt some degree of pain, presenting a final medium VAS scale of 2.

Uma nova técnica para recromia dentária como ausência de sensibilidade / A new dental bleaching techniquen with no sensitiveness

Um sorriso com dentes brancos estabelece o padrão de beleza do mundo atual. Indica saúde, auto-estima e acrescenta algo excepcionalmente fantástico à percepção da beleza de uma pessoa. A recromia dentária tem sido descrita como a técnica mais utilizada no contexto da Odontologia Estética. O procedimento pode ser realizado com duas técnicas distintas: caseira e de consultório. Mais recentemente, foi lançado um upgrade para a recromia assistida pelo profissional no consultório, com a utilização de fontes híbridas de lasers-leds para ativação de um novo gel clareador. Este artigo tem por objetivo descrever uma técnica para recromia dentária, com um novo gel à base de peróxido de hidrogênio a 25% com urucum e juá, associado à ativação luminosa híbrida, com ausência de sensibilidade, que é um dos efeitos colaterais mais indesejáveis descritos pelos pacientes.

Dentine hypersensitivity: analysis of self-care products

Dentine hypersensitivity is a condition that is often present in individuals, leading them to seek dental treatment. It has been described as an acute, provoked pain that is not attributable to other dental problems. Its actual prevalence is unknown, but it is interpreted as very unpleasant by individuals. Several therapeutic alternatives are available to manage dentine hypersensitivity, involving both in-office treatment and home-use products. The aim of this literature review was to evaluate self-care products for managing dentine hypersensitivity. Among the products available, dentifrices and fluorides are the most studied self-care products, with positive effects. However, a high percentage of individuals is affected by the placebo effect. Among dentifrices, those containing potassium salts seem to be the most promising. Dental professionals need to understand the advantages and limitations of these therapies and use this knowledge in a positive approach that might help in decreasing dentine hypersensitivity among patients.

Dentinal hypersensitivity?--Can this agent be the solution?

AIM: To test the efficacy of desensitizing tooth paste containing EMS salts in alleviating dentinal hypersensitivity, reducing plaque accumulation, and reducing gingivitis. METHODS: A randomised, single blind, parallel placebo controlled study was conducted in 40 cases. The cases were randomly assigned to test and control groups. The test group was instructed to use the test tooth paste (containing EMS salts) and control group a placebo tooth paste (without any therapeutic agents) for a period of 6 weeks. The hypersensitivity levels were measured with scratchometer and verbal rating scale. Student t test and wilcoxon's Mann-Whitney test were used to compare the test and control groups. RESULTS AND CONCLUSION: The results indicated that both the test as well as the control toothpastes were effective in alleviating dentinal hypersensitivity as well as reducing gingivitis. However, the test toothpaste was superior in alleviation of dentinal hypersensitivity.

The effect of propolis on dentinal hypersensitivity and level of satisfaction among patients from a university hospital Riyadh, Saudi Arabia.

Propolis has been used since ancient times in folk medicine for its beneficial effects. It is a mixture of resin, essential oils and waxes mixed with bee glue; also it contains amino acid, minerals, ethanol, vitamin A, B Complex, E, Pollen and highly active ingredient known as Bioflavenoid (Simon Martin 1991). To date, there have been no studies done on desensitizing effect of Propolis in vivo. So, the aims of this study are to evaluate the effect of Propolis in a clinical trial on subjects with dentinal hypersensitivity, and to assess the level of satisfaction among subjects after they have used the Propolis. Twenty six Saudi female subjects at King Saud University, College of Dentistry, Riyadh, Saudi Arabia, age ranged from 16-40 yr. (mean = 23 yrs.), were included in the study over a period of four weeks. The Cervical Dentinal Sensitivity (C.D.S.) was assessed by two methods: 1--cold air stimuli. 2--Subjective reporting of pain, with a modified questionnaire (Gillam 1997) and a numerical scale 0-10 (Downie et al 1978). The patients were followed up for four weeks after using Propolis, there were two recalls, and the first recall was after one week and the second recall after four weeks of the base line. The results between the base line findings and after four weeks were statistically significant. Eighty five percent of the subjects were found highly satisfied; the Propolis had significant effect on dentinal hypersensitivity during the study period. Further research is needed with double blind clinical trial on a large sample size.

NaF iontophoresis, an alternative to cavity lining--an in vivo study.

The study carried out on 30 teeth in 28 patients of 12-16 years to assess NaF iontophoresis as an alternative to cavity lining revealed that out of 25 cavities which were sensitive to air, water jet and exploration (14 mild, 9 moderate and 2 severe), in 20 cavities the sensitivity decreased to nil, in 9 to mild and in one to moderate following iontophoresis. It was found that in all the cases, the first application of iontophoresis decreased the sensitivity by 50-60 percent and the second by 70-90 percent. Immediately after silver filling there was no sensitivity in 25 teeth, whereas 4 were mildly and one moderately sensitive. After a six month follow up in 24 patients who reported, all the teeth were comfortable.