Analysis of dentin wear and biological properties promoted by experimental inoffice desensitizing materials.

BACKGROUND: This study aimed to evaluate dentin wear and biological performance of desensitizing materials. METHODS: Seventy bovine root dentin blocks were sectioned. Half of the surface of each specimen was untreated (control) and the other half was immersed in EDTA and treated with the following desensitizing materials: placebo varnish (PLA), fluoride varnish (FLU), sodium fluoride (NaF) varnish + sodium trimetaphosphate (TMP), universal adhesive (SBU), S-PRG varnish (SPRG), biosilicate (BIOS), and amelotin solution (AMTN). After application, the specimens were submitted to an erosive-abrasive challenge and the wear analyzed by optical profilometer. Serial dilutions of extracts obtained from the culture medium containing discs impregnated with those desensitizers were applied on fibroblasts and odontoblasts-like cells cultures. Cytotoxicity and production of total protein (TP) by colorimetric assays were determined after 24 h. Data were statistically analyzed using Kruskal-Wallis, Dunn's, One-way ANOVA and Tukey tests (p ≤ 0.05). RESULTS: No dentin wear was observed only for SBU. The lowest dentin wear was observed for AMTN and TMP. Cell viability was significantly reduced after treatment with undiluted extracts of PLA, FLU, TMP and SBU in fibroblasts and TMP and SBU in odontoblast-like cells. SPRG, BIOS and AMTN were cytocompatible at all dilutions tested. Considering TP results, no statistical difference was observed among the groups and high levels for TP were observed after TMP and FLU treatments. CONCLUSIONS: Universal adhesive system may protect dentin with opened tubules from wear after challenge. Extracts of adhesive and fluoride varnishes presented cytotoxic mainly on fibroblasts. The enamel protein may be a future alternative to treat dentin with opened tubules because it may cause low wear under erosive-abrasive challenge with low cytotoxic effects.

Experimental pastes containing niobophosphate and 45S5 bioactive glasses for treatment of dentin hypersensitivity: dentin permeability and tubule obliteration.

OBJECTIVES: This study tested the ability of bioactive pastes containing niobophosphate and 45S5 glasses to reduce dentin permeability and to obliterate dentinal tubules, as a mean of reducing human dentin hypersensitivity. MATERIALS AND METHODS: Experimental pastes with concentrations of 10, 20, and 30 wt% of two bioactive glasses (45S5 or niobophosphate [NbG]) were formulated. A paste without bioactive glass (placebo) and a commercial paste (Nano P, FGM) were used as controls. Forty dentin disc specimens were obtained from caries-free extracted third human molars and divided in 8 groups (n = 5). Percentage of permeability (%Lp) was assessed in a dental permeability machine considering hydraulic conductance, immediately after pastes application and at day 7, day 14, and day 21. The precipitates formed on the surface of the dentin discs (and dentinal tubules) were analyzed by SEM/EDS and micro-Raman spectra. Data of dentin permeability (%) 2-way repeated-measures (ANOVA) and Holm-Sidak post-tests (α = 0.05). Dentinal tubule obliteration was visually (and elemental) evaluated and descriptively reported. RESULTS: The experimental bioactive glass pastes containing NbG and 45S5, regardless of the concentration, reduced dentin permeability in comparison with pastes without bioactive glasses (P < 0.05). The formulated placebo and commercial paste did not reduce permeability over time (P < 0.05). SEM/EDS and micro-Raman analyses showed that both type of bioactive pastes (NbG or 45S5-based) presented mineral precipitates obliterating the dentinal tubules at day 21. NbG seems to offer a better initial effect than 45S5, while at 21 days there is no difference between both glasses. CONCLUSION: Experimental bioactive pastes containing NbG and 45S5 (at concentrations of 10%, 20%, or 30%) have potential to reduce dentin permeability (over time) in comparison with pastes without bioactive glasses; and this occurs on behalf of obliteration of dentinal tubules by microparticle and precipitate formation. CLINICAL RELEVANCE: Bioactive pastes containing NbG and 45S5 may benefit patients presenting dentin hypersensitivity, because these pastes can start acting fast after application and maintain their action up to 21 days.

Occlusion effects of bioactive glass and hydroxyapatite on dentinal tubules: a systematic review.

OBJECTIVE: Bioactive glass and hydroxyapatite are biocompatible materials used as an adjunct to various dental materials. The present study aimed to evaluate the occlusion effects of bioactive glasses and hydroxyapatite on dental tubules. MATERIALS AND METHODS: We searched the PubMed/Medline, Embase, and Web of Science databases for the relevant records. The methodological quality of the studies was assessed by an accepted quality assessment tool. RESULTS: From the electronic databases, 372 articles were retrieved. After evaluating the records, 35 in vitro studies were included. The studies revealed a low risk of bias. The primary outcomes from bioactive glass studies demonstrated the potential efficacy of both bioactive glass and hydroxyapatite in dentin tubule occlusion compared to the control. CONCLUSION: The current systematic review showed that bioactive glass and hydroxyapatite could effectively occlude the dentinal tubules. Thus, desensitizing agents containing bioactive glass and hydroxyapatite can be used to manage dentin hypersensitivity (DH). However, long-term follow-up clinical trials are required in the future before definitive recommendations can be made. CLINICAL RELEVANCE: This work achieved a satisfactorily systematic review for assessing desensitizing agents containing bioactive glass and hydroxyapatite in dentine hypersensitivity treatments recommended for clinical practice and research.

Effectiveness and cytotoxicity of two desensitizing agents: a dentin permeability measurement and dentin barrier testing in vitro study.

BACKGROUND: When evaluating the efficacy and safety of various desensitizing products in vitro, their mechanism of action and clinical utility should be considered during test model selection. This study aimed to evaluate the effects of two desensitizers, an in-office use material and an at-home use material, on dentin specimen permeability, and their dentin barrier cytotoxicity with appropriate test models. METHODS: Two materials, GLUMA desensitizer (GLU) containing glutaraldehyde and remineralizing and desensitizing gel (RD) containing sodium fluoride and fumed silica, were selected. Human dentin specimens were divided into three groups (n = 6): in groups 1 and 2, GLU was applied, and in group 3, RD was applied and immersed in artificial saliva (AS) for 24 h. Dentin specimen permeability before and after each treatment/post-treatment was measured using a hydraulic device under a pressure of 20 cm H2O. The perfusion fluid was deionized water, except in group 2 where 2% bovine serum albumin (BSA) was used. The representative specimens before and after treatment from each group were investigated using scanning electron microscopy. To measure cytotoxicity, test materials were applied to the occlusal surfaces of human dentin disks under which three-dimensional cell scaffolds were placed. After 24-h contact within the test device, cell viability was measured via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. RESULTS: GLU significantly reduced the dentin permeability and occluded the dentinal tubules when 2% BSA was used as perfusion fluid. RD significantly reduced dentin permeability and occluded the tubules, but permeability rebounded after AS immersion. GLU significantly decreased cell viability, but RD was non-cytotoxic. CONCLUSIONS: In vitro GLU application induced effective dentinal tubule occlusion only following the introduction of simulated dentinal fluid. RD provided effective tubule occlusion, but its full remineralization potential was not realized after a short period of immersion in AS. GLU may harm the pulp, whereas RD is sufficiently biocompatible.

Avian Eggshell Slurry as a Dentin Desensitizing Agent:An In Vitro Assessment Using Two Techniques.

AIM: This study aims to evaluate the efficacy of avian eggshell slurry as a desensitizing agent compared to casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing Tooth Mousse. MATERIALS AND METHODS: Eggshell powder was prepared and characterized using a scanning electron microscope (SEM), transmission electron microscope (TEM), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDX). Forty dentin disks were immersed in 6% citric acid for 2 min to simulate hypersensitive dentin (baseline). Disks were then divided into two groups (n = 20) according to treatment received: eggshell slurry and commercially available Tooth Mousse desensitizing agent. Each group was further divided into two subgroups (n = 10). In subgroup 1, dentin discs were immersed in artificial saliva for four weeks whereas, in subgroup 2, discs underwent acid challenge. Environmental scanning electron microscope (ESEM) analysis and hydraulic conductance test were utilized to calculate dentinal tubules occlusion and reduction of dentin permeability percentages, respectively. Statistical analysis was performed using SPSS 22.0 at a significance level p ≤ 0.05. RESULTS: After application of desensitizing agents, the eggshell slurry group showed a significantly higher percentage of dentinal tubules occlusion compared to the Tooth Mousse group, whereas no significant difference existed in the percentage reduction of dentin permeability between both groups. After both immersion protocols, the eggshell slurry significantly occluded more dentinal tubules compared to Tooth Mousse. On the contrary, results of percentage reduction of dentin permeability revealed no significant difference between both subgroups after acid challenge. After artificial saliva immersion, Tooth Mousse showed a significantly higher percentage reduction of dentin permeability compared to the eggshell slurry. CONCLUSION: Avian eggshell slurry can effectively occlude open dentinal tubules compared to commercially available Tooth Mousse desensitizing agent. CLINICAL SIGNIFICANCE: Avian eggshell slurry can be considered a promising material for the treatment of dentin hypersensitivity. How to cite this article: El Tahlawy AA, Saba DA, Bakir NG. Avian Eggshell Slurry as a Dentin Desensitizing Agent: An In Vitro Assessment Using Two Techniques. J Contemp Dent Pract 2021;22(5):532-537.

Influence of Er,Cr:YSGG laser, associated or not to desensitizing agents, in the prevention of acid erosion in bovine root dentin.

This in vitro study evaluated the influence of the Er,Cr:YSGG laser, associated or not to desensitizing agents, in the prevention of acid erosion in bovine root dentin. Eighty dentin specimens were selected and divided into eight groups (n = 10): G1: negative control; G2: positive control (5% fluoride varnish-FV); G3: Er,Cr:YSGG laser; G4: FV + laser; G5: 3% potassium oxalate; G6: 3% potassium oxalate + laser; G7: biphasic calcium silicate/phosphate gel (gel); G8: gel + laser. Laser parameters: 0.5 W, 6.25 J/cm2 at 1-mm distance. The erosive drink used was a cola soft-drink (pH = 2.42 at 4 °C), lasting 5 min, twice a day, with 6-h intervals between the challenges, during 14 days. Kolmogorov-Smirnov and Levene's tests were satisfied. The surface roughness data were submitted to ANOVA and Tukey post hoc tests. For the wear profile, Kruskal-Wallis and Dunn post hoc tests were used. Afterwards, the Spearman correlation test was performed. All statistical tests assumed a significance level of 5% (α = 0.05). G1 presented the highest surface roughness value after the erosive challenge (3.586 µm2 ± 0.205 µm2) and the G7 presented the lowest surface roughness value after the erosive challenge (1.071 µm2 ± 0.180 µm2). For the lost volume, G4 presented the lowest percentage (9.7% ± 0.9%), while G1 had the highest percentage (41.8% ± 2.5%), both with p < 0.05. There was a weak correlation between the response variables (ρ = 0.33). All groups presented lower values of surface roughness and loss of volume when compared to the negative control group. For the surface roughness, the biphasic calcium silicate/phosphate gel presented the best result. For volume loss, the 5% fluoride varnish + Er,Cr:YSGG laser showed the best results compared to the other groups.

Dentin tubule obturation of a bioglass-based dentin desensitizer under repeated exposure to lactid acid and brushing.

BACKGROUND: Dentin hypersensitivity is a frequent finding especially in periodontitis patients. Conventional treatment aims for obstruction of dentin tubules by disabling liquid and osmotic fluctuation to and from the pulpal chamber. A novel bioglass-based desensitizer was shown to obstruct tubules and to resist periodic exposure to lactic acid. Whether this obstruction is resistant to brushing had not been tested so far. Accordingly, the present study aimed to assess dentin tubule obstruction after repeated acid exposure and brushing. METHODS: Sixty dentin discs were cleaned with 17% EDTA, mounted into a pulp fluid simulator and randomly divided into 3 groups: No surface treatment in Group A, Seal&Protect® in group B and DentinoCer in group C. Discs were exposed to 0.1 M non-saturated lactic acid thrice and standardized brushing twice a day for 12 days. At baseline and after 2, 4 and 12 d samples were removed from the setting and prepared for top-view SEM analysis to assess tubule obstruction using the Olley score. Discs were then vertically cut and the section surface morphologically assessed using backscatter imaging. For both vertical and sectional surfaces EDX analysis was used to characterize the surface composition in the tubular and inter-tubular area. RESULTS: Group A showed clean tubular lumina at all time points. From day 2 onwards dentin showed exposed collagen fibers. Group 2 initially showed a complete surface coverage that flattened out during treatment without ever exposing tubules. At baseline, samples of Group C displayed a complete homogeneous coverage. From day 2 on tubules entrances with obstructed lumen became visible. While on day 4 and 12 the dentin surface exposed collagen fibers the lumina remained closed. EDX analysis of the vertical and horizontal views showed that P and Ca were predominant elements in both the inter- and tubular dentin while Si peaks were found in the tubule plugs. CONCLUSION: While group B displayed a packed layer on the surface during the whole investigation time group C samples lost their superficial layer within 48 h. Tubule plugs containing considerable Si proportions indicated previous presence of DentinoCer, while high Ca and P proportions suggest obturation by dentin-like material.

Surface roughness and bacterial adhesion on root dentin treated with diode laser and conventional desensitizing agents.

The treatments for dentin hypersensitivity (DH) may change the surface roughness of the root dentin, which can lead to biofilm accumulation, increasing the risk of root caries. The aim was to compare the surface roughness of root dentin after different treatments of DH and the biofilm formation on those surfaces. After initial surface roughness (Sa) assessment, 50 bovine root fragments received the following treatments (n = 10): G 1-no treatment; G2-5% sodium fluoride varnish; G3-professional application of a desensitizing dentifrice; G4-toothbrushing with a desensitizing dentifrice; and G5-diode laser application (908 nm; 1.5 W, 20 s). The Sa was reevaluated after treatments. Afterward, all samples were incubated in a suspension of Streptococcus mutans at 37 °C for 24 h. The colony-forming units (CFU) were counted using a stereoscope, and the results were expressed in CFU/mL. The one-way ANOVA and the Tukey's tests compared the roughness data and the results obtained on the bacterial adhesion test (α = 5%). G2 (2.3 ± 1.67%) showed similar Sa variation than G1 (0.25 ± 0.41%) and G5 (5.69 ± 0.99%), but different from group G3 (9.05 ± 2.39%). Group 4 showed the highest Sa variation (30.02 ± 3.83%; p < 0.05). Bacterial adhesion was higher in G4 (2208 ± 211.9), suggesting that bacterial growth is greater on rougher surfaces. The diode laser and the conventional treatments for DH may change the surface roughness of the root dentin, but only brushing with desensitizing dentifrice induced a higher bacteria accumulation on root dentin surface.

Evaluation of the effects of Er:YAG laser, Nd:YAG laser, and two different desensitizers on dentin permeability: in vitro study.

The purpose of this in vitro study was to evaluate and compare the efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, PrevDent nano-hydroxyapatite toothpaste plus Repairing Serum Kit (PNH), and NUPRO Sensodyne Prophylaxis Paste with NovaMin (NPP) on dentin permeability reduction. Forty dentin discs obtained from bovine incisors were divided into four study groups: Er:YAG laser-treated (2940 nm; 0.2 W, 80 mJ/pulse, 3 Hz); Nd:YAG laser-treated (1064 nm; 1 W, 10 Hz); PNH-treated; and NPP-treated groups. The quantitative changes in permeability of each dentin disc were measured using a computerized fluid filtration method (CFFM) before and after desensitizer treatments. The data were analyzed using the Wilcoxon, paired-samples t, Kruskal-Wallis, and Mann-Whitney U tests. The dentin surfaces and tubules were also morphologically detected by scanning electron microscopy (SEM). In all groups, dentin permeability was significantly reduced after the desensitizer and laser treatments (p < 0.05). Among the groups, we detected a significant difference in only when comparing the Er:YAG laser- and NPP-treated groups (p = 0.034). SEM analysis revealed physical changes in the dentin surface in all groups. This in vitro study shows that all tested desensitizers and laser treatments reduced dentin permeability. Also, surface changes, such as complete or partial occlusion or shrinkage of dentin tubules, were observed in all groups. Although the laser groups performed best, the PNH protocol can be considered as an alternative therapeutic product. In addition, clinical and laboratory studies should be performed for this product, and their efficacy should be assessed by combined therapy with lasers.

Dentinal tubule sealing effects of 532-nm diode-pumped solid-state laser, gallic acid/Fe3+ complex, and three commercial dentin desensitizers.

The purpose of this study was to compare dentinal tubule sealing effects of a 532-nm diode-pumped solid-state (DPSS) laser, gallic acid/Fe3+ complex, and three commercially available dentin desensitizers. Human premolars (n = 44) extracted for orthodontics had standardized cervical cavities prepared, etched (37% phosphoric acid) and randomly assigned to either a control (n = 4), or one of five treatment groups (n = 8/group). Desensitizing treatments were either a 532-nm DPSS laser, gallic acid/Fe3+ complex, oxalate-based Super Seal™ (SS), DIO™ Enamel Coating Pen Pro Tooth (Dio), or adhesive-type Hybrid Coat™ (HC). Dentinal fluid flow (DFF) was monitored continuously in real time during the application of each desensitizing agent, by using a nanoliter-scaled fluid flow-measuring device. Following treatment, morphological changes on dentinal surfaces and within tubules were observed by scanning electron microscopy (SEM). DFF rates were significantly reduced after treatment in all experimental groups (P < 0.05), except SS (P > 0.05). The gallic acid/Fe3+ complex reduced DFF rates the most, and significantly (P < 0.05) more than the three commercial dentin desensitizers. There were no significant differences in DFF reduction rates between the gallic acid/Fe3+ complex and the DPSS laser groups (P > 0.05). There were no significant differences in DFF reduction rates among the three commercial dentin desensitizers (P > 0.05). SEM examination of treated dentin showed that the degree of occlusion of dentinal tubules correlated closely with the corresponding reduction in DFF rates. The gallic acid/Fe3+ complex and 532-nm DPSS laser were superior to other desensitizing methods in occluding dentinal tubules and reducing DFF rates.

Performance of a bioglass-based dentine desensitizer under lactid acid exposition: an in-vitro study.

BACKGROUND: Dentine hypersensitivity is especially frequent in patients with pronounced periodontal attachment loss. Aim of the treatment is an obstruction of the dentine tubules in order to inhibit liquid or osmotic motion, which is considered as trigger for pain sensations. Novel approaches aim for obstruction by calcium phosphate compounds in order to rely on biocompatible compounds. It was the aim of the study to optically investigate the morphology and to assess the fluid permeability of treated dentine surfaces. METHODS: Dentine discs were pretreated in an ultrasonic bath with 17% EDTA to clean the lumina of the dentine tubules. Samples of group A remained untreated while Seal&Protect® as a conventional desensitizer was applied for group B and DentinoCer in group C. Discs were mounted into a pulp fluid simulator (PFS) with a methylene blue solution in order to create a flow pressure of 0.5 bar. Over 12 d, discs were exposed three times per day to 0.1 M nonsaturated lactic acid. At baseline and after 2, 8 and 12 d samples were removed from PFS and prepared for SEM analysis. Tubule obstruction was assessed quantitatively using Olley scores and by qualitative description of the surface. Absorption spectrometry was used to assess the concentration of leaked methylene blue outside the samples in order to estimate dentine permeability. RESULTS: Untreated discs showed clean lumina of all tubules at all time points and magnifications. From day 2 onwards dentine showed exposed collagene fibers due to acid exposition. Seal&Protect® initially showed homogenous dentine surface coverage that got a more granulomatous aspect in the course of treatment time. Few samples showed sporadic tubules with open lumen at day 8 and 12. Group C showed samples with a homogeneous, even surface. Narrow slits in the superficial layer are visible from day 4 on, but the dentine surface remained invisible and dentine tubules were closed till the end of the investigation period. CONCLUSION: Over 12 d of lactid acid exposure, samples showed complete coverage of the dentine tubules in the chosen in-vitro-model when treated with Seal&Protect® or DentinoCer.

In vitro efficacy of a novel potassium oxalate hydrogel for dentin hypersensitivity.

A novel potassium oxalate-based hydrogel is proposed for treating dentin hypersensitivity and this study evaluates its in vitro performance as a remineralizing, desensitizing agent. Etched disks of human dentin were treated for 10 or 20 min using the test hydrogel, to mimic a professional application with dental mouth guards. Dentin disks were evaluated in terms of permeability indexes in a fluid-filled system, the surface morphology was assessed by scanning electron microscopy, and the structural properties were studied using X-ray diffraction analysis. The potassium oxalate hydrogel significantly reduced dentin permeability, in a time-dependent manner, and occluded most of the patent dentinal tubules via crystal precipitation, forming a remineralized layer. After hydrogel treatments, an acid solution (pH 4.2) was applied to the disks for 30 s, or 1, 2, or 5 min, in order to reproduce a plaque-like oral acidity, and further analysis showed a good resistance of the remineralized layer to the acid challenge. The potassium oxalate-based hydrogel showed a better performance over commercially available products and artificial saliva, appearing a promising candidate for the treatment of dentin hypersensitivity.

The association between Nd:YAG laser and desensitizing dentifrices for the treatment of dentin hypersensitivity.

This study aims to evaluate the association between Nd:YAG laser (with and without a photoabsorber) and two desensitizing dentifrices containing 15% NovaMin or 8% arginine, as potential treatments for dentin hypersensitivity (DH). DH was simulated by EDTA application for 2 min. Specimens were then analyzed with an environmental scanning electron microscope (ESEM) to ensure open dentin tubules (ODT), counted by using ImageJ software. Specimens were randomized into eight groups (n = 10): Laser (L), Laser+Photoabsorber (LP), Arginine (A), Arginine+Laser (AL), Arginine+Laser+Photoabsorber (ALP), NovaMin (N), NovaMin+Laser (NL), and NovaMin+Laser+Photoabsorber (NLP). Laser irradiation was performed with 1 W, 100 mJ, 10 Hz, ≅85 J/cm2; 4 irradiations of 10 s each, with 10 s intervals between them. After treatment, specimens were again analyzed by ESEM and submitted to erosive/abrasive cycling for 5 days. A final ESEM analysis was performed. Data were analyzed with two-way repeated measure ANOVA and Tukey tests (α = 0.05). After treatment, groups N, NL, and NLP presented the lower number of ODT, but they did not different from LP, ALP, and AL. Group A presented the highest number of ODT and it did not differ from group L. Groups L, AL, ALP, and LP presented intermediate results, without differing from each other. After cycling, group A presented the highest number of ODT and did not differ significantly from the other groups, except NLP. None of the associations tested presented better tubule occlusion than NovaMin by itself. Arginine was the only treatment that presented improved tubule occlusion when associated with Nd:YAG laser.

The effect of calcium phosphate-containing desensitizing agent on the microtensile bond strength of multimode adhesive agent.

OBJECTIVE: The aim of this study was to investigate the effect of calcium phosphate containing desensitizing pretreatments on the microtensile bond strength (MTBS) and microleakage of the multimode adhesive agent to dentin. MATERIALS AND METHODS: In this study, twelve noncarious, freshly extracted human third molar teeth for MTBS and 20 premolar teeth for the microleakage test were used. The teeth were restored using Clearfil Universal Bond + Clearfil APX and Teeth mate Desensitizer (TMD). For MTBS test, Group 1: Self-etch, Group 2: Etch and rinse (G1 and 2, nondesensitizer treatment served as a control), Group 3: TMD/self-etch, Group 4: Acid-etch/TMD/etch and rinse. For microleakage test, Class V adhesive cavities (3 mm × 2 mm × 2 mm) were prepared and restored as mentioned before. The restored teeth were subjected to thermal cycling. The MTBS test was performed in all procedures. The MTBS data were submitted to a one-way ANOVA and post hoc Tukey test (P P Results: Control groups exhibited a higher mean MTBS value than TMD groups, and there were statistical differences between the groups. TMD groups also demonstrated significantly less microleakage than control groups (P Conclusions: This study proves that the application of TMD with a multimode adhesive bonding system produced significantly lower MTBS and microleakage.

Di-Calcium Phosphate and Phytosphingosine as an Innovative Acid-Resistant Treatment to Occlude Dentine Tubules.

The present investigation evaluated the ability of an experimental di-calcium phosphate (DCP) desensitising agent used alone or combined with phytosphingosine (PHS) to occlude dentine tubules and resist a citric acid (CA) or artificial saliva (AS) challenge. Three groups of human dentine specimens (DS) were treated with the following: (1) PHS alone, (2) DCP or (3) a combination of PHS and DCP. Dentine hydraulic conductance of DS was evaluated using a digital flow sensor at 6.9 kPa. The average fluid volume for each of the treated DS was used to calculate the total dentine permeability reduction (%P) prior to and following CA immersion for 1 min or AS immersion for 4 weeks. The treated DS were subjected to both scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy analysis. Statistically significant differences (%P) were identified between the groups by ANOVA and Fisher's multiple comparison test (p < 0.05), respectively. Interestingly, both PHS and DCP appeared to work synergistically. DS treated with DCP or PHS/DCP demonstrated a significant reduction (%P) prior to and following CA or AS challenge (p < 0.05). Both the SEM and FTIR analyses showed consistent brushite crystals occluding the dentine tubules. Conversely, the application of PHS alone failed to demonstrate any significant reduction of dentine permeability (p > 0.05) or show any evidence of occlusion of the dentine tubules. DCP can be used alone or combined with PHS to decrease the dentine permeability as well as to resist a CA and AS challenge. These results would, therefore, suggest that DCP may be a suitable treatment option for dentine hypersensitivity.

Effects of desensitizing toothpastes on the permeability of dentin after different brushing times: An in vitro study.

PURPOSE: To investigate the effects of three commercially available desensitizing toothpastes on dentin permeability, and compare the efficacy of each product for reducing dentin permeability in the short term according to the frequency and duration of usage. METHODS: 100 dentin discs with no caries were prepared from freshly extracted human third molar teeth. The dentin discs were brushed with three desensitizing toothpastes or with a non-desensitizing toothpaste and distilled water, which served as control. The 100 dentin slices were randomly divided into two groups (n= 50): one group underwent continuous brushing (brushed for 3 minutes continuously), and the other group underwent discontinuous brushing (brushed three times, each time for 1 minute). Then, the two groups were divided into five subgroups (n = 10) for the five brushing applications. Dentin permeability was measured with a hydraulic permeability system before and after brushing. RESULTS: All desensitizing toothpastes reduced dentin permeability significantly after treatment. Sensodyne Repair and Protect (calcium sodium phosphosilicate) and discontinuous brushing reduced dentin permeability significantly compared with continuous brushing. Dentin permeability values showed no significant difference between the three toothpastes after 3 minutes of continuous brushing. When comparing the three toothpastes under discontinuous brushing conditions after 3 minutes, Sensodyne Repair and Protect (calcium sodium phosphosilicate) reduced dentin permeability significantly. CLINICAL SIGNIFICANCE: Sensodyne Repair and Protect (calcium sodium phosphosilicate) and discontinuous brushing reduced dentin permeability significantly compared with continuous brushing. Moreover, brushing with Sensodyne Repair and Protect (calcium sodium phosphosilicate) resulted in the lowest dentin permeability compared with those of the other two toothpastes. These results indicated that Sensodyne Repair and Protect may relieve dentin hypersensitivity.

A Randomized Clinical Trial Investigating the Effect of Particle Size of Calcium Sodium Phosphosilicate (CSPS) on the Efficacy of CSPS-containing Dentifrices for the Relief of Dentin Hypersensitivity.

OBJECTIVES: To investigate the effect of reducing the particle size of calcium sodium phosphosilicate (CSPS) bioactive glass from ~14 µm (NovaMin®) to ~4 µm (Vitryxx®), and of changing the fluoride source in a 5% CSPS dentifrice from sodium monofluorophosphate (SMFP) to sodium fluoride (NaF) on the efficacy of CSPS-containing dentifrices in dentin hypersensitivity (DH) relief. METHODS: A randomized, controlled, examiner-blind, five-treatment arm, parallel group, stratified, exploratory study of NaF dentifrices containing 2.5% or 5% small particle size CSPS (~4 µm), NaF or SMFP dentifrices containing 5% CSPS (~14 µm), and a regular fluoride dentifrice in healthy subjects with DH. Sensitivity to tactile stimulus (Yeaple probe) and evaporative (air) stimulus (Schiff Sensitivity Scale, visual analogue scale) was assessed at baseline and after one, two, four, and eight weeks' twice-daily treatment. The study was not statistically powered to detect significant between-treatment differences. RESULTS: One hundred thirty-three of 134 randomized subjects completed the study. All treatments showed similar, statistically significant (p < 0.007) improvements in DH compared to baseline at Weeks 2, 4, and 8. No trends favoring any specific treatment were observed. Treatments were generally well tolerated. CONCLUSIONS: The apparent absence of a positive treatment effect for the CSPS-containing dentifrices compared to the regular fluoride dentifrice is inconsistent with other previously reported efficacy studies for CSPS dentifrices.

Calcium sodium phosphosilicate had some benefit on dentine hypersensitivity.

DATA SOURCES: Medline (via Pubmed), Embase, Web of Science, CENTRAL (The Cochrane Library), and the Chinese Biomedical Literature Database. Search strategy was limited to articles published in English and Chinese. No restriction applied to date of publication and a supplemental manual search was conducted by reviewing the reference lists for related paper and articles. Grey literature was also searched in ClinicalTrials.gov, the National Research Register, OpenGrey and the WHO's international clinical Trial Registry Platform. STUDY SELECTION: Randomised controlled trials in humans with DH that compared topical CSPS in any modality and any concentration to a negative (placebo) control. The primary outcome was the DH pain response to routine activities or to thermal, tactile, evaporative or electrical stimuli, and the secondary outcome was the side effect of CSPS use including discomfort, oral hygiene deterioration or dental staining.Data extraction and synthesisStudy selection, data extraction and risk bias assessment were carried out in duplicate by two calibrated reviewers. Any disagreement was resolved via discussion after consulting a third reviewer. Mean differences (MDs) and standard deviations (SDs) were used to summarise data in studies with continuous outcomes. Heterogeneity was assessed using the I(2) test. Meta-analysis was performed when similarities were found among the included studies. The Grading of Recommendations Assessment Development and Evaluation (GRADE) System's Profiler was used to assess the quality of the body of the evidence. RESULTS: Eleven trials were included comparing CSPS with a negative control. Four articles that focused on post-periodontal therapy were extracted as an independent analysis group. CSPS was used in topical administration with concentrations ranging from 2.5%-15%. Follow-up times ranged from 15 days to eight weeks. DH pain was elicited by tactile, evaporative or thermal stimuli. A 10 cm visual analogue scale (VAS) was the most commonly used for measurements. Five studies revealed a low risk of bias, one study had a high risk of bias and five studies had an unclear risk of bias. Seven of the studies were regarded as having a potential conflict of interest.For the primary outcome (DH) Subjects in the DH group (four studies) showed that toothpaste containing 5% CSPS was favoured compared with a negative control at almost every time point, however one study did not report a significant difference between these treatments at two weeks.The results from the from the grey literature (two studies) did not show significant differences between the CSPS and control groups and the results were not in agreement with the other studies. Another study observed effects of both 2.5% and 7.5% CSPS-containing toothpaste: 7.5% CSPS was more effective at relieving DH than a negative control, whereas no significant difference was found between 2.5% and the negative controls.For the secondary outcome (adverse events): six studies did not observe adverse reactions. The remaining studies reported minor adverse events, although most were not orally related.Toothpaste containing 5% CSPS versus negative control: the 5% CSPS-containing toothpaste showed a better desensitising effect at both two and six weeks regardless of the applied stimuli (evaporative, two weeks: MD = -0.68; 95% CIs = -1.15, -0. 20; I2 = 59%; evaporative, six weeks: MD = -1.69; 95% CIs = -1.86, -1.52; I2 = 42%; thermal, two weeks: MD = -0.59; 95% CIs = -1.33, 0.14; I2 = 84%; and thermal, six weeks: MD = -1.70; 95% CIs = -2.17, -1.23;I2 = 72%). The quality of evidence was categorised as 'moderate'.Prophylaxis paste containing 15% CSPS versus negative control: prophylaxis paste containing 15% CSPS showed a better desensitising effect on post-periodontal therapy DH pain than a negative control, immediately after prophylaxis and at four weeks, as determined using evaporative or tactile stimuli, and the results showed relatively low heterogeneity (evaporative, immediate: MD = -0.87; 95% CIs = -1.23, -0.51; I2 = 0%; evaporative, four weeks: MD = -0.93; 95% CIs = -1.11, -0.75; I2 = 41%; tactile, immediate: MD = -9.59; 95%CIs = -12.17, -7.01; I2 = 55%; and tactile, four weeks: MD = -8.34; 95% CIs = -10.87, -5.80; I2 =0%). The quality of evidence was classified as 'low'.The two studies that assessed patients' self-assessments of dentine sensitivity were not pooled because of clinical heterogeneity. CONCLUSIONS: The majority of the studies included in the review found that sodium phosphosilicate was more effective than negative control at alleviating dentine hypersensitivity, used either as toothpaste to alleviate DH or as a prophylaxis paste to treat post-periodontal therapy DH. The review found moderate quality of evidence that 5% CSPS-containing toothpaste is effective for use as an at-home treatment to relieve DH. There is low quality evidence that prophylaxis paste containing 15% CSPS is favoured over a negative control at reducing post-periodontal therapy hypersensitivity. It remains unclear whether concentrations of more than 5% CSPS have increased risk of side effects. The results are based on a small number of clinical trials. Seven of the studies were industry or partially industry-sponsored.

The effect of desensitizing dentifrices on dentin wear and tubule occlusion.

PURPOSE: To evaluate the effect of desensitizing dentifrices on dentin erosive wear, using a 5-day erosion-abrasion-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 (α = 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 then by 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.

Efficacy of different "in-office" desensitizing treatment methods: An in vitro SEM analysis.

PURPOSE: To evaluate, in vitro, the obliteration of dentin tubules promoted by different desensitizing methods, before and after pH cycling. METHODS: Human dentin blocks of 4x4 mm were randomly divided into: control group (n = 20): no treatment; Group GH (n = 20): surface treatment with a solution containing glutaraldehyde (5.1%), HEMA (36.1%), sodium fluoride (NaF), and deionized water; Group NP (n = 20): surface treatment with a calcium phosphate gel containing nanostructured hydroxyapatite crystals, NaF and NK; and Group ARG (n = 20): surface treatment with a paste containing CaCO3 and 8% arginine. After treatment, 10 samples of each group were evaluated in scanning electron microscopy (SEM) while another 10 were included in a pH cycling procedure for 48 hours, and then analyzed in the SEM. All SEM images were evaluated by three calibrated examiners regarding dentin tubular obliteration. Mann-Whitney and Kruskal-Wallis tests were used for data analysis (P < 0.05). RESULTS: The GH, NP, and ARG groups promoted immediate obliteration higher than the control group (P < 0.05) with NP and ARG groups superior to GH group (P < 0.05). After pH cycling, an increase in tubular obliteration in the GH group was observed, which was similar to the NP and ARG groups (P > 0.05), even though all groups promoted higher obliteration than the control group (P < 0.05). All treatments were effective in a tubular obliteration.