A novel treatment based on powder jet deposition technique for dentin hypersensitivity: a randomized controlled trial.

BACKGROUND: This study aimed to evaluate the efficacy and safety of dentin hypersensitivity (DH) treatment using a newly developed device based on a powder jet deposition (PJD) technique that creates a hydroxyapatite (HAP) layer on the dentin surface, thereby alleviating the hypersensitivity. The effect of the PJD treatment was compared with that of conventional treatment using Teethmate Desensitizer (TMD; calcium-phosphate containing material with TTCP (Ca4(PO4)2O) and DCPA (CaHPO4)), which has been used clinically in Japan with well-confirmed effectiveness. MATERIALS AND METHODS: A randomized controlled trial was conducted including 35 patients who had symptoms of DH in two or more quadrants. Two test teeth were selected per patient (70 teeth in total) and randomly assigned to PJD or TMD treatment. The efficacy was evaluated using the improvement rate for air and scratch pain according to the scores obtained via visual analog scale 12 weeks after treatment. The safety assessment was performed focusing on gingival index (GI) and spontaneous pain. The t-test was used to analyze the non-inferiority of PJD treatment compared to TMD treatment. RESULTS: The improvement rate of air pain was 69.0% for PJD and 69.7% for TMD. The improvement rate of scratch pain was 80.8% for PJD and 81.7% for TMD. Non-inferiority with a margin of 10% was not observed for both air and scratch pain. No change was observed in GI from baseline and the improvement rate of spontaneous pain for PJD was higher than that for TMD. CONCLUSION: Non-inferiority of PJD to TMD treatment was not observed in this study; however, it was not statistically demonstrated, and the results were thus interpreted as inconclusive. PJD did improve the DH symptoms, as did TMD. PJD's therapeutic effect was most likely attributable to the deposition of a HAP layer on the tooth surface, which would alleviate hypersensitivity for at least 12 weeks without causing severe adverse events. TRIAL REGISTRATION: UMIN-CTR. ID: UMIN000025022. date: 02/12/2016.

Clinical Evaluation of Monolithic Zirconia Crowns: A Short-Term Pilot Report.

PURPOSE: This study aimed to prospectively evaluate the clinical performance of monolithic zirconia crowns made of yttria-stabilized tetragonal zirconia polycrystal. MATERIALS AND METHODS: A total of 26 crowns placed on premolar or molar teeth in 18 patients were evaluated at the time of crown placement and at 2 weeks, 6 months, 1 year, and 2 years after placement. RESULTS: Twenty-five crowns rated as satisfactory according to the California Dental Association quality evaluation system. Most of the abutment and antagonist teeth showed good periodontal condition. An enamel cracking occurred on one antagonist tooth 1 year after placement. CONCLUSION: Monolithic zirconia crowns can be a clinically acceptable prosthetic option.

Evaluation of thermal stress in hydroxyapatite film fabricated by powder jet deposition.

This study aimed to create a thick hydroxyapatite (HA) film on the surface of a human tooth via a powder jet deposition (PJD) device for dental handpieces, and to examine the microstructural and mechanical properties of the HA film. In particular, the effects of thermal stress on this film were evaluated. The HA film was created by blasting 3.18-µm HA particles, calcinated at 1,200°C, onto the enamel substrate at room temperature and atmospheric pressure. An HA film with an area of 3 mm × 3 mm was prepared and polished. The following HA film parameters were evaluated from the three-dimensional surface profile: surface roughness, Vickers hardness, and bonding strength before and after artificial aging induced by 500 cycles of thermal cycling (5-55°C). The HA particles in the deposited film were densely packed, and the surface of the HA film was unchanged after thermal cycling. There were also no significant differences in the hardness and the bonding strength of the HA film before and after thermal cycling. The HA film created in this study demonstrated excellent microstructural and mechanical properties, even after the application of thermal stress.

Effect of hydroxyapatite film formed by powder jet deposition on dentin permeability.

A powder jet deposition (PJD) process can be used to create a thick hydroxyapatite (HA) film on the surface of a human tooth. This study aimed to investigate in vitro the ability of an HA film, applied using PJD, to diminish dentin permeability. Discs of human coronal dentin were cut perpendicular to the tooth axis and the smear layer was removed by EDTA treatment. The HA film was created by accelerating HA particles, calcinated at 1200°C, onto the dentin discs at room temperature and atmospheric pressure. The surfaces and cross-sections of the HA PJD-treated samples were observed using scanning electron microscopy. Their permeability was indirectly recorded with a split-chamber device utilizing a chemiluminescence technique. MS-coat, a commercial dentin-desensitizing agent, was also evaluated for its effect on reducing liquid flow through the dentin. The scanning electron microscopy images showed that the HA particles were successfully deposited onto the dentin and solidly into the dentin tubules. The permeability of dentin after application of the HA films was significantly lower than that following application of MS-coat. This study showed the potential clinical application of PJD techniques in desensitizing dentin hypersensitivity.

Characteristics of hydroxyapatite film formed on human enamel with the powder jet deposition technique.

This study aimed to create hydroxyapatite (HAp) film by powder jet deposition with manipulating the blasting nozzle above human enamel and to examine the microstructural and mechanical properties of the HAp film and the bonding strength at the interface between the HAp film and the enamel substrate. HAp particles calcinated at 1200°C with an average size of 4.7 µm were used. The HAp particles were mixed with carrier gas (N2) to form an aerosol flow and was accelerated and blasted from the nozzle onto the enamel substrate at room temperature and atmospheric pressure. To evaluate the microstructure, scanning electron microscope (SEM) images of the surface and cross section of the HAp films and a three-dimensional profile of the HAp films were observed. To evaluate the mechanical properties, the micro-Vickers hardness and the bonding strength of the HAp films to the enamel substrate were measured. The deposition area of the HAp film was over 3 × 4 mm. The average and maximum thickness were about 30 and 40 µm, respectively. No significant difference was observed between the hardness of the HAp film and the enamel (p > 0.05). The bonding strength of the HAp film was the same as the bonding strength between composite resin and enamel. Compared with previous reports, wider and thicker HAp film was created on the enamel substrate successfully. The HAp film, which has same hardness with enamel and same bonding strength to the enamel with composite resin, would be a candidate as dental restorative materials.