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.

Effect of preheating nano-hybrid and bulk-fill composites with warm airstream on their microtensile bond strength to dentin.

Aims: This study assessed the effect of preheating nano-hybrid and bulk-fill composites with warm airstream on their microtensile bond strength (MTBS) to dentin. Materials and Methods: In this in vitro study, dentin was exposed in 42 extracted premolars that were assigned to two groups (n = 21) for bonding to EverX Posterior bulk-fill and Grandio nano-hybrid posterior composite. Each group was subdivided into three subgroups for preheating of composite to 50°C by a commercial composite warmer (Subgroup 1), a warm airstream by a hair dryer for 10 s (Subgroup 2), and no heating (room temperature; Subgroup 3). Composite cylinders with a 4-mm height were bonded to the tooth surface with a 5th-generation bonding agent using the incremental technique and cured (each increment for 30 s). The MTBS to dentin was measured, and the bonding interface was evaluated under a stereomicroscope and a scanning electron microscope (SEM). Data were analyzed using one-way and two-way ANOVA, Tukey's test, and independent t-test (α =0.05). Results: In both composite groups, the mean MTBS of the warm airstream subgroup was significantly higher than that of warmer (P < 0.001) and control (P < 0.001) subgroups. The mean MTBS of the warmer subgroup was significantly lower than that of control subgroup (P = 0.01). The MTBS of the EverX composite was significantly higher than that of the Grandio composite only in the warmer group (P < 0.05). Adhesive failure occurred more frequently in all groups with the highest frequency in airstream subgroup of both composite types. Conclusion: Preheating with a warm airstream significantly increased the MTBS of both composite types to dentin.