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1.
Braz Oral Res ; 33: e115, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939497

RESUMO

The aim of this study was to investigate how Brazilian dentists perceive and manage dentin hypersensitivity (DH) in their clinical routine. A 13-item questionnaire-based survey was developed and sent electronically to a convenience sample of dentists. The questionnaire assessed the personal and dental practice characteristics of the sample, the occurrence of DH in their daily clinical practice, and management strategies. The data were analyzed descriptively and together with the chi-square test (a = 0.05). A total of 353 responses were obtained from September 2017 to March 2018. Of all the respondents, 62% were females, 49.9% reported fewer than five years of dental practice, and 70.5% were self-identified as private practitioners. Most of the dentists reported an estimated frequency (30-60%) of patients with DH in their practice. The most frequently cited (91.79%) trigger of DH was air blast and/or scratching with a probe. The first-choice strategy to manage DH was a dentin desensitizer (48.16%). The number of years in clinical practice did not influence DH relapse frequency (p = 0.76) significantly, or consider DH treatment as a problem (p = 0.22). The present findings indicate that, regardless of clinical experience, dentists in Brazil still consider DH management a challenge in their daily dental practice. In addition, the results suggest that guidelines should be developed to disseminate the available knowledge regarding this condition in ways that may influence decision-making processes among practitioners.


Assuntos
Sensibilidade da Dentina/terapia , Gerenciamento Clínico , Padrões de Prática Odontológica/estatística & dados numéricos , Brasil , Tomada de Decisão Clínica , Dessensibilizantes Dentinários/uso terapêutico , Odontólogos/estatística & dados numéricos , Feminino , Humanos , Masculino , Inquéritos e Questionários
2.
J Appl Oral Sci ; 27: e20180442, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30994776

RESUMO

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.


Assuntos
Polpa Dentária/metabolismo , Incisivo/metabolismo , Oxigênio/metabolismo , Clareadores Dentários/efeitos adversos , Clareamento Dental/efeitos adversos , Adolescente , Adulto , Peróxido de Carbamida/efeitos adversos , Polpa Dentária/efeitos dos fármacos , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/induzido quimicamente , Sensibilidade da Dentina/prevenção & controle , Feminino , Humanos , Peróxido de Hidrogênio/efeitos adversos , Incisivo/efeitos dos fármacos , Masculino , Oximetria/métodos , Valores de Referência , Fatores de Tempo , Clareamento Dental/métodos , Cremes Dentais/uso terapêutico , Resultado do Tratamento , Adulto Jovem
3.
Oral Health Prev Dent ; 17(2): 107-115, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30968066

RESUMO

PURPOSE: To compare the efficacy of a 2.5% w/w smaller particle-size (ca 4 µm) calcium sodium phosphosilicate (CSPS) dentifrice (test) to an occluding dentifrice (8% w/w arginine) (comparator) and a negative control dentifrice in an 8-week, randomised, controlled, parallel-group, stratified (maximum baseline Schiff sensitivity score) study in adults with dentin hypersensitivity. MATERIALS AND METHODS: The sensitivity of two selected teeth was assessed at baseline and after 1, 2, 4 and 8 weeks in response to evaporative (air) (Schiff sensitivity score and visual analogue scale [VAS]) and tactile (tactile threshold) stimuli. RESULTS: Of 151 randomised subjects, 147 completed the study. Statistically significant changes from baseline were reported for test and comparator dentifrices at all weeks on all measures (p < 0.05) with no statistically significant differences between them. The negative control dentifrice group was statistically significantly different from baseline in all measures by week 8 (p < 0.05). Test and comparator dentifrices demonstrated statistically significantly greater improvements in Schiff sensitivity from week 2 compared to the negative control (p < 0.05). There was a statistically significant difference in favour only of the comparator dentifrice over the negative control at week 8 when examining tactile threshold (p = 0.0435) and at week 4 with VAS (p = 0.0425), with no other between-group differences. The dentifrices were generally well tolerated. CONCLUSION: No statistically significant differences were found between a small particle size 2.5% w/w CSPS dentifrice and an 8% w/w arginine dentifrice in terms of a dentine hypersensitivity decrease.


Assuntos
Arginina/uso terapêutico , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Vidro , Cremes Dentais/uso terapêutico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
4.
J Dent ; 83: 1-6, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30710652

RESUMO

OBJECTIVES: To assess the efficacy of 8% arginine containing prophylaxis products over 24 weeks in subjects with dentin hypersensitivity (DH). METHODS: 297 patients with established DH (Schiff score 2, 3) in three European study centers were randomly assigned to either 8% arginine and calcium carbonate in-office prophylaxis paste and the respective toothpaste (test group) or fluoride-free prophylaxis paste and sodium monoflourophosphate toothpaste as a negative control group. Air blast (Schiff Score) and tactile (Visual Analog Scale) sensitivity scores were assessed at baseline (BL_0), after single application of the prophylaxis paste (BL_1) and after 4, 8, and 24 weeks of continuous at-home use of the toothpaste. RESULTS: 273 subjects completed the study. Test and control group presented statistically significant percentage reductions (t-test, p < 0.05) in Schiff Score at BL_1 and at 24 weeks relative to BL_0 (difference in %; test group: -23.6, -44.9, control group: -8.8, -32.7). The pooled Schiff Score for the two evaluated teeth yielded a significantly greater alleviation of DH in the test group than in the control group at all evaluation appointments (Ancova, p < 0.05; difference in %: 15.3, 7.4, 10.6, 17.2). CONCLUSIONS: A significant relief of DH was demonstrated after application of the 8% arginine prophylaxis products over 24 weeks compared to a negative control. CLINICAL SIGNIFICANCE: Whilst DH is influencing patients' eating, drinking and tooth brushing habits as well as social life interactions it is important that clinicians are able to offer evidence based immediate and long-lasting treatment methods in order to manage their patients' discomfort.


Assuntos
Arginina/uso terapêutico , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Carbonato de Cálcio/uso terapêutico , Humanos , Fosfatos , Cremes Dentais , Resultado do Tratamento
5.
J Dent ; 82: 11-21, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30611773

RESUMO

OBJECTIVES: To evaluate the desensitizing effect of nano-hydroxyapatite (n-HAP) on dentine hypersensitivity (DH). SOURCES: Seven electronic databases were searched on April 27, 2018. STUDY SELECTION: Randomized clinical trials (RCTs) were included based on the PICO strategy: Participants - Humans with DH; Intervention - n-HAP-containing desensitizing; Comparison -n-HAP-free treatments or placebo/negative control; and Outcomes - relief of DH. The risk of bias was classified by the Cochrane guidelines. Five meta-analyses were performed to evaluate the efficacy of n-HAP with regard to pain assessment stimuli (primary outcome); comparison of n-HAP with other treatments or placebo/negative control, and effectiveness of at-home and in-office n-HAP use (secondary outcomes). The quality of the evidence was evaluated using the GRADE. DATA: Six RCTs with 4 weeks of follow-up were included in the meta-analysis. For the primary outcome, n-HAP showed a better desensitizing effect for evaporative stimuli (SMD -1.09 [-1.24, -0.94], p < 0.00001) and tactile stimuli (SMD -0.93 [-1.42, -0.43]) than other treatments (p = 0.0002). However, there was no difference between n-HAP and other treatments for the cold stimuli (SMD -0.17 [-0.81, 0.48], p = 0.61). In an overall analysis, n-HAP-containing treatment showing the most significant desensitizing effect (SMD -0.93 [-1.19, -0.68], p < 0.00001) with a high quality of evidence for pooled results. In the secondary outcomes, n-HAP showed the best effect in the overall analysis (p < 0.05) with moderate quality evidence. CONCLUSIONS: The n-HAP-containing treatment showed better clinical performance than other treatments for DH relief. However, long-term follow-up RCTs are required in the future before definitive recommendations can be made. CLINICAL SIGNIFICANCE: Dentin hypersensitivity is a common global condition and its multifactorial etiology has led to the development of several treatments. The n-HAP-containing treatment showed greater DH relief when compared to other desensitizing agents, placebo or negative control.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Durapatita/farmacologia , Humanos , Medição da Dor , Resultado do Tratamento
6.
Oral Health Prev Dent ; 16(5): 439-444, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30460357

RESUMO

PURPOSE: To determine in vitro the protection potential against discolouration of two OTC (over-the-counter) desensitising products on enamel and dentin in comparison to a standard toothpaste and water by means of a spectrophotometer. MATERIALS AND METHODS: A total of 96 samples of bovine enamel-dentin complex and 48 of bovine dentin were alternatively immersed in red wine, tea, coffee or water after having been treated by a sodium monofluorophosphate- and calcium phosphate-based product (Curodont Protect), an amine fluoride-based toothpaste (Elmex Red), a stannous chloride-based toothpaste (Elmex Protection Erosion) or distilled water (negative control). Initial (T0) and final colour (T1, after 4 weeks of immersion in staining solutions) of each specimen were assessed by a spectrophotometer. Statistical analysis was done by means of repeated measures ANOVA followed by Fisher's LSD post-hoc test. Differences between T0 and T1 were considered stastistically significant at p ≤ 0.05. RESULTS: When enamel samples were measured over a black background, ΔE00 values (T0-T1) varied from 2.2 (SD 0.7) for amine fluoride-based product/water to 53.9 (SD 7.6) for amine fluoride-based-product/red wine. When dentin samples were measured over a black background, ΔE00 values (T0-T1) varied from 5.4 (SD 0.9) stannous chloride based product/water to 61.6 (SD 3.7) amine fluoride-based product/red wine. CONCLUSION: Specifically, the application of the sodium monofluorophosphate was able to statistically significantly (p ≤ 0.05) reduce discolouration induced by the staining solutions tested only on the enamel-dentin complex, while distilled water and the stannous fluoride-based product were able to statistically significantly (p ≤ 0.05) reduce discolouration induced by the staining solutions tested in pure dentin samples.


Assuntos
Dessensibilizantes Dentinários/uso terapêutico , Descoloração de Dente/prevenção & controle , Cremes Dentais/uso terapêutico , Fosfatos de Cálcio/uso terapêutico , Café , Esmalte Dentário/diagnóstico por imagem , Dentina/diagnóstico por imagem , Fluoretos/uso terapêutico , Humanos , Técnicas In Vitro , Medicamentos sem Prescrição , Fosfatos/uso terapêutico , Espectrofotometria , Chá , Compostos de Estanho/uso terapêutico , Descoloração de Dente/diagnóstico por imagem , Vinho
7.
Stomatologiia (Mosk) ; 97(5): 11-18, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30346414

RESUMO

The aim of the study was to increase the effectiveness of treatment hyperesthesia of tooth tissues by improving medical and hygienic complexes based on the study of structural changes in dentin. A two-stage study was conducted. In the course of the experimental stage, the microstructure of the tooth dentin surface was studied in terms of its relief on an atomic force microscope in normal conditions, with hypersensitivity and under the influence of the studied preparations (Gluma Desensitizer, Tokuyama Shield Force Plus, Colgate SensitivePro-Relief, Biorepair Oral Care), the material for studing was human teeth with hypersensitive dentin (100) of 1-2 degrees and 25 teeth without hyperesthesia (control group). In the groups for the clinical study were included 100 people with localized hyperesthesia of teeth I-II degree, which, depending on the medical-hygienic complexes used, were divided into 2 groups, 4 subgroups of 25 people. The clinical efficacy of the proposed treatment regimens was assessed using indices: Schiff sensitivity, NRS pain scale, tooth hyperesthesia intensity and prevalence, OHI-S hygiene index in dynamics (before and after treatment, at 3 and 9 months). As a result of the in vitro experiment it was established that after the use of professional desensitizers, the roughness parameters of teeth with hypersensitivity approach the values of a healthy tooth, and after using home remedies there is no qualitative change in the surface. In clinical conditions, it was found that the means for professional use have a significant effect of reducing the sensitivity of teeth, the subsequent treatment of hyperesthesia of the teeth at home is necessary to achieve a stable result. The obtained results allowed to optimize the pathogenetic treatment regimens for dentine hypersensitivity and to integrate the developed medical-hygienic complexes.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Hiperestesia , Dentina , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Humanos , Fluoreto de Sódio
8.
Am J Dent ; 31(4): 177-183, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30106532

RESUMO

PURPOSE: To evaluate the effect of desensitizing dentifrices on dentin wear and tubule occlusion using a three-phase, single blind, crossover in situ trial. METHODS: The dentifrices containing Arginine and calcium carbonate (1,450 ppmF) and Novamin, (~1,426 ppmF) were tested in two conditions: A: abrasion and B: erosion/abrasion. A dentifrice without desensitizing agents was used as control (1,450 ppmF). In each study phase, 10 volunteers used intra-oral appliances containing dentin specimens (pre-treated with EDTA, to simulate hypersensitive dentin), which were either submitted to erosion with a cola-like drink (pH 2.6), 4×/day (2 minutes), followed by toothbrushing, using electric toothbrushes, with standard pressure (2×/ day, 5 seconds), or toothbrushing only. Dentin surface loss (SL, in µm) was determined with optical profilometry at the 3rd and 5th days of cycling. Dentin surface was analyzed with environmental scanning electron microscopy (ESEM), post EDTA and post cycling, and the dentin tubules were counted using Image J software. Data were statistically analyzed (α= 0.05). RESULTS: For condition A and B, there were no significant differences in SL among toothpastes in both experimental times. There were also no significant differences between times within groups. For ESEM, in A, Toothpaste with Novamin was the only dentifrice that showed significantly less opened tubules post cycling than post EDTA. In B, Toothpaste with Novamin and control toothpaste presented less opened tubules post cycling. In conclusion, toothbrushing with the tested dentifrices promoted similar levels of dentin loss; however, for tubule occlusion, the toothpaste with Novamin was the only toothpaste effective for both conditions, abrasion and erosion/abrasion. CLINICAL SIGNIFICANCE: Ideally, desensitizing dentifrices should promote obliteration of the dentin tubules or nerve desensitization, without further contributing to the progression of dentin wear.


Assuntos
Dentifrícios , Dessensibilizantes Dentinários , Sensibilidade da Dentina , Erosão Dentária , Dentina , Dessensibilizantes Dentinários/uso terapêutico , Humanos , Método Simples-Cego , Escovação Dentária , Cremes Dentais
9.
Am J Dent ; 31(4): 189-194, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30106534

RESUMO

PURPOSE: To quantify dentin tubule occlusion and correlate this with pain reduction in vivo. METHODS: This was a single-center, randomized two treatment, examiner-blind, parallel study. 20 participants with confirmed dentin hypersensitivity (DH) were evaluated by Schiff Air Blast, VAS Air Blast and replica impression of the tooth surface to visualize tubule occlusion at baseline and following 4-week twice daily use of either an occluding toothpaste (8% strontium acetate, 1,040 ppm fluoride) or a non-occluding toothpaste (1,450 ppm fluoride). RESULTS: Both treatments increased tubule occlusion significantly from baseline to 4 weeks (P= 0.01) with significant decreases in pain score only seen with the occluding toothpaste (Schiff, P= 0.01; VAS, P= 0.01). Schiff pain score after 4 weeks was markedly reduced following treatment with the occluding toothpaste as compared to the non-occluding toothpaste, (P= 0.05) with no significant differences between the pastes for occlusion score or patient reported VAS, although the scores favored the occluding toothpaste. CLINICAL SIGNIFICANCE: Occlusion scores as obtained by replica impression techniques with SEM imaging correlate significantly with DH pain scores confirming proof of concept. With further refinement, this technique could be used to accurately quantify tubule occlusion in vivo and the associated pain reduction achieved by occluding toothpastes.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Dentina , Manejo da Dor , Arginina , Carbonato de Cálcio , Dessensibilizantes Dentinários/uso terapêutico , Fluoretos , Humanos , Dor , Fosfatos , Escovação Dentária , Cremes Dentais , Resultado do Tratamento
10.
Niger J Clin Pract ; 21(8): 1029-1033, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30074006

RESUMO

Aim and objectives: The aim and the objectives were. (1) to assess the efficacy of a desensitizing toothpaste containing 8.0% arginine-calcium carbonate (Colgate® Sensitive Pro-Relief™), (2) to assess the efficacy of a desensitizing toothpaste containing 8.0% arginine-calcium carbonate (Colgate® Sensitive Pro-Relief™) used in combination with iontophoresis, and (3) to compare the effectiveness of the above methods. Subjects and Methods: Two groups of 40 patients each having dentinal hypersensitivity were treated using 8% proarginine and iontophoresis. The patients were recalled after 1, 2, and 4 weeks. The scores were tabulated and the results were analyzed using SPSS statistical software. Results: Visual analog scale between the two groups showed a significant difference from the 1st week till the 4th week. ANOVA values showed the reduction in the dentinal hypersensitivity in Group 2 using the iontophoresis along with the 8.0% arginine-calcium carbonate toothpaste. The Cochran-Mantel-Haenszel correlation test of the Schiff's dentinal hypersensitivity cross-tabulation showed P < 0.001 which was statistically significant reduction after the 4th week following the application of 8.0% arginine-calcium carbonate along with iontophoresis. Conclusion: Iontophoresis, when used along with Colgate® Sensitive Pro-Relief™ toothpaste, can provide additional benefit as this provides a better sealing effect.


Assuntos
Arginina/uso terapêutico , Carbonato de Cálcio/uso terapêutico , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Iontoforese , Fluoreto de Sódio/uso terapêutico , Cremes Dentais/uso terapêutico , Adulto , Idoso , Arginina/administração & dosagem , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Método Simples-Cego , Fluoreto de Sódio/administração & dosagem , Escovação Dentária , Cremes Dentais/química , Resultado do Tratamento
11.
Am J Dent ; 31(3): 135-140, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30028931

RESUMO

PURPOSE: To evaluate the effectiveness in reducing dentin hypersensitivity (DH) of a commercial toothpaste containing 8% arginine, calcium carbonate and fluoride when applied by a dental professional immediately prior to a professional dental prophylaxis and again after subjects brushed twice daily with the toothpaste at home for 2 weeks, and additionally to assess whether the % reductions in DH observed in the study are comparable to those found in previously published pivotal studies. METHODS: This clinical study was a single-center, user-blind, monadic study conducted in Mississauga, Canada. Adult subjects who presented with a tactile hypersensitivity score (Yeaple Probe) between 10 and 50 grams of force and an air blast hypersensitivity score of 2 or 3 (Schiff Cold Air Sensitivity Scale) and met all inclusion and exclusion criteria were entered into the study. Immediately following baseline assessment, qualifying subjects received a single topical application of the test toothpaste to two selected hypersensitive teeth by a dental professional using a fingertip and massage for 1 minute per tooth, after which they received a professional dental prophylaxis. Subjects then brushed at-home twice daily for 1 minute with their assigned toothpaste for a period of 2 weeks. Tactile and air blast sensitivity examinations were conducted after the dental cleaning procedure and again after 2 weeks of routine twice daily tooth brushing. RESULTS: 39 subjects complied with the protocol and completed the clinical study. Immediately post-prophylaxis, subjects exhibited statistically significant reductions from baseline of 228.9% (P< 0.001) in tactile hypersensitivity and 48.9% (P< 0.001) in air blast hypersensitivity. Furthermore, after brushing twice daily (morning and evening) for a period of 2 weeks, subjects exhibited statistically significant reductions from baseline of 317.8% (P< 0.001) in tactile hypersensitivity and 90.1% (P< 0.001) in air blast hypersensitivity. These results are consistent with the results of previously published clinical studies, which demonstrated similar % reductions in DH to a single in-office professional application of the desensitizing prophylaxis paste and to a single direct topical self-application of the desensitizing toothpaste. CLINICAL SIGNIFICANCE: The results of this clinical study, together with the results of published pivotal studies, demonstrate that a desensitizing toothpaste containing 8% arginine and calcium carbonate, with or without fluoride, provides statistically significant reductions in dentin hypersensitivity when applied by a dental professional prior to a professional dental prophylaxis. The results also demonstrate that this desensitizing toothpaste provides statistically significant reductions in dentin hypersensitivity when used subsequently as an adjunct to routine twice daily tooth brushing.


Assuntos
Arginina , Carbonato de Cálcio , Dessensibilizantes Dentinários , Sensibilidade da Dentina , Cremes Dentais , Adulto , Ar , Arginina/uso terapêutico , Carbonato de Cálcio/uso terapêutico , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Método Duplo-Cego , Fluoretos , Seguimentos , Humanos , Fosfatos , Fluoreto de Sódio , Escovação Dentária , Resultado do Tratamento
12.
J Dent ; 76: 125-131, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29981778

RESUMO

OBJECTIVES: To evaluate the ability of a modified in situ model to differentiate dentinal tubule occlusion properties of toothpaste formulations over 10 days of treatment. METHODS: This was a single-centre, three-treatment period, crossover, randomised, single-blind study with healthy participants wearing two lower oral appliances, each retaining four dentine samples, for 10 treatment days during each period of the study. Samples were power-brushed ex vivo twice on each treatment day with a Test toothpaste containing 0.454% stannous fluoride, a Control fluoride toothpaste containing 0.76% sodium monofluorophosphate, or mineral water. Dentine samples were subjected to in situ acid challenge (orange juice) on Days 9 and 10. Scanning electron microscopy images obtained at baseline and after 1, 4, 8 and 10 days of treatment were graded for degree of surface coverage by four calibrated examiners; the primary study endpoint was Day 8. RESULTS: After 4, but not 8, days' treatment, the degree of tubule occlusion increased in the dentine samples treated with the Test or Control toothpastes compared with the water-treated samples (p < 0.01 and p < 0.05, respectively). Following the acid challenge (Day 10), there was a statistically significantly greater degree of occlusion in the Test toothpaste-treated dentine samples compared with those treated with water (p < 0.01). No other comparisons were statistically significant. All study treatments were generally well-tolerated. CONCLUSIONS: This modified in situ model was unable to demonstrate statistically significant between-treatment differences in dentinal tubule occlusion after 8 days. Conversely, there are recognised developments that could be made to better identify product differences. Clinicaltrials.gov: NCT02768194. CLINICAL SIGNIFICANCE: Dentine hypersensitivity can be managed through brushing with stannous fluoride toothpastes, which occlude patent dentine tubules. Clinical studies measure pain but in situ models are needed to demonstrate occlusion intra-orally. However, this study did not demonstrate superior occlusion with stannous toothpaste; further methodological development is required to investigate its mode of action.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Dentina , Cremes Dentais , Adulto , Dentina/efeitos dos fármacos , Dentina/ultraestrutura , Dessensibilizantes Dentinários/farmacologia , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Feminino , Humanos , Masculino , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Método Simples-Cego , Fluoretos de Estanho/farmacologia , Cremes Dentais/química , Cremes Dentais/farmacologia , Cremes Dentais/uso terapêutico , Resultado do Tratamento , Adulto Jovem
13.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 36(3): 301-307, 2018 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-29984933

RESUMO

OBJECTIVE: This systematic review and Meta-analysis aimed to compare the efficacy of calcium sodium phos-phosilicate (CSPS) and potassium nitrate as desensitizing agents for the treatment of dentin hypersensitivity (DH). METHODS: A thorough search in The Cochrane Library, PubMed, Embase, Chinese WanFang Data, CBM, and CNKI were conducted for studies published up to June 2017. Randomized controlled trials (RCTs) of the treatment of DH with CSPS and potassium nitrate toothpaste were included. Quality assessment and data extraction were performed by two reviewers independently, and Meta-analysis was performed by using RevMan 5.3 software. RESULTS: Eight RCTs involving 411 patients were included. Experimental group comprised 203 and control group had 208 patients. The Meta-analysis indicated the superior effect of CSPS dentifrice on air blast sensitivity at 2, 4, 6, and 8 weeks of follow-up [SMD=-1.85, 95%CI (-2.89, 
-0.81), P=0.000 5, I²=93%], [SMD=-1.61, 95%CI (-1.96, -1.26), P<0.000 01, I²=49%], [SMD=-3.79, 95%CI (-7.18, -0.40), P=0.03, I²=98%], and [SMD=-2.13, 95%CI (-2.69, -1.58), P<0.000 01] , respectively. No significant effects were seen at 12 weeks [SMD=-0.63, 95%CI (-1.47, 0.20), P=0.14, I²=71%]. CSPS dentifrice showed a better desensitizing effect at 2, 4, 6, 8, and 12 weeks of follow-up on cold water sensitivity [SMD=-1.07, 95%CI (-1.48, -0.66), P<0.000 01, I²=69%], [SMD=
-1.29, 95%CI (-1.81, -0.76), P<0.000 01, I²=64%], [SMD=-1.20, 95%CI (-1.57, -0.83), P<0.000 01, I²=86%], [SMD=-1.30, 95%CI (-2.51, -0.08), P=0.04, I²=82%], and [SMD=-0.79, 95%CI (-1.27, -0.31), P=0.001], respectively. No significant effects at 1 week of follow-up [SMD=0.00, 95%CI (-0.62, 0.62), P=1]. The favorable effect of CSPS dentifrice on tactile sensitivity was more obvious than the control group at 2, 4, and 8 weeks of follow-up [SMD=-1.31, 95%CI (-2.00, -0.62), P=0.000 2, I²=67%], [SMD=-1.37, 95%CI (-1.74, -0.99), P<0.000 01, I²=23%], and [SMD=-1.33, 95%CI (-1.82,-0.84), P<0.000 01], respectively. No significant effects at 1 week of follow-up [SMD=-0.32, 95%CI (-0.94, 0.31), P=0.32] were observed. CONCLUSIONS: Current evidence indicated that CSPS was more effective than potassium nitrate at reducing DH. The evidence generated by this review was based on a small number of individuals. High-quality and large sample size as well as ideally-designed clinical trials are required in the future before definitive recommendations can be made.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Nitratos , Compostos de Potássio , Cremes Dentais , Cálcio , Dessensibilizantes Dentinários/uso terapêutico , Vidro , Humanos , Nitratos/uso terapêutico , Compostos de Potássio/uso terapêutico , Sódio
14.
J Dent ; 72: 64-70, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29551346

RESUMO

OBJECTIVES: Desensitizing agents are usually included in the composition of bleaching agents to reduce bleaching-induced tooth sensitivity (TS). This randomized clinical trial (RCT) evaluated the risk and intensity of TS and color change after at-home bleaching with a desensitizing-containing (3% potassium nitrate and 0.2% sodium fluoride) and desensitizing-free 10% carbamide peroxide (CP) gel (Whiteness Perfect, FGM). METHODS: A triple-blind, within-person RCT was conducted on 60 caries-free adult patients. Each participant used the gel in a bleaching tray for 3 h daily for 21 days in both the upper and lower dental arches. The absolute risk and intensity of TS were assessed daily through the 0-10 VAS and NRS scale for 21 days. Color change was recorded using shade guides (Vita Classical and Vita Bleachedguide) and the Easyshade spectrophotometer at baseline, weekly and 30 days after the end of the bleaching. The risk and intensity of TS were evaluated by the McNemar and Wilcoxon Signed Rank tests, respectively. Color change (ΔSGU and ΔE) were evaluated by the Mann-Whitney test and a paired t-test, respectively (α = 0.05). RESULTS: No difference in the TS and color change was observed (p > 0.05). CONCLUSIONS: The incorporation of potassium nitrate and sodium fluoride in 10% carbamide peroxide at-home bleaching gel tested in this study did not reduce the TS and did not affect color change (RBR-4M6YR2).


Assuntos
Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/prevenção & controle , Clareadores Dentários/efeitos adversos , Clareamento Dental/efeitos adversos , Adolescente , Adulto , Peróxido de Carbamida/efeitos adversos , Cor , Sensibilidade da Dentina/etiologia , Feminino , Humanos , Peróxido de Hidrogênio/efeitos adversos , Masculino , Pessoa de Meia-Idade , Nitratos/uso terapêutico , Compostos de Potássio/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Espectrofotometria , Clareamento Dental/métodos , Descoloração de Dente , Adulto Jovem
15.
Oper Dent ; 43(5): 472-481, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29570018

RESUMO

OBJECTIVE: To evaluate the risk and intensity of bleaching-induced tooth sensitivity (TS) after in-office bleaching following topical application of a resin-based glutaraldehyde desensitizer. METHODS: Thirty-three patients were randomly assigned to the experimental (Gluma Desensitizer Liquid, Heraeus Kulzer, Hanau, Germany) and placebo groups. The placebo or Gluma Desensitizer Liquid was applied for one minute prior to application of an in-office bleaching gel. Bleaching was performed with 35% hydrogen peroxide gel (three applications × 15 minutes each) over two sessions, one week apart. The color of the anterior teeth was evaluated before and 21 days after treatment using the VITA Classical shade guide, Bleachedguide 3D, and Easyshade spectrophotometer. TS during and after the bleaching was recorded according to the visual analog (VAS) and numerical rating (NRS) scales. All data were submitted to statistical analysis (α=0.05). RESULTS: There was no significant difference in absolute risk or intensity of TS between the two groups (risk and VAS, p=0.93 and 0.31, respectively; NRS, p≥0.45). At the end of the bleaching protocol, tooth whitening was observed in both groups, as evident from color change in shade guide units (ΔSGU, 4.1-7.1; both guides) and overall color change (ΔE, 7.4-9.3 units); however, there were no significant differences in whitening between the two groups ( p>0.11). CONCLUSION: Gluma Desensitizer Liquid was not able to reduce the risk or intensity of TS. Bleaching efficacy was not affected by application of the desensitizer.


Assuntos
Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Glutaral/uso terapêutico , Ácidos Polimetacrílicos/uso terapêutico , Clareamento Dental/efeitos adversos , Adolescente , Adulto , Sensibilidade da Dentina/induzido quimicamente , Sensibilidade da Dentina/prevenção & controle , Feminino , Humanos , Masculino , Método Simples-Cego , Clareamento Dental/métodos , Clareadores Dentários/efeitos adversos , Clareadores Dentários/uso terapêutico , Adulto Jovem
16.
Lasers Med Sci ; 33(6): 1237-1244, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29455306

RESUMO

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.


Assuntos
Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Ácido Gálico/química , Ferro/química , Lasers de Estado Sólido/uso terapêutico , Dentina/efeitos dos fármacos , Dentina/ultraestrutura , Dessensibilizantes Dentinários/farmacologia , Líquido Dentinal/efeitos dos fármacos , Líquido Dentinal/efeitos da radiação , Humanos
17.
J Appl Oral Sci ; 26: e20160473, 2018 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-29412363

RESUMO

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. 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). 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. 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.


Assuntos
Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/induzido quimicamente , Sensibilidade da Dentina/prevenção & controle , Etodolac/uso terapêutico , Peróxido de Hidrogênio/efeitos adversos , Clareadores Dentários/efeitos adversos , Clareamento Dental/efeitos adversos , Adolescente , Adulto , Cor , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Feminino , Humanos , Masculino , Medição da Dor , Reprodutibilidade dos Testes , Medição de Risco , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
18.
Indian J Dent Res ; 29(1): 51-55, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29442087

RESUMO

Objectives: This randomized clinical trial tested the effect of three different desensitizing agents on reduction of pain due to hypersensitive cervical dentin lesions. Materials and Methods: Twenty-eight individuals with 84 teeth diagnosed with cervical dentin hypersensitivity (DH) in at least one tooth in any three of the four quadrants were selected. Patients exhibiting pain scores of two or more on the visual analog scale (VAS) were included in the study. Each quadrant in an individual was randomly assigned to one of the three treatment groups based on computer-generated random number. The desensitizing agents used were Profluorid Varnish (Voco: Cuxhaven Germany), Admira Protect (Voco: Cuxhaven Germany), and PRG-Barrier Coat (Shofu: japan). One operator recorded the baseline sensitivity scores after evaporative and tactile stimuli by visual analog score system. The second operator who was not aware of the baseline values applied the desensitizing agents and recorded the sensitivity scores. VAS scores for both the stimuli were noted immediately after application, 1 week, and after 1 month. The data were analyzed using repeated measure ANOVA and post hoc Tukey's multiple comparison tests (P < 0.05 was considered statistically significant). Results: There was a significant reduction in VAS scores from baseline in all the three groups at all the time intervals (P < 0.001). Admira Protect showed significant reduction of hypersensitivity scores at 1 month compared to other groups (P < 0.001). Conclusion: Admira Protect was proved to be better in reducing pain due to DH than PRG-Barrier Coat and Profluorid Varnish after 1 month of application.


Assuntos
Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Adolescente , Adulto , Humanos , Pessoa de Meia-Idade , Medição da Dor , Adulto Jovem
19.
Clin Oral Investig ; 22(2): 617-631, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29330655

RESUMO

OBJECTIVE: The aim of this review is to conduct a systematic review and meta-analysis comparing the effectiveness of in-home or in-office treatments for dentin hypersensitivity. MATERIALS AND METHODS: An electronic search without restriction on dates or languages was performed in four electronic databases until March 2017. In addition, hand-searches in regular journals and in the gray literature were also conducted. To develop the search strategy, clinical questions were formulated using the PICOS method. Eligibility criteria included randomized clinical trials (RCTs) that compared the effectiveness of different agents for the treatment of dentin hypersensitivity through chemical occlusion, physical occlusion, nerve desensitization, or photobiomodulation (low-level light therapy). This systematic review was registered in PROSPERO under number CRD42016039394. RESULTS: Twenty-five RCTs (16 parallel; 9 split-mouth), published from 1992 to 2016, were included. The results of the meta-analysis showed that in-office subgroups treated with chemical or physical occlusion of dentin tubules and nerve desensitization had a statistically significant difference from placebo, with P < 0.00001, P < 0.00001, and P = 0.02, respectively. For in-home treatments, the results of the meta-analysis showed that only those subgroups treated with chemical occlusion of dentin tubules and nerve desensitization exhibited a statistically significant difference from placebo, with P < 0.00001 and P = 0.03, respectively. CONCLUSIONS: The results of pairwise meta-analysis suggest that among in-office treatments, dentinal tubule occlusion (whether chemical or physical) and nerve desensitization provide the best outcomes for treatment of dentin hypersensitivity. For in-home treatments, only chemical occlusion of dentin tubules and nerve desensitization showed a greater treatment efficacy than placebo and the difference was statistically significant.


Assuntos
Sensibilidade da Dentina/terapia , Desmineralização do Dente/terapia , Dessensibilizantes Dentinários/uso terapêutico , Humanos , Terapia com Luz de Baixa Intensidade
20.
Int J Dent Hyg ; 16(2): e79-e87, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28925034

RESUMO

OBJECTIVES: The purpose of this study was to determine the efficacy of 3.14% dipotassium oxalate monohydrate-containing strip on the relief of dentinal hypersensitivity (DH). A second objective was to determine whether there was a difference in DH levels when the strip was self-applied vs applied by a dental professional. METHODS: Sixty subjects were randomized into self-applied, professionally applied or placebo-strip groups. Dentinal hypersensitivity was evaluated by a blinded examiner, using the Schiff Air Scale (SAS). A verbal rating scale (VRS) was also used to measure the subjects' perception of pain. Measures were taken at baseline, 30 minutes, 4 and 8 weeks post-treatment. RESULTS: There was a significant reduction in DH in all three groups (P ≤ .05) at 30 minutes and 8 weeks post-treatment. At the 4-week follow-up, only the self- and professionally applied (active ingredient) groups had a significant reduction in DH compared to baseline. When comparing the reduction in DH levels between groups, the only significant difference occurred between the professionally applied treatment group and the placebo group at the 4-week follow-up. There were no significant differences in DH reduction levels achieved between the self- and professionally applied groups (P > .05). CONCLUSIONS: This study confirmed the short-term (4 weeks) effectiveness of a single application of 3.14% dipotassium oxalate monohydrate-containing strip. Self- and professional application were not shown to be different.


Assuntos
Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Oxalatos/uso terapêutico , Administração Tópica , Adulto , Dessensibilizantes Dentinários/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Minnesota , Oxalatos/administração & dosagem , Medição da Dor , Resultado do Tratamento
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