Reduction in dentin permeability using mildly supersaturated calcium phosphate solutions

Obliterating potential of active products for dentin hypersensitivity treatment under an erosive challenge

OBJECTIVES

To compare the effect of 5 desensitizing agents on the hydraulic conductance (Lp) of dentin and to analyze its surface under a Laser Scanning Confocal Microscope (LSCM) before and after an erosive challenge.

METHODS

Lp was analyzed in the following sequence: in the presence of smear layer (pMin), after a 15-second acid etching (pMax), after treatment with a desensitizing agent (pTreat) and after a 1-minute erosive challenge (6% citric acid - pEro). Fifty 1.0 ± 0.2 mm-thick dentin disks were prepared from sound human third molars and were randomly distributed into 5 groups (n = 10): FG-Fluoride gel (control), SA-Sensiactive, PR-Sensitive Pro-Relief, NP-Desensibilize Nano-P and EV-Enamel Pro Varnish. Data were analyzed by two-way ANOVA and Tukey tests (α<0.05). Additional specimens were analyzed under a Laser Scanning Confocal Microscope (LSCM) and by Energy Dispersive X-ray Spectroscopy (EDS).

RESULTS

All materials reduced the Lp in some extent, except for FG and EV. After the erosive challenge, SA was the only material effectively able to keep the same Lp of the post-treatment phase, while the other products showed lower resistance upon an erosive challenge. Under the LSCM, the SA and NP materials were more effective to obliterate the opened dentin tubules and demonstrated higher resistance upon an erosive challenge. The EDS analysis evidenced levels of Ca, O, P, Si, Na and S.

CONCLUSIONS

Product containing potassium oxalate was the most effective in reducing Lp of dentin samples before and after an erosive challenge. Under a LSCM, products containing potassium oxalate or hydroxyapatite crystals seemed to be occluding the dentin tubules after an erosive challenge.

Short-term response of three resin-based materials as desensitizing agents under oral environmental exposure

OBJECTIVE

This paper focuses on clinical responses after 7 days of oral exposure to two resin-based materials as desensitizing agents compared to a fluoride varnish and on morphological and analytical study as a means to elucidate the mechanism of action.

MATERIALS AND METHODS

The elemental composition of Vertise™ Flow (VF), Universal Dentine Sealant (UDS) and Flor-Opal® Varnish (FOV) were investigated by using an X-ray energy dispersive spectrometer (EDX) in conjunction with a scanning electron microscope (SEM). SEM morphology of the material-treated dentine surfaces and pain reduction ability according to the Visual Analogue Scale (VAS) were evaluated in selected hypersensitive teeth. Post treatments and 7 day controls were recorded with SEM and VAS measurements. Clinical data was analysed with the Student's t-test for paired data, with a 5% significance level.

RESULTS

Silicon, ytterbium and alumina were the most present elements in VF, whilst calcium, chloride, silicon and alumina were highest in UDS. Within a 7 day oral environment all the tested materials modified the treated-dentine surfaces showing tubular occlusion of different morphology. Clinically, the efficacy of all materials was similar after a 7-day examination. However, VAS scores were significantly reduced if compared with the baseline (p < 0.05).

CONCLUSIONS

Within the limits of this study, data indicate that both resins are effective in sealing tubules and reducing VAS. A resin-related effect on the dentine's morphology was observed, which may influence the long-term response of the resins in the treatment of dental hypersensitivity, which requires further investigation.

Dentin permeability reduction by a sequential application of calcium and fluoride-phosphate solutions

OBJECTIVE

A sequential topical application of calcium and fluoride-phosphate solutions was reported to occlude open dentin tubules, mainly with fluoroapatite precipitates by a rapid ionic reaction, and to be effective at treating dentin hypersensitivity. However, its ability to reduce dentin permeability (Lp) is unknown. The aim of this in vitro study was to evaluate the effect of this treatment on Lp.

METHODS

Nine extracted human third molars were sectioned transversely to obtain 0.5 mm-thick discs, which were then etched and rinsed. Aqueous solutions of 5% (w/w) disodium phosphate containing 0.3% (w/w) sodium fluoride (A) and 10% (w/w) calcium chloride (B) were prepared. The sequential application of the A&B solutions was repeated three times on each disc, which was then rinsed with distilled water. The Lp of the discs was measured before and after the application using a modified Pashley's fluid flow measuring system. The differences in the Lp values between the conditions before and after the solution applications were analysed using a generalized estimating equation method and paired t-test. Scanning Electron Microscopy (SEM) was used to observe the dentin surfaces.

RESULTS

All nine discs consistently indicated reduced Lp following the application of the A&B solutions. There was a significant decrease in the mean Lp [microL/(cm(2) s cm H(2)O)] from baseline (-0.27+/-0.25, p=0.011). Overall, an average decrease of 34% Lp occurred after the application of the A&B solutions. SEM observation indicated that the reaction products covered the entire dentin disc surface.

CONCLUSION

The application of the A&B solutions was effective at reducing the Lp of the dentin discs.

Preparation and properties of nano-sized calcium fluoride for dental applications

OBJECTIVES

The aim of the present study was to prepare nano-sized calcium fluoride (CaF(2)) that could be used as a labile F reservoir for more effective F regimens and as an agent for use in the reduction of dentin permeability.

METHODS

Nano-sized CaF(2) powders were prepared using a spray-drying system with a two-liquid nozzle. The properties of the nano-CaF(2) were studied and the effectiveness of a fluoride (F) rinse with nano-CaF(2) as the F source was evaluated. The thermodynamic solubility product of the nano-CaF(2) solution was determined by equilibrating the nanosample in solutions presaturated with respect to macro-CaF(2). Reactivity of the nano-CaF(2) was assessed by its reaction with dicalcium phosphate dehydrate (DCPD). F deposition by 13.2 mmol/L F rinse with the nano-CaF(2) as the F source was determined using a previously published in vitro model.

RESULTS

X-ray diffraction (XRD) analysis showed pattern of low crystalline CaF(2). BET measurements showed that the nano-CaF(2) had a surface area of 46.3m(2)/g, corresponding to a particle size of 41nm. Transmission electron microscopy (TEM) examinations indicated that the nano-CaF(2) contained clusters comprising particles of (10-15) nm in size. The nano-CaF(2) displayed much higher solubility and reactivity than its macro-counterpart. The CaF(2) ion activity product (IAP) of the solution in equilibrium with the nano-CaF(2) was (1.52+/-0.05)x10(-10), which was nearly four times greater than the K(sp) (3.9 x 10(-11)) for CaF(2). The reaction of DCPD with nano-CaF(2) resulted in more F-containing apatitic materials compared to the reaction with macro-CaF(2). The F deposition by the nano-CaF(2) rinse was (2.2+/-0.3)mug/cm(2) (n=5), which was significantly (p<0.001) greater than that ((0.31+/-0.06)mug/cm(2)) produced by the NaF solution.

SIGNIFICANCE

The nano-CaF(2) can be used as an effective anticaries agent in increasing the labile F concentration in oral fluid and thus enhance the tooth remineralization. It can also be very useful in the treatment for the reduction of dentin permeability.

Reduction in dentin permeability using a slurry containing dicalcium phosphate and calcium hydroxide

Treatments that obdurate dentin tubules have been used for reducing dentin hypersensitivity. The purpose of this study was to determine the effect of a treatment with a slurry of micron sized calcium phosphate on the hydraulic conductance (L(p)) of etched dentin discs in vitro. The treatment slurry was prepared by mixing a powder mixture of dicalcium phosphate anhydrous and calcium hydroxide with a solution that contained sodium fluoride and carboxymethyl cellulose. The mean baseline L(p) (in mL cm(-2) s(-1) H(2)O cm(-1)) was 2.07 +/- 1.45 (mean +/- SD; n = 13)). After one treatment and 2, 4, and 7 days of incubation in a protein-free saliva-like solution (SLS), the mean relative L(p), presented as % of baseline, were 65 +/- 16, 42 +/- 27, 36 +/- 26, and 33 +/- 27 (n = 13), respectively. The L(p) values of the baseline and treatment after incubation in the SLS were significantly (p < 0.05) different. Scanning electron microscopic examination showed partial obturation of dentin tubules in the treated dentin. X-ray diffraction and chemical analyses indicated the major product formed from the slurry was a fluoride-containing hydroxyapatite. Treatment appeared effective in further reducing L(p) of dentin discs after incubation in the SLS.

Managing dentin hypersensitivity

BACKGROUND

The objective of this review is to inform practitioners about dentin hypersensitivity (DH) and its management. This clinical information is described in the context of the underlying biology.

TYPES OF STUDIES REVIEWED

The authors used MEDLINE to find relevant English-language literature published in the period 1999 to 2005. They used combinations of the search terms "dentin*," "tooth," "teeth," "hypersensit*," "desensiti*" and "desensitiz*." They read abstracts and then full articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action.

RESULTS

The prevalence of DH varies widely, depending on the mode of investigation. Potassium-containing toothpastes are the most widely used at-home treatments. Most in-office treatments employ some form of "barrier," either a topical solution or gel or an adhesive restorative material. The reported efficacy of these treatments varies, with some having no better efficacy than the control treatments. Possible reasons for this variability are discussed. A flowchart summarizes the various treatment strategies.

CLINICAL IMPLICATIONS

DH is diagnosed after elimination of other possible causes of the pain. Desensitizing treatment should be delivered systematically, beginning with prevention and at-home treatments. The latter may be supplemented with in-office modalities.

Inhibition of compound action potentials following administration of dental self-etching primer/adhesives

Self-etching dentin adhesive systems, a new generation of dental-bonding agents, were investigated for their ability to block nerve conductance in the rat sciatic nerve model. Clearfil SE Bond, Mac Bond and FL Bond were used as test materials. Isolated rat sciatic nerves obtained from female albino rats were placed between two electrodes in a bath containing Tyrode solution. The bonding agents were brought into contact with the nerves and the evoked compound action potentials were recorded versus time before and after contact with the materials. Statistical analysis was performed using the Friedman and Wilcoxon Signed-Ranks tests (P = 0.01) to compare the mean percentage of inhibition between test materials versus time. All test materials were able to block nerve transmission rapidly (3.3 +/- 0.5, 5.1 +/- 2.3 and 8.0 +/- 1.9 min for SE Bond, Mac Bond and FL Bond, respectively). Significant differences were found between FL Bond and SE and Mac Bond (P < 0.01). These results indicated that the bonded systems tested, intended primarily as dentinal tubule occluders, may also exert some direct desensitizing effect on intratubular or pulpal nerve terminals in extremely deep cavities or pulpal microexposures, contributing to decreased postoperative pain.