Efficacy of Gluma Desensitizer® on dentin hypersensitivity in periodontally treated patients

Combined Effects of Glutaraldehyde-based Desensitizer and Nd: YAG Laser on Dentinal Tubules Occlusion

AIM

The aim of this study was to assess the impact of Nd:YAG laser, glutaraldehyde-based desensitizer (GD), or their combination on occluding dentinal tubules.

MATERIALS AND METHODS

Fifty dentin samples were obtained from non-carious human third molars and randomly divided into five groups (n = 10): (1) Control group treated with 37% phosphoric acid, (2) GD group, (3) Nd:YAG laser group (1064 nm, 100 µs, 10 Hz, 300 µm fiber, 1 W power, 100 mJ energy, and 85 J/cm2 energy density), (4) GD followed by Nd:YAG laser group, and (5) Nd:YAG laser followed by GD group. Scanning electron microscopy (SEM) was used to capture five images from each sample for analysis of dentinal tubules using Image J software. SEM/EDX elemental analysis was performed to determine the main mineral contents. Data analyzed using one-way ANOVA and Tukey's post hoc test for statistical comparisons.

RESULTS

Laser and combination groups showed a significant decrease in dentinal tubule counts compared with the control and GD groups (p < 0.0001). There were no significant differences in open dentinal tubule counts between the control and GD groups, as well as between the laser and combination groups. However, significant differences were observed in the total area, average size of the tubules, and percentage area between the control group and the treatment groups (GD, laser, GD + laser, laser + GD). No significant difference was found in the Ca/P ratio between the tested groups.

CONCLUSION

The use of Nd:YAG laser alone or in combination with GD was more effective in occluding dentinal tubules compared to GD alone.

CLINICAL SIGNIFICANCE

This study has shown that Nd:YAG laser alone and in combination with GD has superior dentinal tubule occlusion in vitro. Its clinical use in the treatment of dentinal hypersensitivity may overcome the drawback of conventional treatment approaches for dentin hypersensitivity needing repeated applications to achieve continuous relief from pain since acidic diet and toothbrushing result in the continuing elimination of precipitates and surface coatings. How to cite this article: Alzarooni AH, El-Damanhoury HM, Aravind SS, et al. Combined Effects of Glutaraldehyde-based Desensitizer and Nd: YAG Laser on Dentinal Tubules Occlusion. J Contemp Dent Pract 2024;25(1):52-57.

Effect of sodium fluoride varnish, Gluma, and Er,Cr:YSGG laser in dentin hypersensitivity treatment: a 6-month clinical trial

Dentinal hypersensitivity (DH) is a common clinical condition usually associated with exposed dentinal surfaces. The aim of this study was to study the effect of sodium fluoride varnish, Gluma, and Er,Cr:YSGG laser, in the dentin hypersensitivity treatment. One hundred sixty-five teeth with dentin hypersensitivity in 55 patients were involved in this study. Teeth are divided into five groups based on the received treatment (n = 33): G group: Gluma; F group: sodium fluoride varnish (5%); L group: Er,Cr:YSGG laser (wavelength 2780 nm, frequency 20 Hz, power 0.25 W, energy density 44.3 J/cm², and pulse width of 150 µs at distance of 1 mm for 30 s) which was followed by Er,Cr:YSGG laser; GL group: Gluma + laser; VL group: both sodium fluoride varnish and Gluma, which are common treatments for hypersensitivity, were selected as control groups. The treatment was performed in one session, and the sensitivity to air spray conditioning was recorded after the treatment, at 15 min, 1 week, 1 month, and 6 months as the VAS. Statistical analysis was performed using SPSS Ver. 21 software. One-way ANOVA was used to compare the VAS between all treatment groups at each time-point. One-way repeated measurements ANOVA (RM-ANOVA) and two-way-repeated measurements ANOVA (RM-ANOVA) were used to compare the hypersensitivity of each group and sensitivity of all treatment groups, respectively. Tukey post hoc test was used to compare the groups pairwise. The hypersensitivity between different groups at before and 15 min after the treatment was not significantly different (P = 0.063). The hypersensitivity of all studied groups was decreased after the treatment. The Er,Cr:YSGG laser, alone or in combination with Gluma, in 1 week, 1 month, and 6 month follow-ups, had significantly reduced the hypersensitivity instead of sodium fluoride varnish. All treatments significantly reduced the dentin hypersensitivity up to 6 months. Er,Cr:YSGG laser alone or in combination with Gluma was more effective than sodium fluoride varnish; however, it was not significantly different from other treatments. In a 6-month follow-up of dentine hypersensitivity treatment, Gluma had a significantly higher effect than sodium fluoride. Trial registration: IRCT20190422043343N1. Registered 19 July 2019.

Effect of desensitizing agents on dentin hypersensitivity after non-surgical periodontal therapy: A systematic review and meta-analysis

OBJECTIVE

To investigate the effectiveness of desensitizing agents (DA) on dentin hypersensitivity (DH) after non-surgical periodontal treatment (NSPT) through a systematic review and meta-analysis.

DATA

The PICO strategy was used to include randomized clinical trials in human subjects with DH (P) after NSPT treated with DA (I) compared to those treated with placebo or control (C) to identify DH relief (O). The Cochrane guidelines and GRADE was used to classify the risk of bias and the quality of the evidence, respectively.

SOURCES

PubMed, Web of Science, Scopus, Lilacs, Cochrane Library databases, and OpenGrey were searched on the 20^th of May 2020.

STUDY SELECTION

Nine studies were included in the quantitative synthesis. Five meta-analyses were performed. Three meta-analyzes assessed the effectiveness of DA compared to a placebo or control in relation to pain assessment stimuli and two meta-analyzes assessed the mechanism of action of DA. For the mechanical stimulus in overall analysis, the control group presented a higher mean of pain reduction (SMD 1.03 [0.73, 1.32], p < 0.001) with very low certainty of evidence. For water (SMD -0.78 [-1.22, -0.35], p = 0.0009) and evaporative in overall analysis (SMD -1.21 [-1.79, -0.64], p < 0.001) stimuli, the DA decreased DH pain with very low and low certainty of evidence, respectively.

CONCLUSION

Due to the limited quality of evidence, there is no definitive conclusion on the effectiveness of DA on DH after NSPT. Thus, further clinical studies with a low risk of bias and high-quality evidence are encouraged to reinforce the certainty of evidence on that issue.

CLINICAL SIGNIFICANCE

The use of desensitizing agents show promise for relief of dentin hypersensitivity after non-surgical periodontal therapy.

Evaluation of 3 different treatment modalities for conservative management of attrited, sensitive molar teeth - A preliminary 12-week report

Management of symptomatic attrited molar teeth presents various challenges. Aim of the study was to manage and evaluate the outcome of sensitive, attrited molar teeth using three different treatment options, including bioglass-containing desensitising toothpaste, Gluma desensitiser and coronal a pulpotomy using a calcium silicate-based product, Biodentine. A total of 61 attrited molar teeth, for which the patients had expressed tooth sensitivity, were included. Depending on the pulp status, treatment groups were allotted using block randomisation. Post-treatment sensitivity was assessed at 48 h, 4 and 12 weeks using 10-point visual analog scale (VAS) and Schiff Cold Air Sensitivity Scale (SCASS). Data were analysed using non-parametric statistical tests. Pulpotomies achieved significantly the least post-treatment sensitivity scores at all scheduled recalls. This interim 12-week report on management concludes that a pulpotomy, using Biodentine, was able to achieve significantly higher number of asymptomatic teeth when compared to other treatment choices.

Evaluation and Comparison of Efficacy of Gluma® and D/Sense® Desensitizer in the Treatment of Root Sensitivity Induced by Non-Surgical Periodontal Therapy

BACKGROUND:

Dentinal hypersensitivity is one of the most common sequels of non-surgical periodontal therapy. Resulted discomfort may restrain patients from oral hygiene maintenance, thus affects the long-term success of periodontal therapy. So, it becomes a prime concern of the clinician to manage the post-operative hypersensitivity.

AIM:

This clinical investigation aimed to evaluate and compare the efficacy of D/Sense^® and Gluma^® in preventing post-operative sensitivity after non-surgical periodontal therapy.

MATERIAL AND METHODS:

The present randomised, double-blind, split-mouth study was conducted on forty-five (22 male, 23 female) systemically healthy patients, with the mean age of 40 ± 17.5 years. Visual Analogue scale was used to evaluate root sensitivity after application of tactile and cold stimuli at baseline, 1, 2, 4 and 6 weeks after scaling and root planing. After scaling and root planning, the sites were randomly divided into different groups for the application of desensitising agents. Collected data were analysed by using, analysis of variance (ANOVA) for inter-group and paired t-test for intra-group comparisons.

RESULTS:

No adverse or side effects were reported by any of the patients throughout the study period. Gluma^® showed a statistically significant reduction in the VAS score for root sensitivity as compared to D/Sense^®, at 1, 2- and 4-weeks follow-up period (p < 0.05). Whereas, at 6th-week follow-up, both the solution showed almost similar score for root hypersensitivity. Intragroup comparison for D/Sense^® revealed a significant difference in scores from baseline to all intervals (p < 0.05), except baseline to 6 weeks (p > 0.05). Whereas Gluma^® showed a significant difference in scores from baseline to 2nd-week follow-up (p < 0.05).

CONCLUSION:

The result of the present investigation revealed that application of Gluma® resulted in better control on iatrogenic root hypersensitivity as compared to the D/Sense^® during the initial follow-up period.

Ability of three desensitizing agents in dentinal tubule obliteration and durability: An in vitro study

Aim:

The purpose of this study was to evaluate the effectiveness of three desensitizing agents on dentinal tubule obliteration and their durability in use on the dentinal tubules.

Materials and Methods:

Sixty specimens were obtained from 30 extracted sound human maxillary first premolars. Each tooth was mesiodistally sectioned to obtain 30 buccal and 30 lingual surfaces, and enamel was removed in order to simulate hypersensitive dentin. Specimens were divided into four groups with 15 specimens each. Group 1 samples were immersed in artificial saliva, Group 2 samples were coated with Vivasens, Group 3 samples were coated with VOCO Admira Protect, and Group 4 samples were coated with Neo Active Apatite suspension. These specimens were examined under scanning electron microscope (SEM) to find out the occluding ability of the respective products. The specimens were brushed to find out their durability for 1 week and 1 month and were examined under SEM.

Statistical Analysis:

The results were statistically analyzed by analysis of variance (ANOVA) and Tukey's test.

Results:

Group 1 differed significantly from the Vivasens, Admira, and Neo Active Apatite groups at 5% level of significance (P < 0.05). The Vivasens group differed significantly from the Admira and Neo Active Apatite groups at 5% level of significance (P < 0.05).

Conclusion:

The Ormocer-based Admira Protect showed the best results.

Microleakage in Class V Composite Restorations after Desensitizing Surface Treatment with Er:YAG and CO2 Lasers

Aims: Glutaraldehyde, CO₂ and Er:YAG lasers can be used for treatment of dentin hypersensitivity. However, their application may have adverse effects on the clinical service of restorations. This study aimed to assess the microleakage in composite restorations following surface treatment with Glutaraldehyde desensitizer, CO₂ and Er:YAG laser irradiation for treatment of dentin hypersensitivity. Materials and methods: This experimental study was conducted on 60 extracted sound human teeth. Class V cavities were prepared measuring 3×3 mm using a diamond bur. Specimens were randomly divided into 4 groups of 15. Group one:no surface treatment, Group two:applying Glutaraldehyde desensitizer, Groups of three and four were irradiated with CO₂ and Er:YAG lasers, respectively. Surfaces were restored with bonding agent (Single Bond 2, 3M, USA) and Z250 composite (3M, USA). Specimens were thermocycled and immersed in 1% methylene blue solution for 24 hours. Microleakage scores were assessed under a stereomicroscope at ×20 magnification. Data were analyzed using SPSS and the Kruskal Wallis test (P=0.05). Results: There was no significant difference between microleakage of groups in enamel margins (P=0.694). The difference in microleakage at the dentin margin was significant between groups (P=0.018). Conclusions: Application of Glutaraldehyde-desensitizer and CO₂ laser irradiation of surfaces prior to composite restoration do not increase microleakage at the enamel or dentin margins but tooth surface treatment with Er:YAG laser significantly increased the microleakage at the dentin margins.

Comparative evaluation of NovaMin desensitizer and Gluma desensitizer on dentinal tubule occlusion: a scanning electron microscopic study

Purpose

In this study, the effect of calcium sodium phosphosilicate (NovaMin) desensitizing agent, which is a powder-based system, and hydroxyethyl methacrylate and glutaraldehyde (Gluma desensitizer), which is liquid-based system, on dentinal tubule occlusion was analyzed by scanning electron microscope. The effects of the above two along with one control group were compared to determine the more effective method of sealing the dentinal tubules after initial application.

Methods

Twenty specimens were allocated to each of 3 groups: Control, Gluma desensitizer, and NovaMin. Two additional samples were also prepared and treated with Gluma and NovaMin; these samples were longitudinally fractured. The specimens were prepared from extracted sound human premolars and were stored in 10% formalin at room temperature. The teeth were cleaned of gross debris and then sectioned to provide one to two dentin specimens. The dentin specimens were etched with 6% citric acid for 2 minutes and rinsed in distilled water. Control discs were dried, and the test discs were treated with the desensitizing agents as per the manufacturer's instructions. The discs as well as longitudinal sections were later analyzed under the scanning electron microscope. The proportions of completely occluded, partially occluded, and open tubules within each group were calculated. The ratios of completely and partially occluded tubules to the total tubules for all the groups was determined, and the data was statistically analyzed using nonparametric tests and statistical significance was calculated.

Results

NovaMin showed more completely occluded tubules (0.545±0.051) while Gluma desensitizer showed more partially occluded tubules (0.532±0.075). The differences among all the groups were statistically significant (P≤ 0.05).

Conclusion

Both materials were effective in occluding dentinal tubules but NovaMin appeared more promising in occluding tubules completely after initial application.

Assessing the risk of bias in randomized controlled trials in the field of dentistry indexed in the Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) database

CONTEXT AND OBJECTIVE

Well-conducted randomized controlled trials (RCTs) represent the highest level of evidence when the research question relates to the effect of therapeutic or preventive interventions. However, the degree of control over bias between RCTs presents great variability between studies. For this reason, with the increasing interest in and production of systematic reviews and meta-analyses, it has been necessary to develop methodology supported by empirical evidence, so as to encourage and enhance the production of valid RCTs with low risk of bias. The aim here was to conduct a methodological analysis within the field of dentistry, regarding the risk of bias in open-access RCTs available in the Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) database.

DESIGN AND SETTING

This was a methodology study conducted at Universidade Federal de São Paulo (Unifesp) that assessed the risk of bias in RCTs, using the following dimensions: allocation sequence generation, allocation concealment, blinding, and data on incomplete outcomes.

RESULTS

Out of the 4,503 articles classified, only 10 studies (0.22%) were considered to be true RCTs and, of these, only a single study was classified as presenting low risk of bias. The items that the authors of these RCTs most frequently controlled for were blinding and data on incomplete outcomes.

CONCLUSION

The effective presence of bias seriously weakened the reliability of the results from the dental studies evaluated, such that they would be of little use for clinicians and administrators as support for decision-making processes.

Desensitizing bioactive agents improves bond strength of indirect resin-cemented restorations: preliminary results

Objective:

The aim of this study was to assess the bond strength of indirect composite restorations cemented with a resin-based cement associated with etch-and-rinse and self-etching primer adhesive systems to dentin treated or not with a bioactive material.

Materials and Method:

Twenty bovine incisor crowns had the buccal enamel removed and the dentin ground flat. The teeth were assigned to 4 groups (n=5): Group I: acid etching + Prime & Bond NT (Dentsply); Group II: application of a bioactive glass (Biosilicato®)+ acid etching + Prime & Bond NT; Group III: One-up Bond F (J Morita); Group IV: Biosilicato® + One-up Bond F. Indirect composite resin (Artglass, Kulzer) cylinders (6x10mm) were fabricated and cemented to the teeth with a dualcure resin-based cement (Enforce, Dentsply). After cementation, the specimens were stored in artificial saliva at 37^oC for 30 days and thereafter tested in tensile strength in a universal testing machine (EMIC) with 50 kgf load cell at a crosshead speed of 1 mm/min. Failure modes were assessed under scanning electron microscopy. Data were analyzed statistically by ANOVA and Tukey's test (95% level of confidence).

Results:

Groups I, II and III had statistically similar results (p>0.05). Group IV had statistically significant higher bond strength means (p<0.05) than the other groups. The analysis of the debonded surfaces showed a predominance of adhesive failure mode for Group III and mixed failure mode for the other groups.

Conclusion:

The use of desensitizing agent did not affect negatively the bonding of the indirect composite restorations to dentin, independently of the tested adhesive systems.

The effect of dentin desensitizer with different layers on thermal changes on the pulp during fabrication of provisional restoration

PURPOSE

This study investigated the effects of different desensitizers and an adhesive material application on pulpal temperature rise during direct provisional restoration polymerization.

MATERIALS AND METHODS

Two dentin desensitizers (Systemp, Ivoclar; BisBlock, Bisco) and a dentin adhesive (Prime Bond, Dentsply) were applied to the dentin surfaces as single layer or double layer. One autopolymerizing methacrylate (Prevision, Heraeus Kulzer) and one light polymerizing composite (Revotek LC, GC) provisional restoration materials were used in this study. A total of 160 dentin disks were prepared from extracted molars. These dentin disks were placed on an apparatus developed to measure temperature rise. After the desensitizer or dentin adhesive application, provisional materials were polymerized according to the manufacturers' instructions. The temperature increase was measured under the dentin disk with a J-type thermocouple wire that was connected to a data logger. Differences between initial and highest temperature reading were taken, and 10 readings were averaged to determine the mean value in temperature rise. Statistical analysis was performed with three-way analysis of variance followed by Tukey HSD test (alpha = 0.05).

RESULTS

Temperature rise varied according to the provisional restoration material used (composite resin, methacrylate) (p < 0.001), the agent thickness (single, double) (p < 0.001), and the agent (desensitizer, adhesive) (p < 0.001). The composite resin-based provisional material induced higher thermal changes than methacrylate based provisional material (p < 0.01).

CONCLUSION

The thickness of desensitizing agents affected the thermal changes; however, the desensitizers did not affect on the intrapulpal temperature although the type of provisional material used may be effective.