Comparative evaluation of a dentifrice containing calcium sodium phosphosilicate to a dentifrice containing potassium nitrate for dentinal hypersensitivity: A clinical study

Effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing the post vital tooth preparation hypersensitivity: A randomized controlled trial

Aim

Hypersensitivity is the most common clinical problem which is encountered by most of dental patients undergoing a vital tooth preparation for a fixed crown prosthesis. The aim of this study is to evaluate the effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing dentinal hypersensitivity following vital tooth preparation.

Settings and Design

This study is a randomized control trial performed on 119 teeth of 68 patients who are in need of fixed prosthesis treatment.

Materials and Methods

After a thorough clinical examination, patients were allocated into any of the randomly assigned four groups (Control, silver diamine fluoride, potassium nitrate, and glutaraldehyde) and the level of hypersensitivity was measured by blasting air on the surface of tooth at five different intervals (before preparation, after preparation, after application of desensitizers, before cementation and after a follow up period of about 30 days) and is graded using Schiff 's cumulative hypersensitivity index.

Statistical Analysis Used

Kruskal wallis test is used to compare the rate of sensitivity between the 4 groups. Friedman and Wilcoxon test is used to compare the rate of sensitivity at 5 different intervals.

Results

All the desensitizers used in this study reduced the level of hypersensitivity. Among which, silver diamine fluoride was found to be more effective after application, before cementation, and after a follow up period of about 30 days followed by GLUMA and potassium nitrate.

Conclusion

The results of this study suggest that silver diamine fluoride was found to be more effective after application, before cementation of the definitive prosthesis and after a follow up period of 30 days.

Clinical study to monitor dentinal hypersensitivity with episodic use of a desensitising dentifrice

Objectives/Aims:

To evaluate continuous and episodic twice-daily usage regimens of a desensitising dentifrice containing 5% calcium sodium phosphosilicate (CSPS).

Materials and Methods:

In this exploratory, single-centre, randomised, examiner-blind study, subjects with dentinal hypersensitivity were randomised to continuous (24 weeks) use of a 5% CSPS-containing dentifrice or episodic use of the dentifrice comprising two 8-week treatment periods separated by 8 weeks′ use of a standard fluoride dentifrice. Sensitivity was assessed by tactile threshold (Yeaple probe) and evaporative (air) sensitivity (Schiff sensitivity score). Other measures included labelled magnitude scales to assess subjects′ responses to the evaporative stimulus, the Dentine Hypersensitivity Experience Questionnaire and a tooth sensitivity question.

Results:

Seventy-six subjects were randomised to continuous (n=38) or episodic (n=38) use. Small but statistically significant improvements from baseline in Schiff sensitivity scores were observed at weeks 8, 16 and 24 with both regimens (all P<0.05). Increases from baseline in tactile threshold were not statistically significant. No significant between-regimen difference was observed for any endpoint. No treatment-related adverse events were reported.

Discussion:

Dentifrice containing 5% CSPS improved dentinal hypersensitivity with both episodic and continuous twice-daily usage regimens over 24 weeks and was well tolerated.

Conclusion:

No performance differences were observed between the two usage regimens.

Avaliação ex vivoda obliteração de túbulos dentinários humanos pelo uso comparativo de agentes dessensibilizantes convencionais e dessensibilizantes contendo biovidro

O objetivo do presente estudo foi avaliar a eficácia ex vivo de um dentifrício dessensibilizante contendo biovidro (Sensodyne®Repair&Protect, GlaxoSmithKline Brasil Ltd., Rio de Janeiro, Brasil), quanto ao potencial de obliteração dos túbulos dentinários e compará-lo com os dentifrícios convencionais (Colgate® Sensitive Pro-Alívio™, Colgate-Palmolive, São Paulo, SP, Brasil eSensodyne® Rápido Alívio, GlaxoSmithKline Brasil Ltd., Rio de Janeiro, Brasil). Foram utilizados 12 pré-molares humanos divididos em: G1 (n=4) - escovação com Colgate®Sensitive Pró-Alívio; G2 (n=4) - escovação com Sensodyne® Rápido Alívio; e G3 (n=4) - escovação com Sensodyne®Repair&Protect. As amostras foram submetidas à simulação de escovação de um período de oito semanas, com duas escovações diárias e analisadas em microscopia eletrônica de varredura (MEV), quanto à presença e características dos túbulos dentinários; a espectroscopia de raios-X por dispersão em energia (EDS), a fim de avaliar os elementos químicos presentes nos túbulos dentinários. A análise qualitativa da obliteração dos túbulos dentinários foi avaliada por meio das fotomicrografias. Para verificar a distribuição normal dos dados da EDS, utilizou-se o teste de Shapiro-Wilk (p<0,05). De acordo com a normalidade apresentada, foram executados teste t-Studentde amostras pareadas e teste de Wilcoxon. No grupo G1 foi verificada diminuição na luz dos túbulos dentinários, enquanto no G2, além da diminuição dos túbulos, nítida deposição de partículas obliteradoras foi observada. No G3, foi detectada não só a obliteração dos túbulos, mas também a diminuição na quantidade dos mesmos; além da formação de uma camada de hidroxidocarbonato de apatita (HCA)sobre a dentina. A análise conjunta dos dados permitiu concluir que os dentifrícios testados foram capazes de ocluir os túbulos dentinários e que o dentifrício Sensodyne®Repair&Protect apresentou melhor eficácia na obliteração dos túbulos dentinários, seguido respectivamente dos dentifrícios Sensodyne® Rápido Alívioe Colgate®Sensitive Pró-Alívio.

Evaluation of ex vivo effectiveness of commercial desensitizing dentifrices

BACKGROUND

Dentin hypersensitivity is a short, severe pain with fast onset. Therapy aims to either prevent or decrease neural transmission or physically occlude the dentinal tubules. This study aimed to evaluate the effectiveness of commercial desensitizing dentifrice by means of an ex vivo method.

MATERIAL AND METHODS

Samples (n=8 lower human premolars for each group) were randomly allocated into: G1- brushing with Colgate®Sensitive Pro-Relief; G2- brushing with Sensodyne®Rapid Relief; G3- brushing with Sensodyne®Repair & Protect; and G4- brushing with Colgate®Maximum Cavity Protection. The test bodies were submitted to simulated toothbrushing and dentifrices were analyzed regarding their hydrodynamic size, polydispersity index (PI) and zeta potential. Specimens were evaluated using: scanning electron microscopy (SEM); spectroscopy energy dispersive X-ray (EDS); and profilometry. A qualitative analysis of the photomicrographs and topographies was performed.

RESULTS

The dentifrices showed statistical similar physical and chemical characteristics. They also demonstrated obliteration of dentinal tubules when micrographs were observed. Regarding the chemical elements present in the dentin samples, there was a statistically significant difference between the control and experimental surfaces in the four groups.

CONCLUSIONS

Joint data analysis shows that the desensitizing dentifrice showed better results with regards to the obliteration of dentinal tubules compared to positive and negative controls. Key words:Dentin hypersensitivity, dentin desensitizing agents, toothpastes.

Exploratory randomised controlled clinical study to evaluate the comparative efficacy of two occluding toothpastes - a 5% calcium sodium phosphosilicate toothpaste and an 8% arginine/calcium carbonate toothpaste - for the longer-term relief of dentine hypersensitivity

OBJECTIVE

To compare the longer-term clinical efficacy of two occlusion-technology toothpastes - a 5% calcium sodium phosphosilicate (CSPS) toothpaste and a commercially available 8% arginine/calcium carbonate toothpaste - in relieving dentine hypersensitivity (DH). Efficacy was also compared with that of a regular fluoride toothpaste control.

METHODS

This was an exploratory, randomised, examiner-blind, parallel-group, 11-week, controlled study in healthy adults with self-reported and clinically diagnosed DH. After an acclimatisation period, subjects were randomised to one of three study treatments with which they brushed their teeth twice daily. Sensitivity was assessed at baseline and after 1, 2, 4, 6 and 11 weeks treatment in response to evaporative (air) and tactile stimuli (measured by the Schiff Sensitivity Scale/visual analogue scale and tactile threshold, respectively).

RESULTS

A total of 135 subjects were randomised to treatment. The two occlusion-technology toothpastes performed similarly over the 11-week treatment period. All study treatments showed statistically significant reductions from baseline in DH at all timepoints for all measures (p<0.05). Statistically significant and clinically relevant sensitivity relief was observed for both occluding formulations compared with the regular fluoride toothpaste: for evaporative (air) sensitivity within 1 week and for tactile sensitivity at Week 11. No significant differences were detected between the two occluding formulations at any timepoint, for any endpoint. Study treatments were generally well tolerated.

CONCLUSIONS

In this exploratory study, a 5% CSPS occluding toothpaste was effective in relieving DH compared with a regular fluoride toothpaste; an 8% arginine/calcium carbonate anti-sensitivity toothpaste provided similar benefits. Improvements in DH continued throughout the 11-week study.

CLINICAL SIGNIFICANCE

Dentine hypersensitivity (DH) is a common and painful condition. Twice-daily use of a 5% calcium sodium phosphosilicate toothpaste reduces DH within 1-2 weeks of initiating use. Ongoing, twice daily use of the sensitivity toothpastes evaluated in this study was associated with continued, clinically significant improvements in DH.

Evaluation and comparison of efficacy of three desensitizing dentifrices on dentinal hypersensitivity and salivary biochemical characteristics: A randomized controlled trial

BACKGROUND

This study aimed to evaluate and compare the efficacy of three desensitizing dentifrices on dentinal hypersensitivity (DH) and salivary biochemical characteristics.

MATERIALS AND METHODS

A randomized, parallel arm, triple-blinded, clinical trial was conducted over a period of 12 weeks, with a total of three visits: baseline, 6 weeks, and 12 weeks. Calcium sodium phosphosilicate, potassium nitrate and amine fluoride dentifrices were compared. A total of 68 subjects who satisfied the inclusion criteria were included and randomly divided into four groups. Visual analog scale scores for controlled air stimulus were used to assess dentinal sensitivity and salivary pH and buffering capacity were recorded at baseline, 6 and 12 weeks.

RESULTS

All groups showed a reduction in sensitivity scores at 6 and 12 weeks. The calcium sodium phosphosilicate group showed a higher degree of effectiveness in reducing DH than potassium nitrate, amine fluoride dentifrices, and placebo for sensitivity measures. Salivary pH of calcium sodium phosphosilicate group was more toward neutral, and the buffering capacity of the same group showed significant changes from baseline to 6 and 12 weeks compared to the other groups.

CONCLUSION

The desensitizing toothpaste containing calcium sodium phosphosilicate was found to be more effective in reducing DH and showed improvement in salivary biochemical characteristics over a period of 12 weeks compared to others.