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

Effects of Propolis-Based Herbal Toothpaste on Dentine Hypersensitivity

INTRODUCTION

The objective of this in vitro study was to compare the effectiveness of a propolis-based herbal toothpaste with 5% sodium fluoride varnishin obstructing human dentinal tubules; Scanning electron microscopy was utilised to obtain quantitative and qulitative data on tubular obstruction.

METHODS

Thirty-nine extracted human premolar teeth were collected. The cementum layer was removed using a water-cooled diamond bur and the smear layer using ethylenediaminetetraacetic acid (EDTA) 17%. Then, the samples were randomly divided into 3 groups (n = 13 each), as follows: group 1: dentin discs exposed to the propolis-based herbal toothpaste (Herbex); group 2: dentin discs exposed to 5% sodium fluoride varnish; and group 3: control. Then, all discs were observed and imaged in 4 non-overlapping fields by an electron microscope at 2000× magnification. The topography and number of open, closed, and semi-closed tubules were counted in all images. The data were analysed using Kruskal-Wallis test, Mann-Whitney U test, and Friedman test. The statistical analysis was performed with SPSS statistic 22.0 software, with a significance level of α = 0.05.

RESULTS

In pairwise comparisons of the groups considering the percentage of open, closed, and semi-closed tubules, the difference was not statistically significant between the 5% sodium fluoride varnish and propolis groups in the closed and semi-closed tubules, but it was statistically significant with the control group. Additionally, the percentage of open tubules in the propolis-based herbal toothpaste group was significantly lower than in the 5% sodium fluoride varnish and control group.

CONCLUSIONS

Both propolis-based herbal toothpaste and 5% sodium fluoride varnish is effective in blocking human dentin tubules to various extents.

Single-session associative protocol for dentin hypersensitivity management: a 1-year randomized, blinded clinical study

Objectives

This study aimed to establish a single-session associative protocol for non-restorative management of dentin hypersensitivity (DH).

Materials and Methods

Twenty-four individuals with DH and a minimum sensitivity level of 4 on the visual analog scale (VAS) were selected. The study was conducted in a split-mouth design, with each participant (n = 20) having at least 1 affected tooth in all quadrants. The management protocols consisted of control group: universal adhesive, Neural Desensitizing Protocol group: 5% potassium nitrate, Mixed Desensitizing Protocol (PAM) group: 5% sodium fluoride and 5% potassium nitrate, Remineralizing Desensitizing Protocol (PDR) group: surface-partially reacted glass technology photopolymerizable varnish. Evaluations were performed immediately after application, at 1 week, 1 month, 2 months, and 12 months using the VAS sensitivity test.

Results

The scores were subjected to statistical analysis using the Friedman test (p < 0.05), Durbin-Conover test (p < 0.05), and Wilcoxon test (p < 0.05). At the 12-month evaluation, all groups showed statistically significant differences compared to the initial assessment. For the evaluation after 12 months, there was a statistically significant difference between the PAM group, the control group, and the PDR group.

Conclusions

It can be concluded that all groups were effective in controlling DH, but there were significant results in the control group and PDR group. The clinical relevance of this study is to demonstrate that the application of single-session desensitizing protocols can be effective in controlling DH for up to 12 months.

Trial Registration

Brazilian Clinical Trials Registry Identifier: RBR-4r63d7s.

The Synergistic Effect of Ozonated Oil and Desensitising Toothpaste on Dentinal Tubule Occlusion: An In Vitro Study

Introduction Dentin hypersensitivity (DH) is the most common problem encountered by clinicians. It can be managed either by blocking neural activities or by occluding tubules. Ozonated oil facilitates the simple passage of desensitizing agents into dentinal tubules. Aim This study aimed to evaluate the effect of ozonated oil on dentinal tubule occlusion before and after the application of desensitizing toothpaste. Materials and methods The study was carried out in Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, India. The sample size of the study was 80. The first group contained specimens for control. The second group comprised specimens treated with ozonated oil. The third group comprised specimens being treated with a desensitizing agent. The fourth group contained specimens treated with both the desensitizing agent and ozonated oil. The specimens then received an acid challenge. The specimens were observed under a scanning electron microscope (SEM) before any therapy, after the application of the therapeutic agents and after the 37.5% ortho-phosphoric acid challenge. Results Inferential statistics to compare between the groups was calculated using one-way analysis of variance (ANOVA) statistics. Post-hoc Tukey's honestly significant difference (HSD) was performed to compare the groups. The mean scores of the partial tubular occlusion of Group 1, Group 2, Group 3 and Group 4 before the acid challenge were 0.035, 0.691, 0.564 and 0.368, respectively. The maximum score was obtained in the case of Group 2, which was statistically significant. The mean scores for partial tubule occlusion after the acid challenge for Group 1, Group 2, Group 3 and Group 4 were 0.055, 0.531, 0.733 and 0.142, respectively. There was evidence of maximum partial tubule occlusion after the acid treatment in the case of Group 3. The mean scores of Group 1, Group 2, Group 3 and Group 4 before the acid challenge were 0.019, 0.309, 0.442 and 0.609, respectively. The maximum score was obtained in the case of Group 4, implying a greater number of total tubular occlusions before the acid challenge. The mean scores of the total tubular occlusions after the acid challenge for Group 1, Group 2, Group 3 and Group 4 were 0.047, 0.465, 0.272 and 0.890, respectively. There was evidence of maximum tubule occlusion in the case of Group 4, which was statistically significant. Conclusion Overall, the application of a desensitizing toothpaste with ozonated oil holds promise as a potentially more effective treatment approach for DH. Further research and clinical studies may be needed to fully validate its efficacy and safety in dental practice.

Comparison of retention of cast crown luted with glass ionomer cement in presence of two different types of desensitizer agent on extracted teeth-an in vitro study

Background

Dentin hypersensitivity is common problem between procedure of vital tooth preparation and cementation procedure of final prosthesis. So, use of desensitizing agents may be helpful to minimize the errors.

Aim

To Compare retention of cast crown luted with glass ionomer cement in presence of two different types of desensitizer agent on extracted teeth.

Material

Desensitizing agents used are bioactive Glass and GLUMA, Glass Ionomer Cement has been used as luting agent. Other required items are crown cutting bur, airotor handpiece, spatula, glass Cement carrier, microtip brush, universal testing machine.

Methodology

In this study total number of 60 premolars with good coronal anatomy, which are extracted for orthodontic purposes, were collected from Department of oral and maxillofacial surgery, Institute of dental Sciences. Then they were mounted individually in die stone block. Tooth preparation for the metal prosthesis of maxillary and mandibular premolars was carried out following the standard principles of tooth preparation use milling surveyor and they are grouped randomly into Group A- Luting cement (Control group), group B- Luting cement + Kulzer Gluma Desensitizer, group C- Luting cement + Bioactive glass. After fabrication of metal coping, tooth conditioning has been carried out then cementation was done using GIC. Retention of coping was checked using universal testing machine.

Result

A comparison was made for the mean stress value within three groups. GIC + Bioactive had the highest mean stress (6.52 ± 1.81) followed by Control group (3.88 ± 2.37). GIC ± Gluma had the least mean stress of 2.59 ± 1.19.

Conclusion

Bioactive glass + GIC exhibited higher retentive value as compared to prosthesis luted only with GIC and GIC + Gluma. So clinically it can be inferred that for vital tooth preparation bioactive glass can be used as desensitizing agent for the intermediate period till the permanent crown is luted.

Influence of the combined effect of desensitizing dentifrices and universal adhesives on dentin bond strength under erosive conditions

OBJECTIVE

This study aimed to evaluate whether the use of desensitizing dentifrices containing obliterating agents can affect bond strength of eroded/abraded dentin.

METHODOLOGY

A total of 100 dentin samples were obtained from human molars. The teeth were cut into 3 mm-thickness discs and allocated in five groups (n=20), according to the toothpaste used: WoF - abrasion with fluoride-free toothpaste (Cocoricó); Arg - toothpaste containing arginine (Colgate Sensitive Pro-Relief); Nov - calcium sodium phosphosilicate toothpaste (Sensodyne Repair and Protect); SnF - fluoride-containing toothpaste (AmF/SnCl2/SnF2 - Elmex Erosion); and Control (no erosive/abrasive process). The erosive/abrasive cycle consisted of immersion in citric acid (1%, pH 2.6, 5 min, 4×/day) and abrasion (2×/day, 120-20 sec abrasion, 100 sec immersion) with each toothpaste. During intervals, samples were immersed in artificial saliva. This cycle was performed for five days. Two resin cylinders (2 mm in diameter) were constructed on each sample for the shear bond strength test using a universal adhesive system. The self-etch and etch-and-rinse (Scotchbond Universal) strategies were employed, each in half of the total sample (n=10). Bond strength (MPa) was measured in a shear test and failure modes were assessed with a stereomicroscope. Statistical analysis was performed using the two-way analysis of variance (ANOVA) and Tukey tests (p<0.05).

RESULTS

A statistically significant difference was found between the adhesive strategies tested (p<0.001), with the self-etching form showing higher values than the etch-and-rinse. Moreover, no significant differences were observed between the tested toothpastes (p=0.750) and interactions (p=0.438).

CONCLUSION

The use of toothpaste containing obliterating agents does not affect bond strength to dentin subjected to erosive/abrasive conditions when a universal adhesive is used. However, the self-etch strategy might be preferred for eroded/abraded dentin.

Penetration and durability of CPP-ACP paste and sodium fluoride varnish as desensitizing agents: An in vitro comparison

Background

This study aimed to investigate and compare the penetration and durability of two dentin desensitizers, sodium fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, using electron microscopy.

Methods

The study was performed on 60 dentin specimens prepared from extracted human premolars. After applying 17% EDTA to remove the smear layer, the specimens were divided into two groups. MI Paste and Bi-fluoride varnish were applied to the specimens. Microscopic images of 20 samples were obtained immediately. Twenty other samples were accessed after 15 days, and the other 20 were accessed after 30 days of toothbrushing and thermal cycling. Both surface and longitudinal cross-sectional images (after sample fracture) were studied. Data were analyzed with two-way ANOVA and Mann-Whitney U test at a significance level of P<0.05.

Results

The mean depth of material penetration was significantly time-dependent and fluctuated in both groups. There was a significant difference between the mean level of plugs between 0, 15, and 30 days (P<0.001). Penetration increased with time for the MI Paste group, while in the Bi-fluoride group, the increase was significant at 15 and 30 days than immediately after application. The mean thickness of the plugs was significantly different at the three time periods, and MI Paste showed a sudden decrease in plug thickness after 15 days.

Conclusion

Immediately after application, Bi-fluoride occluded dentinal tubules more effectively, and its durability after abrasion and thermal fatigue were higher than MI Paste.

Effect of Various Lasers With or Without Systemp.desensitizer on Dentine Tubules: An In Vitro Scanning Electron Microscopy Analysis

Objective: The current study was carried out to evaluate the effects of laser and Systemp.desensitizer therapy. Further, scanning electron microscopy (SEM) was used to determine the effects of individual or combined desensitizers on human dentinal tubules. Background: The most common clinical condition that makes people uncomfortable is dentin hypersensitivity (DH). Both lasers and drugs that reduce sensitivity have been used to treat DH. Materials and methods: A total of 100 dentinal samples were taken from newly extracted third molars (affected) and divided into 10 groups (A to J), that is, control (A); Systemp.desensitizer (B); diode laser (980 nm) (C); Nd:YAG laser (D); Er:YAG laser (E); Er,Cr:YSGG laser (F); Systemp.desensitizer + diode laser (G); Systemp.desensitizer + Nd:YAG laser (H); Systemp.desensitizer + Er:YAG laser (I); and Systemp.desensitizer + Er,Cr:YSGG laser (J). SEM was used to evaluate the dentinal specimens in each group (longitudinal and transverse portions), and then images of each sample were captured (20 images/sample). In addition, the number of open dentinal tubules was counted and then the occlusion depth in dentinal tubules was measured. Mann-Whitney and Kruskal-Wallis tests were employed to analyze the obtained data. Results: All treatment procedures and protocols were effective in blocking dentinal tubules (p < 0.05). Compared with the other groups, dentinal tubules in the laser and laser combination therapy groups were significantly obstructed (p < 0.05). Diode and Nd:YAG lasers with or without Systemp.desensitizer showed significantly more tubule occlusion and greater sealing depth than Er:YAG and Er,Cr:YSGG lasers with or without Systemp.desensitizer (p < 0.05). Conclusions: In summary, lasers alone or in combination can play a significant role in occluding the dentinal tubules. However, combining the diode or Nd:YAG laser with Systemp.desensitizers is a more effective treatment strategy and may have immediate and long-lasting effects.

Effectiveness of fluoride-containing toothpastes associated with different technologies to remineralize enamel after pH cycling: an in vitro study

BACKGROUND

To evaluate the efficacy of fluoride-containing toothpastes with different technologies to remineralize artificial caries lesions in enamel.

METHODS

Bovine enamel blocks were divided into three thirds: intact (untreated), demineralized (artificial caries lesion), and treated (caries lesion, pH cycling with dentifrices). Enamel blocks were randomly distributed into five groups (n = 12): Fluoride-free toothpaste, Colgate Oral Care (NC); Arginine-containing toothpaste, Colgate Total Daily Repair (PC); Silicate-based fluoride toothpaste: REFIX technology, regenerador + sensitive (RDC), NR-5 technology, Regenerate Enamel Science (RES), and NOVAMIN technology, Sensodyne Repair and Protect (SRP). The specimens were submitted to a pH cycling model for 6 days. The efficacy of the toothpastes was estimated by calculating the surface microhardness recovery (%SMHR) and the fluorescence recovery (ΔFRE) with quantitative light-induced fluorescence. The cross-sectional micromorphology of the enamel surface was also assessed using scanning electron microscopy. Elemental analyses (weight%) were determined with an energy-dispersive X-ray spectrometer (EDS). The results were compared to that of the control (NC). Data were statistically analyzed (5%).

RESULTS

%SMHR could be ranked as follows: RDC = PC = RES = SRP > NC. Significantly higher %SMHR and ΔFRE means were observed after enamel treatment with RDC (22.7 and 46.9, respectively). PC (%SMHR = 18.8) was as efficacious as RDC to recover the surface microhardness with a significantly lower mean of ΔFRE (19.5). Only RDC was able to promote the formation of a mineralized layer on the surface of enamel enriched with silicon on the surface.

CONCLUSIONS

The silicate-based fluoride toothpaste containing REFIX technology demonstrated greater efficacy in the remineralizing artificial caries than the other products.

Evaluation of Dentin Tubule Plugging Efficiencies and Effects on Dentin Surface Roughness of Dentin Desensitizing Agents, the Er,Cr:YSGG Laser, and Their Combination After Erosion-Abrasion Cycles: An In Vitro Study

OBJECTIVES

The purposes of this in vitro study were to evaluate the tubule plugging efficiencies and effects on the surface roughness of dentin of different dentin desensitizing agents (DDAs; Teethmate Desensitizer, Kuraray; Gluma Desensitizer, Kulzer; Clinpro White Varnish, 3M ESPE; Enamelast, Ultradent) and the Er,Cr:YSGG laser (Biolase, Waterlase), both alone and in combination with DDAs, after application and after an erosion-abrasion cycle.

METHODS AND MATERIALS

For surface roughness examinations, superficial buccal dentin specimens were divided into 10 groups: the control, Teethmate Desensitizer, Gluma Desensitizer, Enamelast, Clipro White Varnish, Er,Cr:YSGG Laser, Teethmate Desensitizer-Laser, Gluma Desensitizer-Laser, and Enamelast-Laser, and Clinpro White Varnish-Laser groups. Profilometric analyses and scanning electron microscopy (SEM) examinations were performed after applications and after a 5-day erosive-abrasive cycle. For the statistical analysis of surface roughness measurements, 2-way analysis of variance (ANOVA), 1-way ANOVA, and Tukey post hoc test were used.

RESULTS

Among the treatments, only DDAs alone did not cause increase in surface roughness after application. All of the laser applications increased the surface roughness of dentin, and after the erosion-abrasion cycle, all of the test groups had increased surface roughness. However, SEM images showed that morphological changes were less frequently observed in all of the experimental groups than in the control group. In addition, all of the laser-DDA combinations had stronger tubule occlusion effects than did DDAs alone, even after erosion-abrasion.

CONCLUSIONS

All of the test treatments showed protective effects on dentin surfaces against the negative effects of erosion-abrasion. The addition of the laser to DDA applications increased tubular plugging efficiencies of DDAs, and the tubule plugs of the combination treatments were resistant to the erosion-abrasion cycle.

Parameters Used With Diode Lasers (808-980 nm) in Dentin Hypersensitivity Management: A Systematic Review

Introduction: The present study aimed to describe parameters used with 808- to 980-nm wavelength diode lasers for managing dentin hypersensitivity and analyze their results. Methods: The inclusion criteria were based on randomized controlled clinical trials using diode lasers at an 808-980 nm wavelength range in patients with dentine hypersensitivity with a minimum of 1-month follow-up. An electronic search for articles on Medline, PubMed and Cochrane databases was performed. The risk of bias was assessed with the Cochrane collaboration tool. Results: Our electronic search resulted in 130 papers, of which 11 articles met the inclusion criteria. A majority of the studies assessed dentine hypersensitivity using the Visual Analogue Scale, which ranged between 2.3 and 8.8 before treatment and significantly reduced to a mean value of 0.45-3.7 after diode laser application. The power settings ranged between 1.5 mW and 3 W with an emission mode of continuous wave, except for 2 authors who used chopped mode. The energy density varied from 2.5 to 128 J/cm2, and the exposure time was between 10 and 120 seconds. The authors applied a minimum of 1 to 4 treatment sessions with a 2-day to 1-week interval between them. Most of the studies mentioned the tooth surface as the treatment site but without describing the specific irradiation points. Conclusion: Despite the heterogeneity of the analyzed variables, a statistically significant improvement in all laser groups was described. However, they cannot be compared homogenously.

Deep and compact dentinal tubule occlusion via biomimetic mineralization and mineral overgrowth

Dentinal tubule (DT) occlusion by desensitizing agents has been widely applied to inhibit the transmission of external stimuli that cause dentin hypersensitivity (DH). However, most desensitizing agents merely accomplish porous blocking or the formation of a superficial tubular occlusion layer, resulting in a lack of mechanical and acid resistance and long-term stability. Herein, combining biomimetic mineralization and mineral overgrowth of the dentinal matrix was shown to effectively occlude DTs, resulting in the formation of a compact and deep occluding mineral layer that is strongly bound to the organic matrix on tubule walls. This DT occlusion method could achieve both mechanical resistance and acid resistance, demonstrating the potential of an inexpensive, long-term, and efficient therapy for treating DH.

Comparative evaluation of the efficacy of light amplification by the stimulated emission of radiation, desensitizing agents, and their combined effect on dentinal hypersensitivity in cuspids and bicuspids – In Vivo Study

Context:

Dentinal Hypersensitivity is the most common dental problem, in order to find a suitable treatment plan this study was conducted incorporating LASER and desensitizing agents on the patients complaining of dentinal hypersensitivity in cuspids and bicuspids. Most of the desensitizing agents provided incomplete relief hence the combination of LASER and Desensitizing agents proved to be successful.

Aim:

The aim of this study is to evaluate and compare the efficacy of individual desensitizing agents and c (LASER) and also to know their potential in reducing dentinal hypersensitivity when both desensitizing agents and LASER are combined together and applied on cuspids and bicuspids.

Setting and Design:

Sixty patients with sensitivity only in cuspids and bicuspids and not having caries, restoration, or undergoing any desensitizing therapy were selected. Patients were divided into 5 groups with 12 patients in each group.

Materials and Methods:

Air blast stimulus was given for 10 s from 1 cm distance on the affected group. Verbal analog score was recorded. Treatment was carried on according to the groups mentioned: Group I – nanohydroxyapatite was applied for 15 min; Group II – biosilicate was applied for 15 min; Group III – LASER application was done twice for 60 s in noncontact mode; Group IV – Nanohydroxyapatite plus LASER application; and Group V – biosilicate plus LASER application. Desensitizing agent was applied with the applicator tip and was left for 15 min. It was then rinsed and again the stimulus was given, and the score was recorded. The same treatment procedure was repeated on 1^st, 7^th, and 14^th day and the score was recorded and analyzed using ANOVA.

Results:

The maximum reduction in sensitivity score was observed in patients where nanohydroxyapatite and LASER application was done.

Conclusion:

All the investigated treatments have promising desensitizing potential, but maximum was found in Group IV > Group V > Group III > Group I > Group II.

Study on Occluding Dentinal Tubules with a Nanosilver-Loaded Silica System In Vitro

The effects of most clinical treatments for dentin hypersensitivity are not long-lasting. To overcome the defects, the mesoporous silica nanoparticles and silver nanoparticles entered the field of oral materials. This study aimed to synthesize a novel, low-cytotoxic dentin desensitizer and investigate its occlusion effects on dentinal tubules. The biphasic stratification approach, a chemical reduction method, and the Stöber method were used to synthesize silver nanoparticle-loaded and nonporous silica-encapsulated mesoporous silica (Ag-MSNs@nSiO₂), which was a noncrystalline structure with an average size of approximately 128 nm and a silver content of 3.506%. Atomic absorption spectrometry and the 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide cell viability assay showed that Ag-MSNs@nSiO₂ slowly released silver ions and had nearly no cytotoxicity. An electron microscope was used to observe the blocking effects on the dentinal tubules of sensitive tooth disc models, which were randomly divided into the following four groups: a deionized water group, a 5.9 M silver nitrate solution group, an Ag-MSNs@nSiO₂ group, and a Gluma desensitizer group. There were no significant differences in the relative area of open dentinal tubules between the Ag-MSNs@nSiO₂ group and the Gluma desensitizer group (P > 0.05). Detection of protein structures showed that multilevel structures of bovine serum albumin in dentin tubules were significantly changed by silver ions from Ag-MSNs@nSiO₂. These results suggest that nearly noncytotoxic Ag-MSNs@nSiO₂ was successfully synthesized by a series of methods. Ag-MSNs@nSiO₂ occluded dentin tubules immediately and effectively. Moreover, the blockage effects may be enhanced and maintained by continuous condensation of proteins in dentinal tubules.

Evaluating the efficacy of desensitizing dentifrices on dentinal hypersensitivity management: A scanning electron microscopic analysis

Introduction

Dentin hypersensitivity (DH) adversely affects quality of life by impairing the ability to eat and drink certain foods, therefore, should be addressed promptly with a contingency plan that includes initial treatment with a noninvasive prophylactic home care approach, followed by in-office treatment if desired result is not achieved.

Aim

The purpose of this study was to evaluate the effectiveness of four different pastes containing 5% NovaMin (Sensodyne Repair and Protect^®), Propolis (Phytoshield Propolis^®), 5% potassium nitrate (Sensodyne^®), and 8% arginine (Colgate Sensitive Pro Relief^®) based toothpastes in the treatment of DH.

Materials and Methods

One hundred dentin slices were cut from the crown section of molars. Etching with 37% orthophosphoric acid was done to open the tubules. Scanning electron microscope (SEM) study was done to ensure that the tubules are opened. The dentin specimens were divided into four groups: Group 1 -5% NovaMin, Group 2 - Propolis, Group 3 - 5% potassium nitrate, and Group 4 - 8% arginine. Samples were brushed for 2 min twice daily with a soft toothbrush for 15 days and were stored in distilled water. The samples were rinsed under running water to remove the toothpaste. The SEM was performed to check the obliteration of tubules.

Results

5% NovaMin group showed more completely occluded dentinal tubules when compared to other groups. The differences among all the groups were statistically significant (P ≤ 0.05).

Conclusion

In the present study, all materials, NovaMin, Propolis, potassium nitrate, and arginine, were effective in occluding dentinal tubules but NovaMin appeared most proficient in occluding tubules, followed by arginine, potassium nitrate, and Propolis. Topical NovaMin is an upcoming agent demonstrating desensitization and remineralization properties.

Efficacy of MI Paste® on Bleaching-Related Sensitivity: Randomized Clinical Trial

Background

To evaluate the effectiveness of MI Paste® in reducing sensitivity associated with vital tooth bleaching.

Methods

This randomized controlled split-mouth clinical trial included 45 subjects that were randomly divided into two groups. In Group 1, the maxillary arch was the control arch (only bleaching), while the mandibular arch was the intervention arch (bleaching and MI Paste®). In Group 2, the mandibular arch was the control arch (only bleaching), while the maxillary arch was the intervention arch (bleaching and MI Paste®). Subjects started with the control arch and then switched to the intervention arch after two weeks. Subjects were instructed to use MI Paste® in a custom tray for 5 minutes, wait for 1 hour, and then bleach overnight using a different tray. Sensitivity was measured using both a thermal sensitivity test and a daily log of sensitivity for 14 days. Shade was evaluated using a colorimeter and a shade guide.

Results

Immediately after treatment, the thermal test sensitivity scores for the arches bleached without MI Paste® were greater than those with MI Paste® (p=0.011). Arches not receiving the MI Paste® treatment showed significantly higher VAS sensitivity scores during the 14-day period of bleaching (p=0.002). The mean score for the 14-day period was 37.9 for the arches not treated with MI Paste® versus 27.5 for the treated arches. Both the intervention group and the control group showed significantly lighter shade relative to baseline (p < 0.001) with no significant difference between them (p=0.42).

Conclusion

MI Paste® significantly reduced the sensitivity associated with bleaching and did not interfere with shade change.

Resistance against Erosive Challenge of Dental Enamel Treated with 1,450-PPM Fluoride Toothpastes Containing Different Biomimetic Compounds

OBJECTIVES

 This in vitro study aimed to characterize the superficial and subsurface morphology of dental enamel treated with fluoridated gels containing different biomimetic compounds after erosive challenge.

MATERIALS AND METHODS

Bovine incisor teeth were sectioned to obtain enamel blocks (4 mm × 4 mm × 6 mm; n = 5) that were demineralized to create an artificial caries lesion and treated by pH cycling interspersed with exposure to fluoridated toothpaste slurries under agitation. During pH cycling (demineralization and remineralization for 2 and 22 hours, respectively) for 6 days, the enamel blocks were exposed to toothpaste slurries under agitation with one of the dental gels: Regenerate Enamel Science (NR-5 technology), Daily Regenerator Dental Clean (REFIX technology), and Sensodyne Repair & Protect (Novamin technology). The enamel blocks were subjected to an erosive challenge, immersed in 50% citric acid for 2 minutes, and then washed with plenty of distilled water. The surface and cross-sectional micromorphology were assessed using scanning electron microscope (SEM). The elemental analyses (weight percentage) were determined with an energy-dispersive X-ray spectroscopy (EDS).

RESULTS

 Enamel treated with the product containing REFIX technology presented a smoother surface morphology compared to the other treatments. The higher resistance to the erosive challenge can be attributed to a silicon-enriched mineral layer formed on the enamel induced by the REFIX-based toothpaste. This was not observed in the specimens treated with the other technology-containing toothpastes.

CONCLUSION

 The REFIX technology seemed to be the most promising compared to the Novamin and NR-5 technologies. In addition to forming a surface mineralized layer, the enamel treated with REFIX technology associated with the pH cycling resisted a subsequent erosive challenge.

Comparative evaluation of the efficacy of the desensitizing and remineralizing agent in the reduction of dentin hypersensitivity after orthodontic debonding - a randomized clinical trial

Introduction

Enamel loss is a common problem during various orthodontic procedures. The study aims to compare the efficacy of a desensitizer and remineralizer in the reduction of the dentin hypersensitivity (DH) associated with enamel microcracks after orthodontic debonding.

Methods

A unicentric two arm parallel study with 30 subjects randomly assigned to each groups following debonding. Group-1 subjects were treated with Gluma® desensitizer (5% glutaraldehyde and 35% hydroxyethyl methacrylate (HEMA)) and the Group-2 intervention included a remineralizing agent GC Tooth Mousse Plus® (casein phospho peptide and amorphous calcium Fluro phosphate (CPP:ACFP)). The Visual Analogue Scale (VAS) was utilized to evaluate DH as subjective perception of pain following the Air blast test and Cold test. The VAS scale was indexed from 0–10 markings based on the intensity of perception. Five different time points T0 and T1 - immediately after debonding and intervention on day 1, T2 – 48 hours, and T3 after 72 hours were taken for the assessment of VAS scores.

Results

The VAS scores for the airblast test for group 1 were (2.73, 0, 0.06, 0.03) and group 2 (2.46, 0, 0.16, 0.13) at different periods. The sensitivity scores for the cold blast test for group 1 were (2.73, 0, 0.13, 0.03) and for group 2 (2.46, 0, 0.16, 0.13). There was 98 percent reduction in DH between T0 and T3 and was statistically significant (p<0.05) for both the groups.

Conclusion

Gluma® desensitizer and GC Tooth Mousse Plus® are equally effective in the reduction of DH in the orthodontic patient following debonding.

Comparative Evaluation of the Remineralizing Potential of Commercially Available Agents on Artificially Demineralized Human Enamel: An In vitro Study

Background

Caries is highly prevalent multifactorial disease, but its progression can be prevented in the initial stage of demineralization through remineralization (RML). Various materials have been proposed for the same, successful outcome can prove to be a boon in the prevention of caries.

Aim

The aim of the study is to assess the RML potential of four commercially available agents so as to restore the enamel closest to its previous microhardness levels.

Materials and Methods

Sixty permanent intact premolars were randomly divided into six groups: Four test groups - (1) bioactive glass (BAG) Novamin (SHY-NM), (2) nano-hydroxyapatite (nHAp) (Acclaim), (3) functionalized tricalcium phosphate (f-TCP) (Clinpro Tooth Crème), and (4) grape seed extract (GSE); one positive control - (5) fluoride (1000 ppm) containing dentifrice (Colgate Calci-Lock); and one negative control - (6) distilled water. The samples were initially evaluated for baseline surface microhardness (SMH); later on, these samples were placed in the demineralizing solution for 48 h in an incubator at 37°C, and postdemineralization again SMH was measured. Thereafter, the samples were subjected to the pH cycling for consecutive 21 days, and SMH was recorded. The SMH was evaluated using a Vickers microhardness tester. Statistical analysis was done using a post hoc Tukey test for each group based on the stage of treatment and one-way ANOVA for comparison among different groups.

Results

BAG Novamin showed SMH recovery at 96.75% followed by f-TCP at 95.83%, nHAp at 90.88%, and GSE at 48.71%. Statistically significant differences were observed between the first three groups and the rest of the groups after RML stage.

Conclusion

BAG Novamin, f-TCP, and nHAp showed considerable RML followed to a lesser extent by GSE.

Is there evidence for Novamin application in remineralization?: A Systematic review

Background

Calcium sodium phosphor-silicate material, a type of bio-glass was originally developed as an implant material to regenerate bone and recently adapted for use in oral care products (NovaMin Technology Inc.). Novamin is used for many dental problems like hypersensitivity, gingivitis, bleeding, non-carious lesions, carious lesions, whitening and is currently emerging as one of the treatment modality for the remineralization of the tooth. Since the prescription of these novel materials to the patients are based on cost effectiveness, efficacy and effectiveness, a clinician should make decision based on best available evidence. Hence, the objective of this review is to find out the current evidence available on the use of Novamin as an agent for remineralization.

Materials and methods

Relevant articles were searched and screened from several databases including PubMed, Cochrane review, Science Direct and trip which were published till 1988 to July 2017; The articles relevant to the objective of this review were included (RCT's) and articles out of interest of this review were excluded. The primary outcome for the chosen studies is the remineralization capacity of Novamin. Data extraction is done independently and jointly by 3 authors using data collection forms. Studies obtained were evaluated using the Cochrane Collaboration tools for accessing risk bias. The assessment of the quality of the evidence and the bias risk was obtained using the Grading of Recommendations Assessment Development and evaluation System.

Results

The articles from the database obtained for further review was N = 1. According to the study reviewed, the baseline comparisons using decalcification index obtained between Novamin study group (ReNew) and the control group (Crest) yield a P-value of 0.97 whereas after a 3 months interval follow up the value is 0.0403 suggesting there was a trend towards improvement in white spot lesions in the control group and at 6 months' time point the p-value is 0.81 concluding that there are no significant difference of remineralization process obtained by using traditional toothpaste and Novamin.

Conclusion

Review shows that Novamin has significantly less clinical evidence to prove its effectiveness as a remineralization agent in treating both carious and non-carious lesion. Hence, better designed clinical trials should be carried out in the future before definitive recommendations can be made.

Effect of a stannous fluoride toothpaste on dentinal hypersensitivity: In vitro and clinical evaluation

BACKGROUND

The authors conducted an in vitro and a clinical study to assess the effect of a toothpaste containing stannous fluoride to occlude dentin tubules and reduce dentinal hypersensitivity.

METHODS

For the in vitro study, the authors treated the surface of human dentin specimens with test or control toothpaste slurries and then evaluated them by using various spectroscopic techniques. For the clinical study, male and female participants who met the inclusion criteria brushed their teeth twice daily for 1 minute with test or control toothpaste. The authors assessed dentinal hypersensitivity by using tactile and air blast stimuli at baseline and after 4 and 8 weeks. All statistical tests of hypotheses were 2 sided, with a significance level of α set at .05.

RESULTS

Results from in vitro studies showed that the test toothpaste effectively occluded the dentinal tubules with a deposit consisting of tin, zinc, phosphate, and silicon. The test and control toothpastes occluded the tubules 82% and 35%, respectively. Clinically, at the 4- and 8-week examinations, the test toothpaste provided statistically significant (P < .001) improvements in tactile dentinal hypersensitivity scores of 27.8% and 42.0% and in air blast hypersensitivity scores of 21.4% and 32.3%, respectively, relative to the control toothpaste.

CONCLUSIONS

The in vitro results indicate the toothpaste containing 0.454% stannous fluoride effectively coated dentin surfaces and occluded patent dentin tubules. Compared with the control toothpaste, the test toothpaste provided a significant reduction in dentinal hypersensitivity after 8 weeks of product use.

PRACTICAL IMPLICATIONS

A multi-benefit option for patients with dentinal hypersensitivity.

Therapeutic Management of Demineralized Dentin Surfaces Using a Mineralizing Adhesive To Seal and Mineralize Dentin, Dentinal Tubules, and Odontoblast Processes

Dentin hypersensitivity is attributable to the exposed dentin and its patent tubules. We proposed the therapeutic management of demineralized dentin surfaces using a mineralizing adhesive to seal and remineralize dentin, dentinal tubules, and odontoblast processes. An experimental self-etch adhesive and a mineralizing adhesive consisting of the self-etch adhesive and 20 wt % poly-aspartic acid-stabilized amorphous calcium phosphate (PAsp-ACP) nanoparticles were prepared and characterized by X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, transmission electron microscopy (TEM), and scanning electron microscopy. After 60 acid-etched midcoronal dentin disks were treated with distilled water (control), a desensitizing agent (Gluma), the experimental self-etch adhesive, and the mineralizing adhesive, dentin permeability was measured and mineralization was evaluated by Raman, FTIR, XRD, TEM, and selected-area electron diffraction, irrespective of abrasive and acidic challenges. In vitro cytotoxicity of the adhesive and the mineralizing adhesive was assessed by Cell Counting Kit-8. The mineralizing adhesive possessed excellent biocompatibility. We proposed a hybrid mineralization layer composed of the light-cured mineralizing adhesive and the mineralized dentin surfaces, as well as interiorly mineralized resin tags and odontoblast processes inside of the dentinal tubules. This hybrid mineralization not only reduced dentin permeability but also resisted abrasive and acidic attacks.

Clinical Evaluation of Nd:YAG Laser With and Without Dentin Bonding Agent for the Treatment of Occlusal Hypersensitivity

Purpose:

The aim of the present study was to evaluate and compare both the immediate and delayed desensitizing effects of the Nd:YAG (neodymium-doped:yttrium aluminum garnet; Nd3+:Y3Al5O12) laser with and without dentin bonding agent (DBA) on occlusal dentinal hypersensitivity (DH).

Methods and Materials:

Twenty-one patients with a total of 117 chronic occlusal hypersensitive teeth were selected. Each subject had at least three hypersensitive teeth. These teeth were randomly allocated into three groups: group 1, DBA on the occlusal surface; group 2, Nd:YAG laser (1064-nm wavelength, 30 mJ of energy, 10 pulse/s, 60 seconds, two times); and group 3, Nd:YAG laser (1064-nm wavelength, 30 mJ of energy, 10 pulse/s, 60 seconds, two times) with DBA. Pain was assessed using a visual analog scale after stimulation of the sensitive teeth by using the sharp tip of an explorer and an air blast prior to treatment and immediately, one week, one month, and three months after treatment by one blinded examiner.

Results:

A significant reduction in occlusal DH occurred at all time points in all of the experimental groups. The three groups showed significant improvements in discomfort immediately after treatment and after one week (p&lt;0.001), but the Nd:YAG laser with DBA group had greater efficacy when compared with the other groups. The Nd:YAG laser group and Nd:YAG laser with DBA group had no significant differences at one month and three months after treatment (p&gt;0.05); however, their desensitizing efficacy was superior to the DBA group.

Conclusions:

The Nd:YAG laser with DBA may be most effective in the long-term treatment of occlusal DH, although other measures also reduce DH.

In Vitro Effect of Innovative Desensitizing Agents on Dentin Tubule Occlusion and Erosive Wear

Purpose:

The purpose of this study was to evaluate the effects of four in-office desensitizing products on dentin tubule occlusion and erosive wear.

Methods:

Dentin hypersensitivity was simulated by EDTA application for five minutes. The specimens were randomly allocated into five groups (n=11), according to treatment: No treatment - Control (C), Duraphat (DUR), Desensibilize Nano P (NP), ClinPro XT Varnish (XTV), and ClinPro White Varnish (CWV). They were then submitted to erosive/abrasive cycling for five days. After EDTA, treatment, and cycling, the specimens were analyzed with an environmental scanning electron microscope (ESEM) to verify the number of opened dentin tubules (ODT) which were counted by using ImageJ software, and with a profilometer to determine the surface curvature/loss. ESEM data were analyzed with two-way repeated measure analysis of variance and Tukey tests. For the profilometer, data were analyzed with Kruskal-Wallis, Tukey, and Mann-Whitney tests.

Results:

After treatment, all groups showed lower ODT than the control, without significant differences between them. After cycling, the only group that showed lower ODT than the control was group XTV; however, it did not significantly differ from the other groups. For the profilometric analysis, there were significant differences in SL between the experimental times after treatment and after cycling for all groups (p&lt;0.05). After cycling, no surface loss was detected in groups DUR and XTV, which presented a significantly different curvature than group NP and the control group, but not from group CWV. Surface loss was detected for the control and groups NP and CWV, without difference among them.

Conclusion:

All desensitizing agents tested presented promising results concerning the obliteration of dentin tubules immediately after treatment. XTV was the only desensitizer capable of preventing the reopening of the tubules after the erosive/abrasive challenges. XTV and DUR presented a protective effect against dentin erosive wear.

Performance of a bioglass-based dentine desensitizer under lactid acid exposition: an in-vitro study

Background

Dentine hypersensitivity is especially frequent in patients with pronounced periodontal attachment loss. Aim of the treatment is an obstruction of the dentine tubules in order to inhibit liquid or osmotic motion, which is considered as trigger for pain sensations. Novel approaches aim for obstruction by calcium phosphate compounds in order to rely on biocompatible compounds. It was the aim of the study to optically investigate the morphology and to assess the fluid permeability of treated dentine surfaces.

Methods

Dentine discs were pretreated in an ultrasonic bath with 17% EDTA to clean the lumina of the dentine tubules. Samples of group A remained untreated while Seal&Protect® as a conventional desensitizer was applied for group B and DentinoCer in group C. Discs were mounted into a pulp fluid simulator (PFS) with a methylene blue solution in order to create a flow pressure of 0.5 bar. Over 12 d, discs were exposed three times per day to 0.1 M nonsaturated lactic acid. At baseline and after 2, 8 and 12 d samples were removed from PFS and prepared for SEM analysis. Tubule obstruction was assessed quantitatively using Olley scores and by qualitative description of the surface. Absorption spectrometry was used to assess the concentration of leaked methylene blue outside the samples in order to estimate dentine permeability.

Results

Untreated discs showed clean lumina of all tubules at all time points and magnifications. From day 2 onwards dentine showed exposed collagene fibers due to acid exposition. Seal&Protect® initially showed homogenous dentine surface coverage that got a more granulomatous aspect in the course of treatment time. Few samples showed sporadic tubules with open lumen at day 8 and 12. Group C showed samples with a homogeneous, even surface. Narrow slits in the superficial layer are visible from day 4 on, but the dentine surface remained invisible and dentine tubules were closed till the end of the investigation period.

Conclusion

Over 12 d of lactid acid exposure, samples showed complete coverage of the dentine tubules in the chosen in-vitro-model when treated with Seal&Protect® or DentinoCer.

Preventive Use of a Resin-based Desensitizer Containing Glutaraldehyde on Tooth Sensitivity Caused by In-office Bleaching: A Randomized, Single-blind Clinical Trial

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.

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.

Effect of GLUMA desensitizer on the retention of full metal crowns cemented with Rely X U200 self-adhesive cement

PURPOSE

Considering the importance of retention in the success and long-term clinical service of fixed partial dentures (FPDs) as well as the existing controversy regarding the effect of GLUMA desensitizer on the retention of full metal crowns cemented with RelyX U200 self-adhesive cement, this study aimed to assess the effect of GLUMA desensitizer on the retention of full metal crowns cemented using RelyX U200.

MATERIALS AND METHODS

In this experimental study, 20 sound human premolars were prepared; a 0.5 mm chamfer finish line was prepared above the cementoenamel junction. The teeth were randomly assigned to two groups: a desensitizer group (n = 10, treated with GLUMA desensitizer) and a control (n = 10, no surface treatment). Full metal crowns were fabricated of base metal alloy and had a ring. All crowns were cemented with RelyX U200 and subjected to retention test by using a universal testing machine. The data were analyzed using SPSS version 20 and independent t-test.

RESULTS

The mean tensile bond strength was significantly higher in the GLUMA desensitizer group (230.63 ± 63.8 N) compared to the control group (164.45 ± 39.3 N) (P≤.012).

CONCLUSION

GLUMA desensitizer increases the tensile bond strength of RelyX U200 self-adhesive cement to dentin.

An In-vitro Comparison of Nano Hydroxyapatite, Novamin and Proargin Desensitizing Toothpastes - A SEM Study

INTRODUCTION

Dentinal Hypersensitivity (DH) is commonly encountered clinical condition in dental practice which affects 8-57% of the adult population presenting for dental treatment, but the treatment of the same remains doubtful.

AIM

The purpose of this study was to evaluate and compare the effects of three different desensitizing agents (15% nano hydroxyapatite crystals; 5% novamin and 8% proargin) on dentinal permeability and tubule occlusion in-vitro. Scanning Electron Microscope (SEM) was used to evaluate the effect of these commercially available desensitizing toothpastes.

MATERIALS AND METHODS

A total of 40 disc shaped dentin specimens were dissected from extracted premolars. Dentin discs of 1mm were obtained with the help of diamond discs. Ten specimens were randomly selected and allocated to the evaluation groups A (control group), B (Nano-hydroxyapatite), C (Novamin) and D (Proargin). Each treatment group dentine disc specimen was treated with the respective slurry for two minutes for a period of seven days. Each disc was subjected to a pre- and post-treatment SEM analysis to evaluate the changes occurring in the dentinal tubules.

RESULTS

The qualitative analysis showed no occlusion of the dentinal tubules in Group A (control group) and Group B (nano-hydroxyapatite) showed 98.1% tubule occlusion. Group C (Novamin) and D (Proargin) showed 83.1% and 69.1% tubule occlusion respectively. Quantitative analysis showed a statistical significant difference between Group B and D (p< 0.005) and no statistical significant difference between group B and C (p= 0.235). Similarly, there was no significant difference between Group C and D as (p=0.235).

CONCLUSION

It was concluded that all the three desensiting agents were effective in the dentine tubule occlusion. In addition efficacy of nano-hydroxyapatite toothpaste was greater compared to the other desensiting agents.

Efficacy of Diode Laser and Gluma on Post-Preparation Sensitivity: A Randomized Split-Mouth Clinical Study

OBJECTIVE

This study aimed to compare the efficacy of a 940-nm diode laser and Gluma desensitizer on post-preparation sensitivity of prepared teeth.

MATERIALS AND METHODS

Twenty patients with 76 teeth participated in the study. For each patient, prepared molar or premolar in one quadrant were individually irradiated by laser. In the symmetrical quadrant, Gluma was applied onto the prepared teeth. No treatment was performed in the control group. Temporary crowns were placed after preparation. Pain response to tactile stimulus was assessed at one day, one week, and two weeks using visual analog scale (VAS). Intergroup comparisons were made with Kruskal Wallis test (p < 0.05).

RESULTS

Mean VAS scores of the control group were statistically higher than laser and Gluma groups (p < 0.017). The difference between VAS scores of the laser and Gluma groups was statistically insignificant (p > 0.05).

CONCLUSIONS

A significant reduction in level of sensitivity after both treatments was observed. The reduction of sensitivity with Gluma was not significantly superior to laser. No significant additional reduction occurred in level of sensitivity from the first day to the second week after both treatments.

CLINICAL SIGNIFICANCE

The application of Gluma or a 940-nm diode laser may be considered as effective in reducing sensitivity after tooth preparation without superiority of either method. (J Esthet Restor Dent 28:405-411, 2016).