Analysis of YouTube videos as a source of information about dentin hypersensitivity

OBJECTIVES

Even though tooth sensitivity is a prevalent dental issue today, more information is available to patients via social media concerning the subject. This study aimed to examine what patients may learn about tooth sensitivity from online videos on YouTube™ and evaluate the accuracy of the information given.

METHODS

In this cross-sectional investigation, two experienced periodontologists used the keyword 'tooth sensitivity' to conduct an organized search into YouTube videos containing knowledge regarding dentin hypersensitivity. Videos' type, origin, number of days since upload, duration, number of views, likes and dislikes, and comments were all noted; the viewing rate and interaction index were calculated. Videos were graded based on their content. The DISCERN and Global Quality Scales were used to rate each video's level of quality and reliability.

RESULTS

After the initial 260 videos were examined, 199 were kept for additional study. Healthcare professionals, hospitals, and colleges posted the great majority of the videos. There was a significant positive relationship between the number of views and Total Content scores of the videos, the viewing rate, comments, and likes (p < 0.05). Significant relationships were obtained between total discernment, video type, source of upload, and global quality variables, and Total Content scores (p < 0.05).

CONCLUSIONS

When looking for information on dentin hypersensitivity, patients might find watchable, reliable, and helpful videos on YouTube™.

Preemptive use of ibuprofen and desensitizer decreases immediate tooth sensitivity after in-office bleaching: A triple-blind, randomized, placebo-controlled clinical trial

BACKGROUND

The authors evaluated the synergistic analgesic effect of preemptive administration of 400 mg of ibuprofen (IBU) and potassium fluoride 2% (KF2), both in isolation or combination, on the painful perception of tooth sensitivity after tooth bleaching.

METHODS

Fifteen patients participated in this triple-blind, randomized, placebo-controlled clinical trial. The study used a crossover design for drug administration and a split-mouth design for desensitizer agent. Four paired groups were formed: IBU plus KF2 (IBU + KF2); IBU (IBU + placebo KF); KF2 (placebo IBU + KF2), and placebo (placebo IBU + placebo KF). The outcome measure was the perception of tooth sensitivity, assessed using a visual analog scale. Data were collected at 4 different times: immediately after tooth bleaching (baseline) and after 6, 30, and 54 hours. Statistical analysis was performed using the Friedman test and relative risk.

RESULTS

IBU plus KF2 was found to be more effective in reducing tooth sensitivity immediately after bleaching (baseline) compared with the placebo group (P < .05). The risk of experiencing moderate or severe tooth sensitivity was approximately 4 times higher in the placebo group than in the IBU plus KF2 group (relative risk, 4.00; 95% CI, 1.01 to 15.81; P = .025).

CONCLUSIONS

The combined use of 400 mg of IBU and KF2 appears to be beneficial in managing postbleaching tooth sensitivity. It provides a superior analgesic effect compared with placebo.

PRACTICAL IMPLICATIONS

The preemptive administration of IBU plus KF2 reduces tooth sensitivity after tooth whitening when compared with placebo. This clinical trial was registered in the Brazilian Clinical Trials Registry Platform. The registration number is U1111-1249-8191.

The Impact of the Gender on the Pulp Vitality Testing for the Various Types of the Conducting Media: An Original Research

Introduction

To identify gender-based differences in pulpal sensory thresholds in human teeth utilizing various conducting media.

Materials and Methods

The study involved 50 participants of both genders equally distributed. The maxillary central incisors were the teeth selected for the intervention. The three conducting media that were put to the test were Colgate Sensitive Pro-Relief Enamel Repair Toothpaste (CS), Himalaya herbals sensitivity toothpaste (HS), and Lignox 2% gel (LG). Subject's sensory threshold readings as well as the Visual analogue scale (VAS) scores were noted at the tiniest sensation they experienced. Following an ANOVA, a post hoc analysis was performed to confirm the significance between the three media.

Results

Lox 2% Jelly significantly reduced sensory threshold values compared to the other conducting media (P < 0.001). Comparing the sensory threshold values of the sexes showed that men have greater values. Male and female readings differed significantly in the Lox 2% Jelly group (P = 0.021), whereas Colgate Sensitive Pro-Relief Enamel Repair Toothpaste, Himalaya herbals sensitivity toothpaste (P < 0.001) groups showed highly significant variances. All the three conducting media had a highly significant variance for the VAS scores. (P < 0.001).

Conclusion

The conducting material used and gender affect the pulpal sensory thresholds to electric impulses produced by EPT.

The effect of photobiomodulation therapy associated with casein phosphopeptide-amorphous calcium phosphate fluoride paste on the treatment of posthome whitening tooth sensitivity and color change: A randomized clinical trial

OBJECTIVE

This study assessed whether combining photobiomodulation therapy (PBMT) with casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) paste can effectively reduce post-home whitening tooth sensitivity (TS) without compromising shade change.

METHODS

Fifty participants were selected and assigned to one of four groups: (1) PLACEBO group-received a placebo paste and PBMT simulation; (2) PBMT group-received a placebo paste + PBMT; (3) CPP-ACPF group-received CPP-ACPF paste and PBMT simulation; (4) CPP-ACPF + PBMT group-received both CPP-ACPF paste and PBMT. The participants used whitening trays containing 22% carbamide peroxide for 2 h a day for 21 days. TS was measured daily using a visual analog scale, while shade change was assessed using a spectrophotometer: before bleaching treatment (T0), after the first (T1), second (T2), and third (T3) weeks of treatment, and 30 days (T4) after completing the whitening treatment.

RESULTS

Intragroup analysis revealed that the PLACEBO group had the highest increase in sensitivity during the whitening treatment. The CPP-ACPF and PBMT groups showed no significant difference tooth whitening (TW) between weeks regarding aesthetic change. The CPP-ACPF and PBMT group exhibited a significant reduction in TS between the first and third and between the second and third weeks TW, but not between the first and second. Conversely, the PLACEBO group showed a higher sensitivity than the other groups (p < .05). The CPP-ACPF and PBMT groups did not differ from each other. Furthermore, the CPP-ACPF and PBMT group showed a greater decrease in sensitivity than the PLACEBO group at T1, T2, and T3 (p < .01), and was significantly differed from CPP-ACPF and PBMT groups only at T2 and T3. All groups confirmed TW effectiveness. Student's and paired t-test did not reveal any significant difference between groups (p > .05).

CONCLUSION

Therefore, PBMT associated with CPP-ACPF paste can reduce TS without compromising the efficacy of TW.

Whitening efficacy and tooth sensitivity in a combined in-office and at-home whitening protocol: A randomized controlled clinical trial

OBJECTIVE

This controlled randomized clinical trial determined the whitening efficacy and the intensity and absolute risk of tooth sensitivity in dual whitening when prefilled at-home whitening trays were used between in-office whitening intervals.

MATERIALS AND METHODS

An in-office whitening agent containing 35% hydrogen peroxide was used. A prefilled tray with a whitening agent containing 6% hydrogen peroxide was used for at-home whitening. Sixty-six subjects were randomly assigned to three groups. Group I: at-home whitening was performed 10 times between the in-office whitening treatments. Group II: at-home whitening was performed five times between the in-office whitening treatments. Group III: only in-office whitening was performed. The tooth color changes were evaluated using a spectrophotometer. A visual analog scale was used to express the pain intensity.

RESULTS

All the groups showed increased ΔE*ab, ΔE00 , and ΔWID with increased whitening sessions. Group I at the 3rd whitening session showed significantly higher ΔE*ab, ΔE00 , and ΔWID than group III. Tooth sensitivity showed higher values up to 24 h after whitening.

CONCLUSIONS

Although dual whitening with the prefilled tray and in-office whitening had higher whitening ability than in-office whitening alone, the intensity and absolute risk of tooth sensitivity was similar.

CLINICAL RELEVANCE

The dual whitening might produce faster and stronger whitening effects than in-office whitening alone.

The Use of Diode Low-Power Laser Therapy before In-Office Bleaching to Prevent Bleaching-Induced Tooth Sensitivity: A Clinical Double-Blind Randomized Study

INTRODUCTION

The present study aimed to investigate the effectiveness of low-level laser therapy (LLLT) use before in-office bleaching to prevent an increase in the risk and intensity of tooth sensitivity.

METHODS

Thirty patients were selected. Before bleaching with 38% hydrogen peroxide, the participants were randomly divided into two groups of 15 subjects. Test group: the patients' teeth were subjected to a preliminary LLLT procedure by an 810 nm diode laser with 0.5 W for 30 s for an energy density of 15 J/cm² and a group placebo. All patients were instructed to report their cold sensitivity experiences immediately, 1 h, 24 h, and 48 h after the end of bleaching via a VAS score.

RESULTS

The results obtained show an increase in VAS values for both groups (290 and 490 vs. 224 and 234 of baseline time of test and placebo group, respectively); afterward, the VAS value seemingly decreases at 1 h after the end of bleaching, approaching the baseline VAS for the test group (274) in comparison to the placebo group.

CONCLUSIONS

The use of preliminary diode LLLT could represent a valid possibility to reduce the occurrence of tooth sensitivity post-whitening and shorten recovery time in cases where tooth sensitivity occurs.

The Retention Effect of Resin-Based Desensitizing Agents on Hypersensitivity-A Randomized Controlled Trial

Recently, the development of dental materials has increased the availability of various hyperesthesia desensitizers. However, there are no studies on the duration of retreatment in terms of adherence rates. Thus, the adhesion rates of resin-based desensitizers were investigated. We used a conventional desensitizer and a recently developed desensitizer containing calcium salt of 4-methacryloxyethyl trimellitic acid (C-MET) and 10-methacryloyloxydecyl dihydrogen calcium phosphate (MDCP). These colored agents were applied to the surfaces of premolars and molars, and the area was measured from weekly oral photographs. Areas were statistically analyzed and mean values were calculated using 95% confidence intervals. A p-value of <0.05 was considered statistically significant. These rates were significantly higher on the buccal side of the maxilla and lower on the lingual side of the maxilla. In addition, the desensitizer containing C-MET and MDCP displayed significantly higher adhesion rates. It is suggested that this will require monthly follow-ups and reevaluation because both agents cause less than 10% adherence and there is almost no sealing effect after 4 weeks. In addition, the significantly higher adhesion rate of the desensitizer containing C-MET and MDCP indicated that the novel monomer contributed to the improvement in the adhesion ability.

Evaluation of a Hypersensitivity Inhibitor Containing a Novel Monomer That Induces Remineralization-A Case Series in Pediatric Patients

BACKGROUND

Recently, tooth deformities have been frequently encountered by pediatric dentists. Severe enamel hypomineralization sometimes induces pain such as hyperesthesia, but composite resin restoration is difficult because it often detaches without any cavity preparation. Resin-based hypersensitivity inhibitors for tooth physically seal the dentinal tubules. It was reported that hypersensitivity inhibitor containing novel adhesive monomers forms apatite and induces remineralization in vitro. Therefore, these case series assessed the clinical effects of remineralization and the suppression of hypersensitivity by Bio Coat Ca (Sun Medical, Shiga, Japan).

METHODS

After mechanical tooth cleaning was performed, the hypersensitivity inhibitors were applied and cured by light exposure. Changes in hypersensitivity were determined by visual analog scale (VAS). The improvement of hypomineralization was evaluated by the change in color tone based on the digital images of intraoral photographs.

RESULTS

After repeated monthly treatments, these cases showed decreased hypersensitivity after the fourth application, while the opaque white and brownish color improved on the seventh application.

CONCLUSION

This novel hypersensitivity inhibitor with calcium salt of 4-methacryloxyethyl trimellitic acid (C-MET) and 10-methacryloyloxydecyl dihydrogen calcium phosphate (MDCP) not only suppressed hypersensitivity but also improved cloudiness and brown spots in recently erupted permanent teeth in presented cases.

3D Printed In Vitro Dentin Model to Investigate Occlusive Agents against Tooth Sensitivity

Tooth sensitivity is a painful and very common problem. Often stimulated by consuming hot, cold, sweet, or acidic foods, it is associated with exposed dentin microtubules that are open to dental pulp. One common treatment for tooth hypersensitivity is the application of occlusive particles to block dentin microtubules. The primary methodology currently used to test the penetration and occlusion of particles into dentin pores relies upon dentin discs cut from extracted bovine/human teeth. However, this method is limited due to low accessibility to the raw material. Thus, there is a need for an in vitro dentin model to characterize the effectiveness of occlusive agents. Three-dimensional printing technologies have emerged that make the printing of dentin-like structures possible. This study sought to develop and print a biomaterial ink that mimicked the natural composition and structure of dentin tubules. A formulation of type I collagen (Col), nanocrystalline hydroxyapatite (HAp), and alginate (Alg) was found to be suitable for the 3D printing of scaffolds. The performance of the 3D printed dentin model was compared to the natural dentin disk by image analysis via scanning electron microscopy (SEM), both pre- and post-treatment with occlusive microparticles, to evaluate the degree of dentinal tubule occlusion. The cytocompatibility of printed scaffolds was also confirmed in vitro. This is a promising biomaterial system for the 3D printing of dentin mimics.

One-year follow-up comparing at-home bleaching systems outcomes and the impact on patient's satisfaction: Randomized clinical trial

OBJECTIVE

To compare at-home systems with reduced daily time of use (10% hydrogen peroxide [HP] gel with prefilled (PT) or customized trays (CT), and 10% carbamide peroxide [CP] gel), with the conventional nightguard vital bleaching (10% CP). Bleaching efficacy, adverse effects, and patient's satisfaction were evaluated.

METHODS

Sixty participants were randomly divided into treatments (14 days): Opalescence GO (OGO)-10%HP PT-30 min, White Class-10%HP CT-30 min, Opalescence PF-10%CP CT-2 h, and Opalescence PF-10%CP CT-8 h. Color difference (visual and spectrophotometer), tooth sensitivity (visual analogue scale), gingival condition (Löe index), enamel mineralization (laser fluorescence), and patients' satisfaction (questionnaire) were assessed. Statistical tests were applied (5%).

RESULTS

After 1 year, color difference was similar for the groups (p > 0.05). All groups showed similar sensitivity risk (p > 0.05). The intensity of sensitivity and gingival irritation was mild for all gels, but higher for OGO. Fluorescence after bleaching remained similar to those of sound enamel. All participants were satisfied with treatments.

CONCLUSIONS

All systems produced similar bleaching efficacy, which was maintained after 1 year. Patients were satisfied with bleaching outcomes. Tooth sensitivity occurred in all groups, but with overall mild intensity. No relevant gingival irritation and enamel demineralization was observed.

CLINICAL SIGNIFICANCE

Bleaching with 10% HP gels in prefilled and CTs represent efficacious alternative for tooth color change, with patients' acceptance similar to conventional 10% CP. Patients must be warned about the mild sensitivity and gingival irritation potential, mainly with PTs.

Clinical effects of the exposure to red wine during at-home bleaching

OBJECTIVES

This clinical trial evaluated the effects of red wine exposure on the effectiveness of at-home bleaching with 10% carbamide peroxide, degree of tooth sensitivity, and levels of periodontal inflammatory markers.

METHOD AND MATERIALS

Eighty participants were assigned to two groups, namely, those who drank red wine (experimental group), and those who did not drink red wine (control group). The experimental group participants rinsed their mouths with 25 mL of red wine four times a day during the bleaching period. Shade evaluation was assessed visually by using the Vita Classical and Vita Easyshade techniques. Tooth sensitivity was evaluated by the numeric and visual analog scales, and the salivary and gingival crevicular fluids were collected for assessment of nitric oxide (NO) levels, a marker of inflammation. Differences in color change were analyzed by one-way analysis of variance (ANOVA). The absolute risks of tooth sensitivity were compared by the Fisher exact test. Tooth sensitivity intensity data sets for both the visual analog scale and the numeric rating scale were compared using the Wilcoxon signed rank test (α = .05). Repeated measures and two-way ANOVA followed by the Bonferroni test were used to assess time-course and differences between groups in NO production.

RESULTS

The bleaching technique was effective regardless of wine consumption (P > .05). Tooth sensitivity was classified as mild, with no differences between groups (P > .05). Red wine reduced both the gingival crevicular fluid and salivary levels of NO (P < .05).

CONCLUSION

Red wine does not interfere with the effectiveness and sensitivity of at-home teeth bleaching with 10% carbamide peroxide and protects against bleaching-induced inflammation.

Assessment of the effect of experimental bleaching agent with nano-bioactive material on postoperative sensitivity: A randomized, triple blind clinical trial

OBJECTIVES

This clinical study aimed to evaluate the effect of incorporating bioactive nanoparticles (n-Bm) inside an in-office bleaching gel on the risk and intensity of tooth sensitivity (TS) and on bleaching effectiveness.

MATERIALS AND METHODS

Sixty-six participants were selected and randomly assigned into two groups: control-only in-office gel and experimental-in-office gel with n-Bm. Teeth were bleached in two sessions (3 × 15-min). TS was recorded using a VAS and NRS. The color change was evaluated by subjective (VITA Classical and VITA Bleachedguide) and objective (Easyshade spectrophotometer) methods at baseline and 30 days after the end of treatment. The TS was evaluated by McNemar, Wilcoxon Signed Rank, and paired t test. The color changes between groups were compared using paired t test (α = 0.05).

RESULTS

No significant differences between the groups were observed in the risk (control = 27% [95%IC 18-39]; experimental = 21% [95%IC 13-32]) and intensity of TS, as well as in the color change (p >0.05) for any color measurement.

CONCLUSION

The inclusion of n-Bm into the bleaching agents did not affect the whitening effectiveness, as well as the risk and intensity of TS between groups. However, the results of the absolute risk of TS were low for both in-office gels used.

CLINICAL SIGNIFICANCE

Despite no significant differences between groups, both experimental bleaching agents present suitable results with low values for TS.

Effectiveness of remineralization agents on the prevention of dental bleaching induced sensitivity: A randomized clinical trial

OBJECTIVES

This study aims to compare the use of different remineralization agents before in-office bleaching for decreasing bleaching induced sensitivity.

METHODS

A total of 64 volunteers were randomly divided into four groups. Before undergoing in-office bleaching with 38% hydrogen peroxide gel (three applications of 15 min each, one session), clinicians applied a placebo gel (control group), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), neutral sodium fluoride gel (NSF) or nano-hydroxyapatite solution (n-HAP) on all buccal surfaces of teeth. The gel was left undisturbed for 4 min. The efficacy of tooth whitening was assessed by determining the colour change using SGU. Patients recorded their tooth sensitivities on the VAS scale. Kruskal-Wallis test followed by Mann-Whitney U test was used to compare changes in tooth colour and intensity of tooth sensitivity between groups.

RESULTS

Overall, there was no significant difference in shade change between the groups. Control and CPP-ACP groups showed significantly higher rates of hypersensitivity than NSF and the n-HAP group (p < 0.05).

CONCLUSIONS

The use of a remineralization agent (n-HAP/NSF) before in-office bleaching did not affect the bleaching efficacy but did reduce tooth sensitivity. The before bleaching treatment use of an n-HAP solution can be suitable for reducing bleaching born sensitivity as well as commonly used NSF remineralizing gel before in-office tooth bleaching can reduce tooth sensitivity, the most common side effect associated with this procedure.

Amelogenesis imperfecta: use of cyanoacrylate as a desensitizing agent and its impact on oral health-related quality of life

Amelogenesis imperfecta (AI) is a rare hereditary condition characterized by abnormal enamel formation and increased tooth sensitivity. There are no defined therapeutic recommendations for tooth sensitivity in patients with AI. The aim of the present case report of a 5-year-old girl with AI is to describe the use of cyanoacrylate as a desensitizing agent on the patient's permanent molars and report the impact of this treatment on her oral health-related quality of life (OHRQoL). After 4 sodium fluoride varnish applications were unsuccessful in relieving sensitivity affecting the molars, cyanoacrylate was applied 5 times (at intervals of 7, 15, 30, and 180 days after the first application). Pain scores were recorded on a visual analog scale before and after each intervention, and the OHRQoL was measured using a questionnaire (Early Childhood Oral Health Impact Scale [ECOHIS]) administered prior to the first cyanoacrylate application and on the last day of the protocol. In this patient, cyanoacrylate seemed to be effective at decreasing tooth sensitivity in immature permanent molars affected by AI, as demonstrated by reductions in the frequency of complaints of dental pain, difficulty in drinking cold beverages, and difficulty in eating some foods.

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.

Does the addition of potassium nitrate to carbamide peroxide gel reduce sensitivity during at-home bleaching?

BACKGROUND

A systematic review with meta-analysis was conducted to assess the effect of adding potassium nitrate to carbamide peroxide gels on bleaching efficacy and on reducing the risk and intensity of tooth sensitivity.

METHODS

PubMed, Scopus, Web of Science, LILACS, BBO, and Cochrane Library databases and the gray literature were searched. IADR abstracts, records of trials, dissertations and theses were also searched. The Cochrane Collaboration risk of bias tool was used to assess the quality of the studies.

RESULTS

Six studies were included in the systematic review and most of them had unclear risk of bias for the key domains, and of these only five were included in the meta-analysis. The risk ratio (RR) for sensitivity was 0.93 (95% CI = 0.73 to 1.19, P = 0.56). The standardized mean difference for pain intensity was -0.10 (95% CI = -0.36 to 0.16, P = 0.45), and for colour change was 0.12 (95% CI = -0.22 to 0.46; P = 0.49).

CONCLUSIONS

No significant differences were observed between the groups with and without addition of the desensitizer in the gel. The addition of potassium nitrate to carbamide peroxide gel did not reduce the risk and intensity of tooth sensitivity during at-home bleaching. Colour change was not influenced by the addition of potassium nitrate to the gel.

Effect of anti-inflammatory and analgesic drugs for the prevention of bleaching-induced tooth sensitivity: A systematic review and meta-analysis

BACKGROUND

In-office dental bleaching results in a high risk of tooth sensitivity caused by the inflammatory process of the pulpal tissue. In this systematic review, the authors aimed to evaluate the effect of administering anti-inflammatory and analgesic drugs for the prevention of tooth sensitivity associated with in-office dental bleaching.

TYPES OF STUDIES REVIEWED

The authors searched the databases MEDLINE via PubMed, Scopus, Web of Science, and Cochrane Library for clinical trials. They searched in ClinicalTrials.gov for unpublished trials. The authors included only randomized clinical trials comparing anti-inflammatory and analgesic drugs with a placebo and evaluating tooth sensitivity after in-office bleaching. They imposed no restrictions regarding publication dates or languages.

RESULTS

The authors identified 5,050 studies after the removal of duplicates. They qualitatively and quantitatively analyzed the 11 studies remaining after the title and abstract screening. Nine studies showed a low risk of bias. The authors found no effect of the drugs on the risk (9 studies evaluated this outcome). Using a visual analog scale, the authors identified a similar level of sensitivity evaluated up to 1 hour (10 studies evaluated this outcome) and 24 hours (8 studies evaluated this outcome). They observed similar results using the numeric rate scale (8 and 6 studies used this tool, up to 1 hour and 24 hours respectively). The Grading of Recommendations Assessment, Development, and Evaluation approach showed a high level of evidence for all outcomes.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The high level of evidence available does not support the administration of anti-inflammatory and analgesic drugs to prevent tooth sensitivity caused by in-office dental bleaching.

[Clinical evaluation of the effect of reducing tooth sensitivity caused by in office bleaching using dentifrices]

OBJECTIVE

To evaluate tooth sensitivity and the efficacy of in-office bleaching when using different desensitizing dentifrices.

METHODS

In total, 150 eligible individuals were recruited and randomized by computer-generated block randomization into three groups: potassium nitrate group (n=50), stannous fluoride group (n=50), and placebo group (n=50). Participants were asked to use a desensitizing dentifrice and toothbrush 15 days prior to and after the in-office bleaching. Each patient received a one-session in-office bleaching with 35% hydrogen peroxide whitening gel. The in-office bleaching included three 15 min operations, totally 45 min. Tooth sensitivity was evaluated by 100 mm visual analog scale (VAS) scores immediately 0 d and 1 d, 2 d, 7 d, 14 d, and 30 d after in-office bleaching. In total, 48 (96%), 45 (90%), and 46 (92%) individuals in the potassium nitrate, stannous fluoride, and placebo groups, respectively, completed the follow-up observations.

RESULTS

Data were analyzed using analysis of covariance (ANOVA). For tooth sensitivity produced by in-office bleaching, the mean VAS values of the three groups were analyzed. At 0 d immediately after surgery, the mean VAS of the potassium nitrate group was 39.22±15.08, which was lower than that of the stannous fluoride group (47.18±12.59) and the placebo group (52.53±14.05), and the difference was statistically significant (P<0.05). The results of the stannous fluoride group and the placebo group were similar, and the difference was not statistically significant (P>0.05). On 1 day postoperatively, the mean VAS of the potassium nitrate group was 38.27±16.52, which was lower than that of the stannous fluoride group (44.69±14.92) and the placebo group (44.45±13.54), P<0.05. The results of the stannous fluoride group and the placebo group were similar, and the difference was not statistically significant (P>0.05). The mean values of VAS were similar 2 d, 7 d, 14 d and 30 d after operation, and the difference was not statistically significant (P>0.05).

CONCLUSION

Compared with the stannous fluoride group and the placebo group, the use of potassium nitrate desensitizing toothpaste 15 days before surgery can effectively alleviate the tooth sensitivity during and after in-office bleaching.

[Clinical evaluation of the effect of reducing tooth sensitivity caused by in office bleaching using dentifrices]

OBJECTIVE

To evaluate tooth sensitivity and the efficacy of in-office bleaching when using different desensitizing dentifrices.

METHODS

In total, 150 eligible individuals were recruited and randomized by computer-generated block randomization into three groups: potassium nitrate group (n=50), stannous fluoride group (n=50), and placebo group (n=50). Participants were asked to use a desensitizing dentifrice and toothbrush 15 days prior to and after the in-office bleaching. Each patient received a one-session in-office bleaching with 35% hydrogen peroxide whitening gel. The in-office bleaching included three 15 min operations, totally 45 min. Tooth sensitivity was evaluated by 100 mm visual analog scale (VAS) scores immediately 0 d and 1 d, 2 d, 7 d, 14 d, and 30 d after in-office bleaching. In total, 48 (96%), 45 (90%), and 46 (92%) individuals in the potassium nitrate, stannous fluoride, and placebo groups, respectively, completed the follow-up observations.

RESULTS

Data were analyzed using analysis of covariance (ANOVA). For tooth sensitivity produced by in-office bleaching, the mean VAS values of the three groups were analyzed. At 0 d immediately after surgery, the mean VAS of the potassium nitrate group was 39.22±15.08, which was lower than that of the stannous fluoride group (47.18±12.59) and the placebo group (52.53±14.05), and the difference was statistically significant (P<0.05). The results of the stannous fluoride group and the placebo group were similar, and the difference was not statistically significant (P>0.05). On 1 day postoperatively, the mean VAS of the potassium nitrate group was 38.27±16.52, which was lower than that of the stannous fluoride group (44.69±14.92) and the placebo group (44.45±13.54), P<0.05. The results of the stannous fluoride group and the placebo group were similar, and the difference was not statistically significant (P>0.05). The mean values of VAS were similar 2 d, 7 d, 14 d and 30 d after operation, and the difference was not statistically significant (P>0.05).

CONCLUSION

Compared with the stannous fluoride group and the placebo group, the use of potassium nitrate desensitizing toothpaste 15 days before surgery can effectively alleviate the tooth sensitivity during and after in-office bleaching.

Clinical evaluation of color change and tooth sensitivity with in-office and home bleaching treatments

Background

Among the number of vital bleaching techniques currently available to the clinicians, home bleaching and in-office bleaching are widely used in dental practice.

Aim and Objectives

The aim of this in vivo study was to compare the clinical performance, durability, and related tooth sensitivity with two vital bleaching procedures (in-office and at-home bleaching), in a split-mouth design.

Patients and Methods

Thirty adult participants having teeth shade mean of A2 or darker were selected for the study. One-half of the maxillary arch of each patient received in-office bleaching with 35% hydrogen peroxide gel, and the other half received 16% carbamide peroxide night guard bleaching. Shade evaluation was done with shade guide and spectrophotometer at 1, 2, 3, and 4 week intervals during bleaching and postoperatively at 3 and 6 month intervals. Tooth sensitivity was recorded using the visual analog scale during the experimental period.

Statistical Analysis

Collected data of color and sensitivity readings were subjected to statistical analysis using SPSS/PC version 20 software. Intergroup comparison through unpaired t-test and within the groups using paired t-test was done.

Results

At-home and in-office bleaching procedures are equally effective in producing tooth whitening. Color evaluation after 3 and 6 months showed more color decline for in-office bleaching procedure. For sensitivity parameter also, in-office procedure recorded higher sensitivity compared to home bleaching (P < 0.05).

Conclusion

Both the bleaching procedures are equally effective in producing tooth whitening. In-office bleaching recorded higher levels of tooth sensitivity and greater color rebound than home bleaching.

A randomized clinical trial on the efficacy of a new oxalate-containing sensitivity relief strip following professional vs self-application

OBJECTIVES

The purpose of this study was to determine the efficacy of 3.14% dipotassium oxalate monohydrate-containing strip on the relief of dentinal hypersensitivity (DH). A second objective was to determine whether there was a difference in DH levels when the strip was self-applied vs applied by a dental professional.

METHODS

Sixty subjects were randomized into self-applied, professionally applied or placebo-strip groups. Dentinal hypersensitivity was evaluated by a blinded examiner, using the Schiff Air Scale (SAS). A verbal rating scale (VRS) was also used to measure the subjects' perception of pain. Measures were taken at baseline, 30 minutes, 4 and 8 weeks post-treatment.

RESULTS

There was a significant reduction in DH in all three groups (P ≤ .05) at 30 minutes and 8 weeks post-treatment. At the 4-week follow-up, only the self- and professionally applied (active ingredient) groups had a significant reduction in DH compared to baseline. When comparing the reduction in DH levels between groups, the only significant difference occurred between the professionally applied treatment group and the placebo group at the 4-week follow-up. There were no significant differences in DH reduction levels achieved between the self- and professionally applied groups (P > .05).

CONCLUSIONS

This study confirmed the short-term (4 weeks) effectiveness of a single application of 3.14% dipotassium oxalate monohydrate-containing strip. Self- and professional application were not shown to be different.

Effectiveness of two different desensitizing varnishes in reducing tooth sensitivity: a randomized double-blind clinical trial

PURPOSE

The aim of this study is to evaluate and compare the effectiveness of two different desensitizing varnishes.

MATERIALS AND METHODS

Ninety healthy adults suffering from tooth sensitivity were divided into three groups. Two different varnishes were used for the study: Fluor Protector S, containing 7700 ppm fluoride (group I), and Cervitec F, containing 1400 ppm fluoride and 0.3% chlorhexidine (group II). A placebo containing water and ethanol was applied for the third group. Tooth sensitivity was collected according the Schiff' scale at baseline and after 30 and 90 days.

RESULTS

Group I and group II improved with statistically significant results. Group III did not show any improvements.

CONCLUSIONS

Desensitizing varnishes are a valid treatment for tooth hypersensitivity.

Efficacy of desensitizing agents on postoperative sensitivity following an in-office vital tooth bleaching: A randomized controlled clinical trial

Aim:

To assess and compare the incidence and intensity of experienced after an in-office vital tooth bleaching in case of dental fluorosis using two different types of desensitizing agents, at different time periods.

Materials and Methods:

Sixty-nine subjects with mild-to-moderate fluorosis were randomly divided into three groups of 23 each. Group I — control group (placebo), group II—potassium nitrate 5% and sodium monofluorophosphate 0.7% (Sensodent KF), and group III—Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) (Tooth Mousse). In-office vital tooth bleaching was done using 35% hydrogen peroxide liquid (Pola office) in two sessions. Desensitizing agent was applied for 10 min after each session. Postoperative sensitivity was recorded after 24 h and 7 days. The statistical analysis was done using chi-square test, analysis of variance (ANOVA), and post hoc Tukey's test.

Results:

The experimental groups showed significantly less incidence and intensity of sensitivity compared to control group, whereas there was no difference between them.

Conclusion:

The desensitizing agents used in the study show effective reduction after an in-office vital tooth bleaching.

Clinical performance of topical sodium fluoride when supplementing carbamide peroxide at-home bleaching gel

This clinical study evaluated the use of 0.11% topical sodium fluoride (SF) desensitizing agent to treat tooth sensitivity during a nightguard tooth whitening procedure. Thirty-two subjects bleached their teeth with 10% carbamide peroxide (CP) gel using an at-home bleaching technique with custom trays. During bleaching treatment, subjects were divided into 2 groups (n = 16). The subjects in Group 1 received a topical gel containing 0.11% SF; the subjects in Group 2 received a placebo gel (PG). Each subject was instructed to place the gel in his/her bleaching tray for 30 min every day following bleaching treatment. Results showed the use of SF did not affect the whitening efficacy of the 10% CP gel. Subjects who received the PG had significantly higher tooth sensitivity when compared with subjects who received SF (P < 0.00). The use of daily 0.11% SF after 10% CP bleaching gel reduced tooth sensitivity during the bleaching treatment.

Tooth bleaching with hydrogen peroxide and nano-hydroxyapatite: a 9-month follow-up randomized clinical trial

OBJECTIVES

The aim of this study was to compare the amount of tooth colour change, rebound rate and tooth sensitivity in patients submitted to a bleaching technique with 6% hydrogen peroxide (HP) with or without 2% nano-hydroxyapatite (n-HA).

METHODS

Sixty subjects were included in this examiner-blinded, randomized clinical trial using a 6% HP gel with or without 2% n-HA. Tooth colour and tooth sensitivity were analysed before and after treatment. All data were analysed statistically.

RESULTS

After bleaching, both treatments demonstrated significant improvements in tooth shade (P < 0.05 for both groups). At the 9-month recall, tooth shade remained significantly lighter than at baseline (P < 0.05 for both groups). However, a relapse of the tooth shade was observed compared with the immediate post-bleaching result (P < 0.05). 6% HP with 2% n-HA produced significantly lower sensitivity (P < 0.05) than the bleaching product without n-HA. Colour change evaluation resulted in no difference between the two groups.

CONCLUSION

Both treatments demonstrated significant improvements in tooth shade. The bleaching effectiveness of the tested products was comparable. The use of 6% HP with 2% n-HA reduced the incidence of sensitivity during the bleaching treatment compared to a bleaching agent that did not contain n-HA.