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Made available in DSpace on 2022-04-28T17:30:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-12-28 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Introduction: Gingival recession (GR) is a relevant clinical condition due to its high prevalence worldwide, which leads to aesthetic demands and dentin hypersensitivity. Collagen matrices have been associated with different designs of coronally advanced flaps (CAFs) to treat GR defects. However, the literature lacks long-term follow-up of this treatment option. The aim of this study is to present the long-term follow-up (up to 7 years) of two GR defects (associated or not with noncarious cervical lesion) treated with a CAF and a collagen matrix (CM). Case presentation Case 1 underwent a CAF associated with a CM to treat a single GR defect. After 7 years, Case 1 presented with 3 mm of recession reduction, which corresponds with the 85.7% of root coverage. Case 2 presented two GR defects associated with noncarious cervical lesions (NCCLs). The NCCLs were partially restored with resin composite and then underwent a modified CAF for multiple defects and a CM. After 5 years of follow-up, Case 2 presented with 1.5 and 2.5 mm of recession reduction, which corresponds with the average 83.3% defect coverage. Conclusion These two cases may show that CMs can provide long-term stable outcomes in the treatment of GR defects. Fed Univ Pernambuco UFPE, Dept Prosthesis & Surg Orofacial, Recife, PE, Brazil Sao Paulo State Univ, Inst Sci & Technol, Div Periodont, UNESP, Av Engn Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP, Brazil Private Educ Inst, Sao Paulo, Brazil Sao Paulo State Univ, Inst Sci & Technol, Div Periodont, UNESP, Av Engn Francisco Jose Longo 777, BR-12245000 Sao Jose Dos Campos, SP, Brazil CAPES: 001 CNPq: 304269/2019-0

Objective To review different modes of application of hydroxyapatite for treatment of dentin hypersensitivity via dentinal tubule occlusion. Methods Literature search for the systematic review was done using key words 'hydroxyapatite and dentin hypersensitivity', 'hydroxyapatite and dentinal tubule occlusion', 'hydroxyapatite and dentin permeability', and 'dentinal tubule occlusion' on Pubmed, Science Direct and Web of Science databases for articles published over 10 years, from 2009 to 2018. Results Of the 132 research articles initially identified, 97(73.5%) related to the 10-year study period. After detailed screening, 16(16.5%) studies were included. The results of in vitro studies showed that application of hydroxyapatite caused dentinal tubule occlusion leading to reduction in dentin permeability and reduction in dentin hypersensitivity. Conclusions Hydroxyapatite has the potential to reduce dentin hypersensitivity via dentinal tubule occlusion within 2-8 weeks.

Made available in DSpace on 2022-05-01T10:19:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Xenogeneic matrices (XMs) have been increasingly used for root coverage procedures. This study compared the use of two types of XM (collagen matrix [CM] and xenogeneic acellular dermal matrix [XDM]) associated with the coronally advanced flap technique (CAF) to treat single gingival recessions. Methods: Seventy-five patients presenting single RT1 gingival recession were treated by CAF (control group, n = 25), CAF+CM (test group 1, n = 25), or CAF+XDM (test group 2, n = 25) and completed 6-month follow-up. Clinical, patient-centered, and esthetic assessments were performed and intra- and intergroup differences were analyzed. Results: At 6 months, the mean recession reduction for CAF, CAF+CM, and CAF+XDM was 2.4 ± 0.8 mm, 2.4 ± 0.9 mm and 2.1 ± 0.8 mm, respectively (P > 0.05). The corresponding mean percentage of root coverage was 78.9% ± 26.2% for CAF, 78.0% ± 28.5% for CAF+CM, and 65.6% ± 26.9% for CAF+XDM (P > 0.05). Dentin hypersensitivity and esthetic conditions showed significantly improvements in all groups. Test groups presented significant gains in gingival thickness (GT; CAF+CM: 0.4 ± 0.3 mm; CAF+XDM: 0.4 ± 0.2 mm) compared to the control group (CAF: 0.0 ± 0.1 mm; P

The main objective of this study was to enhance the blockage of dentinal tubules using nanobioglass in the presence of diode (980 nm) and Nd:YAG lasers in order to reduce permeability and dentin hypersensitivity.Thirty-six dentinal samples were randomly divided into 6 subgroups (n = 6): (A) control, (B) diode laser (980 nm, 3-W), (C) Nd:YAG laser (1064, 1.0-W), (D) nanobioglass, (E) nanobioglass + diode laser (980 nm), (F) nanobioglass + Nd:YAG laser. The average number of open dentinal tubules was qualitatively and quantitatively evaluated by scanning electron microscopy (SEM). Data were evaluated by SPSS software version 22, Kruskal-Wallis test, and Mann-Whitney tests with Bonferoni's correction (α = 0.008).Based on the results of Mann-Whitney test, there was a significant difference in the mean number of open dentinal tubules between the control group and the other groups (p 0.008). However, the difference among the other groups was not statistically significant (p 0.008).Findings of this study showed that high-power laser radiation, such as Nd:YAG and diode (980 nm) alone or with nanobioglass, has a significant effect on the blockage of dentinal tubules.Introduction of non-invasive methods with long-term and lasting effect on reducing pain and discomfort caused by dentin hypersensitivity.

Dentin hypersensitivity (DH) is characterized by short or transient sharp pain arising from exposed dentin in response to thermal, physical, osmotic, or chemical elements (Holland et al., 1997, West et al., 2011). According to the hydrodynamic theory, hypersensitivity results from the rapid movement of the fluid within the dentinal tubules (Brannstrom et al., 1968). It is imperative to the efficacy of the DH treatment to address the etiological factors of the condition (Femiano et al., 2017). Desensitizing therapies consist of the use of chemical substances, laser irradiation, restorative treatments, periodontal surgeries which aim basically to control the hydrodynamic mechanisms of pain. However, these treatments do not achieve predictable results in all patients and may lose their effect over time (Cartwright, 2014, Zhu et al., 2015, Sole-Magdalena et al., 2017). Bioactive glass materials have been proposed for the treatment of DH (David, 2010, Curtis et al., 2010, Barry et al., 2011, Sauro et al., 2011, Cartwright, 2014, Hall et al., 2017, Bansal and Mahajan, 2017). The mechanism of action of bioactive glass starts when the material is exposed to an aqueous environment. The sodium ions (Na+) in the particles immediately are switched with hydrogen cations (H+ or H3O+). This rapid release of ions allows the calcium ions (Ca+2) in the particle structure, as well as the phosphate ions (PO4-3), to be released from the glass particles. The initial reactions occur in seconds of exposure and the release of the Ca+2 and PO4-3 ions continues as long as the particles are exposed to an aqueous environment. A localized and transient increase in pH occurs during the initial material exposure due to the release of Na+. This increase in pH helps to precipitate the Ca+2 and PO4-3 ions of the particle to form a layer of calcium phosphate Ca(PO4)2. As particle reactions and the deposition of calcium and phosphorus complexes are maintened, the layer crystallizes into hydroxycarbonate apatite which is chemically and structurally equal to biological apatite. The combination of residual particles and the newly formed apatite layer lead to physically occluding the dentin tubules, resulting in remission or pain reduction (Zhong et al., 2002, Zanotto et al., 2004, Hench, 2006). The maintenance of this layer on the dentin surface is a major challenge for the materials existing in the market, besides knowing the effectiveness of them for the treatment of DH. Studies have shown the absence of parameters such as: patient follow-up time, control groups, assessment scale for degree of pain, DH diagnostic methods and form of application of the product (Matranga et al., 2017, Hannigan and Lynch, 2013, Kim et al., 2011, Pandis et al., 2011, Fleming et al., 2013). The use of bioactive materials is a promising proposal for DH due to the the neoformation of a bioactive barrier on dentin surface (Bansal and Mahajan, 2017). They showed the ability to occlude the dentinal tubules and form a mechanically strong layer of hydroxyapatite on the dentin surface, which can resist degradation by repeated acid challenges (Du et al., 2008). Thus, the aim of this systematic review was to assess randomized controlled trials (RCT) carried out in the permanent teeth of adult patients in the DH treatment with bioactive dentrifices, either at-home or in-office.

Objective To investigate the treatment efficacy of low-level light therapy on dentin hypersensitivity. Materials and methods Following the PRISMA guideline, six electronic databases supplemented with bibliographies were searched till December 2020. Two reviewers performed the screenings independently with a reliability assessment. Studies fulfilling the pre-registered eligibility criteria were included for risk-of-bias assessment and data synthesis. Results Thirty-five articles ultimately informed this systematic review based on the eligibility criteria and underwent risk-of-bias assessment (ĸ = 0.86). Quantitative results were deduced by meta-analysis of 20 randomised controlled trials: LLLT showed favourable outcomes compared to placebos for immediate (SMD: 1.09, 95% CI: 0.47 to 1.70), interim (SMD: 1.32, 95% CI: 0.41 to 2.23), and persistent efficacies (SMD: 2.86, 95% CI: 1.98 to 3.74). However, substantial heterogeneity existed among included studies (I2: 64–95%). Regarding comparisons with other desensitising strategies, LLLT showed no significant benefits in DH alleviation over others except fluorides for interim efficacy (SMD: 0.31, 95% CI: 0.10 to 0.52) and persistent efficacy (SMD: 0.45, 95% CI: 0.03 to 0.86). Conclusions This systematic review shows that LLLT has positive immediate, interim, and persistent DH-treatment efficacies compared with placebo. No superior treatment effects of LLLT were observed except fluoride agent use. Further studies are warranted—RCTs with low risk of bias, consistent technical settings, comprehensive assessments, and long follow-up periods. Clinical relevance This systematic review bridges a critical research gap by analysing clinical evidence in the DH-alleviating efficacy of LLLT in comparison with placebo and other in-office desensitising strategies.

Objective: to evaluate the efficacy of non-invasive procedures through biomimetic mineralization of a fluoride gel, bioactive glass materials with and without fluoride and self-organizing biomimetic peptides in the treatment of dentinal hypersensitivity due to early non-carious cervical lesions. Materials and methods: Twenty-eight patients with self-reported history of dentin hypersensitivity were evaluated sequentially for evidence of erosion, abrasion or gingival recession at facial cervical region. Patients were randomly distributed into four treatment groups of seven patients each according to the type of the treatment (group I: Elmex Gele'e, group II: BioMin™ F, group III: BioMin™ C group IV: CurodontTM D’senz). The teeth were subjected to five follow up periods (baseline, after 3,6,9 and 12 weeks) and assessed in response to evaporative air-blast stimulus utilizing Schiff Sensitivity and Visual Analogue Scales. Electrical test was performed utilizing electrical pulp tester. The extent of tubule occlusion was examined under scanning electron microscope using negative replica of randomly selected patients. Results: All the tested groups showed different degrees of relieving dentinal hypersensitivity symptoms. The difference between the studied groups was statistically significant. Under SEM, group II, III and IV showed complete tubule occlusion. However, group I showed partial tubule occlusion. Conclusions: Elmex® gelee, BioMin™ F, BioMin™ C and Curodont™ D’senz were effective to manage dentin hypersensitivity related to early non-carious cervical lesions based on the biomimetic mineralization concept that has focused on permanent management of dentin hypersensitivity. Keywords: Fluoride, Bioactive glass, self-organizing biomimetic peptides, non-carious cervical lesions, dentin hypersensitivity.

AIM The aim of the present study was to compare the capacity of three dissimilar commercially accessible desensitizing products for the occlusion of dentinal tubules using a scanning electron microscope (SEM). MATERIALS AND METHODS The nondiseased human mandibular premolar teeth, ninety in number, were amassed for this study. The blocks subsequently made were subjected to polishing using abrasive paper to facilitate dentinal surface exposure. The samples were randomly allocated to one of the following three groups: Group I, samples to be treated with Admira Protect; Group II, samples to be treated with MI paste, Group III, samples to be treated with Remin Pro. Photomicrograph of every sample was taken to evaluate the occlusion of the dentin tubule under 2000× magnification of the SEM. RESULTS MI paste exhibited the greatest dentin tubular occlusion with a value of 2.746 ± 0.530 followed by Admira Protect (3.498 ± 0.202) and Remin Pro (4.594 ± 0.364) in that order. Amid the various desensitizing materials used, statistically significant differences (p

Dentin hypersensitivity (DH) is characterized by pain caused by an external stimulus on exposed dentin. Different therapeutic approaches have been proposed to mitigate this problem; however, none of them provide permanent pain relief. In this study, we synthesized and characterized experimental bioactive glasses containing 3.07 mol% SrO or 3.36 mol% K2 O (both equivalent to 5 wt% in the glass), and evaluated their effect on dentin permeability to verify their potential to treat DH. The experimental materials were characterized by field-emission scanning electron microscopy, Fourier transform infrared spectroscopy, micro-Raman spectroscopy, and X-ray diffraction to confirm the respective structures and chemical compositions. The reduction in the hydraulic conductance of dentin was evaluated at the three stages: minimum permeability; maximum permeability (24% ethylenediaminetetraacetic acid [EDTA] treatment); and final dentin permeability after treatment with the bioactive glasses. They all promoted a reduction in dentin permeability, with a significant difference for each sample and posttreatment group. Also, a significant reduction in dentin permeability was observed even after a simulated toothbrushing test, demonstrating effective action of these materials against DH. Besides, incorporating 3.07 mol% SrO was a positive factor. Therefore, strontium's desensitizing and re-mineralizing properties can be further exploited in bioactive glasses to promote a synergistic effect to treat DH.

Objectives This study aimed to test the efficacy of two experimentally produced eggshell-based toothpastes on dentinal tubules occlusion. Materials and Methods Two experimental eggshell toothpastes, based on natural ingredients, with or without titanium dioxide nanoparticles (TNPs) were produced and coded “TNPs eggshell toothpaste [TNPsESTP]” or “eggshell toothpaste [ESTP],” respectively. Mid-coronal dentin discs, from 28 human extracted molar teeth, etched with 37% phosphoric acid for 60 seconds to simulate the hypersensitive dentin, were randomly divided into four groups—G1: no treatment (negative control), G2: ESTP treated, G3: TNPsESTP treated, and G4: Biorepair treated (positive control). All treated discs were brushed for 2 weeks and 1 month using a toothbrush simulator at 40 mm/s. Dentinal tubules occlusion was studied using a cross-polarization optical coherence tomography (CP-OCT) and scanning electron microscopy (SEM). Statistical Analysis Unpaired t-test was conducted using GraphPad software (San Diego, California, United States). Continuous variables were expressed as means ± standard deviation and p < 0.05 was considered statistically significant. Results From CP-OCT, a marked increase in surface reflectivity of dentin was observed after brushing with tested toothpastes. ESTP and NPsESTP showed higher or comparable grayscale values than Biorepair indicating increase in surface density of dentin. From SEM, at 2 weeks, ESTP showed comparable number of completely occluded dentinal tubules to Biorepair. TNPsESTP showed significantly lower numbers of CODT than Biorepair. At 1 month, the number of CODT was difficult to count for all treated groups. Both ESTP and TNPsESTP showed significantly higher numbers of partially occluded dentinal tubules than Biorepair. Conclusion ESTP or TNPsESTP could offer a cost-effective substitute for the treatment of dentin hypersensitivity.

CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior A hipersensibilidade dentinária (HD) e as lesões cervicais não cariosas (LCNCs) são alterações que possuem altos índices de prevalência e incidência e que influenciam de maneira expressiva na qualidade de vida da população mundial. Nesse sentido é importante entender melhor a relação da dor em dentes com LCNCs, além de propor manejos das doenças na fase de HD e de LCNCs mais profundas que necessitem de tratamento endodôntico. Capitulo 1: avaliar por meio de estudo clínico randomizado, a eficácia de diferentes concentrações de oxalato de potássio (5 e 10%) na redução da HD, após um protocolo de quatro sessões de aplicação, com acompanhamento de 12 meses. Capitulo 2: avaliar por meio de um estudo observacional os efeitos da profundidade e espessura da dentina em dentes com LCNC na resposta à dor dental quando testes de diagnóstico clínico foram aplicados. Capitulo 3: avaliar por meio de um estudo in vitro o ângulo de flexão do instrumento, a resistência à fratura dos dentes, áreas preparadas, áreas superpreparadas e não preparadas, após diferentes acessos endodônticos em dentes com LCNC. Após a análise dos resultados, pode-se concluir que ambas as concentrações de oxalato de potássio (5 e 10%) testadas podem ser consideradas um tratamento eficaz para HD por pelo menos 6 meses. Dentes com LCNCs de até 2mm de profundidade apresentam níveis semelhantes de dor para: hipersensibilidade dentinária, polpa e tecido perirradicular independente da profundidade da LCNC, porém lesões com ≤1,0mm de profundidade apresentaram maior espessura de dentina remanescente nos achados tomográficos. Acesso conservador em dentes com LCNC pode resultar em maior ângulo de flexão de lima, sobrepreparo, e pior instrumentação no terço médio (mesiodistal/ vestibulolingual) do que o acesso tradicional, mas os dentes se apresentaram maior resistencia à fratura. Dessa forma é possível apresentar o manejo da HD e LCNCs profundas que necessitam de endodontia, além de compreender melhor o diagnóstico de dentes em diferentes profundidades. Dentin hypersensitivity (DH) is a condition with high prevalence and incidence rates, which influences the quality of life of the world population. In this sense, it is important to better understand the relationship between pain in teeth and NCCLs, in addition to proposing a treatment in the HD phase and for deeper NCCLs that require endodontic treatment. Chapter 1: to evaluate, by means of a randomized clinical study, the efficacy of different concentrations of potassium oxalate (5 and 10%) in the relieving of DH, after a protocol of four sessions. Chapter 2: to evaluate, by means of a observational the effects of NCCL dentin depth and thickness on the response to dental pain when clinical diagnostic tests were applied. Chapter 3: evaluate by means of a in vitro the flexion angle of the instrument, the fracture resistance of the teeth, prepared areas, over prepared and the unprepared areas, after different endodontic access in teeth with NCCL. After analyzing the results, it can be concluded that to evaluate, by means of a randomized clinical study, the efficacy of different concentrations of potassium oxalate (5 and 10%) in the relieving of DH, after a protocol of four sessions. tooth with NCCL up to 2mm depth presents similar levels of pain for: dentin hypersensitivity, pulp and periradicular tissue independent to NCCL depth, however, lesions with ≤1.0mm-depth showed greater remain detin thickness in tomographic findings. Conservative access in teeth with NCCL can result in a more flexion angle of the file, over prepared showed worse instrumentation in middle third (bucclingual/ mesiodistal) than tradicional access, but the teeth became more resistant to fracture. In this way, it is possible to present the management of HD and deep NCCLs that require endodontics treatment, in addition to better understanding the diagnosis of teeth at different depths. Tese (Doutorado) 2024-08-24

The aim of the present study was to assess the duration of dentin tubule occlusion by the calcium phosphate precipitation (CPP) method in the vital teeth of beagle dogs. Vital teeth were treated using the CPP method, potassium oxalate, or a bonding agent (Liner bond II) after cavity preparation and acid etching. The dentin tubules of all groups, except for the bonding agent, opened more widely with time in the absence of plaque control. Dentin tubules treated with the CPP method were open and no precipitate remained in the absence of plaque control. Differences were observed in dentin tubule occlusion when plaque control was achieved by daily tooth brushing. The majority of dentin tubules were occluded with an apatitic precipitate seven days after the CPP method with plaque control. The present results demonstrated that the CPP method is useful with proper plaque control.

Aim This study aims to evaluate the efficacy of avian eggshell slurry as a desensitizing agent compared to casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing Tooth Mousse. Materials and methods Eggshell powder was prepared and characterized using a scanning electron microscope (SEM), transmission electron microscope (TEM), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDX). Forty dentin disks were immersed in 6% citric acid for 2 min to simulate hypersensitive dentin (baseline). Disks were then divided into two groups (n = 20) according to treatment received: eggshell slurry and commercially available Tooth Mousse desensitizing agent. Each group was further divided into two subgroups (n = 10). In subgroup 1, dentin discs were immersed in artificial saliva for four weeks whereas, in subgroup 2, discs underwent acid challenge. Environmental scanning electron microscope (ESEM) analysis and hydraulic conductance test were utilized to calculate dentinal tubules occlusion and reduction of dentin permeability percentages, respectively. Statistical analysis was performed using SPSS 22.0 at a significance level p ≤ 0.05. Results After application of desensitizing agents, the eggshell slurry group showed a significantly higher percentage of dentinal tubules occlusion compared to the Tooth Mousse group, whereas no significant difference existed in the percentage reduction of dentin permeability between both groups. After both immersion protocols, the eggshell slurry significantly occluded more dentinal tubules compared to Tooth Mousse. On the contrary, results of percentage reduction of dentin permeability revealed no significant difference between both subgroups after acid challenge. After artificial saliva immersion, Tooth Mousse showed a significantly higher percentage reduction of dentin permeability compared to the eggshell slurry. Conclusion Avian eggshell slurry can effectively occlude open dentinal tubules compared to commercially available Tooth Mousse desensitizing agent. Clinical significance Avian eggshell slurry can be considered a promising material for the treatment of dentin hypersensitivity. How to cite this article: El Tahlawy AA, Saba DA, Bakir NG. Avian Eggshell Slurry as a Dentin Desensitizing Agent: An In Vitro Assessment Using Two Techniques. J Contemp Dent Pract 2021;22(5):532-537.

Objectives: To evaluate the efficiency and stability of Nano seashell, Sodium Fluoride and Signal Complete 8 in treatment of dentine hypersensitivity. Methods: Forty freshly extracted premolar teeth were collected, disinfected, and sliced into 1.0± 0.1mm thickness. The dentin discs were randomly divided into two main groups of 20 discs each. Group 1(n=20): Dentin discs subjected to treatment not followed by acid challenge. Group 2 (n=20): Dentin discs subjected to treatment followed by acid challenge. Each group was further subdivided into 4 subgroups of 5 discs each according to the treatment used; Subgroup A (Control group): discs received no treatment; Subgroup B: discs treated with Sodium Fluoride paste; Subgroup C: discs treated with Nano Seashell paste; Subgroup D: discs treated with Signal Complete 8 toothpaste. Evaluation of dentinal tubules obliteration was done under scanning electron microscope. Results: There was a significant change in the diameter of tubules and percentage of occlusion for group 1. Group 2 (subjected to acid challenge after treatment) has shown high stability for subgroup B (Sodium Fluoride), followed by subgroup D (Signal Complete 8) then subgroup C (Nano seashell paste). Conclusion: Nano seashell and Sodium Fluoride caused significant increase of occluded dentinal tubules than Signal complete 8 but the mineral deposits formed by Sodium Fluoride showed higher resistance to acidic environment than those formed by Nano seashell.

Dentine hypersensitivity is defined as short, sharp pain from exposed dentin in reaction to thermal, evaporative, tactile, osmotic, or chemical stimuli. This condition is associated with non-carious cervical lesions (erosion, abrasion and abfraction), gingival recessions, periodontal disease, among other dental problems. Due to its multifactorial nature, the diagnosis of dentin hypersensitivity is often difficult and confusing for the dental surgeon. There is no single strategy that can solve this condition in all patients and it is the responsibility of the dental surgeon to know its characteristics in order to propose an effective treatment plan for patients. Therefore, this review aims to show the main characteristics of dentin hypersensitivity, as well as the challenges associated with clinical management, for understanding and mastery in clinical practice. La hipersensibilidad dentinaria se define como un dolor corto y agudo de la dentina expuesta como reacción a estímulos térmicos, evaporativos, táctiles, osmóticos o químicos. Esta condición normalmente está asociada a lesiones cervicales no cariosas (erosión, abrasión y abfracción), recesiones gingivales, enfermedad periodontal, entre otros problemas odontológicos. Por su naturaleza multifactorial, el diagnóstico de la hipersensibilidad dentinaria suele ser difícil y confuso para el cirujano dentista. No existe una estrategia única que pueda resolver esta condición en todos los pacientes y es de responsabilidad del cirujano dentista conocer sus características para proponer un plan de tratamiento eficaz para sus pacientes. Por tal motivo, la presente revisión tiene como objetivo mostrar las principales características de la hipersensibilidad dentinaria, así como los desafíos asociados a su manejo clínico, para su entendimiento y dominio en la práctica clínica.

Purpose: To assess the effectiveness of calcium sodium phosphosilicate in reducing dentin hypersensitivity compared to other dentin tubule occluding molecules. Methods: A structured research question was formulated, and an electronic search of available literature was carried out via PubMed, Google Scholar, and Scopus. A hand search as well as a gray literature search were also carried out. The search produced a total of 67 articles. Of these, only eight articles were eligible to be included in our review. Risk of bias and study quality were checked using Cochrane tool. The review was registered in The International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42018096200. Results: The results show a reduction in dentin hypersensitivity with calcium sodium phosphosilicate compared to many other molecules. However, nanohydroxyapatite showed a better desensitizing effect compared to Novamin. Conclusion: According to the available evidence, 5 % calcium sodium phosphosilicate containing toothpaste is more effective reducing dentin hypersensitivity compared to many other dentinal tubule occluding molecules.

This five-phase, single-blind, crossover in situ trial evaluated the effects of desensitizing or anti-erosive toothpastes on dentin erosive wear and tubule occlusion. Some characteristics such as relative dentin abrasivity (RDA), viscosity (V), cytotoxicity, and fluoride and calcium (Ca) availability of the toothpastes were also tested. Samples were positioned on removable intraoral appliances from 15 volunteers (n=4), according to the groups, C-control (0 ppm fluoride), F-sodium monofluorophosphate (MFP), A-MFP and arginine+calcium carbonate, CSP-calcium sodium phosphosilicate, and CS-MFP and calcium silicate+sodium phosphate. Erosion-abrasion cycling was performed (1% citric acid, 2min, 6×/day; toothbrushing, 5s, 2×/day). Surface loss (SL) was evaluated by optical profilometry. Environmental scanning electron microscopy images (ESEM) counted the number of open dentin tubules (ODTs). Data were statistically analyzed (α=0.05). There were no significant differences in SL among groups (p=0.468). The ODT for CSP, CS, and A groups were significantly lower than the control. CSP and CS presented significantly less ODT than F, but they did not significantly differ from A. F and CS were more abrasive than all the other toothpastes; CSP was more abrasive than A, and C was the least abrasive. CSP presented higher V (p

Noncarious cervical lesions (NCCLs) are a common clinical finding often linked with dentin hypersensitivity (DH). Aim. The aim of the study was to evaluate the influence of diode laser for the treatment of DH on microleakage of subsequent NCCL restorations. Materials and Methods. Forty-eight extracted human premolars were collected. All teeth received standardized cervical preparation on both the buccal and palatal surfaces and were randomly divided into three groups ( n = 16 ) according to the restorative material used: nanohybrid composite resin (CR), resin-modified glass ionomer (RMGI), and conventional glass ionomer (GIC). The prepared cavities on the palatal surfaces were treated by diode laser using SIROlaser Blue (Sirona Dental Systems, Bensheim, Germany) prior to restoration, while preparations on the buccal surfaces were directly restored. After thermocycling, the teeth were immersed in methylene blue dye for microleakage evaluation under 40x magnification at both occlusal and cervical margins. The Kruskal-Wallis test followed by the Bonferroni tests was conducted to determine inter- and intragroup differences ( P < 0.05 ). Results. All restorative materials tested showed some degree of microleakage with no statistically significantly different scores with or without the use of laser desensitization prior to restorative treatment. Group CR showed the least microleakage, followed by group RMGI, while group GIC showed the highest. Cervical margins showed greater microleakage than the occlusal margins where the difference was statistically significant in the RMGI group without laser pretreatment ( P = 0.006 ) and in both groups CR ( P = 0.02 ) and RMGI ( P = 0.006 ) with the laser pretreatment. Conclusion. Application of diode laser for the treatment of DH prior to the restoration of teeth with NCCL did not affect the microleakage of all the restorative materials tested. All the materials showed some degree of microleakage, which was higher in gingival margins compared to occlusal margins. The resin composite shows the least microleakage among all the tested materials.

This clinical trial aimed to compare the effects of low-level laser therapy (LLLT), Er,Cr;YSGG laser, and fluoride varnish, as compared to the placebo laser on decreasing dentin hypersensitivity (DH). This randomized, double-blinded clinical trial included 60 jaw quadrants in 24 patients who underwent periodontal surgery. The quadrants were randomly assigned to 4 groups and received treatments as follows. Group 1: LLLT with a combination of red and infrared wavelengths, group 2: Er,Cr:YSGG laser (0.25 W and 0.5 W), group 3: fluoride varnish, and group 4: placebo laser. The sensitivity response to the cold spray was recorded using visual analogue scale (VAS) at baseline, immediately, and 1 week post-treatment. The data were analyzed by repeated measures analysis at the significance level of P

Objective: To compare the mean dentin hypersensitivity after using GC tooth mousse versus fluoride varnish in patients with dentinal hypersensitivity due to non-carious cervical lesions. Study Design: Randomized Control Trial. Setting: Watim Dental College, Rawalpindi. Period: February to August 2019. Material & Methods: A total number of 166 patients were enrolled in the study. Informed consent and demographic information were taken. The subjects were randomized by using random number table to minimize bias. Patients were divided into 2 groups. Fluoride varnish (group 1) which is the control group and GC Tooth Mousse which is group 2, both were used 3 times in the first day during the first week. On follow up the tooth sensitivity was noted. The follow up appointment to measure the level of dentinal hypersensitivity was done after the given treatment on the 7th day of the first week. For measuring the dentin hypersensitivity, the Visual Analogue Scale was used. The data that was collected was entered and 1 then it was analyzed on SPSS version 21. Results: In this study mean age of the fluoride varnish group patients was 44.14±8.95 years, in GC tooth mousse group patients was 44.24±9.04 years. The mean pain score of fluoride varnish group patients was 1.98±1.43 while in GC Tooth Mousse paste group patients was 2.39±1.21 (p-value=0.048). Conclusion: Fluoride varnish group showed significantly lower mean dentin hypersensitivity than to GC tooth mousse group in patients with dentinal hypersensitivity with caries free cervical lesions.

Jian Yu,* Luyao Yi,* Rui Guo, Jingmei Guo, Hongye Yang, Cui Huang The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongye Yang; Cui HuangThe State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Wuhan, 430079, Hubei Province, People’s Republic of ChinaEmail yanghongye@whu.edu.cn; huangcui@whu.edu.cnBackground: The dentin exposure always leads to dentin hypersensitivity and/or caries. Given the dentin’s tubular structure and low mineralization degree, reestablishing an effective biobarrier to stably protect dentin remains significantly challenging. This study reports a versatile dentin surface biobarrier consisting of a mesoporous silica-based epigallocatechin-3-gallate (EGCG)/nanohydroxyapatite delivery system and evaluates its stability on the dentinal tubule occlusion and the Streptococcus mutans (S. mutans) biofilm inhibition.Materials and Methods: The mesoporous delivery system was fabricated and characterized. Sensitive dentin discs were prepared and randomly allocated to three groups: 1, control group; 2, casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) group; and 3, the mesoporous delivery system group. The dentin permeability, dentinal tubule occlusion, acid and abrasion resistance, and S. mutans biofilm inhibition were determined for 1 week and 1 month. The in vitro release profiles of EGCG, Ca, and P were also monitored.Results: The mesoporous delivery system held the ability to sustainably release EGCG, Ca, and P and could persistently occlude dentinal tubules with acid and abrasion resistance, reduce the dentin permeability, and inhibit the S. mutans biofilm formation for up to 1 month compared with the two other groups. The system provided prolonged stability to combat oral adverse challenges and served as an effective surface biobarrier to protect the exposed dentin.Conclusion: The establishment of the dentin surface biobarrier consisting of a mesoporous delivery system indicates a promising strategy for the prevention and the management of dentin hypersensitivity and caries after enamel loss.Keywords: epigallocatechin-3-gallate, nanohydroxyapatite, mesoporous silica, dentin, biofilm

Resume. Nowadays, aesthetics plays an important role in dentistry due to the increased attention of people to the beauty and attractiveness of the smile, which is known as an effective tool in achieving both personal and professional purposes. Therefore, the whitening of discolored teeth is one of the promising directions in aesthetic dentistry. To date, there is much controversy among dentists about the effectiveness and, the most importantly, the safety of teeth whitening. The prevention of dentin hypersensitivity is among the main tasks associated with the safe and comfortable treatment and follow-up period for patients. In order to avoid the negative consequences of hyperesthesia, the teeth whitening procedure should be finished with remineralizing therapy. Thought there are a large number of techniques and products for the treatment of hyperesthesia, the question of their most appropriate selection and combination is remaining unresolved and is relevant to meet the steadily growing population demands. Purpose: to highlight the latest views on techniques and products for remineralizing therapy in the process of teeth whitening based on the analysis of relevant literature. Results. Numerous bleaching methods are mainly based on applying high concentrations of hydrogen peroxide. At present, the safety of whitening methods remains controversial and thus requiring further research. The problem of improving techniques aimed at preventing the side effects of professional whitening on the oral tissues and organs are remaining relevant. The problems associated with professional whitening include the decreased resistance of hard dental tissues, the appearance of areas of demineralization and hyperesthesia in the hard dental tissues. At present, a wide range of products has been proposed to treat and prevent the development of teeth hypersensitivity. However, the most effective of them, which could be offered to patients after professional whitening have not been identified yet. To prevent and treat dental hyperesthesia effectively, fluoride-containing remineralizing remedies are widely used to diminish dentin sensitivity. There are studies demonstrating the highest incidence of teeth hyperesthesia during light catalytic and chemical bleaching Therapeutic and prophylactic agents, which contain calcium, phosphorus and fluoride ions, which promote dental enamel remineralization, have been proposed. The use of remineralizing gels before the procedure of medical teeth whitening reduces the occurrence of dental hyperesthesia. That is why many manufacturers of bleaching systems have begun to add desensitizing components to their composition. Thus, Opalescence Boost PF gel contains potassium nitrate and fluorine, Philips Zoom whitening gel contains amorphous calcium phosphate, in addition; remineralizing gel Relief ACP with amorphous calcium phosphate is offered to reduce the occurrence of teeth hypersensitivity during whitening procedure. The results of our research have shown the most significant changes expressed by a decrease in organic acids, maximum increase in concentrations of calcium ions in oral fluid, occur when using photo-bleaching system Beyond Polus, while minimal changes are observed when using chemical activation system Opalescence Xtra Boost. The combination of a reminalizign remedies based on zinc-substituted hydroxyapatite carbonate with laser phonophoresis can be recommended be apply after any bleaching techniques and they have been proved to be the most effective. Conclusion. There is a wide range of techniques and products of remineralizing therapy applied in the process of teeth whitening. Various options of remineralizing therapy and applying different compounds reducing teeth sensitivity after teeth whitening procedure are described in the article. Many formulas have been already developed to ensure patient comfort after a whitening procedure, and in particular to prevent the development of hyperesthesia. Some manufacturers incorporate remineralizing remedies in the whitening system that allows dentists to solve the problem of teeth hypersensitivity effectively.

OBJECTIVE: The objective of this study was to compare the efficacy of dentifrices containing potassium nitrate and strontium chloride in reducing dentinal sensitivity pain. METHODOLOGY: A pilot study was conducted in Islamic International Dental Hospital Islamabad, Pakistan (Duration two weeks). Forty participants were selected, aged between 18-40 years, having dentin hypersensitivity with the minimum score of 4 on Visual Analog Scale. Participants were randomly allocated with dentifrices containing 5% w/w potassium nitrate and 10 % w/w strontium chloride and were asked to use it for 2 weeks and come back for follow up. Statistically significant correlations were found using the Man Whitney test. A pre-designed proforma was used to acquire information about the patient. Sensitivity was determined with the aid of the Visual Analog Scale. RESULTS: There was greater reduction in moderate pain from 85.8% to 71.4% with strontium chloride and from 84.2% to 79% with potassium nitrate. CONCLUSION: 10 % w/w strontium chloride is more effective than the 5% w/w potassium nitrate for the management of dentin hypersensitivity. KEYWORDS: Toothpastes, Sensitivity, Strontium Chloride, Potassium Nitrate HOW TO CITE: Kiani AZ, Hassan S, Rafiq T. Clinical comparison of 5% potassium nitrate and 10% strontium chloride toothpastes in alleviating dentin hypersensitivity following manual scaling: A pilot study. J Pak Dent Assoc 2021;30(1): 56-60.

This study sought to assess intrapulpal temperature rise following two dentin hypersensitivity (DH) treatment protocols using the 810-nm diode laser. In this randomized clinical trial, 45 maxillary and mandibular incisors and premolars were randomly divided into three groups primary phase (no intervention), 1 W diode laser for 10 s (group 1), and 0.5 W diode laser for 60 s (group 2). In all groups, the access cavity was prepared, and the thermocouple was placed in the pulp chamber and fixed by Cavit. Intrapulpal temperature was measured immediately after access cavity preparation and every minute for 10 min in the primary phase. In the second phase group 1, the temperature was measured with 2-s intervals after irradiation for 10 s and group 2, with 15-s intervals after irradiation for 60 s. Data were analyzed using repeated measures ANOVA and t test (P ≤ 0.05). The mean stabilized baseline temperature was 32 °C. The mean temperature rise was 5 °C. In both experimental groups, the stabilized temperature after laser irradiation was significantly higher than the baseline temperature (P 0.05). Time to stabilize temperature after irradiation in group 1 was significantly shorter than that in group 2 (P

Aim: Dentine hypersensitivity is a common oral problem. This pilot study investigated the prevalence of dentine hypersensitivity in the diverse population across four centres of Bihar and Jharkhand. Materials and Methods: A multi-stage, random sampling method was used to investigate the study population. A total of 5622 subjects were examined at four centres in Bihar and Jharkhand. Subjects were divided into 8 age groups. Participants completed a dentine hypersensitivity questionnaire and underwent clinical examination. The diagnosis of dentine hypersensitivity was confirmed. Gingival recession of sensitive teeth was measured by a Williams periodontal probe. Results: Among 5622 subjects, 1253 were found to be suffering from dentin hypersensitivity indicating a prevalence of 22.28%. Females were more prone to dentin hypersensitivity with male to female ratio of 1:1.31. While subjects in age group of 50-59 were predominantly affected, the molars and premolars were commonly affected with dentin hypersensitivity. Conclusion: The prevalence of dentine hypersensitivity in East India was 22.28%, indicating that it is a common condition. For its effective management, public education about the condition and effective treatment of dentine hypersensitivity are required. Clinical Significance: Assessment of prevalence of hypersensitivity in this demographical location would enable the dental care health workers to devise strategies to educate masses about the prevention and management of this disease

Background Dentin hypersensitivity (DH) is defined as an exaggerated sensitivity of vital dentin exposed to thermal, chemical and tactile stimuli. This study aimed to evaluate, through a literature review, the applicability of high- and low-intensity lasers in the treatment of DH for the past 10 years, as well as its therapeutic potential. Material and methods The electronic databases MEDLINE/PubMed and LILACS were searched using the descriptors ("Dentin Sensitivity" OR "Dentin Hypersensitivity") AND ("Low-Level Therapy" OR Laser), for articles published between 2010 and 2020. Only randomized clinical trials with full-text and full case resolution were included. Results We found 187 articles in total, among which 61 were pre-selected and 10 included in this literature review. Conclusions Considering the found results and their possible limitations, high- and low-intensity lasers, associated or not with other therapies, have demonstrated beneficial effects in the treatment of DH, being considered a promising, safe, easy, and effective field of research, reducing pain sensitivity and preserving pulp vitality. Key words:Dentin sensitivity, dentistry, laser.

The underlying dentin could be exposed to a humid atmosphere filled with bacteria if the covering enamel layer is broken because of external chemical and physical conditions. Accordingly, some diseases like bacterial invasion and dentin hypersensitivity often occur, which impact the daily life of patients. The study is aimed at evaluating the occluding effects of mesoporous calcium silicate nanoparticles (MCSNs) on the dentinal tubules in vitro and in vivo, as well as the antibacterial property and drug delivery ability when loaded with chlorhexidine (CHX) in vitro. MCSNs were synthesized according to the standard protocol. After a series of complimentary evaluations in vitro and in vivo, it was found that MCSNs and CHX–MCSNs could continually form apatite-like enamel layers on the exposed dentinal tubules and significantly reduced dentin permeability both in vitro and in vivo. Besides, MCSN and CHX–MCSN possessed low cytotoxicity in vitro, and only mild pulp inflammation was observed in two MCSNs containing groups in vivo. In addition, MCSN loaded with CHX released CHX sustainably and revealed a significant antibacterial effect against E. faecalis in vitro. Therefore, the results suggest that MCSN could be used as a promising biomaterial to occlude the dentinal tubules and carry antibiotics for avoiding further pulp infection.

Hyperesthesia (from the Greek hyper - increase and aisthesis - sensation) means any increase in pain sensitivity of the tooth tissues to external irritants of temperature, chemical and tactile nature. The number of the patients with hypersensitivity of the hard dental tissues has increased sharply in recent years and according to various authors’ findings it is from 60% to 90%. A wide range of prevalence fluctuations is observed in different age groups. The age of people with certain symptoms of teeth hypersensitivity is 25-50 years while the highest frequency is among the people aged 30-40 years. Starting from an earlier age women suffer more often than men. The generalized form of hyperesthesia is usually associated with such general causes as the functional state of the nervous system, endocrine diseases, disorders of mineral metabolism in the body. The localized forms of hyperesthesia are caused mainly by the defects in the hard tissues of individual teeth or periodontium. Rapid and effective treatment of hyperesthesia of the hard dental tissues is an important and urgent problem of modern practical dentistry. Therefore, a great amount of the techniques for the treatment of this pathology is constantly increasing. Now one of the most common methods is the local impact on the hard dental tissues. The aim of the study is to analyze the specialized medical literature that is concerned with modern methods and techniques for the treatment of hypersensitivity of the hard dental tissues. Materials and methods of the research. The review of the literature sources on modern concepts of the treatment of hyperesthesia of the hard dental tissues has been made and the information has been analyzed. Results. The problem of hypersensitivity of the tooth tissues has led to the invention of a whole class of the drugs aimed at its elimination. These medications have different chemical nature, the mechanism of the action on the tissues and even the indications for their use, but the purpose of all these medical preparations is common as they are aimed at reducing hypersensitivity of the tooth tissues. A wide range of the techniques is proposed to eliminate the problem of tooth sensitivity. One of the most common methods of the treatment is a local effect on the hard dental tissues which is aimed directly at the relief of the hydrodynamic mechanism. According to this theory, the stimulus which causes pain increases the flow of the fluid in the dentinal tubules that leads to the changes in osmotic pressure and increased activity of the nerve endings in its turn. Therefore, taking into account the mechanism of the action of desensitizing toothpastes they are divided into those ones that reduce the excitability of the nerve fiber and those ones that contribute to the obstruction of the dentinal tubules. Nowadays there have been also accumulated a sufficient number of clinical and experimental observations indicating that one of the main causes of dentin hypersensitivity is any disturbance of phosphorus-calcium metabolism of the hard dental tissues. A number of authors have shown that people with the generalized form of hyperesthesia has pronounced hypophosphatemia which is combined with the decrease in the content of inorganic phosphorus and calcium in the oral fluid. In this regard, the drugs of calcium (gluconate, chloride, glycerophosphate) and fluoride (sodium fluoride) are widespread in the treatment of dentin hyperesthesia and they are used by application and rubbing into sensitive areas, electro- and phonophoresis, in the form of varnishes and gels, as well as in toothpastes. Unfortunately, the mechanisms of dentinal pain have not been fully studied and its symptoms are nonspecific and subjective. Therefore, there is no ideal composition for the treatment of sensitive dentin. In addition, the result of the therapy occurs in many cases over a long period of time. Conclusion. Thus, according to modern ideas, the treatment of hypersensitivity of the hard dental tissues can be carried out in two ways: desensitization of the nerve fibers to reduce the corresponding response to irritation; obturation of the dentinal tubules to restore intra-tubular osmotic pressure. These days one hundred percent result in the treatment has not been achieved, so it is important to find and develop new techniques and methods to eliminate teeth hyperesthesia.

Made available in DSpace on 2021-06-25T22:23:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-12-16 Introduction: Gingival recession (GR) is a prevalent problem that is related to esthetic demands and dentin hypersensitivity. Frequently, GR is associated with non-carious cervical lesion (NCCLs) forming a combined defect (CD), which requires restorative and surgical treatment. Connective tissue graft procedures allow predictable root coverage but can result in patient discomfort. Case Presentation: This first case report describes multiple GRs associated with B+ NCCL at teeth #4 and #6 of a 27-year-old patient with a thin periodontal phenotype. The aim of this report was to evaluate the 6-month outcome of a new volume-stable collagen matrix (VCMX) combined with modified coronally advanced flap (MCAF) and partial restoration to treat CDs. After 6 months, significant improvement was observed regarding CD coverage (69.05%), recession reduction (2.25 mm), gingival thickness gain (0.74 mm), and keratinized tissue width gain (0.75 mm). In addition, excellent esthetic evaluation and patient comfort were achieved by using the biomaterial. Conclusion: VCMX associated with MCAF and partial restoration may be an option to treat multiple recession defects plus B+ NCCLs. Sao Paulo State Univ UNESP, Inst Sci & Technol, Div Periodont, Ave Eng Francisco Jose Longo 777, Sao Jose Dos Campos, SP, Brazil Sao Paulo State Univ UNESP, Inst Sci & Technol, Div Periodont, Ave Eng Francisco Jose Longo 777, Sao Jose Dos Campos, SP, Brazil

Objectives To compare the efficacy of calcium sodium phosphosilicate (CSPS) and arginine dentifrices on dentin permeability and acid tolerance. Material and Methods Sixty dentin discs were randomly assigned into 3 groups, then brushed for 1 min with CSPS, arginine, or fluoride (control) dentifrices. To test acid tolerance, each disc was soaked in 6% citric acid for 1 min. Dentin permeability was measured before, following brushing, and acid challenge. Ten discs per group were similarly treated and evaluated for tubule occlusion following a single dentifrice application, while other five discs per group were employed in an acid tolerance assay. Results The percentage reduction in dentin permeability was 39.26%, 32.27%, and 21.71% in the arginine, CSPS, and control groups, respectively. The differences in dentin permeability reduction between the arginine and CSPS groups following brushing and acid challenge were not significant (p = 0.398 and p = 0.211, respectively). The arginine dentifrice demonstrated a significant reduction in permeability compared with the control (p = 0.011). In addition, the occlusion exhibited by the arginine and CSPS dentifrices was more resistant to acid challenge compared with that of the control (p

Background Novel materials used for dentin hypersensitivity (DH) treatment, including hydroxyapatite-based desensitizers, are not only effective in occluding dentinal tubules, but are also biocompatible and non-toxic. A newly formulated desensitizer containing hydroxyapatite was evaluated in comparison to commercially available desensitizers. Objectives To compare the occluding efficacy and durability of 3 commercially available desensitizing agents with a pharmaceutical composition developed by the authors based on hydroxyapatite (HAp). Material and methods For the experiment, 40 disc-shaped dentin specimens (5 mm thick) were obtained from extracted human teeth. Each disc was divided into 4 sections, so that each desensitizing agent could be applied to each specimen and prepared for further evaluation in most homogenous conditions. The chemical composition of the dentin surfaces was analyzed using scanning electron microscopy (SEM) equipped with an energy-dispersive X-ray spectroscope (EDS), Fourier-transform infrared (FTIR) and Raman spectra techniques. The specimens were immersed in an artificial saliva solution for 24 h, 48 h and 7 days to assess the durability of the layers and the tubule-obliteration effectiveness. Data analysis was performed using Student's t-test with an average value of normal distribution at an unknown variance with a standard deviation (SD) of σ-0.4. Results All the test groups showed some degree of dentinal tubule occlusion or a covering layer, but the HAp-based composition proved to be the longest-lasting. It was concluded that the developed pharmaceutical composition creates a coating on the dentin surface built of hydroxyapatite crystals sized 10-20 μm, which are likely to constitute a reservoir of calcium and phosphate ions, as well as smaller crystals (0.2-0.3 μm) that occlude dentinal tubules. Conclusions The composition containing biocompatible hydroxyapatite effectively occluded dentinal tubules and therefore exhibits a potential for reducing the pain and discomfort caused by dentin hypersensitivity.

BACKGROUND Treatment of periodontitis aims to halt progressive bone and attachment loss and regenerate periodontal structures. In this study, the effect of using an enamel matrix derivative (EMD) as an adjunct to non-surgical periodontal therapy (test) versus non-surgical therapy alone (control) was evaluated. METHODS A prospective, split-mouth, multicenter study evaluated scaling and root planing (SRP) with and without EMD in 51 patients presenting with moderate to severe periodontitis (PPD = 5 to 8 mm) in at least 2 pockets per contralateral quadrants within the same arch. The primary outcome variable was change in clinical attachment level (CAL) after 12 months. Secondary variables included probing pocket depth (PPD), bleeding on probing (BoP), gingival margin level, dentin hypersensitivity, and percent of pockets converted to sites no longer requiring surgical treatment. RESULTS CAL changed significantly (P

Gingival recession is the exposure of the root surface resulting from migration of the gingival margin apical to the cementoenamel junction (CEJ). It may be localized or generalized and can be associated with one or more tooth surfaces. Even though gingival recession may occur without any symptoms it can give rise to pain from exposed dentin, patient concern about loss of the tooth, poor esthetics or root caries. The denuded root surfaces cause deterioration in the esthetic appearance, dentin hypersensitivity, and inability to perform proper oral hygiene procedures. The Bernotti V-Y flap is a coronally advanced flap technique with a “VY” flap design, which consist of a microsurgery technique with or without connective tissue graft, that will improve mucosal biotype and keratinized band in a predictable way for isolated mucosal recession, dehiscence and translucent tissue at teeth or implant sites. It is a conservative flap design, inspired by Semilunar and Modified Semilunar Tarnow’s technique, to minimize interproximal crestal bone loss and possible loss of papillae around teeth or implants, marginal mucosal position is stabilized avoiding adverse aesthetic outcomes. Miller’s Class I and II recession defects with a minimum height of (two) 2 mm are suitable to be selected to perform the Bernotti V-Y flap. The Bernotti V-Y flap consist of a pedicle flap, making a ¨V ¨incision apically to the recession defect and the flap is coronally advanced. Stability and aesthetic outcomes are achieved with the Bernotti V-Y flap. Keywords: Bernotti VY, Gingival recession, Root coverage.

Relevance.In adolescence, focal demineralization after orthodontic treatment is highly prevalent. This, in turn, leads to symptomatic hypersensitivity in the absence of other predisposing factors (recessions, exposure of cervical dentin, increased abrasion, etc.). Reviewed the mechanism for reducing hypersensitivity and remineralizing of calcium-sodium phosphosilicate, also the effectiveness of using a prophylactic toothpaste with this component in adolescents.Materials and methods.A single-center, non-comparative open study was conducted to evaluate the effectiveness of the Sensodyne Restoration and Protection toothpaste at the Department of Pediatric Dentistry and Orthodontics, USMU for 4 weeks. 22 adolescents aged 14-16 years with focal demineralization of enamel in the stain stage after completion of orthodontic treatment participated in the study.Results.The use of toothpaste with calcium-sodium phosphosilicate after a month of use leads to a decrease in the hygiene index by 23.38%, a decrease in hypersensitivity according to the results of the Schiff air index by 56.94% (p ≤ 0.05), and a tendency to an increase in the level of mineralization and a decrease in areas of white spot lesions.Conclusions. Toothpaste with calcium-sodium phosphosilicate has a cleansing effect and reduces sensitivity and can be recommended for adolescents with focal demineralization against the background of orthodontic treatment.

Background: This study aimed to assess the microhardness and morphology of permanent dentin following the application of Iranian and foreign-made desensitizing toothpastes. Methods: This in vitro, experimental study evaluated 48 dentin samples prepared of the extracted sound human permanent molars. Dentin samples were randomly divided into three groups (n=16) and subjected to the application of Pooneh Iranian desensitizing toothpaste, Colgate Sensitive Pro- Relief (Poland), and no intervention (negative control). Each dentin sample was then immersed in 5 mL of a demineralizing solution for 10 hours and underwent a demineralization/remineralization cycle (pH cycling) for 14 days. The mean microhardness of the samples was measured at baseline after demineralization and after 14 days. One sample of each toothpaste group was selected for the scanning electron microscopy (SEM) assessment of dentin morphology. Finally, repeated-measures ANOVA was used to analyze the effect of time and type of toothpaste on microhardness using SPSS, version 21. Results: The comparison of the mean microhardness of the control group with experimental groups revealed no significant difference at baseline or after demineralization (P > 0.05) although this difference was significant after 14 days (P < 0.001). The mean microhardness of the two toothpaste groups was not significantly different at different time points (P > 0.05). Finally, the SEM assessment revealed a greater tubular obstruction in Pooneh group after 14 days. Conclusions: Pooneh Iranian-made desensitizing toothpaste was comparable to Colgate Sensitive Pro-Relief foreign-made desensitizing toothpaste in terms of the microhardness of permanent dentin. It even demonstrated superior performance with regard to the obstruction of dentinal tubules.

Nos tempos atuais, vivencia-se um aumento da expectativa de vida da população, com isso está sendo observado um maior desgaste da estrutura dentária. Quando há perda de esmalte dentário, ocorre uma exposição dos túbulos dentinários, causando desconforto e uma sensação dolorosa ao paciente chamada de hipersensibilidade da dentina. Os estímulos que desencadeiam essa sensação dolorosa aguda, provocada e de curta duração podem ser de origem química, térmica, evaporativa, tátil ou osmótica. Esse desgaste dentário tem a possibilidade de ocorrer em virtude de processos crônicos de dissolução ácida, sem presença de bactérias (erosão), do desgaste mecânico repetitivo (abrasão), da oclusão traumática (abfração) e de desgaste fisiológico (atrito), que são as lesões cervicais não cariosas e ocasionam um problema tanto estético quanto funcional. Este trabalho tem por finalidade mostrar os fatores etiológicos, classificação, aspectos clínicos, mecanismos de ação e opções terapêuticas das lesões cervicais não cariosas e da hipersensibilidade de dentina, possibilitando ao Cirurgião-dentista o conhecimento de um diagnóstico diferencial das lesões para que possa ter a melhor conduta perante o paciente. Foram observados fatores extrínsecos e intrínsecos associados, e que o trauma oclusal é o principal fator etiológico o qual predispõe o surgimento das demais lesões. Para esse estudo, foi feito um levantamento de referências bibliográficas em bancos de dados como PubMed/SciELO/BBO/Lilacs, juntamente com dois livros, durante o mês de maio de 2020, no intuito de proporcionar uma visão geral sobre o tema.

The purpose of this study was to investigate whether tooth-brushing with a microcurrent was effective in inducing dentinal tubule occlusion. The specific aims of the study were (1) to evaluate the effectiveness of tooth-brushing with a microcurrent on dentinal tubule occlusion by using scanning electron microscopy (SEM); and (2) to compare the dentinal fluid flow rate after tooth-brushing with a microcurrent by using a sub-nanoliter-scaled fluid flow measuring device (NFMD). All experimental groups showed partially occluded dentinal tubules and crystal-like structures at a specific microcurrent intensity indicated that tooth-brushing with a microcurrent could efficiently occlude dentinal tubules. The decrease in dentinal fluid flow rate in the tooth-brushing with microcurrents group indicated that dentinal tubules were occluded and the flow of dentinal fluid had decreased.

Dentin hypersensitivity can be reduced by the use of a remineralization agent to hinder movement of fluids within the dentin tubules. Penetration of particles into the tubules and a continuous release of Ca2+ and phosphate ions can induce the mineralization of a material mimicking the mineral component of dentin, sealing the tubules. In this work, we have used complementary electron microscopy techniques to investigate the ultrastructure of dentin and crystallization and occlusion effects when using amorphous calcium magnesium phosphate (ACMP) microspheres on extracted human molars. Application of the particles in a gel intended for at-home use resulted in intra-tubular mineralization of a carbonate substituted hydroxyapatite (HA). Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) showed that crystallization was initiated on the peritubular dentin (PTD) with undirected crystal growth leading to the formation of a porous material. We additionally investigated the effects from using a fluoride toothpaste to potentially improve the remineralization and anti-cariogenic properties of the ACMP microspheres. Energy dispersive x-ray spectroscopy (EDX) using TEM in scanning mode (STEM) showed that fluoride incorporation resulted in an increase in aspect ratio of the crystals, crystal growth directed towards the center of the tubule lumen and densification of the mineralized material. Thus, ACMP microspheres are promising alternatives as occluding agents and the efficacy of the particles could be further improved with the complementary use of a fluoride toothpaste.

Non-Carious Cervical Lesions (NCCL) are characterized by irreversible and gradual loss of mineralized tissue near enamelcement junction, and they may cause dentin hypersensitivity, characterized by an acute and short-term pain. They can be treated through restorative procedures and removal of etiologic agents. This case report used composite resin for restoring one NCCL in inferior premolar. Selective acid etching and two-step adhesive system were done. The final result provided a satisfactory aesthetic, besides eliminating dentin hypersensitivity.

Introduction:Tooth hypersensitivity is among the most common patient complaints caused by the response of exposed dentin to external stimuli. No definite treatment has been suggested so far for dentin hypersensitivity (DH). This study aimed to compare the efficacy of the diode laser alone and in combination with Gluma and chromophore in occluding opened dentine tubules and the treatment of DH.Methods:This in vitro study was conducted on 30 extracted human third molars kept in 0.1% thymol solution. The teeth were mounted in transparent acrylic resin and the buccal enamel was cut to expose the outer third of dentin. The samples were then divided into 6 groups of negative control (no smear layer removal), positive control (smear layer removal with 6% citric acid application), 810 nm diode laser irradiation (energy density 55.55 J/cm2 , 1 W for 20 seconds in a continuous mode), chromophore (1 mg/mL indocyanine green, ICG) plus diode laser irradiation (1 W, 20 seconds), Gluma plus diode laser irradiation, and Gluma + chromophore + diode laser. Dentinal tubules were evaluated under a scanning electron microscope at x2000 magnification. The mean percentage of the obstruction of dentinal tubules was reported as mean and standard deviation. Considering the normal distribution of the data, two-way ANOVA was applied to compare the efficacy of treatments, and an independent-samples t test was used for pairwise comparisons at PResults:The highest mean percentage of the obstruction of dentinal tubules was noted in the diode laser/chromophore/Gluma group (65.68±12.31%) while the lowest value was noted in the diode laser/Gluma group (24.33±5.90%). Pairwise comparisons revealed significant differences between all groups (PP=0.20).Conclusion:It seems that chromophore increases the efficacy of the diode laser for the obstruction of dentinal tubules.

To evaluate the effectiveness of different protocols for the treatment of cervical dentin hypersensitivity (CDH) in non-carious cervical lesions (NCCLs). The CONSORT checklist was used to design this study. The sample with n = 74 participants (389 NCCLs) was randomly allocated into three groups: G1, potassium oxalate (Oxa-Gel BF); G2, GaAlAs (gallium-aluminum-arsenate) low-power laser (100 mW, 808nn, 60 J/cm2); and G3, potassium oxalate (Oxa-Gel BF) associated with the GaAlAs low-power laser. The CDH was triggered by the evaporative stimulus test (EST) and by the tactile stimulus test (TST). The visual analog scale (VAS) was used to quantify the degree of CDH. Changes in sensitivity were assessed from baseline over 3 weeks. Data were analyzed for NCCLs using mixed-effects models with unstructured direct product covariance structure (α = 0.05). After the first application, participants from G1 and G3 had a reduction in CDH (p

ремінералізація, гіперчутливість, десенситизація, емаль, дентинRemineralisation agents not only strengthen enamel resistance, but also can occlude dentine tubules, reducing teeth sensitivity. This article provides an overview of various available agents used for enamel remineralisation and dentin hypersensitivity treatment. Conventional fluorides are used in the form of solutions, varnishes, foam, gels, dentifrices, showing low remineralising and desensitising ability as compared to newer fluoride-content products. Deep fluoridation is an effective method for reducing dentin hypersensitivity for a long time; its remineralising potential is used for white spot lesions treatment, caries prevention, and fissure sealing. Most novel fluoride compounds showed higher remineralising and desensitising abilities as compared to conventional fluorides. Deep penetration fluoridation is an effective method for remineralisation and reducing dentin hypersensitivity in long time. Despite of the fact that calcium phosphate systems have demonstrated a benefit over conventional fluorides in remineralisation their desensitising ability was not confirmed by various studies. The use of bioactive glass in remineralisation and desensitisation is quite promising, but further researches need to be undertaken to prove its efficacy. «Curodont» and synthetic nanohydroxyapatite from biomimetic systems showed good results in the above-mentioned treatments, but more researches are required to confirm their clinical efficacy. There is no doubt that iontophoresis with calcium and fluoride substances is still the most effective method in the office remineralisation, however, its potential effect in desensitisation has to be better evaluated. Efficacy of different kinds of lasers alone or in combination with a remineralisation agent has been confirmed mostly in vitro studies, therefore, there is a lack of clinical trials to prove their benefit. In latter studies, dentin sealants and desensitisers occluded dentin tubules were superior to conventional fluorides and synthetic nanohydroxyapatites. Simultaneously, the data about calcium phosphate and deep penetration fluoridation efficacy over such desensitisers as dentin sealants and nerve sensitivity inhibitors are controversial and indicate that additional studies are required to deepen our knowledge of the insufficiently explored area of reducing dentin hypesensitivity. In spite of the new advances, the ideal treatment modality for remineralisation does not exist. Within last decades, dentistry has made significant steps towards the elusive goal of enamel remineralisation and dentin desensitisation, but more long-term сlinical controlled studies are needed to confirm and quantify these findings, as well as to identify additional factors that can potentiate these processes.

Occlusion of exposed dentin tubules may eliminate or reduce dentin hypersensitivity by hindering fluid movements within the tubules. In this study, the mode of action of spherical particles of amorphous calcium magnesium phosphate (180-440 nm in diameter) was studied. A degradation study of the particles in Tris-HCl buffer showed that the particles continuously released Ca2+, Mg2+, and phosphate, and XRD analysis revealed the formation of hydroxyapatite (HA) after 1 week. The occluding effect and efficacy of the spherical particles as an occluding agent were evaluated in an in vitro study. The ACMP particles were incorporated in a gel intended for at-home use and tested on extracted human molars. Application of the particles followed by incubation in artificial saliva resulted in occlusion of exposed tubules, and examination with SEM showed that the particles could penetrate the tubules down to 100 μm from the dentin surface. Transformation of the particles into nanocrystalline HA-structures (nanoHA) was initiated at the dentin surface within 12 h of application, and tubule penetration of the particles, accompanied by further ion release and diffusion of ions, resulted in deep intratubular occlusion in the majority of the tubules within 3 days from application. NanoHA was tightly adhered to the tubule walls, filling the entire tubule volume after 7 days. The results of this study demonstrate the mode of action of the amorphous calcium magnesium phosphate particles in occluding exposed dentin tubules. Interaction with saliva and transformation of the particles within the tubules inducing further mineralization indicate that the particles may be used as an effective treatment to reduce dentin hypersensitivity.

Objective: To determine the effectiveness of Sylc (a bioactive glass-based powder) delivered by an air polishing system compared to fluoride varnish application in managing Dentin Hypersensitivity (DH). Methods: This study was a double-blinded randomized clinical trial where 50 participants with DH in at least one tooth with a non-carious cervical lesion were included and randomized into two groups (25 participants each) to receive either Sylc air polishing or fluoride varnish application. Baseline and post-intervention measurements of pain were carried out using evaporative, thermal and tactile stimuli using a modified visual analog scale at 3 minutes, 1, 2, 3and 4 weeks, 6 months and 1 year post-intervention. Data for pain intensity was recorded and analyzed for each group. Results: For the three stimuli used, Sylc air polishing showed statistically significant reduction of pain intensity (P Conclusion: Sylc air polishing was effective in relieving pain due to DH after 3 weeks and up to 1 year post-intervention, which showed that it can be used as a long-term treatment for DH.

Objective Dentin remineralization is of considerable clinical interest for dentin hypersensitivity and developing biomimetic analogs that can regulate hydroxyapatite (HAp) nucleation and growth remains a challenge. This study aimed to evaluate in vitro the potential for dentin remineralization using the following biomimetic in situ prepared poly(catechols): poly(dopamine), poly(DOPA), poly(caffeic acid) and a synthesized DOPA-peptide possessing collagen and calcium-binding domains (DOPA-Ahx-(Gly)3-(Glu)5). Methods Dentin samples were immersed in a freshly prepared phosphate-buffered saline (PBS) containing the respective catechol and laccase. After the reaction, they were immersed in calcium and phosphate remineralization solution, which was changed every day for 10 days. Samples of intact and demineralized dentin were used as control groups and kept in deionized water under the same experimental conditions. The remineralized dentin was characterized by scanning electron microscopy (SEM), Micro-energy dispersion X-ray fluorescence spectroscopy (μEDX) and X-ray diffraction (XRD). Results The application of different poly(catechols) and DOPA-peptide promoted crystal nucleation and the formation of HAp, which partially covered both the dentin surface and dentinal tubules walls. Significance By mimicking the role of charged non-collagenous proteins in vivo, polymers consisting of catechol groups showed the ability to modify demineralized dentin surface properties, promoting mineral formation. The use of poly(catechols) may be encouraged for the development of a therapeutic technique for dentin hypersensitivity.