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Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry “Dentin Hypersensitivity,” based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

Context: Lasers have been used as one of the most promising new modalities for dentin hypersensitivity. A synergistic action of lasers in association with desensitizing agents can favor the permanence of the desensitizer for a longer time than when they are used alone. Aims: The present study was aimed to evaluate the morphological characteristics of dentin surface by scanning electron microscopy after fluoride application and irradiation with 980 nm diode laser and their combined application. Materials and Methods: Sixty extracted human premolars were collected, prepared, and randomized into three groups. Group A involved tooth treated with sodium fluoride (NaF); Group B involved tooth irradiated by 980 nm GaAlAs (diode) laser; and Group C consisted of tooth sections irradiated by a diode laser with prior application of NaF. The morphological alterations were evaluated and compared using a scanning electron microscope. Statistical Analysis: The Kruskal–Wallis test was used for multiple group comparisons, and the post hoc Dunn's multiple comparison test was used for intergroup comparisons. Results: Group C, the fluoride-laser treated group, showed the lowest diameter of dentinal tubules (0.077 ± 0.021 μm) and had significantly the lowest number of open dentine tubules. Dunn's multiple comparison tests revealed that Group C had statistically significant tubule diameter reduction and had the lowest number of open tubules compared to both Group A and Group B (P < 0.0001 and P = 0.0007, respectively). In addition, Group C had significantly greater intertubular distance when compared to both Group A and Group B (P < 0.001). Conclusion: The 980 nm diode laser presents a promising new potential for treating dentin hypersensitivity, both alone and in conjunction with desensitizing agents. However, clinical trials are required to use it in regular clinical practice.

Introduction: This study aimed to evaluate the dentinal hypersensitivity (DH) after manual and ultrasonic scaling. Materials and Methods: In this study 900 teeth were assessed. Plaque index and gingival recession were measured. Prior to scaling and root planning (SRP), DH was measured clinically using a periodontal probe and air jet. The patients reported the discomfort using the Visual Analogue Scale (VAS). Later the teeth in the two opposite quadrants were manually scaled and the other two quadrants were ultrasonically scaled. After 2 weeks, DH was reevaluated with the same two methods. The data were analyzed using the SPSS. Results: The DH of 900 teeth in 34 patients was included. 67.6% (23) of participants reported pre-scaling DH and 85.3% (29) experienced post-scaling DH. The prevalence of DH had no significant difference before and after SRP in manual group and ultrasonic group. Also, after SRP, no significant difference was observed between manual and ultrasonic scaling. Conclusion: Manual and ultrasonic methods did not increase DH after SRP compared to baseline. Post-scaling DH was not significantly different between the manual and ultrasonic SRP. DH was related to gingival recession. So that, pre-and post- scaling DH were higher in patients with gingival recession.

Abstract Objective Objective was to investigate the effect of NovaMin toothpaste and two experimental toothpastes on surface microhardness of hypersensitive dentin. Methods Eighty specimens were prepared and divided randomly into eight groups (n = 10/group) according to the tested toothpastes (NovaMin, moringa and propolis toothpastes) and the acidic challenge (with or without 6% citric acid challenge). Enamel surfaces were removed, and the dentin surfaces were exposed on which the three tested toothpastes were brushed twice a day for 1 week using an electric toothbrush, then a 4-d citric acid cycling model with pH 5 was performed. The prepared specimens were stored in artificial saliva until the microhardness test was performed. Statistical analysis was done using One-way ANOVA followed by Tukey post hoc test. Results NovaMin-containing toothpaste showed an increased dentin surface microhardness following a week of twice daily brushing compared to other groups. However, NovaMin-containing toothpaste showed the highest microhardness values following pH cycling with citric acid of pH 5 compared to other tested groups. Conclusions NovaMin-containing toothpaste showed a partial recovery of dentin microhardness at pH 5 during the acidic challenge. Moreover, propolis- and moringa-containing toothpastes had an insignificant effect on dentin surface microhardness with and without citric acid challenge.

According to the “hydrodynamic theory,” dentinal pain or sensitivity is caused by dentinal fluid movement following the application of various stimuli to the dentin surface. Recent convergent evidence in Vitro has shown that plasma membrane deformation, mimicking dentinal fluid movement, activates mechanosensitive transient receptor potential (TRP)/Piezo channels in odontoblasts, with the Ca2+ signal eliciting the release of ATP from pannexin-1 (PANX-1). The released ATP activates the P2X3 receptor, which generates and propagates action potentials in the intradental Aδ afferent neurons. Thus, odontoblasts act as sensory receptor cells, and odontoblast-neuron signal communication established by the TRP/Piezo channel-PANX-1-P2X3 receptor complex may describe the mechanism of the sensory transduction sequence for dentinal sensitivity. To determine whether odontoblast-neuron communication and odontoblasts acting as sensory receptors are essential for generating dentinal pain, we evaluated nociceptive scores by analyzing behaviors evoked by dentinal sensitivity in conscious Wistar rats and Cre-mediated transgenic mouse models. In the dentin-exposed group, treatment with a bonding agent on the dentin surface, as well as systemic administration of A-317491 (P2X3 receptor antagonist), mefloquine and 10PANX (non-selective and selective PANX-1 antagonists), GsMTx-4 (selective Piezo1 channel antagonist), and HC-030031 (selective TRPA1 channel antagonist), but not HC-070 (selective TRPC5 channel antagonist), significantly reduced nociceptive scores following cold water (0.1 ml) stimulation of the exposed dentin surface of the incisors compared to the scores of rats without local or systemic treatment. When we applied cold water stimulation to the exposed dentin surface of the lower first molar, nociceptive scores in the rats with systemic administration of A-317491, 10PANX, and GsMTx-4 were significantly reduced compared to those in the rats without systemic treatment. Dentin-exposed mice, with somatic odontoblast-specific depletion, also showed significant reduction in the nociceptive scores compared to those of Cre-mediated transgenic mice, which did not show any type of cell deletion, including odontoblasts. In the odontoblast-eliminated mice, P2X3 receptor-positive A-neurons were morphologically intact. These results indicate that neurotransmission between odontoblasts and neurons mediated by the Piezo1/TRPA1-pannexin-1-P2X3 receptor axis is necessary for the development of dentinal pain. In addition, odontoblasts are necessary for sensory transduction to generate dentinal sensitivity as mechanosensory receptor cells.

The aim of this review was to provide dentists with comprehensive information regarding dentin hypersensitivity. This includes presenting its etiology, outlining the process of diagnosis, discussing clinical management strategies, and exploring technical approaches aimed at alleviating sensitivity. Dentin hypersensitivity is characterized by distinctive short, sharp pain arising from exposed cervical dentin in response to various external stimuli. The etiological factors cause two specific changes in teeth. First, the dentin surface must be exposed and denuded, which requires the loss of enamel or gingival recession combined with the loss of cementum. The second condition is the opening of the dentin tubules to allow the sensory mechanisms in the pulpal area following stimulation of the dentin surface. The accurate diagnosis of dentin hypersensitivity before receiving therapies is critical for successful treatment. The diagnosis of the disease starts through investigating the medical history of the patient and examination. In the examination, some techniques such as air stream and water rinsing are used in order to simulate the stimulating factors and to determine the degree of pain of the patient. Numerous materials and methods have been proposed to reduce or alleviate sensitivity. These materials typically exert their effects by either sealing dentin tubules or disrupting the transmission of nerve impulses. Generally, the primary approach in addressing dentin hypersensitivity involves the utilization of toothpaste containing potassium salts and fluoride. Newly introduced materials and in-office methods for treating dentin hypersensitivity include bioactive glasses, iontophoresis, CPP-ACP, and lasers.

Dentin hypersensitivity is a common disease of the oral cavity, which renders the tooth extremely sensitive to stimuli. These symptoms usually result from the exposure of the dentinal tubules to the external environment. There is a need for a treatment for dentinal hypersensitivity that can overcome the shortcomings of the existing agents. This study thus aimed to assess the therapeutic efficacy of no-ozone cold plasma (NCP), which was developed for safe use in the oral cavity, in conjunction with 1.23% acidulated phosphate fluoride (APF) and hydroxyapatite (HA), which are widely used conventional treatments of hypersensitivity. The fluoride content was evaluated using electron probe micro-analyzer (EPMA) analysis. Moreover, we confirmed the effect of NCP pre-treatment on the dentinal tubule occlusion by APF and HA as follows: scanning electron microscopy and energy dispersive X-ray spectrometry were employed to analyze the exposed dentinal tubules, and the calcium and phosphorus content were measured. Furthermore, an additional experiment was conducted using a metal mesh to analyze the working elements of NCP. All experimental results were analyzed by one-way analysis of variance and then by using the Turkey test as a post hoc test. EPMA analysis confirmed that the fluoride content of the APF and NCP group was significantly higher than that of the APF group (p < 0.001). The fluoride content of the group treated with APF and NCP equipped with a metal mesh was significantly lower than that in the group treated with APF and NCP and the group treated with APF and NCP equipped with a cotton mesh (p < 0.01). Moreover, the group treated with NCP pre-treated with HA and APF exhibited significantly greater dentinal tubule occlusion than the other groups (p < 0.05). The same result was confirmed by calculating the calcium/phosphorus ratio (p < 0.05). Pre-treatment of the enamel and dentin surfaces with plasma improved hypersensitivity by enhancing fluoride deposition with APF and dentinal tubule occlusion with HA.

There are two main methods used for dentin hypersensitivity (DH) treatment: dentinal tubule occlusion and blockage of nerve activity. Dentifrices are the most common vehicles for active ingredients used for DH treatment. The aim of this study was to evaluate the efficacy of three toothpastes on dentinal tubule occlusion, mineral acquisition, and dentin hardness. Forty human dentin disks were submerged in 40% citric acid for 30 s and then exposed to tooth brushing for 2 min twice a day for 14 days using three toothpastes: Dontodent Sensitive (group 1), Dr. Wolff’s Biorepair (group 2), and Sensodyne Repair and Protect (group 3). In the control group (group 4), the samples were brushed with water. All of the samples were evaluated using scanning electron microscopy (SEM), energy-dispersive X-ray (EDX), and Vickers dentin hardness determination. On SEM images, the degree of dentinal tubule occlusion was assessed using a five-grade scale. The mean score values in groups 1–4 were 3.60 ± 0.69, 2.20 ± 0.91, 2.30 ± 1.16, and 5.00 ± 0.00, significantly higher in study groups when compared to the control group (Kruskal Wallis test p < 0.05). EDX evaluation showed significantly higher calcium and phosphorus concentrations in groups 1 and 3 when compared to control group d. The mean values of Vickers dentin hardness numbers in groups 1–4 were 243.03 ± 10.014, 327.38 ± 56.65, 260.29 ± 37.69, and 225.83 ± 29.93, respectively. No statistically significant results were obtained when comparing the hardness mean values in groups (Kruskal-Wallis statistical test, p = 0.372 > 0.05). All three toothpastes tested demonstrated significant occlusion of dentinal tubules. Dontodent Sensitive and Sensodyne Repair and Protect toothpastes enhanced the calcium and phosphorus content of the dentin surface. None of the toothpastes increased dentin hardness as a result of mineral acquisition.

The aim of this laboratory study was to investigate and compare the impact of five desensitizing techniques as a treatment fortooth sensitivity on the exposed dentin after an in-office tooth bleaching procedure. Thirty intact human molars were collected for this investigation. The specimens were obtained by transversely cutting 2.5 mm of the crowns, leading to exposure of the dentin. The specimens were cleaned in an ultrasonic bath and treated initially with EDTA gel 15% for 4 min and then with Opalescence Boost bleaching gel (40% H2O2) for two sets of 20 min. Then, the samples were randomly divided into six groups (n = 5) and received one of the following treatments: Group 1 (no treatment—control group), Group 2 (Emofluor gel—0.4% SnF2), Group 3 (MI Paste—CPP-ACPF), Group 4 (BioMinF paste—calcium phospho-fluoro-silicate), Group 5 (air-abrasion with ProSylc—Bioglass 45S5), and Group 6 (Er,Cr:YSGG laser). Subsequently, each sample was observed utilizing scanning electron microscopy (SEM) in order to detect the rate of occlusion of dentin tubules. SEM-EDS analysis revealed no occlusion of the dentin tubules in the control group, while Groups 2, 4, and 5 presented high effectiveness (>95% percentage of occluded tubules), and Groups 3 and 6 presented lower values (21.6 and 26.8%, respectively). It was concluded that althoughall the tested groups presented higher percentages of occlusion of the dentinal tubules compared to the control group, there were differences in effectiveness among them. The most effective treatments were the daily use of BioMinF paste and SnF2-containing gel, as well as air-abrasion with ProSylc powder.

(1) Background: Decalcified enamel and dentin surfaces can be regenerated with non-fluoride-containing biomimetic systems. This study aimed to investigate the effect of a zinc carbonate-hydroxyapatite-containing dentifrice on artificially demineralized enamel and dentin surfaces. (2) Methods: Human enamel and dentin discs were prepared and subjected to surface demineralization with 30% orthophosphoric acid for 60 s. Subsequently, in the test group (n = 20), the discs were treated three times a day for 3 min with a zinc carbonate-hydroxyapatite-containing toothpaste (biorepair®). Afterwards, all samples were gently rinsed with PBS (5 s) and stored in artificial saliva until next use. Samples from the control group (n = 20) received no dentifrice-treatment and were stored in artificial saliva, exclusively. After 15 days of daily treatment, specimens were subjected to Raman spectroscopy, energy-dispersive X-ray micro-analysis (EDX), white-light interferometry, and profilometry. (3) Results: Raman spectroscopy and white-light interferometry revealed no significant differences compared to the untreated controls. EDX analysis showed calcium phosphate and silicon dioxide precipitations on treated dentin samples. In addition, treated dentin surfaces showed significant reduced roughness values. (4) Conclusions: Treatment with biorepair® did not affect enamel surfaces as proposed. Minor mineral precipitation and a reduction in surface roughness were detected among dentin surfaces only. [ABSTRACT FROM AUTHOR]

Introduction: Gingival recession (GR) is a condition in which the gingival border is apical to the cementoenamel junction and the root is exposed to the oral environment. Tobacco use is one of the most important risk factors for the development of destructive types of periodontal disease, as well as a risk factor for GR. Aim: The aim of the present cross-sectional study was to assess the prevalence of gingival recession among patients visiting a university dental hospital setting who are using different forms of tobacco. Materials & Method: This study was conducted during the period of November 2019 to April 2020 in Saveetha Dental College and Hospitals in Chennai among patients with gingival recession who are under the usage of various forms of tobacco. The data were sorted and tabulated in Microsoft Excel and then entered in IBM SPSS software version 23 for descriptive statistics. Results And Discussion: According to the results there is a decline in tobacco users with increase in age, drastically so after the age of 50. Figure 3 shows us that there is a maximum prevalence of GR of 19.60% among the age group 40-50 years and also shows the gradual increase in the prevalence of GR with age in accordance with the number of participants belonging to each age group. There may be a higher chance of prevalence of GR among those who use both the forms of tobacco, i.e smokable and chewable than just a single form of useage. Conclusion: From this retrospective study we conclude that gingival recession is evident in patients who use various forms of tobacco with a prevalence rate of 68.40 %. Highest prevalence of gingival recession among the age groups is 19.60% of age group 40-50 years who majorly smoked and used chewable forms of tobacco. [ABSTRACT FROM AUTHOR]

Objective: Bioactive glass and hydroxyapatite are biocompatible materials used as an adjunct to various dental materials. The present study aimed to evaluate the occlusion effects of bioactive glasses and hydroxyapatite on dental tubules. Materials and methods: We searched the PubMed/Medline, Embase, and Web of Science databases for the relevant records. The methodological quality of the studies was assessed by an accepted quality assessment tool. Results: From the electronic databases, 372 articles were retrieved. After evaluating the records, 35 in vitro studies were included. The studies revealed a low risk of bias. The primary outcomes from bioactive glass studies demonstrated the potential efficacy of both bioactive glass and hydroxyapatite in dentin tubule occlusion compared to the control. Conclusion: The current systematic review showed that bioactive glass and hydroxyapatite could effectively occlude the dentinal tubules. Thus, desensitizing agents containing bioactive glass and hydroxyapatite can be used to manage dentin hypersensitivity (DH). However, long-term follow-up clinical trials are required in the future before definitive recommendations can be made. Clinical relevance: This work achieved a satisfactorily systematic review for assessing desensitizing agents containing bioactive glass and hydroxyapatite in dentine hypersensitivity treatments recommended for clinical practice and research. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate resin infiltration (RI) technique's effects on the in vivo functional treatment of molar hypomineralization (MH)-affected permanent first molars (PFMs). Methods: Fifteen MH-affected PFMs were resin-infiltrated and evaluated for a three-month follow-up (FU). In vivo resin replicas were used for profilometric and scanning electron microscope (SEM) analysis of PFM surfaces; any variation of clinical aspect and dentin hypersensitivity was registered as: T0 equals baseline; T1 equals right after treatment; T2 equals oneweek follow-up; and T3, T4, and T5 equal one-, two-, and three-month FU. Results: At T0, MH-affected surfaces were rougher and more irregular than sound ones; at T1, resin-infiltrated surfaces were smoother while a progressive increase of superficial roughness was observed over time. Hypersensitivity improved at T1 and remained stable over time in severe MH cases. Conclusions: Resin infiltration seems to be a promising treatment, especially in managing severe molar hypomineralization cases for the evaluated follow-up. [ABSTRACT FROM AUTHOR]

Using laser for treatment of dentin hypersensitivity (DH) have recently shown promising results and better immediate reduction in pain scores. However, its efficacy and mechanism of action is controversial. Thus, this study aimed to evaluate the effectiveness of diode laser compared with sodium fluoride varnish in treating DH in patients with gingival recession. Eighteen patients with Miller's class I and class II gingival recession and hypersensitivity in at least two non-adjacent teeth were included in the study. Test surfaces (n = 25) were treated with diode laser, whilst control surfaces (n = 23) were treated with 5% sodium fluoride varnish. Visual Analogue Scale (VAS) scores were recorded for air and tactile stimulus for both groups at baseline, 15 min, 1 month and 3 months post-treatment. Results showed significant (p < 0.05) reduction in VAS scores at 15 min, 1 month and 3 months compared with baseline in both test and control surfaces, with no significant intergroup differences. However, the percentage reduction in DH was more in laser at all evaluation periods. The use of diode laser and sodium fluoride varnish showed good immediate and prolonged results. Further studies are needed to come up with more effective treatment methods. [ABSTRACT FROM AUTHOR]

Background: The behavior of seeking oral health information (OHI), especially the topic of sensitive teeth (ST), among the Indonesian adult population has rarely been studied. Hence, the current work aimed to analyze the characteristics of the Indonesian adult population who reported having ST and to explore their practice of self-medication in terms of their behavior of seeking OHI on the internet. Methods: A cross-sectional study was conducted between January and March 2021 in Indonesia. This study used a self-administered questionnaire comprising questions about sociodemographic data, oral health behavior, diet, and subjective oral health. Bivariate analysis based on a chi-square test was conducted for statistical evaluation. Results: Results showed that 63.3% of the respondents used Google, 24.5% used Instagram, and 24.2% used YouTube to search for OHI about ST. Most of them felt improvement with self-perceived medication, with YouTube (odds ratio [OR] = 5.13, 95% confidence interval [CI] = 2.26, 11.62), Google (OR = 2.94, 95% CI = 1.79–4.84), and Instagram (OR = 1.84, 95% CI = 1.11, 3.06) as their main OHI sources. Conclusions: Internet platforms provide information that helps adults to cope with their ST. Professionals should consider using internet-based interventions as a powerful tool for dental health education.

Abstract 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

Aim: This study aimed to evaluate the effects of immunoglobulin Y (IgY)-loaded amorphous calcium phosphate (ACP) (IgY@ACP) on dentinal tubule occlusion and antibacterial activity.Methodology: IgY@ACP was synthesized based on a biomimetic mineralization strategy. The structure was examined by transmission electron microscopy and Fourier transform infrared spectroscopy. The IgY release property was assessed in vitro. The cell biocompatibility of IgY@ACP was evaluated by CCK-8. The dentin disks were prepared using healthy human molars, and their dentinal tubules were exposed to EDTA. Subsequently, they were randomly selected and treated with or without IgY@ACP for 7 days. The tubule occlusion morphologies and newly formed layers were observed by scanning electron microscopy (SEM) and x-ray diffraction, respectively. To evaluate the acid resistance and abrasion resistance of IgY@ACP, dentin disks that were treated for 1 day were immersed in acid solution or subjected to a toothbrush. The antibacterial effects against Streptococcus mutans (S. mutans) were evaluated by colony-forming unit (CFU) counting, adhesion property assessment, and crystal violet and live/dead bacterial staining. Finally, the occlusion effect was evaluated in rat incisors in vivo. One-way analysis of variance (ANOVA) was performed for statistical analysis. The level of significance was set at 0.05.Results: IgY@ACP presented an amorphous phase with a nanosize (60–80 nm) and sustained release of protein within 48 h. The CCK-8 results showed that IgY@ACP had good biocompatibility. After treatment with IgY@ACP for 1 day, the majority of dentinal tubules were occluded by a 0.3-μm-thick mineralized layer. Seven days later, all dentinal tubules were occluded by mineralization with a thickness of 1.4 μm and a depth of 16 μm. The newly mineralized layer showed hydroxyapatite-like diffraction peaks. In addition, IgY@ACP had good acid and abrasion resistance. After treatment with IgY@ACP, the CFU counting and adhesion rate of S. mutans were significantly reduced, the crystal violet staining was lighter, and the S. mutans staining revealed more dead cells. Most importantly, IgY@ACP had a certain occluding property in rat incisors in vivo.Conclusion: IgY@ACP can effectively occlude dentinal tubules with acid-resistant stability and has prominent anti-S. mutans effects, rendering it a potentially suitable desensitization material in the clinic.

Purpose: Human tooth enamel consists mostly of minerals, primarily hydroxyapatite, Ca10(PO4)6(OH)2, and thus synthetic hydroxyapatite can be used as a biomimetic oral care agent. This review describes the synthesis and characterization of hydroxyapatite from a chemist's perspective and provides an overview of its current use in oral care, with a focus on dentin hypersensitivity, caries, biofilm management, erosion, and enamel lesions.Sources: Reviews and original research papers published in English and German were included.Results: The efficiency of synthetic hydroxyapatite in occluding open dentin tubules, resulting in a protection for sensitive teeth, has been well documented in a number of clinical studies. The first corresponding studies on caries, biofilm management and erosion have provided evidence for a positive effect of hydroxyapatite either as a main or synergistic agent in oral care products. However, more in situ and in vivo studies are needed due to the complexity of the oral milieu and to further clarify existing results.Conclusions: Due to its biocompatibility and similarity to biologically formed hydroxyapatite in natural tooth enamel, synthetic hydroxyapatite is a promising biomimetic oral care ingredient that may extend the scope of preventive dentistry. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the comparative efficacy of three in-office treatment agents in patients presenting with dentin hypersensitivity (DH) at a university teaching hospital.Materials and Methods: A randomised, controlled study was conducted to compare the efficacy of Gluma desensitiser, Pro-Relief and Copal F in relieving the pain of DH. In 68 subjects with 508 hypersensitive teeth, the agents and placebo (distilled water) were applied to 127 hypersensitive teeth each. At baseline, the pain of DH to tactile and evaporative stimuli was measured using the visual analogue scale (VAS) and verbal rating scale (VRS). Post-application assessment was carried out at 10 min, 1 week, 2 and 4 weeks.Results: The mean difference in VAS between baseline and post-treatment periods significantly increased for all the desensitising agents (p < 0.05) with both tactile and air-blast stimuli, except for the placebo. Gluma desensitiser had the highest mean difference at 10 min (3.7 ± 1.8) and 4 weeks (5.4 ± 2.3) for tactile and air-blast stimuli, respectively. However, using the VAS, no statistical significance was noted in the mean differences between the agents. With the application of Gluma desensitiser, a significantly higher number of teeth had no pain at 4 weeks using the VRS.Conclusion: Gluma desensitiser can be suggested as an appropriate desensitising agent for in-office treatment of DH. [ABSTRACT FROM AUTHOR]

The aim of this systematic review is to compare home and office desensitizers containing bioactive glass with control groups in randomized controlled trials (RCT) conducted between 2018 and 2022. According to PRISMA guidelines, three electronic databases (Scopus, PubMed, and Cochrane Library) were searched for published scientific articles in October 2022. RCT with adult participants with dentin hypersensitivity (DH) diagnosed by evaporative, mechanical, or thermal stimulation, with a follow-up period and quantified pain assessment were included in the study. Studies that reported DH due to tooth restoration, crown preparation, bleaching, or periodontal surgery or used bioactive glass-ceramics were excluded. The quality of the studies was assessed using version 2 of the Cochrane Risk-of-Bias Tool for randomized studies (RoB 2 tool). Articles that were duplicative or unrelated to this study were excluded. Nine articles were selected for full-text evaluation, whereas two articles were rejected. The remaining seven reports were included in this review. The calcium sodium phosphosilicate group (CSPS) was not significantly different from the positive control groups. Compared with the control groups, fluoro calcium phosphosilicate (FCPS) may be the most effective long-term treatment option. In terms of DH symptom reduction, the FCPS group performed better than the CSPS group. CSPS at a concentration of 5–15% and FCPS at a concentration of 5% are effective in treating DH in adult participants.

Background: Propolis is a natural resinous substance collected by honeybees, chiefly from buds and the leaves, branches, and bark of trees. Its role as a wound-healing gel has been studied, but the use of a propolis hydrogel in the treatment of dentinal hypersensitivity has not been evaluated. Dentin hypersensitivity (DH) is commonly treated via iontophoresis using fluoridated desensitizers. The aim of the present study was to compare and evaluate the effects of a 10% propolis hydrogel, 2% sodium fluoride (NaF), and 1.23% acidulated phosphate fluoride (APF) when used in conjunction with iontophoresis for the treatment of cervical dentin hypersensitivity (DH). Methods: Systemically healthy patients complaining of DH were selected for this single-centre, parallel, double-blind randomized clinical trial. Three substances were selected as desensitizers for study in the present trial: a 10% propolis hydrogel, 2% sodium fluoride, and 1.23% acidulated phosphate fluoride, all in conjunction with iontophoresis. Any decrease in DH following the application of specific stimuli was assessed at baseline, before and after application, on the 14th day following use, and on the 28th day following the intervention. Results: Intra-group comparisons show diminished values of DH at maximum post-op follow-up intervals which were significantly trimmed down from the baseline (p < 0.05). The 2% NaF demonstrated a significant reduction in DH over 1.23% APF and the 10% propolis hydrogel (p < 0.05). However, there was no statistically significant difference in the mean difference between the APF and propolis hydrogel groups assessed via tactile, cold, and air tests (p > 0.05). Conclusion: All three desensitizers have proved to be useful when used in conjugation with iontophoresis. Within the limitations of this study, a 10% propolis hydrogel can be used as a naturally occurring alternative to commercially available fluoridated desensitizers.

This paper describes novel and innovative amorphous calcium magnesium fluoride phosphate (ACMFP) core-shell microparticles that may be applied in preventive dentistry for the prevention of caries and the treatment of dentin hypersensitivity. The particles can be synthesized with varied fluoride content, up to approximately 6 wt%, without any observable differences in morphology or crystallinity. Fluoride release from the particles is correlated to the fluoride content, and the particles are readily converted to fluoride-substituted hydroxyapatite or fluorapatite in a simulated saliva solution. The remineralization and dentin tubule occlusion potential of the particles was evaluated in vitro on acid-etched dentin specimens, and treatment with the ACMFP particles resulted in complete tubule occlusion and the formation of a dense mineralization layer. The acid resistance of the mineralization layer was improved compared to treatment with analogous particles without fluoride inclusion. A cross-sectional evaluation of dentin specimens after treatment revealed the formation of high aspect ratio fluorapatite crystals and poorly crystalline hydroxyapatite, respectively. The particles of the current study provide a single source vehicle of readily available calcium, phosphate, and fluoride ions for the potential remineralization of carious lesions as well as exposed dentin tubules for the reduction of hypersensitivity.

Aim: The aim of the current research was to evaluate the effectiveness of three desensitizing agents on the occlusion of dentinal tubules. Materials and Methods: Eighty human maxillary and mandibular permanent premolar teeth that were subjected to extraction in the course of orthodontic treatment were utilized in this study. The teeth were subjected to sectioning by employing a double-sided diamond disk. A block was procured from every even cervical dentinal surface with dimensions of 4 mm × 4 mm × 3 mm (L × B × H) by sectioning the tooth transversely. Further, 35% phosphoric acid was utilized for 30 s to cause dentinal etching, thereby exposing the dentinal tubules. The blocks of dentin were assigned at random to one of the following four groups (n = 20): group I: control, group II: bioactive glass containing desensitizing agent, group III: 1% nano-hydroxyapatite containing desensitizing agent, group IV: tri-calcium phosphate-containing desensitizing agent. The exterior of the specimens was scanned and evaluated using a scanning electron microscope. Results: 1% nano-hydroxyapatite-containing desensitizing agent (2.04 ± 0.08) exhibited higher mean dentinal tubular blockage, followed by the bioactive class-containing desensitizing substance (2.26 ± 0.19), tri-calcium phosphate desensitizing agent (2.84 ± 0.10), and the control group (4.18 ± 0.12) in that order. Amid the experimental groups employing the various desensitizing substances, there were significant differences statistically with P < 0.001. Conclusion: The current research concluded that each of the three desensitizing agents was efficient in dentinal tubular occlusion regardless of their different chemical constitution. However, it was noted that 1% nano-hydroxyapatite-containing desensitizing agent was marginally superior to the bioactive glass- and tri-calcium phosphate-containing desensitizing agents. [ABSTRACT FROM AUTHOR]

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach. [ABSTRACT FROM AUTHOR]

Purpose: The present study was carried out to assess and compare the efficacy of OliNano Seal (OS) and Curodont D'Senz (CS) in the treatment of dentin hypersensitivity (DH) and the reduction of dentin permeability. Materials and Methods: The current study was a single-blinded, clinical trial and in vitro study using OS and CS in the treatment of DH. A total of 72 hypersensitive teeth were selected from 18 patients and randomly divided into two groups. Prior to the desensitizing agent's application (the baseline), as well as immediately, 2 weeks, 4 weeks, and 3 months afterward, the evaluated materials were applied. Patients were instructed to use the visual analogue scale (VAS) to score their perception of tactile, air, and cold stimuli (VAS). In total, 90 samples were used for the evaluation, and they were randomly divided into two main groups: group A1, which had the smear layer fully removed, and group A2, which had the smear layer partially removed. According to the desensitizing agent used, each group was divided into three subgroups: OS, CS, and the control group that was left untreated. The results of the dentin permeability test were analyzed using the analysis of variance test, whereas the pain scores were analyzed using the Mann–Whitney test. Results: The study showed that there was a high statistically significant difference between pain scores prior to and after the application of both tested desensitizing agents. Permeability results revealed a high statistically significant difference between the study groups, with the lowest statistically significant mean depth of dye penetration found with OS-treated samples. Conclusion: OS and CS were both effective in the treatment of DH and the reduction of dentin permeability, with OS being more effective within 1 week and sustained up to 3 months. [ABSTRACT FROM AUTHOR]

Background. Limited evidence is available on the effect of milk as a mouthwash on treating dentin hypersensitivity. The present study aimed to compare the effect of milk as a mouthwash with one anti-hypersensitivity mouthwash in decreasing dentin hypersensitivity after non-surgical periodontal treatment. Methods. Patients with generalized moderate-to-severe chronic periodontitis were selected randomly in the present study and underwent scaling and root planing (SRP). Seventy patients with severe dentin hypersensitivity after two days were assigned to two groups. In group A, the patients were asked to use milk as a mouthwash, and in group B, the patients were asked to use anti-hypersensitivity Misswake mouthwash. The patients' hypersensitivity was measured during follow-up visits. The independent t-test was used to compare denim hypersensitivity between the two groups. Statistical significance was set at P<0.05. Results. The results showed a significant decrease in dentin hypersensitivity in both groups on days 15 and 30. In the milk group, 11 and 29 patients fully recovered from dentin hypersensitivity on days 15 and 30, respectively. However, in the anti-hypersensitivity mouthwash group, 8 and 27 patients fully recovered from dentin hypersensitivity on days 15 and 30, respectively. Therefore, more patients benefited from the anti-hypersensitivity effects of milk as a mouthwash. However, the differences were not significant during the whole treatment sessions. Conclusion. Using milk as an inexpensive and available mouthwash can decrease dentin hypersensitivity after SRP. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effect of novel bioactive glass (BAG)-containing desensitizers on the permeability of dentin. Experimental dentin desensitizers containing 3 wt% BAG with or without acidic functional monomers (10-MDP or 4-META) were prepared. A commercial desensitizer, Seal & Protect (SNP), was used as a control. To evaluate the permeability of dentin, real-time dentinal fluid flow (DFF) rates were measured at four different time points (demineralized, immediately after desensitizer application, after two weeks in simulated body fluid (SBF), and post-ultrasonication). The DFF reduction rate (ΔDFF) was also calculated. The surface changes were analyzed using field emission scanning electron microscopy (FE-SEM). Raman spectroscopy was performed to analyze chemical changes on the dentin surface. The ΔDFF of the desensitizers containing BAG, BAG with 10-MDP, and BAG with 4-META significantly increased after two weeks of SBF storage and post-ultrasonication compared to the SNP at each time point (p < 0.05). Multiple precipitates were observed on the surfaces of the three BAG-containing desensitizers. Raman spectroscopy revealed hydroxyapatite (HAp) peaks on the dentin surfaces treated with the three BAG-containing desensitizers. Novel BAG-containing dentin desensitizers can reduce the DFF rate about 70.84 to 77.09% in the aspect of reduction of DFF through the HAp precipitations after two weeks of SBF storage. [ABSTRACT FROM AUTHOR]

Introduction: Dentin hypersensitivity (DH) is one of the most common problems, but to date, no single agent or form of treatment has been found effective. Lasers have promising potential for the treatment of DH. This in vitro study aims to compare and evaluate the desensitising ability of a combination of sodium fluoride varnish (NaF) and Erbium: yttrium-aluminium-garnet (Er: YAG) laser by assessing tubule occlusion and depth of penetration of the agent in dentinal tubules through Scanning electron microscope (SEM) and Confocal laser scanning microscope (CLSM), respectively. Materials and Methods: Forty-five extracted maxillary premolar teeth were included in this study. A 3-mm-thick horizontal slice was prepared from the cementoenamel junction of each tooth. Each slice was transversely separated into two halves as buccal and lingual samples. Ninety samples were obtained, and these samples were randomly divided into six equal groups. Groups A, B, C, and D were used for the evaluation of tubule occlusion with SEM Groups E and F were evaluated for dentin permeability with CLSM. Results: Intergroup comparisons showed statistically significant differences among groups, and it was observed that the combined use of Sodium fluoride and Er: YAG Laser showed better occluding (Group D) and depth penetration (Group F) effect when analysed using SEM and CLSM, respectively. Conclusion: It can be concluded that a combination of fluoride varnish and lasers offers a significant role in dentinal hypersens [ABSTRACT FROM AUTHOR]

Aim: The present trend in health care is toward the use of natural products for curing diseases. "Propolis" or bees wax is a natural, nontoxic resinous material collected by bees from exudates and buds of the plant. It has many beneficial biological and pharmacological properties such as antimicrobial, anti-inflammatory, antifungal, antiviral, and anticancer activities. Propolis is widely applied in dentistry as an anticariogenic agent, hypersensitivity reducing agent, and endodontic disinfection to name a few. The diverse phytochemical constituents of propolis are responsible for its valuable properties. Considering its vast potential, propolis has gained the attention of many researchers. The aim of this study is to offer a comprehensive evidence which will enable the readers and researchers to appreciate the prospects of the application of Indian propolis in present-day dentistry. Material and Methods: In vitro and in vivo studies on Indian propolis and its application in dentistry searches were performed in PubMed, Scopus, and Cochrane library databases up to December 2020. Results: The search identified 31 records; 12 full-text articles which met the eligibility criteria were assessed. Based on the results of in vitro studies, further in vivo studies need to be carried out to prove the feasibility of Indian propolis as an anticariogenic agent, a desensitizing agent, and an intracanal irrigant/medicament in the field of dentistry. Conclusion: Indian propolis has shown an immense amount of potentiality which demands for more clinical research to have sufficient evidence-based literature for future usage in oral health care. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was to estimate the effect of the species concentration of 45S5 bioactive glass (BAG) used as pretreatment on the microshear bond strength (MSBS) of dental fluorosis (DF). Based on the Thylstrup and Fejerskov index, 80 teeth were randomly divided equally into four groups: TFI 0, sound dentin; TFI 1–3, mild fluorosis; TFI 4–5, moderate fluorosis; and TFI 6–9, severe fluorosis. Each group was randomized into five subgroups. After preparing the dentin hypersensitivity model of DF, the dentin was pretreated as follows, Subgroup 1: deionized water (Control group); Subgroup 2: 1% BAG; Subgroup 3: 5% BAG; Subgroup 4: 10% BAG, and Subgroup 5: 20% BAG. Stochastically one specimen was selected from each subgroup for scanning electron microscope and energy dispersive spectrometer analysis. After being made of resin–tooth bonding samples, the remains were in water bath at 37 °C for 24 hr. Subsequently, samples from each subgroup were randomly selected to test MSBS without aging, or after a thermocycle of 5,000 and 10,000 times, respectively. The fracture modes were analyzed. Compared with the group of 1% BAG and Control, the exposure area of tubules in 5%, 10%, and 20% BAG group had significant difference (p <.05). MSBS results indicated that there were significant differences between 10% BAG with other groups. The 20% BAG group showed the lowest MSBS among all groups. Pretreatment of 10% BAG solution may be conductive to enhance the bond strength of DF, while 20% BAG solution adversely. [ABSTRACT FROM AUTHOR]

Aim of the study: The aim of this study was to validate and implement the Romanian version of DHEQ-15. Material and methods: A total of 132 questionnaires DHEQ-15 were distributed among senior dental students (6th year of study). The DHEQ-15 consists of 15 items with coded responses on 7-point Likert scales. The form was translated into Romanian using the forward-backward process. The standard descriptive methods were applied to determine the characteristics of the sample. Results: The response rate of the self-administered questionnaire was 87.87%. A total of 74 students (63.8%) declared that had experienced DH in the last month and 58% of them disagreed that this condition had a negative impact on their lives. The average total score recorded was 46.16 ± 19.680. Conclusions: This is the first study that validates the Romanian version of DHEQ-15. The findings of this research indicate that senior dental students do not consider that DH has a negative impact on their quality of life.

Objective: To compare the clinical efficiency between the conventional sodium fluoride (self-cure) and potassium fluoride (light-cure) varnish in the treatment of hypersensitive dentin at different periods. Methodology: 100 patients were selected based on the inclusion and exclusion criteria. The subjects were randomly divided into two groups- G1 (control): Composeal varnish and G2 (experimental): Protect Light Seal varnish. The level of hypersensitivity of each volunteer was analyzed by the visual analog scale (VAS scale) at 5 minutes, 1 week, and 1-month intervals by using a blow of cold air from the three-way dental syringe. Non-parametric Kruskall-Wallis test and Wilcoxon Signed Rank test were done to compare the pain level scores and to detect the change of pain scores at different periods. Results: Both desensitizers were able to reduce the pain scores significantly (p < 0.001) with time as there was no significant difference (p = 0.991) between them. Although, the potassium fluoride varnish was able to reduce the pain scores to a bearable level (i.e. below 2) within 1 week. Conclusion: The light cure potassium fluoride varnish was able to reduce dentinal hypersensitivity to comfort level within 1week which then further reduced in 1 month. [ABSTRACT FROM AUTHOR]

ObjectivesDentin hypersensitivity often is treated by promotion of dentin tubule occlusion. In this in vitro study we evaluated nanomechanical properties and degree of tubule occlusion conferred to sound and demineralized human root dentin following treatment with a 10% (w/w) strontium acetate solution and its relation to the treatment duration and delivery method.Methods24 human cervical root dentin disks (8 groups of 3) were polished through 0.25 μm. 12 disks were subjected to an acid challenge (1% citric acid, pH 3.8) for 2 min. The specimens were incubated in artificial saliva, treated by soaking or brushing with deionized (DI) water or a solution of 10% strontium acetate for 2 min twice a day for 28 days. The occlusion percent and nanomechanical properties were determined at the baseline, 5, 14 and 28 days. Cross-sectioned specimens were prepared to evaluate the depth affected by strontium acetate / dentin interaction by SEM. Statistical analysis was performed using linear mixed effects models.ResultsA 10% strontium acetate treatment over 5-28 days significantly increased tubule occlusion for normal root dentin and to a lesser extent for demineralized dentin and increased the AFM based nanomechanical properties of demineralized dentin. Brushing was more effective than soaking in recovery of properties of demineralized dentin when treated with strontium. No difference in tubuleocclusion was found between the two delivery methods.SignificanceStrontium acetate itself proved to have the ability to occlude dentin tubules and result in small changes in the mechanical properties of dentin.

Introduction: Dentin hypersensitivity (DH) adversely affects quality of life by impairing the ability to eat and drink certain foods, therefore, should be addressed promptly with a contingency plan that includes initial treatment with a noninvasive prophylactic home care approach, followed by in-office treatment if desired result is not achieved. Aim: The purpose of this study was to evaluate the effectiveness of four different pastes containing 5% NovaMin (Sensodyne Repair and Protect®), Propolis (Phytoshield Propolis®), 5% potassium nitrate (Sensodyne®), and 8% arginine (Colgate Sensitive Pro Relief®) based toothpastes in the treatment of DH. Materials and Methods: One hundred dentin slices were cut from the crown section of molars. Etching with 37% orthophosphoric acid was done to open the tubules. Scanning electron microscope (SEM) study was done to ensure that the tubules are opened. The dentin specimens were divided into four groups: Group 1 –5% NovaMin, Group 2 – Propolis, Group 3 – 5% potassium nitrate, and Group 4 – 8% arginine. Samples were brushed for 2 min twice daily with a soft toothbrush for 15 days and were stored in distilled water. The samples were rinsed under running water to remove the toothpaste. The SEM was performed to check the obliteration of tubules. Results: 5% NovaMin group showed more completely occluded dentinal tubules when compared to other groups. The differences among all the groups were statistically significant (P ≤ 0.05). Conclusion: In the present study, all materials, NovaMin, Propolis, potassium nitrate, and arginine, were effective in occluding dentinal tubules but NovaMin appeared most proficient in occluding tubules, followed by arginine, potassium nitrate, and Propolis. Topical NovaMin is an upcoming agent demonstrating desensitization and remineralization properties.

Background: Dentin hypersensitivity is described as “short sharp pain arising from exposed dentin in response to various stimuli typically thermal, evaporative, tactile, osmotic or chemical and cannot be ascribed to any other form of dental defect or disease.” Dentine hypersensitivity can be treated with various desensitizing agents ,where oral rinse has a promising effect in delivering the therapeutic effect all over the tooth surface including interproximal areas, as they can flow and reach areas where toothpastes are not much effective, hence the occlusion of dentinal tubules using Ayurdhantam medicated an herbal mouthwash was evaluated. Methodology: Twenty such dentinal blocks were obtained; the surfaces of each dentin block were polished using a silicon carbide disc for 30 s to create a basic smear layer. The smear layer is finally detached by applying 17% EDTA solution onto the dentin blocks for 5 min to ensure the patency of the dentinal tubules, following which they were rinsed with distilled water. The specimens were placed into the Ayurdhantam solution (medicated) for 2 min every day for 7 days. The specimens were stored in artificial saliva during the study. The specimens were analyzed under scanning electron microscope (SEM) for the occlusion of dentinal tubules. Results: SEM images showed the partial occlusion of the tubules and a large amount of smear layer. Conclusions: Based on this in vitro experiment carried out, it is shown that Ayurdhantam-medicated mouthwash can be used for treating dentine hypersensitivity effectively.

Bolin Li,1 Chunyan Liu,2,3 Ze-hui Fang,4 Ying Cao,4 Zheng Zhou,3 Haiyan Lu2 1Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School & Hospital of Stomatology, Hebei Medical University, Shijiazhuang 050017, People’s Republic of China; 2Department of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School & Hospital of Stomatology, Hebei Medical University, Shijiazhuang 050017, People’s Republic of China; 3School of Dentistry, University of Detroit Mercy, Detroit, Michigan 48208, USA; 4School & Hospital of Stomatology, Anhui Medical University, Hefei 230032, People’s Republic of ChinaCorrespondence: Zheng ZhouSchool of Dentistry, University of Detroit Mercy, 2700 Martin Luther King Jr. Blvd, Detroit, Michigan 48208, USATel +1-313-494-6667Fax +1-313-494-6666Email zhouzh1@udmercy.eduHaiyan LuDepartment of Orthodontics, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School & Hospital of Stomatology, Hebei Medical University, 383 Zhongshan East Road, Shijiazhuang, Hebei 050017, People’s Republic of ChinaTel/Fax +86 311-86265748Email luhaiyan67@163.comBackground: Dentin hypersensitivity (DH) is a common dental clinical condition presented with a short and sharp pain in response to physical and chemical stimuli. Currently no treatment regimen demonstrates long-lasting efficacy in treating DH, and unesthetic yellow tooth color is a concern to many patients with DH.Aim: To develop a bi-functional material which can occlude dentinal tubules in-depth and remineralize dentin for long-lasting protection of the dentin–pulp complex from stimuli and bleach the tooth at the same time.Methods: A mixture containing CaO, H3PO4, polyethylene glycol and H2O2 at a specific ratio was mechanically ground using a planetary ball. The mineralizing complex paste was characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Dentin was exposed to the synthesized paste for 8 h and 24 h in vitro. The mineralizing property was evaluated using SEM and microhardness tests. Red tea-stained tooth slices were exposed to the synthesized paste for 8 h and 24 h in vitro. The bleaching effect was characterized by a spectrophotometer.Results: The complex paste had very a fine texture, was injectable, and had a gel-like property with 2.6 (mass/volume) % H2O2 concentration. The X-ray diffraction pattern showed that the inorganic phase was mainly monetite (CaHPO4). The mineralizing complex paste induced the growth of inorganic crystals on the dentin surface and in-depth occlusion of dentin tubules by up to 80 μm. The regenerated crystals were integrated into the dentin tissue on the dentin surface and the wall of dentinal tubules with a microhardness of up to 126 MPa (versus 137 Mpa for dentin). The paste also bleached the stained dental slices.Conclusion: The mineralizing complex paste is a promising innovative material for efficient DH management by remineralizing dentin and in-depth occlusion of dentin tubules, as well as tooth bleaching.Keywords: dentin hypersensitivity, remineralization, tooth whitening, planetary ball mill

Introduction: Dentin hypersensitivity (DH) is a common and painful clinical occurrence that can negatively impact patients' quality of life. An arsenal of different desensitizing molecules is available on the market, but no gold standard has yet to be set.Aim: The aim of this study was to perform a review on the potential of nano-hydroxyapatite (n-HA) as a desensitizing toothpaste agent as opposed to placebo or other desensitizing molecules. Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, an electronic search of the PubMed database was conducted from inception up until May 2021. Seven English written randomized controlled trials about the use of n-HA toothpaste in treating adults with DH were assessed for quality via the modified Jadad scale, and included in the review. Non-English studies, publications involving lasers, and studies researching the effect of n-HA on gingival inflammation or postwhitening sensitivity were all excluded. Results and Discussion: Available evidence suggests that n-HA is a promising addition to the growing arsenal of desensitizing treatments available on the market. Conclusion: n-HA remains a viable everyday option that dentists should strongly consider for their patients' pain relief. However, due to the heterogeneity of pain studies and the lack of standardization in trial protocols, no evidence of superiority to other desensitizing agents can be ascertained, thus far.

Aim: The aim of this study was to compare and evaluate the efficacy of professionally applied diode laser and at home applied desensitizing tooth paste for the relief of dentin hypersensitivity. Methods: Thirty patients with dentinal hypersensitivity were selected for the study. The patients were divided into two groups containing fifteen patients each. Group I: patients who used toothpaste containing 8% arginine calcium carbonate and group II: patients who were treated with low-power diode laser. Patients in both groups were assessed using tactile stimuli and air blast stimuli and their response was evaluated using Visual Analogue Scale at baseline, 2 weeks and 4 weeks. Comparison of the differences in scores between group I and group II was assessed using students unpaired't' test. ANOVA test (Fishers's test) and Bonferroni multiple comparison was used to calculate the mean difference in VAS scores. Calculations were performed using statistical package version SPSS 11.5. Results: The results showed significant decrease in Visual Analogue Scale scores as compared to baseline in week 2 as well as in week 4 in both treatment groups. Conclusion: Based on the results of the present study it can be concluded that there was an overall decrease in dentin hypersensitivity in both groups. Hence both desensitising tooth paste and low power diode laser were effective in treating dentinal hypersensitivity. However, long-term study with regard to the same is encouraged. [ABSTRACT FROM AUTHOR]

Objectives: 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. Materials and methods: 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). Results: 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). Conclusions: 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. Clinical relevance: Introduction of non-invasive methods with long-term and lasting effect on reducing pain and discomfort caused by dentin hypersensitivity [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to identify the prevalence and predisposing and etiologic factors of dentin hypersensitivity (DH), as well as the demographic characteristics of patients. Materials and methods: The 1210 patients were examined. The research was based on a two-step investigation: questionnaire and clinical examination. DH was evaluated by the response of the patient to tactile and air-blast stimuli. Loss of attachment and gingival recession of sensitive teeth was measured on the buccal and lingual surfaces. Also, the tooth wear of sensitive teeth was graded on the buccal and lingual surfaces. Comparisons of nonnormally distributed continuous variables were performed using the Mann–Whitney U test and Kruskal–Wallis one-way analysis of variance (ANOVA) and Dunn's post hoc test. Comparisons of categorical variables were performed using Pearson's chi-square, Fisher's exact chi-square, Yates's chi-square, and the Monte Carlo chi-square test. Results: One hundred twenty-four patients reported DH, showing a prevalence for self-reported DH of 10.2%. Eight hundred forty teeth were diagnosed as having DH, giving a clinical diagnosis rate of DH of 29.4%. Females (76.8%), the 31–40 years age group (26%), housewives (36.8%), and high school education level (38%) had the highest prevalence of DH as demographic properties. A cold stimulus was the most common stimuli trigger for hypersensitivity (97.1%). Occasional pain (55.5%) showed the highest prevalence in terms of frequency of DH. A higher rate of DH was found with the use of medium brushes (47.4%) and brushing twice per day (59.4%) for 1–2 min (56.2%) with the circular method (33.8%) as oral hygiene habits. The buccal surface of the lower right central incisors (5.7%) had the highest prevalence. The most affected teeth by DH were incisors (38.4%). The buccal surfaces (86.3%) of teeth showed a higher high prevalence of DH compared with the lingual surface (52.7%), similar to gingival recession (40.9% vs. 15.7%) and loss of attachment (68.3% vs. 42.6%). Conclusions: Clinically diagnosed DH was more common than self-reported DH. Some factors related to patients such as sex (female), the 31–40 years age group, housewives, high school students, using medium brushes, brushing twice per day, and the circular brushing method were more likely to have a risk for DH. Also, buccal surfaces of teeth, gingival recession, and loss of attachment on the buccal surface of teeth should be considered as predisposing factors for DH. Clinical relevance: To control and prevent DH, clinicians should consider patients' demographics, predisposing factors, and etiologic factors. [ABSTRACT FROM AUTHOR]

Background: To synthesize mesoporous titanium dioxide composite hydroxyapatite (TiO2–HAP) and to evaluate its effectiveness in sealing of occluding dentine tubules. Methods: TiO2–HAP was synthesized by chemical precipitation method and characterized using infrared absorption spectrometer, X-ray diffraction, scanning electron microscope, and specific surface area detector. Forty completely extracted molars were prepared and randomly assigned into Control group, Gluma group, HAP group and TiO2–HAP group according to different treatments. The characteristics of HAP and TiO2–HAP and the sealing effectiveness of dentine tubules in these four groups, including infrared spectrum, surface contact angle, pore size distribution, and re-mineralized enamel surface profiles, were analyzed by suitable characterized techniques. The cytotoxicity of the synthesized TiO2–HAP was tested and compared using 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide (MTT) colorimetry. Results: Our results showed TiO2–HAP group had significantly lower contact angle, higher specific surface area, and wider range of pore size distribution than other groups. The majority of dentinal tubules in the TiO2–HAP group were blocked by white matter in a uniformed manner, and the crystals arranged in order grew along the axial direction. In addition, no significant difference in optical density (OD) value was found between control group and TiO2–HAP group (P > 0.05), and cell growth was good in TiO2–HAP group, indicating no cytotoxicity of TiO2–HAP. Conclusions: The MTT assay identified that TiO2–HAP had little effect on the L929 cell line. We showed TiO2–HAP might be used as a remineralization agent in enamel caries-like lesions. [ABSTRACT FROM AUTHOR]

The present study aimed to evaluate the effectiveness of ozone therapy in (1) increasing the compactness of decayed dentin (main aim), (2) reducing dentin hypersensitivity, (3) decreasing the salivary bacterial count, and (4) improving the quality of life in ECC-affected children during a 3-month follow-up. A total of 20 subjects uncooperative with conventional restorative treatment were treated with a 60 s ozone application/week (OzoneDTA®) for 4 weeks. Patients were evaluated at T0 = baseline; T1 = after ozone cycle and T2, T3, T4 = 1, 2, 3-month follow-up, respectively. Dentin compactness was evaluated according to the Affected Dentine Scale (ADS) proposed by the authors; dentin hypersensitivity was recorded with the Wong–Baker Faces Pain Rating Scale (WBFPRS); salivary bacteria were measured with the Saliva Check Mutans Test and quality of life with the Early Childhood Oral Health Impact Scale (ECOHIS). ADS values and salivary bacteria count results were analyzed using non-parametric tests. Statistically significant differences were detected for both parameters between T0 and T1 (p < 0.01). At T1, dentin hypersensitivity was resolved and quality of life improved. Ozone therapy is a simple and painless approach, which might be useful for controlling caries' progression in uncooperative children until appropriate cooperation is achieved. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the effect of photobiomodulation (PBM) combined with 8% strontium acetate (SA8%) in the treatment of dentin hypersensitivity (DH) in non-carious lesions and analyzed the risk factors with the patient's quality of life. Methods: Eighty teeth with DH were randomly allocated into four treatment groups (n = 20): G1, PBM imitation + toothpaste with no active ingredient; G2, PBM imitation + toothpaste with SA8%; G3, PBM + toothpaste without the active ingredient; and G4, PBM + toothpaste with SA8%. Participants were provided with a questionnaire on the experience of dentin hypersensitivity (QEDH) to assess the impact of desensitizing treatment on health-related quality of life (HRQL). Friedman and Kruskal–Wallis tests were used for intra- and intergroup comparisons, and Wilcoxon and Mann–Whitney tests were used to analyze HRQL. All analyses used significance levels of 5%. Results: Intergroup comparisons revealed a significant difference (p < 0.05); G4 had the best response in terms of HD reduction in G4 compared to the other groups on the 7th day of assessment (T3). Only G4 showed a statistically significant difference (p < 0.05) in the reduction of EDH for intragroup analysis. Conclusion: The combination of therapies was more effective in reducing DH than the isolated use of these strategies. Clinical relevance: The combination of therapies is effective in the treatment of DH. [ABSTRACT FROM AUTHOR]

Introduction: Dentin hypersensitivity (DH) is the most common concern faced by most dentists in their day-to-day clinical practice. It is characterized by short-term, acute pain of variable intensity, which occurs in response to thermal, tactile, osmotic or chemical stimuli that cannot be attributed to any other type of defect or dental decay. Casein phosphopeptide varnish is a newer material used to treat dentinal hypersensitivity as it reduces demineralization and promotes remineralization. The aim of this study is to evaluate the efficacy of casein phosphopeptide based varnish (MI Varnish®) vs sodium fluoride-based varnish (Fluoritop SR® varnish) in treating dentinal hypersensitivity. Materials and methods: 40 subjects with a chief complaint of DH were divided into two equal groups, Group A (MI varnish®) and Group B (Fluoritop SR® varnish). Scaling and root planing was done and sensitivity was assessed using Visual analog scale (VAS) at baseline. On the 14th day, sensitivity was reassessed using VAS. The data obtained were subjected to statistical analysis using students‘t’ test. Results: On intragroup comparison, VAS scale showed a statistically significant difference for both the groups. On intergroup comparison, no statistical difference was found between both groups. (p = 0.139) Conclusions: From the above results, it can be concluded that MI varnish® and Fluoritop SR® varnish are equally efficacious in reducing dentinal hypersensitivity.

Abstract Though dentin hypersensitivity (DHS) is one of the most common complaints from patients in dental clinics, there are no universally accepted guidelines for differential diagnosis as well as selection of reliable treatment modalities for this condition. The neurosensory mechanisms underlying DHS remain unclear, but fluid movements within exposed dentinal tubules, i.e., the hydrodynamic theory, has been a widely accepted explanation for DHS pain. As several dental conditions have symptoms that mimic DHS at different stages of their progression, diagnosis and treatment of DHS are often confusing, especially for inexperienced dental practitioners. In this paper we provide an up-to-date review on risk factors that play a role in the development and chronicity of DHS and summarize the current principles and strategies for differential diagnosis and management of DHS in dental practices. We will outline the etiology, predisposing factors and the underlying putative mechanisms of DHS, and provide principles and indications for its diagnosis and management. Though desensitization remains to be the first choice for DHS for many dental practitioners and most of desensitizing agents reduce the symptoms of DHS by occluding patent dentinal tubules, the long-term outcome of such treatment is uncertain. With improved understanding of the underlying nociceptive mechanisms of DHS, it is expected that promising novel therapies will emerge and provide more effective relief for patients with DHS.

Abstract Background As far as we know, little data, whether obtained from self-administered questionnaires or upon dental clinical examination, has been published on the prevalence of sensitive teeth (ST) in the French adult population. The objectives of the present work were to estimate ST prevalence and characteristics in the general population of France and to explore the associated factors. Method A multicentre cross-sectional study was conducted between November 2011 and March 2013 in six French cities. Adult passers-by in public places were invited to answer an electronic questionnaire on a tablet computer. Only people who declared having at least one natural tooth were included in the study. A logistic regression model was used for the multivariate analysis. Results The prevalence of ST during the previous 12 months reported by the sample of 2413 participants was 42.2% [95% CI: 40.2–44.1%]. The final logistic regression model showed significant statistical associations between ST and female gender, use of tobacco, consumption of soft drinks, limited access to oral care and poor oral hygiene habits (p

Abstract Background Currently, different pain scales are used extensively to measure clinical pain, especially in dental practice. Objective This study aims to compare pain scales used in clinical research and dental practice, identifying the easiest to understand by patients with Cervical Dentin Hypersensitivity. Method Seventy-four patients with Cervical Dentin Hypersensitivity were stimulated by a thermic test of the sensitive tooth, followed by application of different pain measurement scales (Visual Analogue Scale, Faces Pain Scales, Numeric Rating Scale, and Verbal Rating Scale) and by a questionnaire to evaluate the patient's perception regarding the ease of understanding scales. The statistic tests used were the Wilcoxon, Spearman correlation, and Chi-Square tests. Results The results founded a strong positive correlation between the scales (r = 0.798 to 0.960 p