Dentin hypersensitivity treatment of non-carious cervical lesions – a single-blind, split-mouth study

Abstract

This study aims to compare the in vivo effect of a desensitizing therapy associated with a restorative technique for the treatment of cervical dentin hypersensitivity (CDH) in non-carious lesions. The sample consisted of 68 teeth with moderate or severe dentin hypersensitivity in 17 individuals (one tooth per quadrant). The sensitivity levels of the teeth were scored, and the teeth were randomly distributed into four groups: T1 -desensitizing gel applied once per week until remission of pain; T2 -desensitizing gel applied once per week followed immediately by restoration with resin composite (Filtek Z250, 3M Espe); T3 -desensitizing gel once per week until remission of pain and then restoration with resin composite; and T4 -restoration with resin composite. Dentin hypersensitivity was assessed at 0, 7, 30, 90 and 180 days. The Kruskal-Wallis, Wilcoxon and Mann-Whitney (p < 0.05) tests were used to compare the treatments. The mean baseline CDH scores were T1 -2.41, T2 -2.41, T3 -2.47, and T4 -2.70 (p > 0.05). At seven and 180 days, the mean CDH scores were as follows: T1 -1.47/0.65, T2 -1.35/0.71, T3 -0.71/0.53, and T4 -1.12/0.59, all of which were significantly lower (p < 0.001) than the baseline scores. The scores at 30, 90 and 180 days were not significantly different when compared to the score of the previous period. At 180 days, CDH scores were similar among groups (p > 0.05). Teeth with moderate or severe hypersensitivity that required a filling responded similarly regardless of whether the desensitizing procedure was carried out prior to the filling.

Efficacy of a bioactive material and nanostructured desensitizing on dentin hypersensitivity treatment

“…The desensitizing effect is due to remineralization, which is based on the ability of the hydroxyapatite layer to occlude the dentinal tubules 19 , in addition to the effect of nerve fiber depolarization by the potassium nitrate present in the material 6,[12][13][14] . This product also resulted in pain decrease over time.…”

“…It is clinically the result of dentin exposure and is characterized by acute, short and temporary pain in response to mechanical, chemical, thermal, or osmotic stimuli and cannot be attributed to any other dental pathology [1][2][3][4] . The most widely accepted theory to explain DH is Brännström's hydrodynamic theory 5 and one of its main causes is non-carious cervical lesions such as abrasion, erosion, and abfraction 6 . In addition, gingival recession also exposes the underlying dentin 1,4 .…”

“…The treatments that act on the pulp nerve mechanoreceptors use potassium salts, tin and strontium which, when present in oral environment, are released in ionic form thus decreasing pain transmission. However, the interruption of treatment leads to a decrease in the concentration of these ions surrounding the mechanoreceptors resulting in the re-establishment of painful stimulus 6,[12][13][14] . Regarding treatment through dentinal tubule obliteration, several substances such as strontium chloride, fluoride, potassium oxalate, inert ceramic particles like silica, alumina, and arginine, among others 1,4,7,13,15-17 may be used.…”

“…According to the manufacturer, the effectiveness of this material is based on its ability to provide ions of calcium, phosphate, and fluoride to demineralized tooth surfaces, which can be reorganized in the form of hydroxyapatite, fluorapatite, and calcium fluoride, with acid resistance similar to that of the natural tooth. In addition to this characteristic of remineralization, based on the ability of the hydroxyapatite layer to occlude the dentinal tubules 19 , potassium nitrate depolarizes the nerve fibers thereby decreasing the pain 6,[12][13][14] .…”

Avaliação in vivo e in vitro de diferentes protocolos no tratamento da hipersensibilidade dentinária cervical

“…Até o momento, nenhum método foi desenvolvido para resolver satisfatoriamente a HD, e as recorrências são comuns (Dababneh et al, 1999;Freitas et al, 2015). Os pacientes com HD devem ser cuidadosamente avaliados para o diagnóstico diferencial e o controle dos fatores etiológicos, porque o tratamento deve trazer um alivio da dor de uma maneira rápida e permanente.…”