CALCIUM PHOSPHATE NANOPARTICLES REDUCE DENTIN HYPERSENSITIVITY : A RANDOMIZED , PLACEBO-CONTROLLED STUDY
Original Articles
2.3 . Application method The targeted area was first cleaned with a cotton pellet . Then , the dentist mixed the powder with the liquid for 15 s to obtain a paste that was immediately applied on the treated areas with a microbrush by gently brushing for 2 min ( Fig . 1 to 4 ). In the same visit , both test and placebo treatments were applied to each patient according to a randomization list . Patients were then asked to rinse their mouth , and within 15 min after the treatment the blinded dentist applied the same air blast stimuli under the same conditions to assess pain scores after treatments ( POST ). Patients were recalled for hypersensitivity assessment of the treated areas after 1 week . At that time point , after data collection , both dentist and patients were unblinded regarding the test or placebo treatment , and the test treatment was applied to the area that previously received the placebo compound . Patients were then recalled after 1 , 3 and 6 months and at each recall the dentist assessed only tooth areas that were treated with test compound since the beginning of the trial .
Figure 1 . Patient requesting desensitization treatment for vestibular areas of maxillary teeth . No presence of cervical lesions or abrasions could be identified as well as other lesions , yet upper right and upper left canines and premolars scored 7 on VAS after air blast test .
Figure 2 . Application of the tested DD on right maxillary teeth ( test site ), same area depicted in Fig 1 .
2.3 . Statistical analysis All statistical analyses were performed using statistical software ( JMP 10.0 , SAS Institute Inc , Cary , NC , USA ). A preliminary check of the normality of distribution and homogeneity of variances was performed using Shapiro-Wilk ’ s and Levène ’ s tests ( p < 0.0001 and p = 0.0014 , respectively ). Since data did not belong to continuous variable ( 0-10 ordinal VAS scores ), were not normally distributed and homoscedasticity was not respected , nonparametrical ANOVA and non-parametric comparisons for each pair using Wilcoxon method ( p < 0.05 ) were used to highlight significant differences between groups .
Figure 3 . Dental occlusal erosions bilaterally on palatal side of maxillary frontal and lateral teeth . Air blast test scored 8 . Patient was referred to a gastroenterologist physician . He was later diagnosed with gastroesophageal reflux disease ( GERD ) and given treatment . Patient refused restorative therapies , requesting treatment of pain symptoms only .
Figure 4 . Application of the test DD on the same area as in Fig 3 .
3 . Results All 25 subjects completed the trial without requesting alternative desensitization treatments or dropping out from the trial . No adverse reactions were reported . The results of the study are displayed in Fig . 5 . Both DD and placebo significantly decreased VAS scores comparing POST and PRE ( p < 0.0001 ) measurements , thus showing similar efficacy ( 35 % and 28 %, respectively ). DD application further decreased scores after 1 week ( 63 % in comparison with PRE ), while placebo application did not show significant differences when compared to POST ( p = 0.09 ). The scores from the areas treated with the DD maintained , throughout the observational period , the levels obtained after 1 week ( maximum decrease in scores = 69 % after 3 months ). At 6 months , a small , non-significant increase in VAS scores was also observed .
4 . Discussion Dentin hypersensitivity is an increasing occurrence , and dental materials or procedures able to reduce the patient ’ s sensitivity are increasingly needed . A variety of therapies are currently available , 2 , 4 , 6 but the most modern and biocompatible approach seems to be the one aiming at reconstituting a barrier and closing the open orifices of the tubules by using biomimetic materials and
13 , 14 , 15 , 16 techniques .
104 Stoma Edu J . 2017 ; 4 ( 2 ): 102-107 http :// www . stomaeduj . com