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