RESUMO
BACKGROUND: Dentin hypersensitivity (DH) is a common problem in the population that can have a significant impact on the quality of life of those who suffer from the condition. OBJECTIVES: Compare the efficacy of two treatments for DH: Ca/PO4 - /F- varnish (Clinpro White Varnish) and ionomeric sealant (IS) (Clinpro XT Varnish) with a placebo. METHODS: Participants (121) with at least one tooth with visual analogue scale (VAS) score of 4 and above were randomly and blindly allocated to the groups. Treatments were performed by a trained researcher. DH was evaluated by another blind researcher after the treatment and after 1 week, 4 weeks, 3 months and 6 months. After 4 weeks, placebo received the DH treatment with IS; thus, the participants were not assessed after 3 and 6 months. Primary outcome was DH reduction after 4 weeks. Differences in VAS scores in the other time intervals and entire values of VAS were considered secondary outcomes. Comparisons were made among the groups (α = 0.05). RESULTS: IS showed the highest VAS value difference between baseline and 4 weeks (mean ± SD: 3.7 ± 2.2), differing significantly from placebo (2.3 ± 1.7) and Ca/PO4/F- varnish (2.6 ± 2.0). Ca/PO4- /F- varnish did not differ from placebo. In all time intervals, VAS values of all groups were significantly lower than the baseline value, without differences among groups. For the long-term differences in VAS values (3 and 6 months), the IS exhibited significantly higher values than Ca/PO4- /F- varnish. CONCLUSIONS: The IS was the most efficacious product for reducing DH, whereas Ca/PO4- /F- varnish did not differ from placebo. Registered in ClinicalTrials.gov (NCT04591444).
Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Cálcio , Fluoreto de Cálcio , Sensibilidade da Dentina/tratamento farmacológico , Método Duplo-Cego , Fluoretos , Fluoretos Tópicos , Humanos , Fosfatos , Qualidade de VidaRESUMO
OBJECTIVE: To evaluate the efficacy of Nd:YAG laser associated with calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion after erosive/abrasive challenges. METHODOLOGY: Dentin specimens were exposed to 17% ethylene diamine tetra-acetic acid (EDTA) solution for 5 min and randomly allocated into five groups: G1, control (no treatment); G2, Nd:YAG laser (1 W, 10 Hz, 100 mJ, 85 J/cm2); G3, Laser + TeethmateTM Desensitizer; G4, Laser + Desensibilize Nano P; and G5, Laser+Nupro®. Specimens underwent a 5-day erosion-abrasion cycling. Hydraulic conductance was measured post-EDTA, post-treatment, and post-cycling. Post-treatment and post-cycling permeability (%Lp) was calculated based on post-EDTA measurements, considered 100%. Open dentin tubules (ODT) were calculated at the abovementioned experimental moments using scanning electron microscopy and ImageJ software (n=10). Data were analyzed using two-way repeated measures ANOVA and Tukey's test (α=0.05). RESULTS: G1 presented the highest %Lp post-treatment of all groups (p<0.05), without significantly differences among them. At post-cycling, %Lp significantly decreased in G1, showed no significant differences from post-treatment in G3 and G4, and increased in G2 and G5, without significant differences from G1 (p>0.05). We found no significant differences in ODT among groups (p>0.05) post-EDTA. At post-treatment, treated groups did not differ from each other, but presented lower ODT than G1 (p<0.001). As for post-cycling, we verified no differences among groups (p>0.05), although ODT was significantly lower for all groups when compared to post-EDTA values (p<0.001). CONCLUSION: All treatments effectively reduced dentin permeability and promoted tubule occlusion after application. COMBINING ND: YAG laser with calcium-phosphate pastes did not improve the laser effect. After erosive-abrasive challenges, treatments presented no differences when compared to the control.
Assuntos
Dessensibilizantes Dentinários , Lasers de Estado Sólido , Cálcio/farmacologia , Dentina , Permeabilidade da Dentina , Lasers de Estado Sólido/uso terapêutico , Microscopia Eletrônica de VarreduraRESUMO
Abstract Objective To evaluate the efficacy of Nd:YAG laser associated with calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion after erosive/abrasive challenges. Methodology Dentin specimens were exposed to 17% ethylene diamine tetra-acetic acid (EDTA) solution for 5 min and randomly allocated into five groups: G1, control (no treatment); G2, Nd:YAG laser (1 W, 10 Hz, 100 mJ, 85 J/cm2); G3, Laser + TeethmateTM Desensitizer; G4, Laser + Desensibilize Nano P; and G5, Laser+Nupro®. Specimens underwent a 5-day erosion-abrasion cycling. Hydraulic conductance was measured post-EDTA, post-treatment, and post-cycling. Post-treatment and post-cycling permeability (%Lp) was calculated based on post-EDTA measurements, considered 100%. Open dentin tubules (ODT) were calculated at the abovementioned experimental moments using scanning electron microscopy and ImageJ software (n=10). Data were analyzed using two-way repeated measures ANOVA and Tukey's test (α=0.05). Results G1 presented the highest %Lp post-treatment of all groups (p<0.05), without significantly differences among them. At post-cycling, %Lp significantly decreased in G1, showed no significant differences from post-treatment in G3 and G4, and increased in G2 and G5, without significant differences from G1 (p>0.05). We found no significant differences in ODT among groups (p>0.05) post-EDTA. At post-treatment, treated groups did not differ from each other, but presented lower ODT than G1 (p<0.001). As for post-cycling, we verified no differences among groups (p>0.05), although ODT was significantly lower for all groups when compared to post-EDTA values (p<0.001). Conclusion All treatments effectively reduced dentin permeability and promoted tubule occlusion after application. Combining Nd YAG laser with calcium-phosphate pastes did not improve the laser effect. After erosive-abrasive challenges, treatments presented no differences when compared to the control.
Assuntos
Lasers de Estado Sólido/uso terapêutico , Dessensibilizantes Dentinários , Microscopia Eletrônica de Varredura , Cálcio/farmacologia , Dentina , Permeabilidade da DentinaRESUMO
Objective: The aim of this article was to describe and discuss a clinical case in which the Nd:YAG laser and a desensitizing agent were associated in a protocol for dentin hypersensitivity (DH) in teeth with molar-incisor hypomineralization (MIH). Background data: DH is a common condition among the population, being one of the main reasons for patients to seek for a dental treatment. MIH can be considered a condition that induces DH. Methods: The patient was referred for evaluation, complaining of hypersensitivity during eating or drinking cold foods. Clinical evaluation revealed the presence of MIH on the first lower molars. Aiming to treat DH, two strategies for dentin desensitization were associated: the use of a high-power laser (Nd:YAG laser, 1.064 nm; Lares Research), with a 300 µm quartz optical fiber, 1 W of power, 100 mJ of energy, 10 Hz of repetition rate, and 85 J/cm2 of energy density, followed by the application of two layers of a desensitizing agent (Gluma Desensitizer). Results: DH was evaluated immediately, after 1 week and after 1 month of the treatment. Clinical outcomes were satisfactory, confirming the efficacy and considerable durability of the protocol used for the reduction of DH originated from MIH. Conclusions: The association of Nd:YAG laser and a desensitizing agent for controlling DH was effective, showing to be an interesting protocol.
Assuntos
Hipoplasia do Esmalte Dentário/complicações , Dessensibilizantes Dentinários/farmacologia , Sensibilidade da Dentina/terapia , Lasers de Estado Sólido/uso terapêutico , Criança , Humanos , Masculino , Medição da DorRESUMO
AIM: This double-blind, placebo-controlled, randomized clinical trial evaluated the effectiveness of Nd:YAG laser and a calcium sodium phosphosilicate-containing paste (NovaMin®) in the treatment of cervical dentin hypersensitivity (CDH). MATERIALS AND METHODS: Seventy patients were randomly allocated into the following experimental groups: control-placebo, calcium sodium phosphosilicate paste (NovaMin®), and Nd:YAG laser (1 W, 10 Hz, 85 J/cm2). Pain was evaluated by means of a visual analog pain scale (VAS) after evaporative stimulation with a jet of air and tactile stimulation with an exploratory probe, before treatment (baseline) and after 5 min, 1week, and 4 weeks. When patients presented more than one tooth with CDH, the mean of the values obtained was calculated. Irradiation with Nd:YAG laser was performed twice in the mesial-distal and twice in the occlusal-gingival direction. The NovaMin®-containing paste was applied with a rubber cup at low speed for 60 s. Patients of the placebo group received simulations of the two treatments. As the data presented normal distribution, the two-way ANOVA repeated measures test was used. RESULTS: In all the experimental times, reduction in pain was demonstrated in comparison with baseline for all treatments (p < 0.05); however, there was no difference among the experimental groups in any of the time intervals evaluated (p > 0.05). CONCLUSION: All treatments were equally effective in reducing the pain of CDH. CLINICAL RELEVANCE: Nd:YAG laser irradiation and the calcium sodium phosphosilicate paste could reduce the symptoms of CDH; thus, they stand out as viable alternatives for the treatment of this condition.