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Objective: This randomized controlled trial aimed to compare nanohydroxyapatite with fluoride on managing post ultrasonic scaling Dentine hypersensitivity (DH). Material and Methods: Thirty patients (aged 20-50 years) with post ultrasonic-scaling DH were included in this study. The sample was randomly divided into three equal groups of 60 teeth each: the first group received nanohydroxyapatite material, the second group received fluoride material and the third group received sterile water as a placebo (controls). The materials were applied once for each patient. All patients were instructed to rate the level of pain before treatment, and after 1 hour, 24 hours, 2 weeks and 1 month on the numerical rating scale (NRS). The Kruskal-Wallis test, Mann-Whitney tests, linear regression analysis were used for the statistical analysis. Significance level was set at 0.05. Results: Both nanohydroxyapatite and fluoride were successful in reducing pain associated with DH when compared with the placebo in subsequent follow-ups (p < 0.05). However, one-hour and one-day post application, nanohydroxyapatite could reduce hypersensitivity pain moreeffectively than fluoride (p < 0.05). Conclusion: Nanohydroxyapatite material was found to besignificantly more effective in reducing the DH that followed ultrasonic scaling one-hour and one-day post application as compared to fluoride and sterile water. Both fluoride and nanohydroxyapatite had similar effect on DH after two-weeks and one-month after application. (AU)

Objetivo: Este ensaio clínico randomizado teve como objetivo comparar a nano-hidroxiapatita com o flúor no manejo da hipersensibilidade dentinária (HD) pós-raspagem ultrassônica. Material e Métodos: Trinta pacientes (com idades entre 20-50 anos) com HD pós-raspagem ultrassônica foram incluídos neste estudo. A amostra foi dividida aleatoriamente em três grupos iguais com 60 dentes cada: o primeiro grupo recebeu material de nano-hidroxiapatita, o segundo grupo recebeu material de flúor e o terceiro grupo recebeu água esterilizada como placebo (controle). Os materiais foram aplicados uma vez para cada paciente. Todos os pacientes foram instruídos a avaliar o nível de dor antes do tratamento, e após 1 hora, 24 horas, 2 semanas e 1 mês na escala de avaliação numérica (NRS). Os testes de Kruskal-Wallis, Mann-Whitney e análise de regressão linear foram usados para a análise estatística. O nível de significância foi estabelecido em 0,05. Resultados: Tanto a nano- hidroxiapatita quanto o flúor foram bem-sucedidos na redução da dor associada à HD quando comparados ao placebo em acompanhamentos subsequentes (p <0,05). No entanto, 1 hora e 1 dia após a aplicação, a nano-hidroxiapatita pode reduzir a dor de hipersensibilidade de forma mais eficaz do que o flúor (p <0,05). Conclusão: O material da nano-hidroxiapatita foi significativamente mais eficaz na redução da HD que se seguiu à raspagem ultrassônica, 1 hora e 1 dia após a aplicação, em comparação com o flúor e a água estéril. Tanto o flúor, quanto a nano-hidroxiapatita apresentou efeito semelhante na HD após 2 semanas e 1 mês após a aplicação (AU)

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OBJECTIVE: This study aimed to identify and compare the self-reported and diagnosed prevalence of dentinal hypersensitivity (DH) in an University population; and to verify accuracy, sensitivity and specificity of DH stimuli tests. MATERIAL AND METHODS: Three hundred and eighty patients (67.2% women and 32.8% men) were assessed by questionnaire, clinical exam, tactile and cold water tests. The intensity of DH was assessed using a visual analogue scale, and a calibrated examiner measured the scores using a caliper. The ICC for intra-examiner was 0.990. Scores above 5 mm were considered sensitive teeth. The association between variables was assessed by Chi-square test. ROC curve analysis determined accuracy, sensitivity and specificity of the tests (p < .05). RESULTS: The mean age of participants was 24.08 years. 158 (41.7%) volunteers self-reported the presence of DH, while, 88.7% of the participants were clinically diagnosed (p = .023). In total, 8958 teeth were evaluated, of those 3367 (37.6%) were diagnosed sensitive. The most prevalent teeth with DH were incisors and premolars. The accuracy of the tests with cold water and tactile were 99%. The sensitivity and specificity for cold water and tactile tests were 99.9%, 99.7%, 99.1% and 87.6%, respectively. CONCLUSION: The self-reported prevalence of DH was significantly lower than that clinically diagnosed. The cold test proved to be a highly accurate stimulus for the diagnosis of DH.

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Treatments for dentine hypersensitivity (DH) may produce positive effects, though do not have lasting results. We investigated the reparative potential of stem cells derived from deciduous teeth (SHEDs) in response to components delivered from substances used in the treatment of the DH, associated or not to laser phototherapy (LPT), to stimulate dentine formation. SHEDs were submitted to substances delivered from a laboratorial P-rich bioactive glass [57SiO2 -26CaO-17P2 O5 (wt %)] or a commercially available desensitizer (Gluma® Desensitizer), associated (or not) to LPT (InGAlP diode laser, 660 nm, 0.028 cm2 , 20 mW, 5 J/cm2 , 7 s, contact mode). Biomaterial characterization was performed by X-ray diffraction, scanning electron microscopy and the particle size was evaluated by dynamic light scattering. SHEDs proliferation and differentiation were analyzed by MTT and Alizarin Red staining, respectively. The conditioned media used in these tests were evaluated regarding their pH and the ionic concentration changes due to ions leached from the bioactive glass (BG). BG majority presented a non-crystalline solid structure and mixed particle sizes characterized by the agglomeration of nanoparticles. Cultures treated with BG alone or in association to LPT showed improved cell growth in relation to Gluma® (p < 0.05). Gluma® was cytotoxic in all tested conditions, regardless irradiated or not. BG associated to LPT induced intense mineral matrix formation. In conclusion, BG releases ionic dissolution products able to promote SHEDs differentiation. BG associated to LPT improves SHEDs proliferation and differentiation in vitro, and may be a promise therapeutic approach for the DH treatment. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 107-116, 2017.

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Objetivo: avaliar o número de aplicações necessárias para a completa obliteração dos túbulos dentinários utilizando diferentes agentes dessensibilizantes. Material e Métodos: a porção do esmalte coronário da face vestibular de 40 incisivos bovinos foi removida com auxílio de lixas para expor a dentina superficial da junção amelo-cementária. Em seguida, as raízes e a porção coronária referente ao terço médio-incisal dos dentes foram removidas. A seguir foi realizada a completa remoção de smear layer, evidenciando os túbulos dentinários. As amostras foram divididas em quatro grupos experimentais conforme o agente dessensibilizante utilizado: verniz fluoretado, adesivo dentinário, dessensibilizante dentinário e creme dental. Os produtos foram aplicados de acordo com as recomendações do fabricante. As amostras foram avaliadas previamente e após o uso dos agentes por microscopia eletrônica de varredura de baixo vácuo. A aplicação do agente e a análise foram realizadas até a completa obliteração dos túbulos dentinários. Os dados foram avaliados estatisticamente em relação ao número de aplicações necessárias utilizando os testes de Kruskal-Wallis e Mann-Whitney (p < 0,05). Resultados: o verniz fluoretado foi o mais eficaz dos agentes avaliados, sendo necessária uma aplicação para a completa obliteração dos túbulos. Para o adesivo dentinário foram necessárias duas aplicações e para o dessensibilizante e o creme dental foram necessárias cinco aplicações. Conclusão: os agentes dessensibilizantes testados necessitam de um número variado de aplicações, sendo o mais eficaz o verniz fluoretado, onde apenas uma aplicação possibilitou a completa obliteração dos túbulos.

Objective: The aim of this study was to evaluate the number of applications necessary for the complete obliteration of dentinal tubules using different desensitizing agents. Materials and Methods: A portion of coronary enamel of the buccal surface of 40 bovine incisors was removed with the aid of sandpaper in order to expose the superficial dentin at the dentin-enamel junction. The roots and the coronary portions of the mesial-incisal third of the teeth were also removed. Complete smear-layer removal was performed, exposing the dentinal tubules. Samples were divided into four experimental groups according to the desensitizing agents used: fluoride varnish; dentin adhesive; dentin desensitizing; and toothpaste. The products were applied in accordance with the manufacturer's recommendations. Samples were evaluated before and after the application of different agents by scanning electronic microscopy of low vacuum. The application of the products and analyses were carried out until complete obliteration of dentinal tubules. Data were evaluated statistically in relation to the required number of applications, using Kruskal-Wallis and Mann-Whitney tests (p < 0.05). Results: The results showed that fluoride varnish was the most efficient of the tested agents, requiring a single application for the complete obliteration of the dentinal tubule. For the dentin adhesive, two applications were necessary and for the dentin desensitizing and toothpaste, five applications were required. Conclusion: The desensitizing agents tested required a distinct number of applications, and the fluoride varnish was the most effective agent, with a single application resulting in the complete obliteration of the dentin tubule.

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Introdução: Vários tratamentos são propostos para a hipersensibilidade dentinária sendo consenso que o objetivo principal do tratamento é a obliteração dos túbulos dentinários. Objetivo: Avaliar o número de aplicações necessárias para a completa obliteração dos túbulos dentinários utilizando diferentes agentes dessensibilizantes. Material e Método: A porção do esmalte coronário da face vestibular de 40 incisivos bovinos foi removida com auxílio de lixas para expor a dentina superficial da junção amelo-cementária. Em seguida, as raízes e a porção coronária referente ao terço médio-incisal dos dentes foram removidas. A seguir foi realizada a completa remoção de smear layer, evidenciando os túbulos dentinários. As amostras foram divididas em 4 grupos experimentais conforme o agente dessensibilizante utilizado: verniz fluoretado, adesivo dentinário, dessensibilizante dentinário e creme dental. Os produtos foram aplicados de acordo com as recomendações do fabricante. As amostras foram avaliadas previamente e após o uso dos agentes por microscopia eletrônica de varredura de baixo vácuo. A aplicação do agente e a análise foram realizadas até a completa obliteração dos túbulos dentinários. Os dados foram avaliados estatisticamente em relação ao número de aplicações necessárias utilizando os testes de Kruskal-Wallis e Mann-Whitney (p0,05). Resultado: O verniz fluoretado foi o mais eficaz dos agentes avaliados, sendo necessária uma aplicação para a completa obliteração dos túbulos. Para o adesivo dentinário foram necessárias duas aplicações e para o dessensibilizante e o creme dental foram necessárias cinco aplicações. Conclusão: Os agentes dessensibilizantes testados necessitam de um número variado de aplicações, sendo o mais eficaz o verniz fluoretado, onde apenas uma aplicação possibilitou a completa obliteração dos túbulos. (AU)

Introduction: Several treatments are proposed for dentin sensitivity and the consensus is that the main objective of the treatment is the complete obliteration of the dentinal tubules. Objective: To evaluate the number of applications necessary for the complete obliteration of the dentinal tubules using different desensitizing agents. Material and Methods: a portion of coronary enamel of the buccal surface of 40 bovine incisors was removed with the aid of sandpaper in order to expose the superficial dentin at the dentin-enamel junction. The roots and the coronary portions of the mesial-incisal third of the teeth were also removed. Complete smear layer removal was performed, exposing the dentinal tubules. Samples were divided into 4 experimental groups as desensitizing agents used: fluoride varnish, dentin adhesive, dentin desensitizing and toothpaste. The products were applied in accordance to the manufacturer's recommendation. Samples were evaluated before and after the application of different agents by scanning electronic microscopy of low vacuum. The application the products and analysis was carried out until complete obliteration of dentinal tubules. Data was evaluated statistically in relation to the required number of applications using Kruskal-Wallis and Mann-Whitney (p<0, 05). Results: Fluoride varnish was the most efficient of the tested agents, requiring a single application for the complete dentinal tubule obliteration. For the dentin adhesive, two applications were necessary and for the dentin desensitizing and toothpaste five applications were required. Conclusion: The desensitizing agents tested require distinct number of applications, and the fluoride varnish is the most effective one, which a single application resulted in the complete dentin tubule obliteration. (AU)

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La hipersensibilidad dentinaria (HD) posterior al raspado y alisado radicular (RAR) ha sido poco estudiada desde una perspectiva preventiva a pesar de su relevancia clínica. El objetivo de esta investigación fue evaluar el efecto de las cremas desensibilizantes en pacientes con indicaciones de raspado y alisado radicular. Para ello, se realizó un estudio longitudinal cuasi-experimental con una muestra no probabilística de 18 pacientes (hombres y mujeres) entre 20 y 50 años de edad, que requerían tratamiento con RAR en dientes posteriores (premolares y primer molar), quienes fueron asignados al azar en cada uno de los tres grupos a evaluar. Las cremas desensibilizantes utilizadas en esta investigación contienen citrato de potasio, nitrato de potasio, fluoruro de sodio y triclosan estas se indicaron un mes antes de realizar los RAR en todos los grupos. Para medir la presencia de hipersensibilidad dentinaria se aplicaron estímulos táctiles y térmicos a los 8, 15 y 22 días posteriores al tratamiento de RAR y se usó la Escala Visual Análoga Graduada (EVAG) para evaluar el dolor. Como resultado se obtuvo menor presencia de HD en el grupo que utilizó citrato de potasio 5.04% y monofluorfosfato 1.1%, aun cuando en los tres grupos se observó disminución de HD durante los tres periodos de medición. Llegando a la conclusión que es pertinente prescribir cremas desensibilizantes con citrato de potasio 5.04% y monofluorfosfato 1.1% a los pacientes con necesidades clínicas similares a los de este estudio un mes antes de planificar los RAR.

The presence of dentine hypersensitivity (DH) after scaling and root planning treatment (RPT) has been scarcely studied from a preventive perspective in spite the clinical relevance of the issue. The aim of this research was to evaluate the preventive effect of some desensitizing dentifrices in patients previous to a RPT. In this sense, a cuasi-experimental, longitudinal study was performed. The non probabilistic sample was constituted by 18 patients (women and men) aged between 20 and 50; all of them diagnosed as requiring scaling and root planning treatment for posterior teeth (premolars and first molars). Subjects were randomly assigned to one of the three groups. The desensitizing toothpaste used in the study contained potassium citrate, potassium nitrate, sodium fluoride and triclosan. These paste were prescribed for patients a month before the RPT. Dentine hypersensitivity was evaluated by using tactile and thermal stimuli applied 8, 25 and 22 days after RPT; the Visual Analogue Scale (VSA) was used to assess pain. Results showed lower presence DH in the 5.04% potassium citrate group and 1.1% monofluor fosfate, even when there was a decrease of DH for the three measurement periods. It was concluded that it would be good to prescribe 5.04% potassium citrate group and 1.1% monofluorfosfate desensitizing agents to patients with clinical needs similar to the ones described in this study, a month before the RPT.

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