RESUMEN
The aim of this clinical, prospective, randomized, and parallel study was to evaluate different in-office treatments for dentin hypersensitivity (DH). One hundred ninety-two teeth with non-cavitated root exposures were treated using different desensitizers: fluoride varnish (Duraphat - FLU); bioactive ceramic solution (Biosilicate - BIOS); universal self-etching adhesive (Single Bond Universal - SBU); bioactive photoactivated varnish (PRG filler - SPRG). The degree of DH was analyzed using a visual analog scale (VAS) and computerized visual scale (CoVAS), before treatments and after 7, 15, and 30 days from the first session. Comparisons among desensitizers were performed using the Kruskal-Wallis and Dunn's tests. Friedman test was used to compare between times (p ≤ 0.05). Comparing desensitizers FLU presented a higher value of DH than BIOS using VAS at 7 days, however, no differences were found using CoVAS analysis. Comparing times, BIOS and SBU showed a reduction in DH after 7 days and SBU showed a reduction at 30 days compared to 7 days using VAS. FLU and SPRG groups reduced DH from 15 days to 30 days using VAS. There was a reduction in DH for FLU, BIOS, and SBU after 7 days and for BIOS this reduction also occurred at 30 days when compared to 15 days using CoVAS. SPRG group showed a reduction from 15 to 30 days. All desensitizers tested were able to reduce the initial sensitivity. The bioactive ceramic solution reduced the DH gradually after 30 days using computerized analysis.
Asunto(s)
Desensibilizantes Dentinarios , Sensibilidad de la Dentina , Humanos , Sensibilidad de la Dentina/tratamiento farmacológico , Desensibilizantes Dentinarios/uso terapéutico , Masculino , Femenino , Estudios Prospectivos , Adulto , Resultado del Tratamiento , Persona de Mediana Edad , Fluoruros TópicosRESUMEN
BACKGROUND: This study aimed to evaluate dentin wear and biological performance of desensitizing materials. METHODS: Seventy bovine root dentin blocks were sectioned. Half of the surface of each specimen was untreated (control) and the other half was immersed in EDTA and treated with the following desensitizing materials: placebo varnish (PLA), fluoride varnish (FLU), sodium fluoride (NaF) varnish + sodium trimetaphosphate (TMP), universal adhesive (SBU), S-PRG varnish (SPRG), biosilicate (BIOS), and amelotin solution (AMTN). After application, the specimens were submitted to an erosive-abrasive challenge and the wear analyzed by optical profilometer. Serial dilutions of extracts obtained from the culture medium containing discs impregnated with those desensitizers were applied on fibroblasts and odontoblasts-like cells cultures. Cytotoxicity and production of total protein (TP) by colorimetric assays were determined after 24 h. Data were statistically analyzed using Kruskal-Wallis, Dunn's, One-way ANOVA and Tukey tests (p ≤ 0.05). RESULTS: No dentin wear was observed only for SBU. The lowest dentin wear was observed for AMTN and TMP. Cell viability was significantly reduced after treatment with undiluted extracts of PLA, FLU, TMP and SBU in fibroblasts and TMP and SBU in odontoblast-like cells. SPRG, BIOS and AMTN were cytocompatible at all dilutions tested. Considering TP results, no statistical difference was observed among the groups and high levels for TP were observed after TMP and FLU treatments. CONCLUSIONS: Universal adhesive system may protect dentin with opened tubules from wear after challenge. Extracts of adhesive and fluoride varnishes presented cytotoxic mainly on fibroblasts. The enamel protein may be a future alternative to treat dentin with opened tubules because it may cause low wear under erosive-abrasive challenge with low cytotoxic effects.
Asunto(s)
Desensibilizantes Dentinarios , Dentina , Fluoruro de Sodio , Animales , Bovinos , Desensibilizantes Dentinarios/farmacología , Fluoruro de Sodio/farmacología , Dentina/efectos de los fármacos , Fluoruros Tópicos/farmacología , Fibroblastos/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Desgaste de los Dientes , Ensayo de Materiales , Polifosfatos/farmacologíaRESUMEN
Abstract The aim of this clinical, prospective, randomized, and parallel study was to evaluate different in-office treatments for dentin hypersensitivity (DH). One hundred ninety-two teeth with non-cavitated root exposures were treated using different desensitizers: fluoride varnish (Duraphat - FLU); bioactive ceramic solution (Biosilicate - BIOS); universal self-etching adhesive (Single Bond Universal - SBU); bioactive photoactivated varnish (PRG filler - SPRG). The degree of DH was analyzed using a visual analog scale (VAS) and computerized visual scale (CoVAS), before treatments and after 7, 15, and 30 days from the first session. Comparisons among desensitizers were performed using the Kruskal-Wallis and Dunn's tests. Friedman test was used to compare between times (p ≤ 0.05). Comparing desensitizers FLU presented a higher value of DH than BIOS using VAS at 7 days, however, no differences were found using CoVAS analysis. Comparing times, BIOS and SBU showed a reduction in DH after 7 days and SBU showed a reduction at 30 days compared to 7 days using VAS. FLU and SPRG groups reduced DH from 15 days to 30 days using VAS. There was a reduction in DH for FLU, BIOS, and SBU after 7 days and for BIOS this reduction also occurred at 30 days when compared to 15 days using CoVAS. SPRG group showed a reduction from 15 to 30 days. All desensitizers tested were able to reduce the initial sensitivity. The bioactive ceramic solution reduced the DH gradually after 30 days using computerized analysis.
Resumo O objetivo deste estudo clínico, prospectivo, randomizado e paralelo foi avaliar diferentes tratamentos em consultório para hipersensibilidade dentinária (HD). Cento e noventa e dois dentes com exposições radiculares não cavitadas foram tratados com diferentes dessensibilizantes: verniz fluoretado (Duraphat - FLU); solução cerâmica bioativa (Biosilicato - BIOS); adesivo autocondicionante universal (Single Bond Universal - SBU); verniz fotoativado bioativo (PRG filler - SPRG). O grau de HD foi analisado por meio da escala visual analógica (VAS) e da escala visual computadorizada (CoVAS), antes dos tratamentos e após 7, 15 e 30 dias da primeira sessão. As comparações entre dessensibilizantes foram feitas pelos testes de Kruskal-Wallis e Dunn. O teste de Friedman foi utilizado para comparação entre os tempos (p ≤ 0,05). Comparando os dessensibilizantes, o FLU apresentou um valor de HD maior do que o BIOS usando VAS aos 7 dias, no entanto, nenhuma diferença foi encontrada usando a análise CoVAS. Comparando os tempos, BIOS e SBU apresentaram redução de HD após 7 dias e SBU apresentou redução aos 30 dias em comparação com 7 dias usando VAS. Os grupos FLU e SPRG reduziram a HD em 15 dias a 30 dias usando VAS. Houve redução de HD para FLU, BIOS e SBU após 7 dias e para BIOS essa redução também ocorreu aos 30 dias quando comparada a 15 dias usando CoVAS. O grupo SPRG apresentou redução de 15 para 30 dias. Todos os dessensibilizantes testados foram capazes de reduzir a sensibilidade inicial. A solução de cerâmica bioativa reduziu o HD gradualmente após 30 dias usando análise computadorizada.