Evaluation and comparison of the effects of a new paste containing 8% L-Arginine and CaCO3 plus KNO3 on dentinal tubules occlusion and dental sensitivity: a randomized, triple blinded clinical trial study

BACKGROUND

Dentin hypersensitivity, often occurring after dental treatments or from erosive lesions, is a prevalent patient complaint. This study introduces a paste combining 8% L-arginine, calcium carbonate, and potassium nitrate to evaluate its impact on dentinal tubules occlusion, dentin permeability, and tooth sensitivity.

METHODS

Dentin surfaces from 24 third molars (thickness: 2 mm) were divided into two groups of 12. One received the experimental paste, while the other received a placebo without desensitizer. Permeability and sealing ability were assessed through scanning electron microscopy (SEM) and dentin permeability measurement. The pastes' effects on hypersensitivity were then examined in a triple-blind, randomized parallel-armed clinical trial with 16 eligible patients. Sensitivity to cold, touch, and spontaneous stimuli was recorded using the VAS scale at various intervals post-treatment. Statistical analysis was conducted using Shapiro-Wilk, Mann-Whitney U, Friedman, and Wilcoxon tests (α = 0.05).

RESULTS

The permeability test demonstrated a significant reduction in dentin permeability in the experimental group (P = 0.002) compared to the control (P = 0.178). SEM images revealed most dentinal tubules in the intervention samples to be occluded. Clinically, both groups showed a significant decrease in the three types of evaluated sensitivity throughout the study. However, no significant difference in sensitivities between the two groups was observed, with the exception of cold sensitivity at three months post-treatment (P = 0.054).

CONCLUSION

The innovative desensitizing paste featuring 8% L-arginine, calcium carbonate, and potassium nitrate effectively occluded dentinal tubules and reduced dentin permeability. It mitigated immediate and prolonged dentin hypersensitivity to various stimuli, supporting its potential role in managing dentin hypersensitivity.

TRIAL REGISTRATION

http://irct.ir : IRCT20220829055822N1, September 9th, 2022.

Comparative Evaluation of the Effectiveness of Three Commercially Available Desensitizing Mouthwash on Dentinal Tubule Occlusion: An In Vitro Scanning Electron Microscopic Study

Aim

To compare and evaluate the effectiveness of three commercially available desensitizing mouthwashes on dentinal tubule occlusion in vitro using a scanning electron microscope (SEM).

Materials and Methods

Twenty-seven premolar maxillary teeth were collected and cleaned to remove debris and tissue using an ultrasonic scaler. Enamel was removed with the help of a high-speed plain cut tungsten carbide fissure bur under continuous water spray. Dentinal discs measuring 5 mm × 5 mm × 3 mm were prepared from the coronal region of the extracted teeth using a double-sided carborundum disc and straight micromotor handpiece. Using carborundum paper, the discs were polished and washed with distilled water. The discs were etched using 37% phosphoric acid to remove any smear layer that was caused by the grinding process and to simulate dentinal hypersensitivity by opening the dentinal tubules. The specimens were again washed and stored in distilled water until use. Samples were then randomly allocated into Group A: calcium sodium phosphosilicate mouthwash, Group B: potassium nitrate mouthwash, and Group C: dipotassium oxalate monohydrate mouthwash. The specimens were immersed in a test tube filled with the respective mouthwash and vigorously shaken for 60 s for simulating the natural mouth rinsing action. This procedure was repeated for 7 days, twice daily. To compare and assess the proportion of dentinal tubule occlusion, all the samples were processed and examined under an SEM.

Results

The efficacy of the mouthwash on the obliteration of dentinal tubules was compared using the Kruskal-Walis analysis of variance test followed by the post hoc Mann-Whitney U test for pairwise comparison. Group A showed completely occluded tubules in 5 (55.6) and mostly occluded tubules in 4 (44.4). Group B showed mostly occluded in 4 samples (44.4) and partially occluded in 5 samples (55.6) and Group C showed completely occluded tubules in 3 samples (33.3) and mostly occluded tubules in 6 samples (66.7). A P value of 0.05 or less is regarded as statistically significant. *P ≤ 0.05 is statistically significant. Between Group A and Group B as well as between Group B and Group C, there was a statistically significant difference. However, a statistically significant difference between Group A and Group C does not exist.

Conclusion

The calcium sodium phosphosilicate group was shown to have the most occlusion of the dentinal tubule, followed by dipotassium oxalate monohydrate and potassium nitrate group.

Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence

As the demand for clinically effective fluoride-free oral care products for consumers increases, it is important to document which types of toothpastes have been shown in clinical studies to be effective in improving oral health. In this review, we included different indications, i.e., caries prevention, improving periodontal health, reducing dentin hypersensitivity, protecting against dental erosion, and safely improving tooth whitening in defining what constitutes improvement in oral health. While there are several professional and consumer fluoride-containing formulations fortified with calcium-phosphate-based ingredients, this review focuses on fluoride-free toothpastes containing biomimetic calcium-phosphate-based molecules as the primary active ingredients. Several databases were searched, and only clinical trials in human subjects were included; in vitro and animal studies were excluded. There were 62 oral health clinical trials on biomimetic hydroxyapatite (HAP), 57 on casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), 26 on calcium sodium phosphosilicate (CSPS, or so called Bioglass), and 2 on β-tricalcium phosphate (β-TCP). HAP formulations were tested the most in clinical trials for benefits in preventing caries, dentin hypersensitivity, improving periodontal health, and tooth whitening. Based on the current clinical evidence to date, fluoride-free HAP toothpaste formulations are the most versatile of the calcium phosphate active ingredients in toothpastes for improving oral health.

A randomized clinical trial for comparing the efficacy of desensitizing toothpastes on the relief of dentin hypersensitivity

The 4-week double-blind clinical trial to manage dentin hypersensitivity (DH) using different desensitizing toothpastes was conducted. 53 participants with DH were enrolled in this trial. The participants were randomized into 3 groups: Group N; no active ingredient-containing toothpaste (Pleasia fluoride-free), Group SC; a toothpaste containing strontium chloride (Sensodyne Original), and Group TP; a toothpaste containing tricalcium phosphate (Vussen S). They were instructed to brush their teeth manually for 3 min, 3 times per day for 4 weeks with the allocated toothpastes, and were assessed at baseline (0), 2, and 4 weeks, respectively. Schiff sensitivity score was recorded to 3 different stimuli (air-blast, cold, and acid) at each assessment. Overall DH was also assessed using a visual analog scale (VAS). The longer participants used the toothpastes, the greater reduction in DH in all groups to the three stimuli. Group TP demonstrated significant reduction of DH compared to group N for air-blast and cold stimuli. Group TP showed significantly lower VAS than group N and SC. Tricalcium phosphate containing toothpaste used in this trial was most useful to reduce DH. It can be one of the treatment options that alleviate DH.

Comparative efficacy of self-administered dentifrices for the management of dentine hypersensitivity - A systematic review and network meta-analysis

OBJECTIVES

This systematic review with network meta-analysis synthesises available randomised controlled trials evidence concerning efficacy of self-administered dentifrices for management of dentine hypersensitivity (DH) pain.

STUDY SELECTION

Following systematic review registration (CRD42019154064), three data bases (MEDLINE, Embase, CENTRAL) were searched to December 2022 for parallel randomised controlled trials conducted in adults diagnosed with DH, using at least two recognised stimuli, assessing the short-term efficacy of home-use dentifrice treatment in reducing pain. Thirty-two studies and 4,638 participants were included. A Network meta-analysis (NMA) approach was used to compare relative effectiveness between interventions.

CONCLUSIONS

Twice daily application of self-applied dentifrice containing formulations of stannous, potassium +/- stannous, or arginine can be recommended for the reduction of dentine hypersensitivity pain. There is a need for standardised methodology guideline development to improve the conduct, analysis and reporting of DH clinical studies.

CLINICAL RELEVANCE

This is the first comprehensive NMA to be performed, that follows guidelines for conduct of DH trials to determine the efficacy of self-applied dentifrices for the management of dentine hypersensitivity. Indirect comparisons can be made between formulations that have not been compared to one another in randomised controlled trials.

Effect Of Calcium Silicate, Sodium Phosphate, and Fluoride on Dentinal Tubule Occlusion and Permeability in Comparison to Desensitizing Toothpaste: An In Vitro Study

This study compared the ability of a calcium silicate-, sodium phosphate-, and fluoride-based (CSSPF) toothpaste (TP) in promoting dentinal tubule occlusion and reducing dentin permeability with that of other commercially available antisensitivity TPs. Seventy-eight dentin discs (1.0±0.1 mm thick) were prepared from the midcoronal area and were treated with 37% phosphoric acid for 2 minutes; then they were randomly divided into six groups according to treatments: No treatment [positive control (PC)], entirely covered with nail varnish [negative control (NC)], hydroxyapatite (HAP)-containing TP [Desensin Repair (DES)], NovaMin-based [Sensodyne Repair & Protect (SEN)], CSSPF-based TP [Regenerate Advanced (REG)], sodium monofluorophosphate, potassium citrate, zinc citrate TP [Signal Sensitive Expert (SIG)]. Dentin permeability was tested by the dye percolation method (DP%). Scanning electron microscope (SEM) micromorphological and energy dispersive X-ray elemental analysis (EDX) of the dentin surfaces were done following each treatment. Results were analyzed using one-way analysis of variance (ANOVA) followed by Tukey post hoc test at a 95% confidence level (α=0.05). All the tested groups showed higher DP% than NC and lower percolation than the PC (p<0.05). REG and SIG were statistically comparable, and showed significantly lower DP% (p<0.05) than SEN and DES. None of the TPs tested was able to obliterate the lumen of the dentinal tubules (DT) completely. REG exhibited the highest weight percentage of calcium deposition, followed by SEN. Compared to the tested desensitizing TPs, CSSPF-based TPs demonstrated equal or less dentin permeability and better DT occlusion.

In situ evaluation of desensitizing toothpastes for protecting against erosive tooth wear and its characterization

OBJECTIVE

This five-phase, single-blind, crossover in situ trial evaluated the effects of desensitizing or anti-erosive toothpastes on dentin erosive wear and tubule occlusion.

MATERIALS AND METHODS

Some characteristics such as relative dentin abrasivity (RDA), viscosity (V), cytotoxicity, and fluoride and calcium (Ca) availability of the toothpastes were also tested. Samples were positioned on removable intraoral appliances from 15 volunteers (n=4), according to the groups, C-control (0 ppm fluoride), F-sodium monofluorophosphate (MFP), A-MFP and arginine+calcium carbonate, CSP-calcium sodium phosphosilicate, and CS-MFP and calcium silicate+sodium phosphate. Erosion-abrasion cycling was performed (1% citric acid, 2min, 6×/day; toothbrushing, 5s, 2×/day). Surface loss (SL) was evaluated by optical profilometry. Environmental scanning electron microscopy images (ESEM) counted the number of open dentin tubules (ODTs). Data were statistically analyzed (α=0.05).

RESULTS

There were no significant differences in SL among groups (p=0.468). The ODT for CSP, CS, and A groups were significantly lower than the control. CSP and CS presented significantly less ODT than F, but they did not significantly differ from A. F and CS were more abrasive than all the other toothpastes; CSP was more abrasive than A, and C was the least abrasive. CSP presented higher V (p<0.05). All toothpastes presented lower cell viability than the control without toothpaste exposure. F and A presented significantly higher values of F^- (p<0.05). All fluoride toothpastes had similar amount of Ca, differing from the control (p<0.05).

CONCLUSION

Although the toothpastes caused similar degree of erosive wear, CSP and CS were able to occlude the dentin tubules.

CLINICAL RELEVANCE

Desensitizing toothpastes containing calcium, sodium, phosphate, and silicate could be a suitable option for treating dentin hypersensitivity.

Efficacy of a dissolvable strip with calcium sodium phosphosilicate (NovaMin®) in providing rapid dentine hypersensitivity relief

OBJECTIVE

To evaluate the efficacy of a dissolvable strip containing 15% w/w calcium sodium phosphosilicate (CSPS) (Novamin®) in providing rapid relief from dentine hypersensitivity (DH).

METHODS

In this examiner-blind, proof-of-principle study, 120 healthy adults with DH were randomized 1:1 to the Test strip, professionally applied to facial surfaces of two selected teeth, or to No treatment. Sensitivity was assessed at baseline and 10min, 2h and 4h post-application in response to evaporative (air) and tactile stimuli (measured by Schiff sensitivity scale/a numeric rating scale and tactile threshold, respectively). Change from baseline was analyzed by ANCOVA.

RESULTS

At 10min post-application, mean Schiff score change from baseline (primary endpoint) was statistically significant with the Test strip (-0.46; 95% confidence intervals [CI]: -0.563, -0.356; p<0.0001) but not with No treatment (-0.02; 95% CI: -0.119, 0.088; p=0.7664). The between-treatment group difference favored the Test strip (difference: -0.44; 95% CI: -0.591, -0.297; p<0.0001). Similar improvements with the Test strip were reported for all other evaporative (air) and tactile sensitivity endpoints (p<0.0001 vs no-treatment) at all timepoints (10min, 2h, 4h). Test strips were considered by most staff and participants slightly/moderately easy to apply (98%). Many participants rated the overall usage experience as "like moderately" (40%) or "like extremely" (20%). There were no treatment-related adverse events.

CONCLUSION

This new CSPS-based technology may provide a novel treatment option for rapid relief from DH (Clinicaltrials.gov NCT02937623).

CLINICAL SIGNIFICANCE

A dissolvable strip containing 15% w/w calcium sodium phosphosilicate (CSPS) demonstrated significantly greater dentine hypersensitivity reductions following a single application compared with no treatment. Strips were well-liked by participants and generally well tolerated. A strip containing CSPS, which dissolves within 10min, may provide rapid relief from dentine hypersensitivity.

[Effect of calcium sodium phosphosilicate and potassium nitrate on dentin hypersensitivity: a systematic review and Meta-analysis]

OBJECTIVE

This systematic review and Meta-analysis aimed to compare the efficacy of calcium sodium phos-phosilicate (CSPS) and potassium nitrate as desensitizing agents for the treatment of dentin hypersensitivity (DH).

METHODS

A thorough search in The Cochrane Library, PubMed, Embase, Chinese WanFang Data, CBM, and CNKI were conducted for studies published up to June 2017. Randomized controlled trials (RCTs) of the treatment of DH with CSPS and potassium nitrate toothpaste were included. Quality assessment and data extraction were performed by two reviewers independently, and Meta-analysis was performed by using RevMan 5.3 software.

RESULTS

Eight RCTs involving 411 patients were included. Experimental group comprised 203 and control group had 208 patients. The Meta-analysis indicated the superior effect of CSPS dentifrice on air blast sensitivity at 2, 4, 6, and 8 weeks of follow-up [SMD=-1.85, 95%CI (-2.89, 
-0.81), P=0.000 5, I²=93%], [SMD=-1.61, 95%CI (-1.96, -1.26), P<0.000 01, I²=49%], [SMD=-3.79, 95%CI (-7.18, -0.40), P=0.03, I²=98%], and [SMD=-2.13, 95%CI (-2.69, -1.58), P<0.000 01] , respectively. No significant effects were seen at 12 weeks [SMD=-0.63, 95%CI (-1.47, 0.20), P=0.14, I²=71%]. CSPS dentifrice showed a better desensitizing effect at 2, 4, 6, 8, and 12 weeks of follow-up on cold water sensitivity [SMD=-1.07, 95%CI (-1.48, -0.66), P<0.000 01, I²=69%], [SMD=
-1.29, 95%CI (-1.81, -0.76), P<0.000 01, I²=64%], [SMD=-1.20, 95%CI (-1.57, -0.83), P<0.000 01, I²=86%], [SMD=-1.30, 95%CI (-2.51, -0.08), P=0.04, I²=82%], and [SMD=-0.79, 95%CI (-1.27, -0.31), P=0.001], respectively. No significant effects at 1 week of follow-up [SMD=0.00, 95%CI (-0.62, 0.62), P=1]. The favorable effect of CSPS dentifrice on tactile sensitivity was more obvious than the control group at 2, 4, and 8 weeks of follow-up [SMD=-1.31, 95%CI (-2.00, -0.62), P=0.000 2, I²=67%], [SMD=-1.37, 95%CI (-1.74, -0.99), P<0.000 01, I²=23%], and [SMD=-1.33, 95%CI (-1.82,-0.84), P<0.000 01], respectively. No significant effects at 1 week of follow-up [SMD=-0.32, 95%CI (-0.94, 0.31), P=0.32] were observed.

CONCLUSIONS

Current evidence indicated that CSPS was more effective than potassium nitrate at reducing DH. The evidence generated by this review was based on a small number of individuals. High-quality and large sample size as well as ideally-designed clinical trials are required in the future before definitive recommendations can be made.

Clinical study to monitor dentinal hypersensitivity with episodic use of a desensitising dentifrice

Objectives/Aims:

To evaluate continuous and episodic twice-daily usage regimens of a desensitising dentifrice containing 5% calcium sodium phosphosilicate (CSPS).

Materials and Methods:

In this exploratory, single-centre, randomised, examiner-blind study, subjects with dentinal hypersensitivity were randomised to continuous (24 weeks) use of a 5% CSPS-containing dentifrice or episodic use of the dentifrice comprising two 8-week treatment periods separated by 8 weeks′ use of a standard fluoride dentifrice. Sensitivity was assessed by tactile threshold (Yeaple probe) and evaporative (air) sensitivity (Schiff sensitivity score). Other measures included labelled magnitude scales to assess subjects′ responses to the evaporative stimulus, the Dentine Hypersensitivity Experience Questionnaire and a tooth sensitivity question.

Results:

Seventy-six subjects were randomised to continuous (n=38) or episodic (n=38) use. Small but statistically significant improvements from baseline in Schiff sensitivity scores were observed at weeks 8, 16 and 24 with both regimens (all P<0.05). Increases from baseline in tactile threshold were not statistically significant. No significant between-regimen difference was observed for any endpoint. No treatment-related adverse events were reported.

Discussion:

Dentifrice containing 5% CSPS improved dentinal hypersensitivity with both episodic and continuous twice-daily usage regimens over 24 weeks and was well tolerated.

Conclusion:

No performance differences were observed between the two usage regimens.

Dentinal Tubule Occluding Effect of Potassium Nitrate in Varied Forms, Frequencies and Duration: An In vitro SEM Analysis

INTRODUCTION

Dentinal hypersensitivity is an exaggerated response to non-noxious sensory stimuli (osmotic, thermal or mechanical changes). An inverse relationship between occluding open tubules and the intensity of sensitivity has been reported. Studies on the efficacy of potassium nitrate used in different forms and frequencies to occlude dentinal tubules are scarce.

AIM

To evaluate, in vitro the dentinal tubule occluding effect of potassium nitrate which differ in form, frequency and duration of application.

MATERIALS AND METHODS

In an in vitro study, 45 extracted human maxillary and mandibular premolars were sectioned using diamond disc to obtain 90 samples which were treated with 6% citric acid and were randomly assigned to three groups: Group 1 was treated with potassium nitrate toothpaste (once and twice daily for two minutes); Group 2 with potassium nitrate mouthwash (once and twice daily for two minutes) and Group 3 served as control (distilled water). Post-treatment, the samples were immersed in distilled water. The samples were subjected to Scanning Electron Microscopy (SEM) at the end of 3, 7 and 14 days. SEM photographs were analysed based on extent of tubular occlusion. Chi-square test was applied to assess the significant difference between the groups.

RESULTS

There was detectable difference in the dentinal tubule occlusion at the end of 3^rd, 7^th and 14^th day between three groups. When compared to the mouthwash, toothpaste yielded better results. Twice daily application for a period of two minutes each was better when compared to once daily for two minutes.

CONCLUSION

Potassium nitrate is effective in occluding dentinal tubules when applied twice daily in toothpaste form than mouthwash form. However, randomised control trials are needed to confirm its efficacy in human subjects.

Exploratory randomised controlled clinical study to evaluate the comparative efficacy of two occluding toothpastes - a 5% calcium sodium phosphosilicate toothpaste and an 8% arginine/calcium carbonate toothpaste - for the longer-term relief of dentine hypersensitivity

OBJECTIVE

To compare the longer-term clinical efficacy of two occlusion-technology toothpastes - a 5% calcium sodium phosphosilicate (CSPS) toothpaste and a commercially available 8% arginine/calcium carbonate toothpaste - in relieving dentine hypersensitivity (DH). Efficacy was also compared with that of a regular fluoride toothpaste control.

METHODS

This was an exploratory, randomised, examiner-blind, parallel-group, 11-week, controlled study in healthy adults with self-reported and clinically diagnosed DH. After an acclimatisation period, subjects were randomised to one of three study treatments with which they brushed their teeth twice daily. Sensitivity was assessed at baseline and after 1, 2, 4, 6 and 11 weeks treatment in response to evaporative (air) and tactile stimuli (measured by the Schiff Sensitivity Scale/visual analogue scale and tactile threshold, respectively).

RESULTS

A total of 135 subjects were randomised to treatment. The two occlusion-technology toothpastes performed similarly over the 11-week treatment period. All study treatments showed statistically significant reductions from baseline in DH at all timepoints for all measures (p<0.05). Statistically significant and clinically relevant sensitivity relief was observed for both occluding formulations compared with the regular fluoride toothpaste: for evaporative (air) sensitivity within 1 week and for tactile sensitivity at Week 11. No significant differences were detected between the two occluding formulations at any timepoint, for any endpoint. Study treatments were generally well tolerated.

CONCLUSIONS

In this exploratory study, a 5% CSPS occluding toothpaste was effective in relieving DH compared with a regular fluoride toothpaste; an 8% arginine/calcium carbonate anti-sensitivity toothpaste provided similar benefits. Improvements in DH continued throughout the 11-week study.

CLINICAL SIGNIFICANCE

Dentine hypersensitivity (DH) is a common and painful condition. Twice-daily use of a 5% calcium sodium phosphosilicate toothpaste reduces DH within 1-2 weeks of initiating use. Ongoing, twice daily use of the sensitivity toothpastes evaluated in this study was associated with continued, clinically significant improvements in DH.

Comparative Evaluation of Effectiveness of Three Desensitizing Tooth Pastes for Relief in the Dentinal Hypersensitivity

Context:

Dentinal hypersensitivity is a sharp pain occurring on exposure of the exposed dentin to various stimuli such as hot, cold, air, tactile, and chemical.

Aim:

This study aimed to compare the effectiveness of three desensitizing pastes in the treatment of dentinal hypersensitivity.

Materials and Methods:

A total of 45 individuals (with two teeth per patient) were considered for this study and randomly divided into three groups, Group 1: treated with 5% NovaMin-containing toothpaste, Group 2: treated with 8% arginine-containing toothpaste, and Group 3: herbal desensitizing toothpaste. Using tactile stimulus and air stimulus, the sensitivity scores were recorded on visual analog scale (VAS), immediately after paste application, then at 2 weeks, and then at the end of 4 weeks and compared.

Results:

There was a significant change in the VAS scores in Group 1 when compared to Group 2 and Group 3. Group 1 showed better reduction in the hypersensitivity in long term.

Statistical Analysis:

One-way ANOVA test, post hoc Tukey test, and post hoc Bonferroni test were used for statistical analysis.

Conclusion:

Desensitizing pastes can be an effective and economical option in the treatment of the dentinal hypersensitivity.

The Effect of Calcium Sodium Phosphosilicate on Dentin Hypersensitivity: A Systematic Review and Meta-Analysis

OBJECTIVE

To investigate the effect of calcium sodium phosphosilicate (CSPS) in treating dentin hypersensitivity (DH) and to compare this effect to that of a negative (placebo) control.

MATERIALS AND METHODS

Several databases, including Medline, EMBASE, Web of Science, The Cochrane Library, and the Chinese Biomedical Literature Database, were searched to identify relevant articles published through January 2015; grey literature (i.e., academic literature that is not formally published) was also searched. Two authors performed data extraction independently and jointly using data collection forms. The primary outcome was the DH pain response to routine activities or to thermal, tactile, evaporative, or electrical stimuli, and the secondary outcome was the side effects of CSPS use. Each study was evaluated using the Cochrane Collaboration tool for assessing risk bias. Meta-analysis of studies with the same participant demographics, interventions, controls, assessment methods and follow-up periods was performed. The Grading of Recommendations Assessment Development and Evaluation System was used to assess the quality of the evidence and the risk of bias across studies.

RESULTS

Meta-analysis demonstrated that toothpaste containing 5% CSPS was more effective than the negative control at relieving dentin sensitivity, with the level of evidence classified as "moderate". In addition, prophylaxis paste containing 15% calcium sodium phosphosilicate was favored over the negative control at reducing post-periodontal therapy hypersensitivity, with the level of evidence categorized as "low". Only two studies reported side effects of CSPS use.

CONCLUSIONS

The majority of studies found that calcium sodium phosphosilicate was more effective than the negative control at alleviating DH. Because strong evidence is scarce, high-quality, well-designed clinical trials are required in the future before definitive recommendations can be made.

Assessment of Pain Intensity in Patients with Dentin Hypersensitivity After Application of Prophylaxis Paste Based on Calcium Sodium Phosphosilicate Formula

Background

One of many functions of the pulp-dentin complex is sensory function. Acute, situated, receding pain after the cessation of the stimulus action is called dentin pain. Dentin hypersensitivity has been described as one of the most painful and least successfully treated chronic ailments of teeth. The aim of this research was the clinical evaluation of the effectiveness of professional polishing paste containing calcium sodium phosphosilicate formula (NovaMin) in eliminating dentin hypersensitivity after a single application.

Material/Methods

The study comprised 92 teeth with dentin hypersensitivity diagnosed on the basis of history and clinical examination. The pain reaction of exposed dentine was induced by tactile and dehydrating stimuli, asking patients to assess the severity of pain on the VAS scale. Clinical trial and survey were carried out twice: before and 1 week after the application of the polishing paste.

Results

After the application of the examined paste, the percentage of teeth reacting with a severe pain to the touch of the probe decreased from 16.3% to 4.3%, and with a moderate pain from 42.4% to 12%. Examination after applying dehydrating stimulus a week after carrying out the application showed a decrease in the proportion of teeth with strong pain from 28.3% to 0% and moderate pain from 38% to 15.2%. The lack of pain increased from 12% to about 50%.

Conclusions

The use of prophylactic professional paste with NovaMin formula in in-office procedure provides the reduction of dentin hypersensitivity noticeable by 1 week after application.

The Efficacy of Selected Desensitizing OTC Products: A Systematic Review

Objectives. The aim of the present study was to review the published literature in order to identify relevant studies for inclusion and to determine whether there was any evidence on the clinical effectiveness of selected desensitizing toothpastes, calcium sodium phosphosilicate (CSPS), amorphous calcium phosphate (ACP), nanohydroxyapatite, and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) on reducing dentine hypersensitivity (DH). Materials and Methods. Following a review of 593 papers identified from searching both electronic databases (PUBMED) and hand searching of relevant written journals, only 5 papers were accepted for inclusion. Results. Analysis of the included studies (3 CSPS and 2 ACP) would suggest that there may be some benefit for patients using these products for reducing DH. No direct comparative studies were available to assess all these products under the same conditions neither were there any comparative randomised controlled studies that compared at least two of these products in determining their effectiveness in treating DH. Conclusions. Due to the small number of included studies, there are limited clinical data to support any claims of clinical efficacy of these OTC products. Further studies are therefore required to determine the efficacy of these products in well-controlled RCT studies with a larger sample size.