Treating cervical dentin hypersensitivity with fluoride varnish: a randomized clinical study

BACKGROUND: This subject-blind randomized clinical trial tested the efficacy of a new 5 percent sodium fluoride varnish (AllSolutions Fluoride Varnish, Dentsply Professional, York, Pa.) for treatment of cervical dentin hypersensitivity. The authors also compared the test varnish with a control fluoride varnish (Duraphat, Colgate Oral Pharmaceuticals, New York City). METHODS: The study involved application of the test or control varnish to 19 subjects (59 teeth) with tooth sensitivity. The authors applied each product once to each tooth, following manufacturers' instructions. They used a visual analog scale (VAS) to assess subjects' responses to compressed air and ice stimuli at six weeks before baseline, at baseline and at two, eight and 24 weeks after treatment. RESULTS: Mean VAS scores for teeth receiving the test varnish dropped from 34.9 (air) and 68.0 (ice) at baseline to 26.3 (air) and 54.7 (ice) at two weeks after treatment. Mean scores at 24 weeks were 20.6 (air) and 34.8 (ice), representing statistically significant differences from baseline values. For the control varnish, mean VAS scores dropped from 36.9 (air) and 64.2 (ice) at baseline to 32.9 (air) and 47.2 (ice) at two weeks, and to 20.8 (air) and 40.3 (ice) at 24 weeks. The authors analyzed the data for statistical significance, accounting for clustering of teeth within subjects. CONCLUSION AND CLINICAL IMPLICATIONS: The test varnish was effective in reducing cervical dentin hypersensitivity. However, the efficacy was not significantly different from that of the control varnish.     

Clinical evaluation of low-level laser therapy and fluoride varnish for treating cervical dentinal hypersensitivity

The aim of this study was to evaluate in vivo the use of low-level galium-aluminium-arsenide (GaAlAs) (BDP 600) laser and sodium fluoride varnish (Duraphat) in the treatment of cervical dentine hypersensitivity. Twelve patients, with at least two sensitive teeth were selected. A total of 60 teeth were included in the trial. Prior to desensitizing treatment, dentine hypersensitivity was assessed by a thermal stimulus and patients' response to the examination was considered to be a control. The GaAlAs laser (15 mW, 4 J/cm2) was irradiated on contact mode and fluoride varnish was applied at cervical region. The efficiency of the treatments was assessed at three examination periods: immediately after first application, 15 and 30 days after the first application. The degree of sensitivity was determined following predefined criteria. Data were submitted to analysis and no statistically significant difference was observed between fluoride varnish and laser. Considering the treatments separately, there was no significant difference for the fluoride varnish at the three examination periods, and for laser therapy, significant difference (P < 0.05) was found solely between the values obtained before the treatment and 30 days after the first application. It may be concluded that both treatments may be effective in decreasing cervical dentinal hypersensitivity. Moreover, the low-level GaAlAs laser showed improved results for treating teeth with higher degree of sensitivity.     

护牙素治疗牙本质敏感症的临床疗效及扫描电镜观察

目的：探讨护牙素治疗牙本质敏感症的临床疗效,并观察其再矿化能力。方法：60例240颗患牙随机分为氟化物涂膜组,护牙素组,护牙素＋氟化物涂膜组。第0d、7d接受治疗,第1d、7d、30d,视觉模拟评分法（VAS法）评价其临床疗效。制作离体牙标本,扫描电镜观察上述三种方法对牙本质小管的封闭效果。结果：与治疗前基线比较,氟化物涂膜组和护牙素＋氟化物涂膜组,第1d、第7d和第30d各个时间点均有显著改善（P〈0.05）;护牙素组,第1d有显著改善（P〈0.05）,第7d和第30d无显著效果（P〉0.05）。不同时间点,氟化物涂膜组疗效显著优于护牙素组、护牙素＋氟化物涂膜组疗效显著优于护牙素组和氟化物涂膜组（P〈0.05）。SEM显示大量钙化物沉积于护牙素＋氟化物涂膜组牙本质小管内。结论：护牙素单独使用,治疗牙本质敏感症的效果欠佳。但作为一种辅助治疗手段,可以增强氟的治疗效果。     

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目的评价氟化泡沫与氟保护漆治疗龈下刮治及根面平整术后敏感的效果。方法选取2009年9月至2011年3月北京大学口腔医院门诊部牙周科行龈下刮治及根面平整术后1周有1颗以上的切牙中等程度敏感的患者209例（患牙503颗）,根据患者的年龄、性别、牙齿数目分层,随机分为对照组（采用生理盐水涂檫根面）、氟保护漆组（采用氟保护漆脱敏治疗）、氟化泡沫组（采用氟化泡沫脱敏治疗）。用视觉模拟评分（VAS）法对牙齿敏感程度进行评估,分别于脱敏前以及脱敏后即刻、1周、1个月记录VAS值,并记录各组临床操作时间。结果脱敏前各组VAS值相近,差异无统计学意义（P〉0．05）;脱敏后各时间点对照组与其余两组差异有统计学意义（P〈0．05）;氟保护漆组在脱敏后1周和1个月时VAS值均低于氟化泡沫组,但差异无统计学意义（P〉0．05）。氟保护漆组每颗牙的平均{临床操作时间与其余两组差异有统计学意义（P〈0．05）。结论氟化泡沫和氟保护漆均可减轻龈下刮治和根面平整术后敏感的程度,氟化泡沫操作更简单,更适合临床推广使用。     

Effect of a fluoride varnish (Duraphat®) in preschool children

The caries-preventive effect of semiannual applications of a fluoride varnish (Duraphat) was tested for 2 years in 225 3-year-old children; 113 children served as a control group. At the baseline examination, 69% of the children in the test group and 75% in the control group were caries-free. The results after 2 years showed an average caries increment of 2.1 surfaces in the test group and 3.7 in the control group. The difference is statistically significant. Thirty-eight percent of the children in the test group and 27% in the control group were still caries-free. The caries reduction was 44%.     

Instant dentin hypersensitivity relief of a single topical application of an in-office desensitizing paste containing 8% arginine and calcium carbonate: A split-mouth,randomized-controlled study

Abstract

Objective. The aim of this study was to evaluate the clinical efficacy of an in-office desensitizing paste containing 8% arginine and calcium carbonate relative to calcium carbonate alone in the reduction of dentin hypersensitivity in a randomized, double-blind, split-mouth clinical trial. Materials and methods. Sixty teeth (30 subjects) with an air blast hypersensitivity score of 2 or 3 (Schiff Cold Air Sensitivity Scale) were randomly assigned to one of two treatment groups: (1) test paste containing 8% arginine and calcium carbonate (elmex sensitive professional desensitizing paste) and (2) control paste: paris white (calcium carbonate). Tactile and air blast dentin hypersensitivity examinations were performed at baseline, immediately after paste application and 4 and 12 weeks later. Results. A statistically significant difference in air blast (p = 0.001) and tactile (p = 0.047) hypersensitivity reduction over time was observed between the two therapy modes. After 12-weeks, statistically significant differences were indicated between the test and control group with respect to baseline-adjusted mean tactile (41.94%; p = 0.038) and air blast hypersensitivity scores (46.5%; p = 0.017). Conclusions. The tested in-office desensitizing paste containing 8.0% arginine and calcium carbonate provides significantly greater hypersensitivity relief compared to calcium carbonate alone.     

两种脱敏药物治疗牙周手术后牙本质敏感症的临床疗效

目的:评价氟保护漆和精氨酸磷酸钙用于牙周根向复位瓣术后早期对根面牙本质敏感症的临床疗效。方法:选择90例重度牙周炎行牙周手术后发生根面牙本质敏感症的病人,共357个患牙,随机分为A、B、C 3组,每组各119个。A组:氟保护漆涂擦法脱敏;B组:精氨酸磷酸钙脱敏抛光膏脱敏;C组(空白对照):不用任何药物。在治疗后即刻和1周后进行脱敏疗效比较。结果:与空白对照组比较,氟保护漆和脱敏抛光膏均有良好的脱敏效果(P<0.05);而两种脱敏药物之间比较无统计学意义(P﹥0.05)。结论:氟保护漆和高露洁脱敏抛光膏在行牙周根向复位瓣术后局部早期应用均能有效减少根面牙本质敏感症的发生,两者均值得临床推广应用。     

Effect of a combination of fluoride dentifrice and varnish on enamel surface rehardening and fluoride uptake in vitro

The purpose of this study was to evaluate the effect of combining fluoride dentifrice (FD) and varnish (FV) on in vitro enamel surface rehardening and on fluoride uptake under a pH-cycling regimen. Seventy-eight bovine enamel blocks with early lesions were used and 52 were divided into four treatment groups: (a) placebo non-fluoridated dentifrice (PD); (b); FD (1100 p.p.m. F as NaF); (c); FV (Duraphat) + PD; and (d) FV + FD. The FV was applied to enamel blocks of groups FV + PD and FV + FD before the pH-cycling regimen, and all of them were submitted to dentifrice during cycling. Surface enamel microhardness was determined on the dental blocks before and after demineralization, and after the pH-cycling regimen. The percentage of surface microhardness recovery (%SMHR) was calculated. Fluoride in the blocks was also determined, after removing three layers of enamel. The highest values of percentage SMHR were observed for the FD group. The greatest fluoride uptake was found in the FD and FV + FD groups, but the difference between them was not statistically significant. It was found that the frequent use of fluoride dentifrice resulted in greater benefit in enamel surface rehardening, with a similar effect on fluoride uptake, when compared with its combination with a single fluoride varnish application.     

The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study

OBJECTIVES: To test the hypothesis that fluoride varnish is effective in reducing demineralization (white spot) lesions adjacent to bonded orthodontic brackets. DESIGN: Two similar samples of extracted bovine incisors, with bonded orthodontic brackets, were separated into an experimental group (fluoride varnish was applied) and control group (no fluoride varnish) to examine the preventive effects of fluoride varnish. SETTING AND SAMPLE POPULATION: The dental clinic of the State University of Maringá--UEM (Maringá, Paraná, Brazil). Thirty-eight extracted bovine incisors with bonded orthodontic brackets. EXPERIMENTAL VARIABLE: Fluoride varnish was applied topically to half of the sample of extracted bovine teeth. No varnish was applied to the other half. OUTCOME MEASURE: The depths of enamel demineralization (white spot) lesions were measured from polarized light microscopy images using image analysis software. RESULTS: The teeth in both the experimental and control groups had been exposed to a cariogenic environment twice a day for 35 days. Those teeth that had been treated with two applications of fluoride varnish (one at the outset and another 15 days later) demonstrated about 38% less mean lesion depth than teeth where no varnish had been applied. CONCLUSION: Orthodontists may wish to consider the application of fluoride varnish during fixed orthodontic therapy to help reduce the development of enamel white spot lesions.     

奥威尔脱敏剂治疗牙本质过敏症的疗效比较观察

目的 观察新型牙本质脱敏剂奥威尔用于治疗牙本质过敏症的临床疗效。方法 选择临床2～3度牙本质过敏症牙本质过敏患者93例189颗患牙,分别应用奥威尔脱敏剂、Gluma脱敏剂及氟化钠甘油对牙齿过敏区进行处理,观察治疗后的即刻疗效以及1、3个月后的持续效果。结果 奥威尔脱敏剂、Gluma脱敏剂及氟化钠甘油3种脱敏剂的即刻有效率分别是:97.01%、90.32%、71.67%,奥威尔与GLUMA脱敏剂组疗效相似,而与氟化钠甘油组相比有显著性差异(P<0.05);1个月后临床治疗有效率观察分别为91.04%、77.42%、61.67%,3个月后观察有效率分别为86.57%、61.29%、46.67%,结果经统计学分析,3组间差异具有统计学意义(P<0.05)。结论 奥威尔牙齿脱敏剂治疗牙齿过敏症具有较好疗效。     

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目的科学评价国内文献报道的奥威尔脱敏剂治疗牙本质过敏症的疗效和安全性。方法网络检索1990---2013年中国生物医学数据库、中国网络期刊全文数据库、万方数据库、维普数据库,收集以奥威尔脱敏剂作为治疗组治疗牙本质过敏症的随机对照试验。通过纳入和排除标准筛选文献,按照Cochrane系统评价方法纳入研究质量,提取数据,用REVMAN5．2软件对同质性研究进行Meta分析。结果纳入6篇研究涉及543例患者共780颗患牙。其中：奥威尔脱敏剂治疗牙本质过敏症即刻疗效的Meta分析,RR值为1．28,RR〉1,95％可信区间为（1．13,1．45）,P〈0．0001;奥威尔脱敏剂治疗牙本质过敏症1个月疗效的Meta分析,合并RR值为1．26,RR〉1,95％可信区间为（O．94,1．71）,P〉0．01（=0．13）;奥威尔脱敏剂治疗牙本质过敏症2个月疗效的Meta分析,只有程秀慧的研究包括,2个月的随访数据,不存在合并分析,单纯由此得到P〉0．01（=0．08）;奥威尔脱敏剂治疗牙本质过敏症3个月疗效的Meta分析,合并RR值为1．39,RR〉1,95％可信区间为（1．11,1．73）,P〈0．01（=0．004）;奥威尔脱敏剂治疗牙本质过敏症6个月疗效的Meta分析,合并RR值为2．14,RR〉1,95％可信区间为（1．77,2．60）,P〈0．00001。结论奥威尔脱敏剂治疗牙本质过敏症在即刻、3个月、6个月的疗效优于单纯使用75％氟化钠甘油;在1个月和2个月的疗效尚无足够的研究数据得出此结论。     

Effects of a sodium fluoride solution and a varnish with different fluoride concentrations on enamel remineralization in vitro

Abstract – To study the efficacy of sodium fluoride varnishes and a NaF solution in remineralization of enamel, 120 slabs of non-carious human enamel enamel were presoftened for 6 h and randomly divided into six groups. The slabs were stored in synthetic saliva for 9 days, except for a daily 30-min immersion in 0.1 M lactic acid-NaOH buffer. During the 9-day period, one group of the slabs received no treatment, and the rest were treated once or three times with 2.3% or 1.1% sodium fluoride varnish Duraphat, or nine times with a 0.1% NaF solution. Finally, the slabs were demineralized for 1 h, and the amount of dissolved Ca and F was determined. Microhardness of enamel was determined initially, after presoftening, after the 9- day period, and after the 1-h demineralization. All fluoride treatments prevented enamel softening almost completely during the 9 days, but the control slabs softened markedly. Fluoride varnishes were more effective than NaF solution. Three applications of 2.3% Duraphat were slightly more effective than any of the other varnish treatments, but one treatment with 2.3% varnish was not more effective than treatments with 1.1% varnish. Enamel treated three times with 1.1% varnish showed the greatest acid resistance during the 1-h demineralization. The results suggest that the efficacy of the varnish was not proportional to the fluoride concentration but rather to the number of applications. Fluoride uptake by enamel was greatest with the most concentrated varnish. Enamel solubility was not, however, directly proportional to the fluoride content of enamel.     

GLUMA CPS脱敏性粘接系统治疗牙本质过敏症的临床研究

目的：试验GLUMA CPS脱敏性粘接系统治疗牙本质过敏症的疗效,并探索其最佳应用方式。方法：将152例361个患牙随机分为4组,3个实验组分别用GLUMA CPS粘接系统中的Primer(牙本质粘接剂）、Conditioner(酸蚀处理剂）＋Primer即C＋P、Conditioner Primer Sealer(封闭剂）即C＋P＋S进行脱敏治疗;对照组用75％氟化钠甘油脱敏,比较各组的有效率,3月后复查。结果：C＋P和C＋P＋S两组有效率显著高于另外两组（P＜0．01）,且两组之间无显著差异（P＞0．05）,3月后亦然。结论：GLUMA CPS脱敏性粘接系统对牙本质过敏症疗效确切而持久,C＋P为其最佳应用方式。     

RECOLITE治疗老年人静止根面龋伴牙本质过敏症的临床研究

目的:观察RECOLITE(脱敏王)治疗老年人静止根面龋伴牙本质过敏症的疗效.方法:实验组使用RECOLITE,对照组使用0.48mol/L的氟化钠溶液.记录第3次治疗后的疗效及实验组3个月后的随访结果.结果:实验组:显效50颗(90.90%),有效3颗(5.45%),无效2颗(3.63%),总有效53颗(96.36%);对照组:显效23颗(40.90%),有效29颗(52.72%),无效3颗(5.45%),总有效52颗(94.90%).两组总有效率差异无显著性(P＞0.05),显效率差异显著(P＜0.05).3个月后实验组疗效:显效43颗(89.58%),有效3颗(6.25%),无效2颗(4.16%),总有效46颗(95.83%).结论:RECOLITE对老年人静止根面龋既有消毒作用又对其伴牙本质过敏症具有治疗作用.     

四种治疗牙本质过敏方法的临床效果研究

目的 通过使用极固宁(A组)、75%氟化钠甘油 (B组)、50%麝香草酚溶液(C组)和自酸蚀粘接剂(D组)治疗牙本质过敏症,观察脱敏疗效.方法 将128例患者中诊断牙本质过敏的240颗牙随机分为 A、B、C、D 4组, 分别用4种脱敏方法治疗1疗程, 即刻及3个月后观察比较疗效.结果 A组即刻及3个月后脱敏有效率均显著优于 B、C、D组 (P＜0.01). 结论 极固宁为相对快速,有效的牙本质脱敏剂.     

Effect of fluoride on caries progression and dentin apposition in rats fed on a cariogenic or non-cariogenic diet

The effect of fluoride in drinking water on the progression of dentinal caries and dentin apposition was studied in Wistar rats. The initiation of enamel caries lesions was first induced for 2 wk with S. sobrinus and a 43% sucrose diet after weaning. Thereafter the animals were fed on either a cariogenic or a non-cariogenic diet and distilled water supplemented with 0, 1, 7 or 19 ppm fluoride. The areas of dentinal caries and dentin apposition were quantified after tetracycline staining. Fluoride reduced dentinal caries progression after the initiation of lesions in the presence of a cariogenic diet at a concentration of 19 ppm F, and without sucrose at 1 ppm F. The effect of fluoride in reducing dentin apposition with a cariogenic diet was dose-dependent, whereas fluoride in non-cariogenic groups had practically no effect on dentin formation. These results suggest that fluoride together with a high concentration of sucrose in the diet might have an odontoblast-mediated effect on the regulation of the progression of dentinal caries.     

QLF法研究一种含氟涂料对离体牛牙釉质的抗酸性效果

目的：采用定量光导荧光系统观察含氟涂料对牛牙釉质的抗酸性效果。方法：20个新鲜拔除的牛前牙,于每个标本唇面建立4个2mm×2mm开窗,随机分为4组,分别用含氟涂料、含氟牙膏、1%氟化钠溶液、去离子水处理,然后浸泡在脱矿液中,分别于处理的第1,2,4,8d,采用QLF法检测各组标本的荧光损失量△F（%）和病变面积△P（mm2）,计算△Q（%,mm2）,并再次处理。结果：用含氟涂料处理的牛牙釉质龋标本,再矿化面积最多、△Q降低最大,且与其他处理组有显著差异（P〈0.05）。结论：同其它方法相比,含氟涂料有利于增进离体牛牙釉质的抗酸性。     

Uptake of KOH-soluble and KOH-insoluble fluoride in sound human enamel after topical application of a fluoride varnish (Duraphat) or a neutral 2% NaF solution in vitro

The uptake of alkali-soluble fluoride (calcium fluoride-like material and adsorbed fluoride) and alkali-insoluble fluoride (apatitically bound fluoride) on sound human enamel from treatment with Duraphat or a neutral 2% NaF solution was investigated in vitro. Blocks from impacted third molars were used. More fluoride was deposited on the enamel from the neutral 2% NaF solution than from the Duraphat treatment. All the fluoride could be dissolved in alkali. Globules of calcium fluoride-like material were demonstrated by scanning electron microscopy. Chemical analysis showed no measurable increase in the apatitically bound fluoride (alkali-insoluble fluoride) after brief exposures. Duraphat-treated samples submerged in water after the exposure lost only about 50% of the deposited fluoride, whereas samples treated with 2% NaF are known to lose all their fluoride under similar circumstances, a condition which may be related to the favorable clinical effect of Duraphat.