Short-term assessment of the Nd:YAG laser with and without sodium fluoride varnish in the treatment of dentin hypersensitivity--a clinical and scanning electron microscopy study

BACKGROUND: The aim of the present study was to evaluate clinically and under scanning electron microscopy (SEM) the efficacy of Nd:YAG laser irradiation alone and in combination with 5% sodium fluoride varnish in the management of dentin hypersensitivity. Methods: The study was conducted on 40 patients divided into four groups who had at least one tooth of Grade III mobility with clinically elicitable dentin hypersensitivity. Following the pretreatment assessment of hypersensitivity using the visual analog scale (VAS) and cold air blast test, the selected tooth in all the groups received 1% citric acid treatment for 1 minute. Group 1 patients received no further treatment; group 2, 3, and 4 patients received additional treatment with 5% sodium fluoride varnish, Nd:YAG laser for 2 minutes, and a combination of 5% sodium fluoride varnish and Nd:YAG laser, respectively. Two hours following treatment, hypersensitivity was again assessed, and the teeth were extracted, sectioned, and scanned using scanning electron microscopy (SEM). RESULTS: The mean VAS score in group 1 showed a 27% increase from baseline, but groups 2, 3, and 4 showed a decrease of 33%, 44%, and 62%, respectively. The mean cold air blast score showed a 22% increase in group 1, but values decreased by 43%, 50%, and 83% in groups 2, 3, and 4, respectively. The number of patent tubules also progressively decreased from group 1 through group 4. CONCLUSIONS: The combination of Nd:YAG laser and 5% sodium fluoride varnish seems to show an impressive efficacy, when compared to either treatment alone, in treating dentin hypersensitivity. The SEM findings seem to relate to the clinical findings in that reduction in number/patency of tubules was associated with improvement in treatment efficacy.     

奥威尔牙膏抗牙本质过敏的疗效研究

目的:评价家庭日常使用奥威尔牙膏后牙本质过敏症状的改善情况。方法:将60名受试者随机分成2组:实验组使用奥威尔牙膏,对照组使用普通牙膏。两组受试者每天刷牙2次共8周,采用VAS记分评价基线0、2、4周和8周受试者的牙本质敏感程度。结果:实验组基线0周时记分为5.92±1.04,4周和8周后为4.39±1.30、3.98±1.19,可显著减少牙本质过敏症状(P<0.05);与对照组4周和8周后记分5.08±1.17、4.65±1.18相比,有显著性差异(P<0.05)。结论:奥威尔牙膏有抗牙本质过敏的效果。     

Comparative Evaluation of Nd:YAG Laser and Fluoride Varnish for the Treatment of Dentinal Hypersensitivity

IntroductionVarious methods and materials are used in the treatment of dentin hypersensitivity. The aim of this randomized prospective controlled clinical trial was to evaluate and compare the desensitizing effects of the neodymium-doped yttrium aluminium garnet (Nd:YAG) laser and fluoride varnish by considering the degree of pre- and posttreatment pain, discomfort, and functional complications.MethodsTwenty patients with clinically diagnosed cervical dentin hypersensitive teeth were included and randomly allocated to either the application of fluoride varnish (group fluoride) or Nd:YAG laser (100 mJ, 20 Hz; group Nd:YAG). The assessment of pain and discomfort was performed by a visual analog scale after an air blast at baseline, immediately after treatment, and at patient visits on weeks 1, 2, 3, and 4.ResultsLaser treatment resulted in significant improvements of discomfort immediately after treatment and after 1 week. At the 2-, 3-, and 4-week examination, the discomfort in group fluoride decreased up to nearly 75% to 85% of baseline scores, whereas the effect of the laser stayed nearly unchanged. The visual analog scale scores for pain at 4 weeks examination were significantly lower in the fluoride group compared with those in the laser group (p < 0.05).ConclusionsNd:YAG laser is a suitable tool for the immediately successful reduction of dentinal hypersensitivity and has better patient satisfaction and shorter treatment time.     

8％精氨酸牙膏降低牙本质敏感的临床试验

目的 评价含8％精氨酸的抗敏牙膏控制牙本质敏感的效果.方法 采用随机、对照、双盲的研究方法,牙本质敏感的评价采用冷空气喷吹法,在常温下距离牙面1 cm处用气枪吹压缩空气,由受试者确认是否敏感,采用数字化疼痛评判法(visual analogue scale,VAS)记录受试者的敏感程度.按照纳入和排除标准纳入受试者,基线时共纳入受试者88人,按照性别和年龄将受试者分层随机分为试验组和对照组,每组44人.试验组使用含8％精氨酸的抗敏牙膏,对照组使用含5.53％柠檬酸钾的抗敏感牙膏.基线调查后,用棉签将1 cm长的牙膏涂抹于敏感牙表面并按摩1 min,进行敏感检测.受试者使用分派的牙膏和牙刷每天刷牙2次,每次至少1 min,分别在第3天和1周时接受回访.结果 所有受试者均完成了1周的临床试验研究.试验组和对照组受试者基线时的冷空气喷吹敏感VAS值(分别为55.51 ±8.48、56.67±10.22)和自我评价敏感VAS值(分别为43.75±6.65、41.98±8.53)差异均无统计学意义(P＞0.05).局部涂抹牙膏并按摩1 min,刷牙3d和1周后试验组冷空气喷吹敏感VAS值和自我评价敏感VAS值均较基线时显著下降(P＜0.01),对照组虽有下降但差异均无统计学意义(P＞0.05).与基线相比,试验组冷空气喷吹敏感VAS值和自我评价敏感VAS值的减少程度在3个时间点均显著高于对照组(P＜0.05).结论 含8％精氨酸的抗敏牙膏在单次局部涂抹后能即刻缓解牙本质敏感,刷牙1周后可有效缓解牙本质敏感.     

Efficacy of Gluma Desensitizer on dentin hypersensitivity in periodontally treated patients

The aim of this double-blind, controlled, split-mouth designed clinical trial was to assess the effect of a single application of Gluma Desensitizer on alleviating dentin hypersensitivity. Twelve subjects entered the study and ten completed the protocol. Each subject had two teeth treated: one with Gluma Desensitizer according to the manufacturer's instructions and one with water. The assessment of pain was performed with the VAS (Visual Analogue Scale), after tactile (probe), thermal (cold blast of water) and thermal/evaporative (cold blast of air) stimuli at baseline, immediately after treatment, after 1 week and after 4 weeks. The mean VAS values for the test and control teeth were compared by the paired t test (alpha = 0.05). Repeated measurements ANOVA was used to compare the different experimental times. The results showed that for test teeth, at baseline, mean VAS values were 1.76 (+/- 2.82), 7.10 (+/- 2.10) and 4.75 (+/- 2.65), and, after 4 weeks, the mean values were 1.70 (+/- 2.31), 5.50 (+/- 3.30) and 4.61 (+/- 3.14), respectively for probe, water and air stimuli. For the control teeth, at baseline, the mean VAS values were 1.86 (+/- 2.92), 6.61 (+/- 2.31) and 4.08 (+/- 2.91) and, after 4 weeks, 2.66 (+/- 3.07), 6.32 (+/- 2.94) e 4.76 (+/- 3.26). There were no statistically significant differences between test and control teeth at any time. No intra-group differences were demonstrated either. It was concluded that Gluma Desensitizer had no effect on hypersensitive teeth from periodontally treated patients for a period up to 4 weeks.     

Treatment of dentin hypersensitivity by Nd:YAG laser

BACKGROUND, AIMS: Promising results using Nd:YAG laser against dentin hypersensitivity have been reported. The aim of this double-blind, controlled, split-mouth designed clinical trial was to assess the effect of a single Nd:YAG laser application on alleviating hypersensitivity. METHODS/RESULTS: Seventeen subjects participated in the study. Each of them had two teeth treated; one with the laser activated and one with nonactivated (placebo), for 2 min The assessment of pain was performed by a VAS, after an air blast at baseline immediately after treatment, at 1 week, 4 weeks and 16 weeks. Mean values of VAS for test and control teeth were compared by paired t-test (alpha = 0.05). The results showed mean baseline VAS values of 6.59 (+/- 1.65) and 6.14(+/- 1.95) for test and control teeth, respectively. Immediately after treatment, these values decreased to 4.09(+/- 2.28) and 3.89(+/- 2.11), respectively. After 1 week, 4 weeks and 16 weeks the mean values for test and control teeth were 3.85 +/- 2.36, 4.03 +/- 1.95, 3.60 +/- 2.66, and 4.44 +/- 2.56, 3.41 +/- 2.30, 3.42 +/- 2.30, respectively. There were no statistically significant differences between test and control at any time. However, both groups improved significantly (P < 0.05) from baseline to immediately after application, and at 1 week, 4 weeks and 16 weeks, respectively. The changes that occurred between immediately after application and 1 week, 4 weeks and 16 weeks, respectively, were not statistically significant. CONCLUSION: It is concluded that the effect of treatment of hypersensitive teeth with Nd:YAG laser is not different from placebo. The observed effects seem to last for at least 16 weeks.     

The Efficacy of Three Desensitizing Agents Used to Treat Dentin Hypersensitivity

BackgroundIn a single-center, double-masked, split-mouth–designed, clinical short-term trial, the authors assessed the clinical responses of teeth with dentin hypersensitivity (DH) after treating the teeth with one of three desensitizing agents across four weeks.MethodsThe authors selected 131 teeth with DH in 11 participants. The authors assessed DH of the teeth by using tactile stimuli and air stimuli and had the participants record the level of sensitivity by means of a visual analog scale (VAS). The authors then treated the teeth with one of three desensitizing agents (Pain-Free [Parkell, Edgewood, N.Y.], BisBlock [Bisco, Schaumburg, Ill.], Seal & Protect [Dentsply DeTrey, Konstanz, Germany]) that they applied according to the manufacturers' instructions. The authors used a split-mouth–designed study in which the teeth in different quadrants of the participants' mouths received different desensitizing agents. The authors also conducted DH evaluations at 10 minutes after treatment and at one, two, three and four weeks. The authors analyzed data statistically by using Mann-Whitney U and Kruskal-Wallis tests.ResultsThe results of the statistical analysis showed that all VAS scores at the posttreatment evaluation periods were reduced significantly compared with those at baseline (P < .05). More teeth were sensitive to air stimuli than to tactile stimuli. The mean VAS scores for DH in the mandibular teeth were significantly higher than for those in maxillary teeth immediately after treatment (for tactile stimuli) and two weeks after the first application (for air stimuli) (P < .05)ConclusionsAll three desensitizing agents were effective in relieving DH up to four weeks, independent of their application procedures. There was, however, a significant reduction in mean sensitivity scores of teeth that had been treated with Seal & Protect and Pain-Free compared with those of BisBlock at weeks two, three and four.Clinical ImplicationsThe study results should be considered with caution, as it is not clear how many of the pain relief effects were related to the natural desensitization of teeth over time.     

Short-term clinical evaluation of four desensitizing agents

AIM: To evaluate the effectiveness of four topical desensitizing agents in providing short-term relief of dentin hypersensitivity. METHODS AND MATERIALS: One hundred sixteen hypersensitive teeth with a positive response to intraoral testing for dentin hypersensitivity were included in this study. The four desensitizing agents tested were Duraphat, 2% fluoride iontophoresis, copal varnish (CV), and Gluma Comfort Bond Plus Desensitizer. Following a specific regimen randomly determined desensitizing agents were applied in an alternating order when patients presented in a clinical setting with a complaint of hypersensitive teeth. A visual analogue scale was used to determine the degrees of hypersensitivity at three points in time. The first being just before the treatment to establish a baseline, then at 24 hours post-treatment, and the last at seven days post-treatment. Differences in the mean pain scores (MPS) between the baseline and post-treatment evaluation periods were used to determine the reduction in dentin hypersensitivity. RESULTS: At baseline the MPS for teeth treated with CV was 5.34 (SD: 2.39), Duraphat was 4.66 (SD: 1.82), Gluma was 6.03 (SD: 2.37), and iontophoresis was 5.76 (SD: 1.37). At 24 hours post-treatment the MPS for CV was 2.1 (SD: 0.95), Duraphat was 1.38 (SD;1.86), Gluma was 0.79 (SD;1.45), and iontophoresis was 1.62 (SD1.97). The reduction in dentin hypersensitivity at 24 hours (difference between baseline MPS and 24 hour MPS) was 5.28 for Gluma, 4.14 for iontophoresis, 3.28 for Duraphat, and 3.24 for CV which were all statistically significant (p<0.05). At seven days, the MPS for CV was 1.55 (SD: 1.44), Duraphat was 1.0 (SD;1.89), Gluma was 0.10 (SD;0.44), and iontophoresis was 0.3 (SD;0.98). Reduction of hypersensitivity between 24 hours and one week was 1.32 for iontophoresis, 0.69 for Gluma, 0.55 for CV, and 0.38 for Duraphat. Only the reductions for iontophoresis and Gluma were statistically significant at seven days (p<0.05). CONCLUSIONS: All agents caused a statistically significant reduction in dentin hypersensitivity within 24 hours of treatment. Gluma performed best at 24 hours while iontophoresis appeared to have an edge at seven days. Long-term studies are needed to determine why this difference exists. Dentin hypersensitivity presents as an emergency condition requiring an effective means of providing immediate relief in the clinician's treatment armamentarium.     

Clinical efficiency of a natural resin fluoride varnish (Shellac F) in reducing dentin hypersensitivity

Summary  Previous in vitro permeability and scanning electron microscopic studies have demonstrated the effectiveness of a new natural based-resin varnish (Shellac F) in dentin permeability reduction and effective tubule occlusion. The aim of this randomized double-blind, controlled, split mouth 8-week clinical study was to evaluate the efficiency of Shellac F in reducing dentin hypersensitivity. Ten patients (eight women: two men) completed the study. A quadrant including at least one hypersensitive tooth (Visual Analog Scale – VAS = 15 mm to air blast) was considered as a unit and randomly assigned to different groups for Shellac F, Duraphat^®, Isodan^®. Three applications of each material were completed at days 0, 1 and 7. The subjective response was assessed by tactile and thermal/evaporative methods. Data were collected at baseline and after the first application, at 15 min, 1, 7, 14, 28 and 56 days. Analysis was based on Kruskall–Wallis test, Wilcoxon signed rank test and the method of the least square means. No statistically significant difference was noted between Shellac F and the two control materials. Regardless of the type of stimulus, Shellac F showed significant immediate and progressive continuous efficiency in reducing dentin hypersensitivity until 56 days (VAS of 14 ± 12 mm and provoking pain force of 89 ± 12 cN, respectively, compared with 38 ± 23 mm and 41 ± 10 cN at baseline), corresponding to a highly effective relief dentin hypersensitivity. Shellac F reduced dentin hypersensitivity and did not differ from the two desensitizing agents used as controls.     

Clinical evaluation of two desensitizing treatments in southern Brazil: A 3-month follow-up

Abstract

Objective. This study aimed to evaluate and compare the effectiveness of two treatments for dentin hypersensitivity in vivo during 90 days of follow-up. Materials and methods. The sample consisted of 117 teeth (13 patients) that were divided into three groups: control with carbomer 940 gel (n = 32) (placebo treatment), 2% sodium fluoride gel (n = 31) and low-level infrared diode laser (n = 54). Prior to the desensitizing treatment, the dentin hypersensitivity status of each tooth was assessed by an evaporative stimulus; the patient's response was evaluated using the Visual Analogue Scale (VAS) and by counting the Exposure Time to Air Blast (ETAB) with a dental air syringe. Re-evaluations of the treatments occurred after 5 min, 7, 15, 30 and 90 days. The statistical analysis was performed using the Kruskal-Wallis test, Friedman test, one-way ANOVA, Tukey's test and Spearman's rank correlation (α = 5%). Results. No significant differences were observed among the low-level laser, 2% topical fluoride and carbomer 940 gel applications. When the methods of evaluation (VAS and ETAB) were compared, there was no difference among the groups with respect to the values for every period of evaluation (p < 0.001), verifying that the scores obtained with the VAS decreased at the same proportion as the remaining time of ETAB increased. Conclusions. This study showed that both tested therapies were efficacious in controlling painful symptoms associated with dentin hypersensitivity over the entire 90-day follow-up period. The treatments were able to reduce the painful symptoms caused by dentin hypersensitivity, including placebo.     

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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。     

Effectiveness of chlorhexidine and sodium fluoride in reducing dentin hypersensitivity.

This investigation was conducted to evaluate the effect of chlorhexidine, sodium fluoride, and sequential rinses of chlorhexidine (Cx) and sodium fluoride (NaF) on dentin hypersensitivity. Forty-four adult patients with dentin hypersensitivity on three teeth were randomly assigned to receive one of four treatment rinses: (1) placebo; (2) 0.12% Cx; (3) 0.2% NaF; or (4) 0.12% Cx plus 0.2 NaF. Patients' responses to cold stimulation were recorded at baseline, two weeks, and four weeks. Pain response was quantified by applying successively decreasing temperature intervals of water (20 degrees C, 15 degrees C, 10 degrees C, 5 degrees C, and 0 degrees C) to exposed dentin. Plaque Index (Silness and L?e) was recorded at baseline only. Data on dentin sensitivity over time were analyzed using a repeated measures ANOVA. This ANOVA was conducted to generate an error term for calculation of Dunn's multiple mean comparison test. A Spearman rank order test was computed to assess correlation between plaque and hypersensitivity at baseline. Results showed the Cx and NaF rinses alone significantly reduced hypersensitivity (p less than .01) at four weeks compared to baseline. Sequential Cx and NaF rinses significantly decreased sensitivity (p less than .01) at both the two- and four-week intervals compared to baseline. At the four-week interval, the sequential Cx/NaF rinse group showed a significantly greater reduction (p less than .01) in hypersensitivity response when compared to placebo. Cx alone, or NaF alone groups. A moderate, positive correlation (r = 0.55) was demonstrated between plaque and dentin hypersensitivity. This was statistically significant at the (p less than .05) level.     

In vivo study on the effectiveness of a lacquer containing CaF2/NaF in treating dentine hypersensitivity

The purpose of this double-blind study was to evaluate the effectiveness of a commercially available fluoride lacquer (Bifluorid 12) containing CaF₂ (6%) and NaF (6%) in reducing dentine hypersensitivity. A fluoride lacquer containing only NaF (6%) served as a control. Twenty-five adult patients complaining about at least two hypersensitive teeth participated in this study. In each patient and at each appointment, one tooth was treated with Bi-fluorid 12, while the other was treated with the control substance. Sensitivity levels were determined before and after the application of each lacquer at baseline as well as at 1, 2 and 3 weeks after the start of study. The final evaluation of hypersensitivity was performed at 4 weeks, and follow-ups were undertaken at 6 and 12 months. A reproducible air blast stimulus and a visual analogue scale were used for evaluation. Results demonstrated a distinct reduction of hypersensitivity after 1, 2 and 3 weeks in the Bi-fluorid 12 group. Initially, no obvious effects could be observed in the control group. However, a clear alleviation could be observed after 2 and 3 weeks with the control. After 4 weeks, the overall sensitivity scores were comparably low, without any significant differences between the two fluoride lacquers. In both groups, the effects of treatment were seen over the 12-month observation period. Bifluorid 12 was considered at least comparable to the control. It is concluded from this study that Bifluorid 12 is effective in the initial reduction of dentine hypersensitivity. The combination of CaF₂/NaF can be recommended for clinical use.     

含5.53%柠檬酸钾牙膏抗牙本质敏感的临床研究

目的：评价含5.53%柠檬酸钾牙膏减轻牙本质敏感症状的效果。方法：试验遵照随机、双盲、对照试验原则,将65名受试者随机分成试验组（含5.53%柠檬酸钾牙膏）和对照组（普通含氟牙膏）,两组受试者每天刷牙2次共4周。采用视觉模拟评分法（VAS）记,牙敏感症状。数据采用非参数检验进行统计分析。结果：与基线相比,使用牙膏4周后,试验组牙本质敏感VAS记分显著降低（P〈0.05）。与对照组相比,试验组4周后的牙本质敏感VAS记分明显低于对照组（P〈0.01）。83.9%的受试者认为使用该牙膏能缓解牙本质敏感症状;77.4%的受试者愿意继续使用该牙膏脱敏。结论：含5.53%柠檬酸钾牙膏具有显著的抗牙本质敏感效果。     

Comparative investigation of the desensitizing efficacy of a new dentifrice containing 5.5% potassium citrate: an eight-week clinical study

OBJECTIVE: This double-blind clinical study was designed to investigate the relative effectiveness of a new desensitizing test dentifrice containing 5.5% potassium citrate, 1.14% sodium monofluorophosphate (MFP) and 10% high-cleaning silica (HCS) in a silica base for reducing dentinal hypersensitivity over an eight-week period, to that of a commercially available desensitizing positive control dentifrice containing 3.75% potassium chloride, 0.32% sodium fluoride and 0.3% triclosan in a silica base. METHODOLOGY: A total of 80 subjects were entered into the study, and stratified into two balanced groups according to their baseline mean thermal (air blast) and baseline mean tactile (Yeaple Probe) sensitivity scores. The two groups were randomly assigned to use either the test dentifrice containing potassium citrate/MFP/HCS, or the positive control dentifrice containing potassium chloride/sodium fluoride/triclosan. The two groups were well balanced with regard to their mean baseline thermal and tactile sensitivity scores, sex and age. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice and a commercially available soft-bristled toothbrush. Dentinal hypersensitivity examinations, which included tactile sensitivity and thermal sensitivity, were conducted at baseline, four weeks, and eight weeks. Examinations were conducted by the same dental examiner on the subjects at each examination. RESULTS: After four weeks' use of their assigned products, those subjects in the test dentifrice group demonstrated no statistically significant difference for controlling dentinal hypersensitivity as compared to the positive control dentifrice group in tactile and air blast. After eight weeks' use of their assigned products, those subjects in the test dentifrice group again demonstrated no statistically significant difference in tactile and air blast sensitivity as compared to the positive control dentifrice group. CONCLUSION: The results of this double-blind clinical study indicate that the use of a commercially available test dentifrice containing 5.5% potassium citrate, 1.14% sodium monofluorophosphate and 10% high-cleaning silica in a silica base demonstrates no statistically significant difference in tactile and air blast sensitivity compared to the commercially available desensitizing positive control dentifrice containing 3.75% potassium chloride, 0.32% sodium fluoride and 0.3% triclosan in a silica base.     

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。     

A randomized,controlled, two-month pilot trial of stannous fluoride dentifrice versus sodium fluoride dentifrice after oxalate treatment for dentinal hypersensitivity

Objectives

To compare the effects of a stannous fluoride dentifrice and a sodium fluoride dentifrice on dentinal hypersensitivity when used with an oxalate-based regimen combining in-office and at-home treatment.

Materials and methods

In this single-center, randomized, controlled, double-blind, pilot clinical trial, 30 subjects were professionally treated at baseline with a 3% oxalate/potassium salt solution on up to two target teeth, then randomized 1:1 to either 0.454% stannous fluoride or 0.243% sodium fluoride overlabeled dentifrice. Both groups were given 6 sensitivity strips (3.14% potassium oxalate gel) and a soft, manual toothbrush. Subjects were permitted to apply strips on up to two teeth, up to three times per tooth, at home as desired throughout the study. Dentinal sensitivity (cold air blast challenge) was assessed at baseline, immediately after post-professional treatment, and at day 60 using the Schiff scale and a Visual Analog Scale (VAS).

Results

Immediately after professional oxalate treatment, the overall mean Schiff and VAS score decreased 25.6% and 22.4% from baseline, respectively (p ≤ 0.001 for both). At day 60, further reductions in both mean scores were seen in both groups. There were no significant differences between the groups at day 60. All treatments were well tolerated.

Conclusions

In subjects treated with oxalates for dentinal hypersensitivity, both stannous fluoride and sodium fluoride dentifrices are well tolerated, are feasible for routine use, and do not detract from the desensitizing effects of an in-office and at-home oxalate combination treatment regimen.

Clinical relevance

Either stannous fluoride or sodium fluoride dentifrices can be recommended to dentinal hypersensitivity patients who undergo professional oxalate treatment.

     

Power toothbrushes, gender, and dentin hypersensitivity

Power toothbrushes require less force for plaque removal than manual brushes. In addition, in vitro studies have indicated that brushing with low force could occlude patent dentin tubules by formation of a smear layer. Hence, lessening the force necessary to remove plaque may reduce dentin hypersensitivity. However, it was recently suggested that the use of an oscillating/rotating power toothbrush could decrease tooth sensitivity as compared to a sonic power toothbrush. Therefore, the objective of the present research was to compare the effect on dentin hypersensitivity of two different types of power brushes, the Optiva Sonicare and the Braun Oral B Ultra Plaque Remover. The null hypothesis was tested in an 8-week, randomized, parallel group, examiner-blind clinical trial. Fifty-nine subjects with a history of dentin hypersensitivity participated. Dentin hypersensitivity-associated pain was elicited using tactile and evaporative stimuli and assessed using a visual analog scale (VAS) instrument. Clinical examinations were carried out at screening and baseline and repeated after 8 weeks of twice daily use of the power brushes. Data analysis was performed on VAS scores obtained at the final visit following adjustment for group differences at baseline. A 35% to 40% reduction in pain as compared to baseline was observed in both treatment groups. Treatment-related differences were not statistically significant. A gender-related effect on dentin hypersensitivity was observed using the tactile stimulus and may merit further investigation. Received: 19 October 1999 / Accepted: 20 January 2000     

自酸蚀粘接剂治疗牙颈部牙本质敏感症的临床研究

目的通过VAS（visual analogue scale）表评价两步法自酸蚀粘接荆Contax治疗牙颈部牙本质敏感症的有效性。方法从临床就诊病人中选择20例确诊为牙颈部牙本质敏感症的患者，用Contax进行脱敏治疗，在应用前后及应用之后的第2周，第4周，第8周和第12周相继进行敏感性测定并以VAS值记录临床测定结果，进行Friedman统计分析。结果统计结果显示，使用Contax前后及应用之后测得的vas值呈逐渐下降趋势，其差异有高度统计学意义（P〈0．01）。结论Contax可以作为一种牙本质脱敏荆有效地降低牙颈部牙本质敏感症状。     

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目的评价含生物活性玻璃成分的脱敏剂与氟保护漆联合应用对牙本质小管的堵塞效果及治疗牙本质过敏症(dentin hypersensitivity,DH)的临床疗效。方法选择2013年6月到2014年6月到中国医科大学口腔医学院干诊科就诊的59例DH患者的120颗患牙,随机分为A组(41颗)、B组(39颗)、C组(40颗),分别使用氟保护漆、奥敏清及氟保护漆与奥敏清联合涂布敏感处,应用视觉模拟评分(visual analogue scale,VAS)法评价其疗效。另选择因正畸需要拔除的完整无龋坏前磨牙20颗,制备成敏感模型后随机分为a、b、c、d四组,每组5颗,a、b、c三组处理方法同上述A、B、C组,d组为空白对照组,用蒸馏水进行处理,扫描电镜观察各组牙本质小管的堵塞情况。结果 A、B、C三组的VAS评分值在处理即刻均明显下降,且随时间推移均有增高趋势;有效率比较,A、C两组在1个月时差异有统计学意义(P<0.05),其他各组间在各时点差异均无统计学意义(P>0.05);各组内比较,A组即刻与1个月时差异具有统计学意义(P<0.05)。扫描电镜观察a、b、c三组牙本质小管均有不同程度堵塞,其中以联合应用组效果最佳。结论含生物活性玻璃成分的脱敏剂与氟保护漆联合应用堵塞牙本质小管的效果最佳,且具有较好的临床效果。