Efficacy of Nano Crystallised Calcium Phosphate (NCCP) and Casein Phosphopeptide – Amorphous Calcium Phosphate (CPP-ACP) for Controlling Postoperative Sensitivity After Power Bleaching-A Comparative In-Vivo Study

Tooth bleaching is one of the most popular cosmetic dental procedures opted by the patients who desire pleasing smile. It is the simplest, least invasive means available to lighten discolored vital teeth. A number of desensitizing agents have been tried in an attempt to counteract bleaching-related sensitivity. This study was done to compare the effect of two different desensitizing agents for controlling post operative sensitivity after power bleach procedure. Sixty volunteers with mild to moderate dental fluorosis in maxillary anterior teeth, who fulfilled the inclusion and exclusion criteria, were randomly selected for this study. After the bleaching procedurea demo was given to the patient while application of desensitising gel and was instructed to use the gel for 14 days.All the patients were recalled at an interval of 1st day, 3rdday, 5th day, 7th day, and on 14th day to record the post operative sensitivity after power bleach procedure. The observations were analyzed using one way analysis of variance (ANOVA), Tukeys post hoc test. On the basis of VAS results, all the groups showed post operative sensitivity of varied intensity at different intervals. NCCP showed less sensitivity followed by CPP-ACP and Control group. Keywords: Power Bleaching, Post operative sensitivity, Nano Crystallized Calcium Phosphate, Casein Phosphopeptide-Amorphous Calcium Phosphate

Comparison of Casein Phosphopeptide with Potassium Nitrate and Sodium Monofluorophosphate Desensitizing Efficacy after In-Office Vital Bleaching—A Randomized Trial

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), potassium nitrate, and sodium monofluorophosphate are desensitizing agents that help in reducing teeth sensitivity. However, indecisive evidence exists regarding their efficacy. Therefore, this study was conducted to compare the desensitizing efficacy of casein phosphopeptide-amorphous calcium phosphate and potassium nitrate with sodium monofluorophosphate agents after in-office vital bleaching. A randomized controlled trial was conducted on 2011 patients. The patients were randomly and equally divided into the CPP-ACP group (group 1), potassium nitrate with sodium monofluorophosphate group (group 2), and placebo gel (group 3). The upper and lower anterior teeth including the first premolar were isolated with a rubber dam, then the bleaching agents were applied on the labial surface of all the teeth, followed by light activation for 15 min. The procedure was repeated 3 times with an interval of 5 min in-between. After carrying out the bleaching procedure, patients were given a desensitizing gel or placebo gel in unmarked syringes with an instruction to apply it every 12 h for up to 3 days. The intensity of pain was recorded using a discomfort interval scale (DIS). A decrease in pain was observed 24 h after the application of the desensitizing gel in groups 1 and 2. However, in group 3, the pain persisted, with 46 (69.69%) patients having moderate pain and 14 (21.21%) developing severe pain over time. A significant difference in discomfort level with time was noted in group 1 (p = 0.015) and group 2 (p = 0.036). However, no significant difference was found in group 3 (p = 0.085). It was concluded that both desensitizing agents performed exceptionally well in reducing teeth sensitivity.

Evaluation and comparision of the clinical effectiveness of diode laser and Gluma as desensitizing agents in the treatment of dentinal hypersensitivity

Dentin hypersensitivity is one of the most common presenting symptoms in dental practice. It may range from mild discomfort to severe pain affecting the person. Laser desensitization has been introduced as a useful tool for the treatment of hypersensitivity. Gluma Dentin Bond is an adhesive system, where the primer contains 5% glutaraldehyde and 35% hydroxyethyl methacrylate. Practitioners have reported a strong desensitizing effect of the Gluma® system on dentin The aim of this study is to evaluate and compare the clinical effectiveness of Diode laser and Gluma ®desensitizing agent in the treatment of dentin hypersensitivity. 24 patients aged between 20 and 50 years was included to assess tooth sensitivity, a controlled air stimulus (evaporative stimulus) was used. Sensitivity was measured using a 10-cm Visual Aanalog Scale (VAS) score. The teeth was randomly allocated to two groups i.e., Group I or II using the lottery method. Gluma® showed a statistically significant reduction in the VAS score as compared to diode laser 1, 2- and 4-weeks follow-up period (p < 0.05). The result of the present investigation revealed that application of Gluma® resulted in better control dentin hypersensitivity as compared to diode laser.

A randomized split mouth clinical trial of the application of the desensitizer agents for tooth sensitivity

Background: Dentin hypersensitivity (DH) affects 3%-75% of the people and is one of the morbid tooth conditions. Hence in the present study we aim to examine the clinical effectiveness of 3 different desensitizing agents in decreasing pain of DH in time of 1 month.Methods: Fifty subjects with cervical DH in at least one tooth in any three of the 4 quadrants were selected. VAS was used to note the pain. Each quadrant in an individual was randomly assigned. Profluorid varnish, Admira protect, and PRG‑Barrier coat was used. VAS scores for the tactile and air stimuli were noted immediately after application, 1 week, and after 1 month. The data was analyzed keeping p<0.05 as significant.Results: VAS significantly reduced for all three groups from the base line (p<0.001). Admira protect showed significant reduction of hypersensitivity scores at 1 month compared to other groups (p<0.001).Conclusions: Admira protect was better at lowering the pain due to DH than PRG‑barrier coat and Profluorid varnish after 1 month of application.

Efeito da aplicação prévia ou adição de dessensibilizantes em géis de peróxido de hidrogênio no esmalte clareado

This in vitro study evaluated the effect of 35% hydrogen peroxide (35HP) gels with different desensitizing agents on color, microhardness and roughness of bleached enamel. Forty enamel-dentin specimens (6x6x2 mm2) were obtained from twenty human molars. After color measurement with a spectrophotometer, the specimens were randomized into four groups (n= 10): 35HPw- 35HP without desensitizing agent; 35HPCa- 35HP with calcium; 35HPK- 35HP with 0.5% potassium nitrate; 35HPTFa- 35HPw + topical application of 5% potassium nitrate and 2% sodium fluoride (TFa). Specimens were evaluated for color (∆Eab* and ∆E00), Vickers microhardness (VHN) and, superficial and volumetric roughness (Ra and Sa, µm) using a 3D non-contact profilometer before and 1-week after bleaching. Data were analyzed by ANOVA and Tukey tests (p< 0.05). Both treatment groups promoted a significant whitening effect and there was no difference between them for any color parameters evaluated. All groups reduced significantly the VHN, but the 35HPK showed a reduction significantly major than the other groups. 35HPCa and 35HP+TFa did not avoid the of Ra and Sa increasing. It can be concluded that 35HP bleaching gels with different desensitizing agents did not affect the whitening efficacy. However, all treatments decreased the microhardness, the addition of calcium into 35HP gel and the application of TFa before bleaching did not revert the enamel roughness under in vitro conditions.

Surface Analysis and Spectrophotometric Evaluation of Different Esthetic Restorative Materials Frequently Exposed to a Desensitizing Agent

Background. Patients with tooth sensitivity are frequently exposed to desensitizing agents on a regular basis. These agents might have an impact on the surface properties and color of existing oral restorations. Accordingly, this study aimed to investigate the color stability, surface microhardness, and surface roughness of resin-modified glass ionomer (RMGIC), amalgomer CR, nanohybrid, and bulk-fill resin composites restorative materials after frequent exposure to a desensitizing agent. Materials and Methods. One hundred and twenty specimens were prepared; 10 specimens for each restorative material were equally subdivided into control and desensitizing-agent-exposed groups in each test. Surface microhardness and surface roughness were evaluated using the Vickers microhardness tester and surface profilometer, respectively. The color change was measured by using a spectrophotometer using the CIE L ∗ a ∗ b ∗ formula. Surface topography was analyzed using a scanning electron microscope (SEM). The collected data were analyzed with Student’s t-test, one-way ANOVA, and Tukey post hoc tests for pairwise comparison at a level of significance of 0.05. Result. The frequent use of a desensitizing agent significantly decreased surface hardness of RMGIC, amalgomer, and bulk-fill composite materials. However, nanohybrid composite exhibited a significant surface hardness increase. The surface roughness of RMGIC, amalgomer, and nanohybrid composite increased significantly. Meanwhile, the bulk-fill resin composite showed a nonsignificant decrease. Both RMGIC and amalgomer exhibited significantly higher values of color change in comparison to those of nanohybrid and bulk-fill composites. Conclusion. The bulk-fill composite seems to be more resistant to discoloration and surface topographical changes than other tested materials on frequent exposure to the desensitizing agent. However, this exposure may pose a negative impact on its surface hardness. Bulk-fill resin composite may be the most suitable esthetic restorative in patients who frequently use desensitizing agents.