TODENTJ-25-03-2019_TODENTJ-12-572 1553507466 Bentham Open doi@benthamopen.net Bentham Open The Open Dentistry Journal TODENTJ 1874-2106 08 31 2018 12 1 Bennett T. Amaechi Kelly C. Lemke Shyamali Saha Jonathan Gelfond Objective: The study aimed to investigate the effectiveness of Apadent Pro (Sangi) Nanohydroxyapatite (nHAP) dental cream to relieve Dentin Hypersensitivity (DHS), compared with a positive control cream containing 20% pure silica (Silica). Methods: In this double-blind, randomized, parallel-group clinical trial, patients diagnosed with DHS and qualified to participate were randomized into two groups, nHAP (n=25) and Silica (n=26). Subjects’ baseline and posttreatment sensitivity were assessed using two pain scales, a four-point Dental Pain Scale (DPS) followed by a linear Visual Analog Scale (VAS), after the application of ice-cold and air stimuli. Subjects used custom-fabricated trays to apply their respective cream for 5 minutes once daily following brushing with standard fluoride toothpaste. Posttreatment sensitivity (efficacy) was assessed every 2 weeks for 8 weeks. Mean treatment outcomes (percentage change from baseline) at each time point were compared using the Tukey HSD test for multiplicity (P<0.05). Results: With either air or cold stimulus, VAS and DPS indicated a significant (P<0.001) reduction in DHS at each time point with either nHAP or Silica. Comparing pain scales, VAS showed no significant difference in DHS reduction between the products with either air or cold. However, with DPS, DHS reduction was significantly (P<0.05) better with Silica than with nHAP at all time points with cold, and at 2, 4, and 8 weeks with air. Conclusion: Both Apadent Pro nHAP and Silica dental creams are effective at promoting the relief of DHS symptoms. When comparing the efficacy of the two compounds to relieve DHS, results of the two pain scales were conflicting. 08 31 2018 572 585 TODENTJ-12-572 1 10.2174/crossmark_policy opendentistryjournal.com benthamopen.com true Peer Reviewed Single blind Checked with iThenticate 2018-5-23 2018-7-11 2018-8-10 2018-08-31 https://creativecommons.org/licenses/by/4.0/legalcode 10.2174/1874210601812010572 1553507466 https://opendentistryjournal.com/VOLUME/12/PAGE/572/ https://opendentistryjournal.com/contents/volumes/V12/TODENTJ-12-572/TODENTJ-12-572.pdf https://opendentistryjournal.com/contents/volumes/V12/TODENTJ-12-572/TODENTJ-12-572.pdf https://opendentistryjournal.com/contents/volumes/V12/TODENTJ-12-572/TODENTJ-12-572.pdf https://opendentistryjournal.com/contents/volumes/V12/TODENTJ-12-572/TODENTJ-12-572.pdf https://opendentistryjournal.com/contents/volumes/V12/TODENTJ-12-572/TODENTJ-12-572.pdf https://opendentistryjournal.com/contents/volumes/V12/TODENTJ-12-572/TODENTJ-12-572.pdf https://opendentistryjournal.com/contents/volumes/V12/TODENTJ-12-572/TODENTJ-12-572.pdf https://opendentistryjournal.com/contents/volumes/V12/TODENTJ-12-572/TODENTJ-12-572.xml J. Can. Dent. Assoc. 69 221 2003 Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc 2003; 69 (4) : 221-6. Int. Dent. J. Addy M. 53 177 2003 10.1111/j.1875-595X.2003.tb00768.x Addy M, Hunter ML. Can tooth brushing damage your health? Effects on oral and dental tissues. Int Dent J 2003; 53 (Suppl.3) : 177-86. Clin. Oral Investig. Petersson L.G. 17 S63 2013 10.1007/s00784-012-0916-9 Petersson LG. The role of fluoride in the preventive management of dentin hypersensitivity and root caries. Clin Oral Investig 2013; 17 (Suppl.1) : S63-71. Community Dent. Health Cartwright R.B. 31 15 2014 Cartwright RB. Dentinal hypersensitivity: A narrative review. Community Dent Health 2014; 31 (1) : 15-20. Int. J. Dent. Hyg. Rees J.S. 2 64 2004 10.1111/j.1601-5029.2004.00068.x Rees JS, Addy M. A cross-sectional study of buccal cervical sensitivity in UK general dental practice and a summary review of prevalence studies. Int J Dent Hyg 2004; 2 (2) : 64-9. J. Clin. Periodontol. Rees J.S. 29 997 2002 10.1034/j.1600-051X.2002.291104.x Rees JS, Addy M. A cross-sectional study of dentine hypersensitivity. J Clin Periodontol 2002; 29 (11) : 997-1003. J. Oral Sci. Porto I.C. 51 323 2009 10.2334/josnusd.51.323 Porto IC, Andrade AK, Montes MA. Diagnosis and treatment of dentinal hypersensitivity. J Oral Sci 2009; 51 (3) : 323-32. Aust. Dent. J. Bartold P.M. 51 212 2006 10.1111/j.1834-7819.2006.tb00431.x Bartold PM. Dentinal hypersensitivity: A review. Aust Dent J 2006; 51 (3) : 212-8. Clin. Oral Investig. Schmidlin P.R. 17 S55 2013 10.1007/s00784-012-0912-0 Schmidlin PR, Sahrmann P. Current management of dentin hypersensitivity. Clin Oral Investig 2013; 17 (Suppl.1) : S55-9. Cochrane Database Syst. Rev. Poulsen S. CD001476 2001 Poulsen S, Errboe M, Hovgaard O, Worthington HW. Potassium nitrate toothpaste for dentine hypersensitivity. Cochrane Database Syst Rev 2001; (2): CD001476. J. Oral Rehabil. Hoang-Dao B.T. 36 124 2009 10.1111/j.1365-2842.2008.01907.x Hoang-Dao BT, Hoang-Tu H, Tran-Thi NN, Koubi G, Camps J, About I. Clinical efficiency of a natural resin fluoride varnish (Shellac F) in reducing dentin hypersensitivity. J Oral Rehabil 2009; 36 (2) : 124-31. J. Contemp. Dent. Pract. Olusile A.O. 9 22 2008 Olusile AO, Bamise CT, Oginni AO, Dosumu OO. Short-term clinical evaluation of four desensitizing agents. J Contemp Dent Pract 2008; 9 (1) : 22-9. Eur. J. Prosthodont. Restor. Dent. Merika K. 14 38 2006 Merika K, HeftitArthur F, Preshaw PM. Comparison of two topical treatments for dentine sensitivity. Eur J Prosthodont Restor Dent 2006; 14 (1) : 38-41. J. Am. Dent. Assoc. Ritter A.V. 137 1013 2006 10.14219/jada.archive.2006.0324 Ritter AV, de L Dias W, Miguez P, Caplan DJ, Swift EJ Jr. Treating cervical dentin hypersensitivity with fluoride varnish: A randomized clinical study. J Am Dent Assoc 2006; 137 (7) : 1013-20. J. Dent. Res. Cunha-Cruz J. 90 304 2011 10.1177/0022034510389179 Cunha-Cruz J, Stout JR, Heaton LJ, Wataha JC, Northwest P. Dentin hypersensitivity and oxalates: A systematic review. J Dent Res 2011; 90 (3) : 304-10. J. Clin. Periodontol. West N.X. 24 209 1997 10.1111/j.1600-051X.1997.tb01833.x West NX, Addy M, Jackson RJ, Ridge DB. Dentine hypersensitivity and the placebo response. A comparison of the effect of strontium acetate, potassium nitrate and fluoride toothpastes. J Clin Periodontol 1997; 24 (4) : 209-15. Adv. Med. Sci. Kowalczyk A. 51 40 2006 Kowalczyk A, Botuliński B, Jaworska M, Kierklo A, Pawińska M, Dabrowska E. Evaluation of the product based on recaldent technology in the treatment of dentin hypersensitivity. Adv Med Sci 2006; 51 (Suppl.1) : 40-2. Br. Dent. J. Tang B. 208 571 2010 10.1038/sj.bdj.2010.500 Tang B, Millar BJ. Effect of chewing gum on tooth sensitivity following whitening. Br Dent J 2010; 208 (12) : 571-7. Chin. J. Dent. Res. Mahesuti A. 17 43 2014 Mahesuti A, Duan YL, Wang G, Cheng XR, Matis BA. Short-term efficacy of agents containing KNO3 or CPP-ACP in treatment of dentin hypersensitivity. Chin J Dent Res 2014; 17 (1) : 43-7. J. Periodontol. Pradeep A.R. 81 1167 2010 10.1902/jop.2010.100056 Pradeep AR, Sharma A. Comparison of clinical efficacy of a dentifrice containing calcium sodium phosphosilicate to a dentifrice containing potassium nitrate and to a placebo on dentinal hypersensitivity: A randomized clinical trial. J Periodontol 2010; 81 (8) : 1167-73. J. Am. Dent. Assoc. Narongdej T. 141 995 2010 10.14219/jada.archive.2010.0313 Narongdej T, Sakoolnamarka R, Boonroung T. The effectiveness of a calcium sodium phosphosilicate desensitizer in reducing cervical dentin hypersensitivity: A pilot study. J Am Dent Assoc 2010; 141 (8) : 995-9. J. Clin. Dent. Salian S. 21 82 2010 Salian S, Thakur S, Kulkarni S, LaTorre G. A randomized controlled clinical study evaluating the efficacy of two desensitizing dentifrices. J Clin Dent 2010; 21 (3) : 82-7. J. Clin. Dent. Sharma N. 21 88 2010 Sharma N, Roy S, Kakar A, Greenspan DC, Scott R. A clinical study comparing oral formulations containing 7.5% calcium sodium phosphosilicate (NovaMin), 5% potassium nitrate, and 0.4% stannous fluoride for the management of dentin hypersensitivity. J Clin Dent 2010; 21 (3) : 88-92. Am. J. Dent. Zaidel L 24 6A 2011 Zaidel L, Patel R, Mello S, et al. nti-hypersensitivity mechanism of action for a dentifrice containing 0.3% triclosan, 2.0% PVM/MA copolymer, 0.243% NaF and specially-designed silica. Am J Dent 2011; 24 : 6A-13A. Am. J. Dent. Chaknis P 24(A) 14A 2011 Chaknis P, Panagakos FS, DeVizio W, Sowinski J, Petrone D, Proskin H. Assessment of hypersensitivity reduction of a dentifrice containing 0.3% triclosan, 2.0% PVM/MA copolymer, 0.243% NaF and specially-designed silica as compared to a dentifrice containing 0.454% stannous fluoride, sodium hexametaphosphate and zinc lactate and to a dentifrice containing 0.243% NaF on dentin hypersensitivity reduction: An 8-week study. Am J Dent 2011; 24(A) : 14A-20A. Dent. Mater. J. Tian L. 33 125 2014 10.4012/dmj.2013-215 Tian L, Peng C, Shi Y, et al. Effect of mesoporous silica nanoparticles on dentinal tubule occlusion: An in vitro study using SEM and image analysis. Dent Mater J 2014; 33 (1) : 125-32. J. Dent. Yu J. 50 21 2016 10.1016/j.jdent.2016.04.005 Yu J, Yang H, Li K, Lei J, Zhou L, Huang C. A novel application of nanohydroxyapatite/mesoporous silica biocomposite on treating dentin hypersensitivity: An in vitro study. J Dent 2016; 50 : 21-9. Key Eng. Mater. Lu K. 330-332 267 2007 10.4028/www.scientific.net/KEM.330-332.267 Lu K, Zhang J, Meng X, Li X. Remineralization effect of the nano-HA toothpaste on artificial caries. Key Eng Mater 2007; 330-332 : 267-70. Koku Eisei Gakkai Zasshi Kani T. 38 364 1988 10.5834/jdh.38.364 Kani T, Kani M, Isozaki A, Shintani H, Ohashi T, Tokumoto T. The effect of apatite-containing dentifrices on artificial caries lesions. Koku Eisei Gakkai Zasshi 1988; 38 : 364-5. Koku Eisei Gakkai Zasshi Kani T. 39 104 1989 10.5834/jdh.39.104 Kani T, Kani M, Isozaki A, Shintani H, Ohashi T, Tokumoto T. Effect of apatite-containing dentifrices on dental caries in school children. Koku Eisei Gakkai Zasshi 1989; 39 : 104-9. Koku Eisei Gakkai Zasshi Ohashi T. 41 214 1991 10.5834/jdh.41.214 Ohashi T, Kani T, Kani M, Isozaki A, Shintani H, Tokumoto T. Remineralization of artificial caries lesions by hydroxyapatite. Koku Eisei Gakkai Zasshi 1991; 41 : 214-23. J. Japan Stom Soc. Nishimura K. 48 199 1999 Nishimura K, Yamaguchi Y, Yoshitake K. Demineralized enamel surface microstructure after brushing using toothpaste containing medical hydroxyapatite under FE-SEM observation. J Japan Stom Soc 1999; 48 : 199-210. Key Eng. Mater. Kim M.Y. 330-332 1347 2007 10.4028/www.scientific.net/KEM.330-332.1347 Kim MY, Kwon HK, Choi CH, Kim BI. Combined effects of nanohydroxyapatite and NaF on remineralization of early caries lesion. Key Eng Mater 2007; 330-332 : 1347-50. J. Dent. Huang S. 38 811 2010 10.1016/j.jdent.2010.06.013 Huang S, Gao S, Cheng L, Yu H. Combined effects of nano-hydroxyapatite and Galla chinensis on remineralisation of initial enamel lesion in vitro. J Dent 2010; 38 (10) : 811-9. Caries Res. Huang S. 45 460 2011 10.1159/000331207 Huang S, Gao S, Cheng L, Yu H. Remineralization potential of nano-hydroxyapatite on initial enamel lesions: An in vitro study. Caries Res 2011; 45 (5) : 460-8. Biomed. Mater. Huang S.B. 4 034104 2009 10.1088/1748-6041/4/3/034104 Huang SB, Gao SS, Yu HY. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomed Mater 2009; 4 (3) : 034104. J. Clin. Dent. Najibfard K. 22 139 2011 Najibfard K, Ramalingam K, Chedjieu I, Amaechi BT. Remineralization of early caries by a nano-hydroxyapatite dentifrice. J Clin Dent 2011; 22 (5) : 139-43. J. Dent. Tschoppe P. 39 430 2011 10.1016/j.jdent.2011.03.008 Tschoppe P, Zandim DL, Martus P, Kielbassa AM. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J Dent 2011; 39 (6) : 430-7. Adv. Dent. Res. Hannig M. 24 53 2012 10.1177/0022034512450446 Hannig M, Hannig C. Nanotechnology and its role in caries therapy. Adv Dent Res 2012; 24 (2) : 53-7. J. Dent. Res. Ohta K 86 1759 2007 Ohta K, Kawamata H, Ishizaki T, Hayman R. Occlusion of dentinal tubules by nano-hydroxyapatite. J Dent Res 2007; 86 (special issue A) : 1759. J. Dent. Res. Kawamata H 2265 2008 Kawamata H, Ohta K, Saito T, Hayman R. Potassium nitrate enhances occlusion of dentinal tubules by nano-hydroxyapatite. J Dent Res 2008; (87(A)): 2265. J. Dent. Res. Kawamata H 89(A) 2988 2010 Kawamata H, Ohta K, Saito T, Hayman R. Investigation of dentinal surface coating by nano-hydroxyapatite. J Dent Res 2010; 89(A) : 2988. Am. J. Dent. Amaechi B.T. 28 33 2015 Amaechi BT, Mathews SM, Ramalingam K, Mensinkai PK. Evaluation of nanohydroxyapatite-containing toothpaste for occluding dentin tubules. Am J Dent 2015; 28 (1) : 33-9. Lancet Huskisson E.C. 2 1127 1974 10.1016/S0140-6736(74)90884-8 Huskisson EC. Measurement of pain. Lancet 1974; 2 (7889) : 1127-31. Pain Ferreira-Valente M.A. 152 2399 2011 10.1016/j.pain.2011.07.005 Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain 2011; 152 (10) : 2399-404. J. Clin. Dent. Sharma D. 24 62 2013 Sharma D, McGuire JA, Amini P. Randomized trial of the clinical efficacy of a potassium oxalate-containing mouthrinse in rapid relief of dentin sensitivity. J Clin Dent 2013; 24 (2) : 62-7. J. Clin. Dent. Hughes N. 21 49 2010 Hughes N, Mason S, Jeffery P, et al. A comparative clinical study investigating the efficacy of a test dentifrice containing 8% strontium acetate and 1040 ppm sodium fluoride versus a marketed control dentifrice containing 8% arginine, calcium carbonate, and 1450 ppm sodium monofluorophosphate in reducing dentinal hypersensitivity. J Clin Dent 2010; 21 (2) : 49-55. J. Clin. Periodontol. Holland G.R. 24 808 1997 10.1111/j.1600-051X.1997.tb01194.x Holland GR, Narhi MN, Addy M, Gangarosa L, Orchardson R. Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. J Clin Periodontol 1997; 24 (11) : 808-13. Br. Dent. J. Orchardson R. 162 253 1987 10.1038/sj.bdj.4806096 Orchardson R, Collins WJ. Clinical features of hypersensitive teeth. Br Dent J 1987; 162 (7) : 253-6. J. Clin. Periodontol. Gillam D.G. 20 383 1993 10.1111/j.1600-051X.1993.tb00378.x Gillam DG, Newman HN. Assessment of pain in cervical dentinal sensitivity studies. A review. J Clin Periodontol 1993; 20 (6) : 383-94. J. Dent. Res. Närhi M.V. 64 564 1985 10.1177/002203458506400411 Närhi MV. The characteristics of intradental sensory units and their responses to stimulation. J Dent Res 1985; 64 (Spec No) : 564-71. J. Clin. Periodontol. Orchardson R. 14 68 1987 10.1111/j.1600-051X.1987.tb00944.x Orchardson R, Collins WJ. Thresholds of hypersensitive teeth to 2 forms of controlled stimulation. J Clin Periodontol 1987; 14 (2) : 68-73. Quintessence Int. Vano M. 45 703 2014 Vano M, Derchi G, Barone A, Covani U. Effectiveness of nano-hydroxyapatite toothpaste in reducing dentin hypersensitivity: A double-blind randomized controlled trial. Quintessence Int 2014; 45 (8) : 703-11. J. Esthet. Restor. Dent. Browning W.D. 24 268 2012 10.1111/j.1708-8240.2011.00437.x Browning WD, Cho SD, Deschepper EJ. Effect of a nano-hydroxyapatite paste on bleaching-related tooth sensitivity. J Esthet Restor Dent 2012; 24 (4) : 268-76. J. Int. Oral Health Gopinath N.M. 7 118 2015 Gopinath NM, John J, Nagappan N, Prabhu S, Kumar ES. Evaluation of dentifrice containing nano-hydroxyapatite for dentinal hypersensitivity: A randomized controlled trial. J Int Oral Health 2015; 7 (8) : 118-22. J. Periodontol. Shetty S. 81 1781 2010 10.1902/jop.2010.100172 Shetty S, Kohad R, Yeltiwar R. Hydroxyapatite as an in-office agent for tooth hypersensitivity: A clinical and scanning electron microscopic study. J Periodontol 2010; 81 (12) : 1781-9. J. Oral Rehabil. West N.X. 29 167 2002 10.1046/j.1365-2842.2002.00851.x West NX, Hughes JA, Addy M. Dentine hypersensitivity: The effects of brushing toothpaste on etched and unetched dentine in vitro. J Oral Rehabil 2002; 29 (2) : 167-74. J. Oral Rehabil. Lee S.Y. 35 847 2008 10.1111/j.1365-2842.2008.01876.x Lee SY, Kwon HK, Kim BI. Effect of dentinal tubule occlusion by dentifrice containing nano-carbonate apatite. J Oral Rehabil 2008; 35 (11) : 847-53. 10.1007/978-0-387-77667-5 de Villiers MM, Aramwit P, Kwon GS, Eds. Biotechnology: Pharmaceutical Aspects. Vol 10: Nanotechnology in Drug Delivery. 2009; 10 Oper. Dent. Wang L. 41 E93 2016 10.2341/15-145-C Wang L, Magalhães AC, Francisconi-Dos-Rios LF, et al. Treatment of dentin hypersensitivity using nano-hydroxyapatite pastes: A randomized three-month clinical trial. Oper Dent 2016; 41 (4) : E93-E101. J. Am. Dent. Assoc. Haywood V.B. 125 1219 1994 10.14219/jada.archive.1994.0154 Haywood VB, Leonard RH, Nelson CF, Brunson WD. Effectiveness, side effects and long-term status of nightguard vital bleaching. J Am Dent Assoc 1994; 125 (9) : 1219-26.