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Effect of different treatments on dentin hypersensitivity: evaluation of cytotoxicity and randomized clinical study

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Author(s):
Fernanda de Souza e Silva Ramos
Total Authors: 1
Document type: Doctoral Thesis
Press: Araçatuba. 2023-08-07.
Institution: Universidade Estadual Paulista (Unesp). Faculdade de Odontologia. Araçatuba
Defense date:
Advisor: Ticiane Cestari Fagundes
Abstract

Objectives: The aim of this study was to investigate the effects of different categories of treatments for dentin hypersensitivity in relation to wear and cytotoxicity using the following protocols: placebo varnish (PLA), fluoride varnish (FLU), sodium fluoride varnish (NaF) + sodium trimetaphosphate (TMP), universal adhesive (SBU), S-PRG varnish (SPRG), biosilicate (BIOS) and amelotin solution (AMTN). Additionally, FLU, SBU, SPRG and BIOS had their clinical longevity evaluated. Methods: Seventy bovine root dentin blocks were sectioned. Half of the surface of each specimen was untreated (control) and the other half was immersed in EDTA and treated with the desensitizing materials. After application, the specimens underwent an erosive-abrasive challenge and the wear was analyzed by optical profilometer. Serial dilutions of extracts obtained from the culture medium containing discs impregnated with those desensitizers were applied on fibroblasts and odontoblasts-like cells cultures. Cytotoxicity and production of total protein (TP) by colorimetric assays were determined after 24h. Regarding clinical trial, 192 non-cavitated root exposures were analyzed using visual analogue (VAS) and computerized visual scales (CoVAS), before treatments (baseline) and after 7, 15, 30 days, 6 and 12 months. Data were analyzed using Kruskal-Wallis, Dunn’s for wear, One-way ANOVA, Tukey, and linear regression model with fixed effects and post-test using orthogonal contrasts for clinical (p ≤ 0.05). Results: SBU was the only material that did not show wear. The lowest wear was observed for AMTN, being statistically similar to TMP. Cell viability was significantly reduced for PLA, FLU, TMP and SBU in fibroblasts-like cell and TMP and SBU in odontoblast-like cell considering undiluted extract. PT showed varied levels of protein concentrations with no difference between groups at 24h for fibroblasts-cell. For clinical study, all desensitizers were effective in reducing DH, compared with baseline data for both scales. On the VAS scale, a significant reduction in DH was observed after 7 days for BIOS and SBU, and after 15 days for FLU and SPRG. For the CoVAS scale, all desensitizers were able to significantly reduce DH after 7 days, except for SPRG, which showed this reduction after 15 days. No desensitizer returned to initial sensitivity level after 12-months for both scales. No statistical differences were found among desensitizers for all times of evaluation, for both scales. Conclusion: Universal adhesive protected the wear of DH after challenge. Undiluted extracts of universal adhesives and fluoride varnishes show cytotoxicity, mainly for fibroblasts. All in-office treatments were effective for reducing DH over 12 months, with similarity levels of pain. (AU)

FAPESP's process: 20/07443-9 - Effect of different treatments on dentin hypersensitivity: evaluation of cytotoxicity and randomized clinical study
Grantee:Fernanda de Souza e Silva Ramos
Support Opportunities: Scholarships in Brazil - Doctorate