Stewardson Dominic A, Crisp Russell J, McHugh Siobhan, Lendenmann Urs, Burke F J Trevor
Conservative Dentistry, University of Birmingham School of Dentistry, Birmingham, UK.
Prim Dent Care. 2004 Jul;11(3):71-6. doi: 10.1308/1355761041208511.
This study reports the effectiveness of Systemp.desensitizer (Ivoclar Vivadent, Schaan, Liechtenstein), when used both with and without an acid-etch step, in the treatment of patients with dentine hypersensitivity in UK dental practices.
Ten general dental practitioners (GDPs) were selected from two practice-based research groups. The GDPs were each requested to use Systemp.desensitizer in the treatment of at least ten patients who presented with pain due to dentine hypersensitivity. Systemp.desensitizer was applied to the sensitive dentine area in strict accordance with the manufacturer's handling instructions, except that the patients were divided into two groups. For the first, group NE, the procedure was to isolate the tooth, gently blot it dry with cotton wool pellets, rub Systemp.desensitizer into the tooth for 20 seconds, then gently air-dry it. For the second, group E, the procedure was identical except that after isolation, the treatment area was etched for 15 seconds with 35% phosphoric acid. Patients were asked to complete a pro forma using a 10 cm visual analogue scale designed to provide details of the extent of their pain before treatment, 24 hours post-treatment, one week post-treatment, one month post-treatment, and three months post-treatment. The zero end of the scale was marked 'no pain' and the 10 cm end was marked 'extreme pain'. The percentage change in the patients' perception of their pain, relative to pretreatment, was calculated using repeated measures analysis and suitable follow-up confidence intervals for the mean changes in perceived pain. Comparisons were then made between the treatment groups NE and E.
Ninety-one patients completed the first pro forma and 77 completed all the pro formas. Overall, there was a significant reduction in pain at each of the time points after treatment but the pattern of pain reduction across the two groups was different. In general, the non-etched group (group NE) saw an 'immediate' reduction in pain which was then fairly consistent across the longer term, whilst, in general, the etched group (group E) saw less reduction in pain 24 hours after treatment, and then further reduction in pain at both one week and one month after treatment. Thus the non-etched group experienced an early reduction whilst the etched group took longer to perceive a reduction in pain; however, there were no statistically significant differences between the reductions in pain scores between the two groups at any of the time points after treatment.
It is concluded that Systemp.desensitizer was effective in reducing pain from dentine hypersensitivity in the patients treated, and this finding was unaffected by whether or not the tooth was acid-etched prior to application of the reagent.
本研究报告了在英国牙科诊所中,使用Systemp脱敏剂(义获嘉伟瓦登特公司,沙恩,列支敦士登)治疗牙本质过敏患者时,有无酸蚀步骤的有效性。
从两个基于实践的研究小组中挑选出10名普通牙科医生(GDPs)。要求每位GDPs使用Systemp脱敏剂治疗至少10名因牙本质过敏而疼痛的患者。除了将患者分为两组外,Systemp脱敏剂严格按照制造商的操作说明应用于敏感牙本质区域。对于第一组NE,操作步骤是隔离牙齿,用棉球轻轻吸干,将Systemp脱敏剂擦入牙齿20秒,然后轻轻吹干。对于第二组E,操作步骤相同,只是在隔离后,用35%的磷酸对治疗区域进行15秒的酸蚀。要求患者使用10厘米视觉模拟量表填写一份表格,以提供治疗前、治疗后24小时、治疗后一周、治疗后一个月和治疗后三个月疼痛程度的详细信息。量表的零端标记为“无疼痛”,10厘米端标记为“极度疼痛”。使用重复测量分析和感知疼痛平均变化的合适随访置信区间,计算患者对疼痛的感知相对于治疗前的百分比变化。然后对治疗组NE和E进行比较。
91名患者完成了第一份表格,77名患者完成了所有表格。总体而言,治疗后每个时间点的疼痛都有显著减轻,但两组的疼痛减轻模式不同。一般来说,未酸蚀组(NE组)的疼痛“立即”减轻,然后在较长时间内相当稳定,而一般来说,酸蚀组(E组)在治疗后24小时疼痛减轻较少,然后在治疗后一周和一个月疼痛进一步减轻。因此,未酸蚀组疼痛早期减轻,而酸蚀组需要更长时间才能感觉到疼痛减轻;然而,治疗后任何时间点两组疼痛评分的减轻之间没有统计学上的显著差异。
得出结论,Systemp脱敏剂在治疗的患者中有效减轻牙本质过敏引起的疼痛,这一发现不受试剂应用前牙齿是否酸蚀的影响。