Olusile Adeyemi Oluniyi, Bamise Cornelius Tokunbo, Oginni Adeleke O, Dosumu Oluwole O
Department of Restorative Dentistry of Faculty of Dentistry, College of Health Sciences at Obafemi Awolowo University in Ile-Ife, Nigeria.
J Contemp Dent Pract. 2008 Jan 1;9(1):22-9.
To evaluate the effectiveness of four topical desensitizing agents in providing short-term relief of dentin hypersensitivity.
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.
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).
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.
评估四种局部脱敏剂在短期内缓解牙本质过敏的效果。
本研究纳入了116颗对牙本质过敏口内测试呈阳性反应的过敏牙齿。所测试的四种脱敏剂分别为多乐氟、2%氟离子导入、珂罗酊清漆(CV)和Gluma Comfort Bond Plus脱敏剂。按照随机确定的特定方案,当患者因牙齿过敏前来临床就诊时,交替使用脱敏剂。采用视觉模拟评分法在三个时间点确定过敏程度。第一个时间点是治疗前以建立基线,然后是治疗后24小时,最后是治疗后七天。基线与治疗后评估期之间的平均疼痛评分(MPS)差异用于确定牙本质过敏的减轻程度。
基线时,用CV治疗的牙齿MPS为5.34(标准差:2.39),多乐氟为4.66(标准差:1.82),Gluma为6.03(标准差:2.37),离子导入为5.76(标准差:1.37)。治疗后24小时,CV的MPS为2.1(标准差:0.95),多乐氟为1.38(标准差;1.86),Gluma为0.79(标准差;1.45),离子导入为1.62(标准差1.97)。治疗后24小时牙本质过敏的减轻程度(基线MPS与24小时MPS之差),Gluma为5.28,离子导入为4.14,多乐氟为3.28,CV为3.24,均具有统计学意义(p<0.05)。七天时,CV的MPS为1.55(标准差:1.44),多乐氟为1.0(标准差;1.89),Gluma为0.10(标准差;0.44),离子导入为0.3(标准差;0.98)。24小时至一周内过敏减轻程度,离子导入为1.32,Gluma为0.69,CV为0.55,多乐氟为0.38。仅离子导入和Gluma在七天时的减轻程度具有统计学意义(p<0.05)。
所有药物在治疗后24小时内均使牙本质过敏有统计学意义的减轻。Gluma在24小时时效果最佳,而离子导入在七天时似乎更具优势。需要进行长期研究以确定为何存在这种差异。牙本质过敏是一种急症状况,在临床医生的治疗手段中需要一种有效的方法来立即缓解症状。