Clinical Oral Investigations

, Volume 22, Issue 2, pp 617–631 | Cite as

Effectiveness for dentin hypersensitivity treatment of non-carious cervical lesions: a meta-analysis

  • Vittorio Moraschini
  • Larissa Salina da Costa
  • Gustavo Oliveira dos Santos



The aim of this review is to conduct a systematic review and meta-analysis comparing the effectiveness of in-home or in-office treatments for dentin hypersensitivity.

Materials and methods

An electronic search without restriction on dates or languages was performed in four electronic databases until March 2017. In addition, hand-searches in regular journals and in the gray literature were also conducted. To develop the search strategy, clinical questions were formulated using the PICOS method. Eligibility criteria included randomized clinical trials (RCTs) that compared the effectiveness of different agents for the treatment of dentin hypersensitivity through chemical occlusion, physical occlusion, nerve desensitization, or photobiomodulation (low-level light therapy). This systematic review was registered in PROSPERO under number CRD42016039394.


Twenty-five RCTs (16 parallel; 9 split-mouth), published from 1992 to 2016, were included. The results of the meta-analysis showed that in-office subgroups treated with chemical or physical occlusion of dentin tubules and nerve desensitization had a statistically significant difference from placebo, with P < 0.00001, P < 0.00001, and P = 0.02, respectively. For in-home treatments, the results of the meta-analysis showed that only those subgroups treated with chemical occlusion of dentin tubules and nerve desensitization exhibited a statistically significant difference from placebo, with P < 0.00001 and P = 0.03, respectively.


The results of pairwise meta-analysis suggest that among in-office treatments, dentinal tubule occlusion (whether chemical or physical) and nerve desensitization provide the best outcomes for treatment of dentin hypersensitivity. For in-home treatments, only chemical occlusion of dentin tubules and nerve desensitization showed a greater treatment efficacy than placebo and the difference was statistically significant.


Evidence-based dentistry Dentin hypersensitivity Dentin desensitizing agent Meta-analysis 



The authors would like to thank Dr. Anely Oliveira Lopes, Department of Restorative Dentistry, School of Dentistry, University of São Paulo, Brazil, for providing some missing information about this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.


  1. 1.
    Goh V, Corbet EF, Leung WK (2016) Impact of dentine hypersensitivity on oral health–related quality of life in individuals receiving supportive periodontal care. J Clin Periodontol 43(7):595–602. CrossRefPubMedGoogle Scholar
  2. 2.
    Addy M (1992) Clinical aspects of dentine hypersensitivity. Proc Finn Dent Soc 88(suppl. 1):407–412Google Scholar
  3. 3.
    Kopycka-Kedzierawski DT, Meyerowitz C, Litaker MS, Heft MW, Tasgaonkar N, Day MR, Porter-Williams A, Gordan VV, Yardic RL, Lawhorn TM, Gilbert GH, National Dental PBRN Collaborative Group (2017) Management of dentin hypersensitivity by practitioners in The National Dental Practice-Based Research Network. J Am Dent Assoc 148:728–736CrossRefPubMedGoogle Scholar
  4. 4.
    Jo G, Simring M, Schreiner S (2004) Attrition, abrasion, corrosion and abfraction revisited: a new perspective on tooth surface lesions. J Am Dent Assoc 135:1109–1118CrossRefGoogle Scholar
  5. 5.
    Moraschini V, Barboza ES (2016) Use of platelet-rich fibrin membrane in the treatment of gingival recession: a systematic review and meta-analysis. J Periodontol 87(3):281–290. CrossRefPubMedGoogle Scholar
  6. 6.
    Brännström M, Astron A (1972) The hydrodynamics of the dentin: its possible relationship to dentinal pain. Int Dent J 22(2):219–227PubMedGoogle Scholar
  7. 7.
    Vano M, Derchi G, Barone A, Pinna R, Usai P, Covani U (2017) Reducing dentine hypersensitivity with nano-hydroxyapatite toothpaste: a double-blind randomized controlled trial. Clin Oral Investig.
  8. 8.
    Han SY, Jung HI, Kwon HK, Kim BI (2013) Combined effects of Er:YAG laser and nano-carbonate apatite dentifrice on dentinal tubule occlusion: in vitro study. Photomed Laser Surg 31(7):342–348. CrossRefPubMedGoogle Scholar
  9. 9.
    Yoshiyama M, Masada A, Uchida A, Ishida H (1989) Scanning electron microscopic characterization of sensitive versus insensitive human radicular dentine. J Dent Res 68(11):1498–1502. CrossRefPubMedGoogle Scholar
  10. 10.
    Liang X, Wei Z, Hu D, Ruan J (2017) Prevalence of dentin hypersensitivity among the residents of Xi'an city, China. Acta Odontol Sacand 75(6):387–393. CrossRefGoogle Scholar
  11. 11.
    Porto IC, Andrade AK, Montes MA (2009) Diagnosis and treatment of dentinal hypersensitivity. J Oral Sci 51(3):323–332. CrossRefPubMedGoogle Scholar
  12. 12.
    Bulman JS, Gillam DG, Eijkman MA, Newman HN (2002) Dentists’ perceptions of dentine hypersensitivity and knowledge of its treatment. J Oral Rehabil 29:219–225CrossRefPubMedGoogle Scholar
  13. 13.
    Miglani S, Aggarwal V, Ahuja B (2010) Dentine hypersensitivity: recent trends in management. J Conserv Dent 13(4):218–224. CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Orsini G, Procaccini M, Manzoli L, Giuliodori F, Lorenzini A, Putignano A (2010) A double-blind randomized-controlled trial comparing the desensitizing efficacy of a new dentifrice containing carbonate/hydroxyapatite nanocrystals and a sodium fluoride/potassium nitrate dentifrice. J Clin Periodontol 37(6):510–517. CrossRefPubMedGoogle Scholar
  15. 15.
    Sowinski J, Ayad F, Petrone M, Devizio W, Volpe A, Ellwood R, Davies R (2001) Comparative investigations of the desensitising efficacy of a new dentifrice. J Clin Periodontol 28(11):1032–1036. CrossRefPubMedGoogle Scholar
  16. 16.
    Swift EJ Jr (2004) Causes, prevention, and treatment of dentin hypersensitivity. Compend Contin Educ Dent 25:95–106PubMedGoogle Scholar
  17. 17.
    Higgins JPT, Green S, eds (2006) Cochrane Handbook for Systematic Reviews of Interventions 4.2.6 [updated September 2006]. In: The Cochrane Library 4Google Scholar
  18. 18.
    Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269CrossRefPubMedGoogle Scholar
  19. 19.
    Shea BJ, Grimshaw JM, Wells GA, Wells GA, Boers M, Andersson N et al (2007) Development of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol 7:10CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Schardt C, Adams MB, Owens T, Keitz S, Fontelo P (2007) Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak 15:7–16Google Scholar
  21. 21.
    Higgins JP, Altman DG, Gøtzsche PC et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 18:d5928CrossRefGoogle Scholar
  22. 22.
    Glass GV (1976) Primary, secondary, and meta-analysis of research. Educ Res 5(10):3–8. CrossRefGoogle Scholar
  23. 23.
    Prabhakar AR, Manojkumar AJ, Basappa N (2013) In vitro remineralization of enamel subsurface lesions and assessment of dentine tubule occlusion from NaF dentifrices with and without calcium. J Indian Soc Pedod Prev Dent 31(1):29–35. CrossRefPubMedGoogle Scholar
  24. 24.
    Saeki K, Marshall GW, Gansky SA, Parkinson CR, Marshall SJ (2016) Strontium effects on root dentin tubule occlusion and nanomechanical properties. Dent Mater 32(2):240–251. CrossRefPubMedGoogle Scholar
  25. 25.
    Han L, Okiji T (2015) Dentin tubule occluding ability of dentin desensitizers. Am J Dent 28:90–94PubMedGoogle Scholar
  26. 26.
    Kym SY, Kim EJ, Kim DS, Lee IB (2013) The evaluation of dentinal tubule occlusion by desensitizing agents: a real-time measurement of dentinal fluid flow rate and scanning electron microscopy. Oper Dent 38(4):419–428. CrossRefGoogle Scholar
  27. 27.
    Lee SY, Kwon HK, Kim BI (2008) Effect of dentinal tubule occlusion by dentifrice containing nano-carbonate apatite. J Oral Rehabil 35(11):847–853. CrossRefPubMedGoogle Scholar
  28. 28.
    Nagata T, Ishida H, Shinohara H, Nishikawa S, Kasahara S, Wakano Y, Daigen S, Troullos ES (1994) Clinical evaluation of a potassium nitrate dentifrice for the treatment of dentinal hypersensitivity. J Clin Periodontol 21(3):217–221. CrossRefPubMedGoogle Scholar
  29. 29.
    Prasad KV, Sohoni R, Tikare S, Yalamalli M, Rajesh G, Javali SB (2010) Efficacy of two commercially available dentifrices in reducing dentinal hypersensitivity. Indian J Dent Res 21(2):224–230. CrossRefPubMedGoogle Scholar
  30. 30.
    Azarpazhooh A, Limeback H, Lawrence HP, Fillery ED (2009) Evaluating the effect of an ozone delivery system on the reversal of dentin hypersensitivity: a randomized, double-blinded clinical trial. J Endod 35(1):1–9. CrossRefPubMedGoogle Scholar
  31. 31.
    Acharya AB, Surve SM, Thakur SL (2013) A clinical study of the effect of calcium sodium phosphosilicate on dentin hypersensitivity. J Clin Exp Dent 5(1):e18–e22. CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Aranha AC, Pimenta LA, Marchi GM (2009) Clinical evaluation of desensitizing treatments for cervical dentin hypersensitivity. Braz Oral Res 23(3):333–339. CrossRefPubMedGoogle Scholar
  33. 33.
    Cunha-Cruz J, Wataha JC, Heaton LJ, Rothen M, Sobieraj M, Scott J, Berg J, Northwest Practice-based Research Collaborative in Evidence-based DENTistry (2013) The prevalence of dentin hypersensitivity in general dental practices in the northwest United States. J Am Dent Assoc 144(3):288–296. CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Rahiotis C, Polychronopoulou A, Tsiklakis K, Kakaboura A (2013) Cervical dentin hypersensitivity: a cross-sectional investigation in Athens, Greece. J Oral Rehabil 40(12):948–957. CrossRefPubMedGoogle Scholar
  35. 35.
    Ylmaz HG, Cengiz E, Kurtulmus-Ylmaz S, Leblebicioglu B (2011) Effectiveness of Er,Cr:YSGG laser on dentine hypersensitivity: a controlled clinical trial. J Clin Periodontol 38(4):341–346. CrossRefGoogle Scholar
  36. 36.
    Pesevska S, Nakova M, Ivanovski K, Angelov N, Kesic L, Obradovic R, Mindova S, Nares S (2010) Dentinal hypersensitivity following scaling and root planing: comparison of low-level laser and topical fluoride treatment. Lasers Med Sci 25(5):647–650. CrossRefPubMedGoogle Scholar
  37. 37.
    Veitz-Keenan A, Barna JA, Strober B, Matthews AG, Collie D, Vena D et al (2013) Treatments for hypersensitive noncarious cervical lesions: a Practitioners Engaged in Applied Research and Learning (PEARL) Network randomized clinical effectiveness study. J Dent Am Assoc 144:495–506CrossRefGoogle Scholar
  38. 38.
    Mehta D, Gowda VS, Santosh A, Finger WJ, Sasaki K (2014) Randomized controlled clinical trial on the efficacy of dentin desensitizing agents. Acta Odontol Scand 72(8):936–941. CrossRefPubMedGoogle Scholar
  39. 39.
    Mehta D, Gowda V, Finger WJ, Sasaki K (2015) Randomized, placebo-controlled study of the efficacy of a calcium phosphate containing paste on dentin hypersensitivity. Dent Mater 31(11):1298–1303. CrossRefPubMedGoogle Scholar
  40. 40.
    Gillam DG, Newman HN, Davies EH, Bulman JS (1992) Clinical efficacy of a low abrasive dentifrice for the relief of cervical dentinal hypersensitivity. J Clin Periodontol 19(3):197–201. CrossRefPubMedGoogle Scholar
  41. 41.
    Gillam DG, Bulman JS, Jackson RJ, Newman HN (1996) Efficacy of a potassium nitrate mouthwash in alleviating cervical dentine sensitivity (CDS). J Clin Periodontol 23(11):993–997. CrossRefPubMedGoogle Scholar
  42. 42.
    Pereira R, Chava VK (2001) Efficacy of a 3% potassium nitrate desensitizing mouthwash in the treatment of dentinal hypersensitivity. J Clin Periodontol 72(12):1720–1725. CrossRefGoogle Scholar
  43. 43.
    Frechoso SC, Menéndez M, Guisasola C, Tejerina JM, Sicilia A (2003) Evaluation of the efficacy of two potassium nitrate bioadhesive gels (5% and 10%) in the treatment of dentine hypersensitivity. A randomised clinical trial. J Clin Periodontol 30:315–320CrossRefPubMedGoogle Scholar
  44. 44.
    Pillon FL, Romani IG, Schimidt ER (2004) Effect of a 3% potassium oxalate topical application on dentinal hypersensitivity after subgingival scaling and root planing. J Periodontol 75(11):1461–1464. CrossRefPubMedGoogle Scholar
  45. 45.
    Zantner C, Popescu O, Martus P, Kielbassa AM (2006) Randomized clinical study on the efficacy of a new lacquer for dentine hypersensitivity. Schweiz Monatsschr Zahnmed 116(12):1232–1237PubMedGoogle Scholar
  46. 46.
    Ritter AV, de Dias LW, Miguel P, Caplan DJ, Swift EJ Jr (2006) Treating cervical dentin hypersensitivity with fluoride varnish: a randomized clinical study. J Am Dent Assoc 137:1013–1020CrossRefPubMedGoogle Scholar
  47. 47.
    Ozen T, Orhan K, Avserver H, Tunca YM, Ulker AE, Akyol M (2009) Dentin hypersensitivity: a randomized clinical comparison of three different agents in a short-term treatment period. Oper Dent 34(4):392–398. CrossRefPubMedGoogle Scholar
  48. 48.
    Vieira AH, Passos VF, de Assis JS, Mendonça JS, Santiago SL (2009) Clinical evaluation of a 3% potassium oxalate gel and a GaAlAs laser for the treatment of dentinal hypersensitivity. Photomed Laser Surg 27(5):807–812. CrossRefPubMedGoogle Scholar
  49. 49.
    Shetty S, Kohad R, Yeltiwar R (2010) Hydroxyapatite as an in-office agent for tooth hypersensitivity: a clinical and scanning electron microscopic study. J Periodontol 81(12):1781–1789. CrossRefPubMedGoogle Scholar
  50. 50.
    Assis JS, Rodrigues LK, Fonteles CS, Colares RC, Souza AM, Santiago SL (2011) Dentin hypersensitivity after treatment with desensitizing agents: a randomized, double-blind, split-mouth clinical trial. Braz Dent J 22(2):157–161. CrossRefPubMedGoogle Scholar
  51. 51.
    Yilmaz HG, Kurtulmus-Yilmaz S, Cengiz E (2011) Long-term effect of diode laser irradiation compared to sodium fluoride varnish in the treatment of dentine hypersensitivity in periodontal maintenance patients: a randomized controlled clinical study. Photomed Laser Surg 29:721–725CrossRefPubMedGoogle Scholar
  52. 52.
    Yilmaz HG, Kurtulmus-Yilmaz S, Cengiz E, Bayindir H, Aykac Y (2011) Clinical evaluation of Er,Cr:YSGG and GaAlAs laser therapy for treating dentine hypersensitivity: a randomized controlled clinical trial. J Dent 39:249–254CrossRefPubMedGoogle Scholar
  53. 53.
    Castillo JL, Rivera S, Aparicio T, Lazo R, Aw TC, Mancl LL, Milgrom P (2011) The short-term effects of diammine silver fluoride on tooth sensitivity: a randomized controlled trial. J Dent Res 90(2):203–208. CrossRefPubMedGoogle Scholar
  54. 54.
    Camilotti V, Zily J, Busato Pdo M, Nassar CA, Nassar PO (2012) Desensitizing treatments for dentin hypersensitivity: a randomized, split-mouth clinical trial. Braz Oral Res 26(3):263–268. CrossRefPubMedGoogle Scholar
  55. 55.
    Guentsch A, Seidler K, Nietzsche S, Hefti AF, Preshaw PM, Watts DC (2012) Biomimetic mineralization: long-term observations in patients with dentin sensitivity. Dent Materials 28(4):457–464. CrossRefGoogle Scholar
  56. 56.
    Gibson M, Sharif MO, Smith A, Saini P, Brunton PA (2013) A practice-based randomised controlled trial of the efficacy of three interventions to reduce dentinal hypersensitivity. J Dent 41(8):668–674. CrossRefPubMedGoogle Scholar
  57. 57.
    Neuhaus KW, Milleman JL, Milleman KR, Mongiello KA, Simonton TC, Clark CE, Proskin HM, Seemann R (2013) Effectiveness of a calcium sodium phosphosilicate-containing prophylaxis paste in reducing dentine hypersensitivity immediately and 4 weeks after a single application: a double-blind randomized controlled trial. J Clin Periodontol 40(4):349–357. CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Sharma D, McGuire JA, Gallob JT, Amini P (2013) Randomised clinical efficacy trial of potassium oxalate mouthrinse in relieving dentinal sensitivity. J Dent 41(Suppl. 4):S40–S48. CrossRefPubMedGoogle Scholar
  59. 59.
    Elias Boneta AR, Ramirez K, Naboa J, Mateo LR, Stewart B, Panagokos F, de Vizio W (2013) Efficacy in reducing dentine hypersensitivity of a regimen using a toothpaste containing 8% arginine and calcium carbonate, a mouthwash containing 0.8% arginine, pyrophosphate and PVM/MA copolymer and a toothbrush compared to potassium and negative control regimens: an eight-week randomized clinical trial. J Dent 41(Suppl. 1):S42–S49. CrossRefPubMedGoogle Scholar
  60. 60.
    Talesara K, Kulloli A, Shetty, Kathariya R (2014) Evaluation of potassium binoxalate gel and Nd:YAG laser in the management of dentinal hypersensitivity: a split-mouth clinical and ESEM study. Laser Med Sci 29:61–68CrossRefGoogle Scholar
  61. 61.
    Freitas Sda S, Sousa LL, Moita Neto JM, Mendes RF, Prado RR (2015) Dentin hypersensitivity treatment of non-carious cervical lesions—a single-blind, split-mouth study. Braz Oral Res 29:45PubMedGoogle Scholar
  62. 62.
    Lopes AO, Eduardo Cde P, Aranha AC (2015) Clinical evaluation of low-power laser and a desensitizing agent on dentin hypersensitivity. Laser Med Sci 30(2):823–829. CrossRefGoogle Scholar
  63. 63.
    Wang L, Magalhães AC, Francisconi-Dos-Rios LF, Calabria MP, Araújo D, Buzalaf M, Lauris J, Pereira JC (2016) Treatment of dentin hypersensitivity using nano-hydroxyapatite pastes: a randomized three-month clinical trial. Oper Dent 41(4):E93–E101. CrossRefPubMedGoogle Scholar
  64. 64.
    Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Meas 20(1):37–46. CrossRefGoogle Scholar
  65. 65.
    Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med 8(1):18. CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Fleming PS, Lynch CD, Pandis N (2014) Randomized controlled trials in dentistry: common pitfalls and how to avoid them. J Dent 42(8):908–914. CrossRefPubMedGoogle Scholar
  67. 67.
    Egger M, Smith GD, Sterne JA (2001) Uses and abuses of meta-analysis. Clin Med 1(6):478–484. CrossRefGoogle Scholar
  68. 68.
    Pandis N (2011) The evidence pyramid and introduction to randomized controlled trials. Am J Orthod Dentofac Orthop 140(3):446–447. CrossRefGoogle Scholar
  69. 69.
    Kleinberg I, Kaufman HW, Wolff M (1994) Measurement of tooth hypersensitivity and oral factors involved in its development. Arch Oral Biol 39:63S–71S. CrossRefPubMedGoogle Scholar
  70. 70.
    Ferreira AN, Silveira L, Genovese WJ, de Araújo VC, Frigo L, de Mesquita RA, Guedes E (2006) Effect of GaAIAs laser on reactional dentinogenesis induction in human teeth. Photomed Laser Surg 24(3):358–365. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Dentistry, Department of PeriodontologyFluminense Federal UniversityRio de JaneiroBrazil
  2. 2.School of Dentistry, Department of Integrated ClinicFluminense Federal UniversityRio de JaneiroBrazil

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