Reducing dentine hypersensitivity with nano-hydroxyapatite toothpaste: a double-blind randomized controlled trial

Abstract

Objectives

The present randomized double-blind clinical trial aimed to compare the efficacy in reducing dentin hypersensitivity of a dentifrice formulation containing nano-hydroxyapatite with a fluoride dentifrice and a placebo.

Methods and materials

One hundred and five subjects were recruited to participate in the study. A computer-generated random table with blocking to one of the three study treatments was used in order to have 35 subjects per group: (1) nano-hydroxyapatite 2% gel toothpaste fluoride free; (2) fluoride gel toothpaste; (3) placebo. Groups 1, 2, and 3 were instructed to treat their teeth for 10 min twice a day with the provided toothpaste gel. The participant’s dentin hypersensitivity was evaluated at baseline and after 2 and 4 weeks using airblast and tactile tests. In addition, a subjective evaluation using a visual analogue scale was used.

Results

Significant lower values of cold air sensitivity and tactile sensitivity (p < 0.05) were found for the test group at 2 weeks and 4 weeks. In addition, statistically significant (p < 0.05) lower values of sensitivity were reported for group 1 compared to those for groups 2 and 3 at 2 and 4 weeks, respectively. The VAS scores were significantly lower (p < 0.05) in the test group at 2 and 4 weeks compared to those at baseline and in the control groups.

Conclusion

The application of nano-hydroxyapatite in gel toothpaste fluoride free is an effective desensitizing agent providing relief from symptoms after 2 and 4 weeks.

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References

  1. 1.

    Bristol AM (2005) Tooth brushing, tooth wear and dentine hypersensitivity—are they related? Int Dental J 55:261–267

    Article  Google Scholar 

  2. 2.

    Rees JS, Addy M (2002) A cross-sectional study of dentine hypersensitivity. J Clin Periodontol 29:997–1003

    Article  PubMed  Google Scholar 

  3. 3.

    Brännström M, Linden LA, Johnson G (1968) Movement of dentinal and pulpal fluid caused by clinical procedures. J Dent Res 47:679–682

    Article  PubMed  Google Scholar 

  4. 4.

    Chung G, Jung SJ, Oh SB (2013) Cellular and molecular mechanisms of dental nociception. J Dent Res 92:948–955. doi:10.1177/0022034513501877

    Article  PubMed  Google Scholar 

  5. 5.

    Absi EG, Addy M, Adams D (1987) Dentine hypersensitivity. A study of the patency of dentinal tubules in sensitive and non-sensitive cervical dentine. J Clin Periodontol 14:280–284

    Article  PubMed  Google Scholar 

  6. 6.

    Milia E, Castelli G, Bortone A, Sotgiu G, Manunta A, Pinna R, Gallina G (2013) Short-term response of three resin-based materials as desensitizing agents under oral environmental exposure. Acta Odontol Scand 71:599–609

    Article  PubMed  Google Scholar 

  7. 7.

    Chidchuangchai W, Vongsavan N, Matthews B (2007) Sensory transduction mechanisms responsible for pain caused by cold stimulation of dentine in man. Arch Oral Biol 52:154–160

    Article  PubMed  Google Scholar 

  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 31:342–348. doi:10.1089/pho.2012.3449

    Article  PubMed  Google Scholar 

  9. 9.

    Markowitz K, Pashley DH (2007) Personal reflections on a sensitive subject. J Dent Res 86:292–295

    Article  PubMed  Google Scholar 

  10. 10.

    Lin PY, Cheng YW, Chu CY, Chien KL, Lin CP, Tu YK (2013) In-office treatment for dentin hypersensitivity: a systematic review and network meta-analysis. J Clin Periodontol 40:53–64. doi:10.1111/jcpe.12011

    Article  PubMed  Google Scholar 

  11. 11.

    Pinna R, Bortone A, Sotgiu G, Dore S, Usai P, Milia E (2015) Clinical evaluation of the efficacy of one self-adhesive composite in dental hypersensitivity. Clin Oral Investig 19:1663–1672. doi:10.1007/s00784-014-1390-3

    Article  PubMed  Google Scholar 

  12. 12.

    Vano M, Derchi G, Barone A, Covani U (2014) Effectiveness of nano-hydroxyapatite toothpaste in reducing dentin hypersensitivity: a double-blind randomized controlled trial. Quintessence Int 45:703–711. doi:10.3290/j.qi.a32240

    PubMed  Google Scholar 

  13. 13.

    Vano M, Derchi G, Barone A, Genovesi A, Covani U (2015) Tooth bleaching with hydrogen peroxide and nano-hydroxyapatite: a 9-month follow-up randomized clinical trial. Int J Dent Hyg 13:301–307. doi:10.1111/idh.12123

    Article  PubMed  Google Scholar 

  14. 14.

    Najibfard K, Ramalingam K, Chedjieu I, Amaechi BT (2011) Remineralization of early caries by a nano-hydroxyapatite dentifrice. J Clin Dent 22:139–143

    PubMed  Google Scholar 

  15. 15.

    Huang SB, Gao S, Cheng L, Yu H (2010) Combined effects of nano-hydroxyapatite and Galla chinensis on remineralisation of initial enamel lesion in vitro. J Dent 38:811–819. doi:10.1016/j.jdent.2010.06.013

    Article  PubMed  Google Scholar 

  16. 16.

    Huang S, Gao S, Yu H (2011) Remineralization potential of nano-hydroxyapatite on initial enamel lesions: an in vitro study. Caries Res 45:460–468. doi:10.1159/000331207

    Article  PubMed  Google Scholar 

  17. 17.

    Lee S, Kwon H, Kim B (2008) Effect of dentinal tubule occlusion by dentifrice containing nano-carbonate apatite. J Oral Rehabil 35:847–853. doi:10.1111/j.1365-2842.2008.01876.x

    Article  PubMed  Google Scholar 

  18. 18.

    Roveri N, Battistella E, Bianchi CL, Foltran I, Foresti E, Iafasco M, Lelli M, Naldoni A, Palazzo B, Rimondini L (2009) Surface enamel remineralization: biomimetic apatite nanocrystals and fluoride ions different effects. J Nanomater 1:1–9. doi:10.1155/2009/746383

    Article  Google Scholar 

  19. 19.

    Roveri N, Battistella E, Foltran I, Foresti E, Iafasco M, Lelli M, Palazzo B, Rimondini L (2008) Synthetic biomimetic carbonate-hydroxyapatite nanocrystals for enamel remineralization. Adv Mater Res 47-50:821–824. doi:10.4028/www.scientific.net/AMR.47-50.821

    Article  Google Scholar 

  20. 20.

    Roveri, N, Foresti E, Lelli M, Lesci, IG. (2009) Recent advancements in preventing teeth health hazard: the daily use of hydroxyapatite instead of fluoride. Recent Patents on Biomedical Engineering 197–215. doi: 10.2174/1874764710902030197

  21. 21.

    Rimondini L, Palazzo B, Iafisco M, Canegallo L, Demarosi F, Merlo M, Roveri N (2007) The remineralizing effect of carbonate-hydroxyapatite nanocrystals on dentine. Mater Sci Forum 1:539–543. doi:10.4028/www.scientific.net/MSF.539-543.602

    Google Scholar 

  22. 22.

    Yuan P, Shen X, Liu J, Hou Y, Zhu M, Huang J, Xu P (2012) Effects of dentifrice containing hydroxyapatite on dentinal tubule occlusion and aqueous hexavalent chromium cations sorption: a preliminary study. PLoS One 7:e45283. doi:10.1371/journal.pone.0045283

    Article  PubMed  PubMed Central  Google Scholar 

  23. 23.

    Browning WD, Cho SD, Deschepper EJ (2012) Effect of a nano-hydroxyapatite paste on bleaching-related tooth sensitivity. J Esthet Restor Dent 24:268–276. doi:10.1111/j.1708-8240.2011.00437.x

    Article  PubMed  Google Scholar 

  24. 24.

    Holland GR, Narhi MN, Addy M, Gangarosa L, Orchardson R (1997) Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. J Clin Periodontol 24:808–813

    Article  PubMed  Google Scholar 

  25. 25.

    Schulz KF, Altman DG, Moher D (2010) CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Trials 11:32

    Article  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Plagmann HC, König J, Bernimoulin JP, Rudhart AC, Deschner J (1997) A clinical study comparing two high-fluoride dentifrices for the treatment of dentinal hypersensitivity. Quintessence Int 28:403–408

    PubMed  Google Scholar 

  27. 27.

    Schiff T, Dotson M, Cohen S, De Vizio W, McCool J, Volpe A (1994) Efficacy of a dentifrice containing potassium nitrate, soluble pyrophosphate, PVM/MA copolymer, and sodium fluoride on dentinal hypersensitivity: a twelve-week clinical study. J Clin Dent 5:87–92

    PubMed  Google Scholar 

  28. 28.

    Sowinski J, Ayad F, Petrone M, DeVizio W, Volpe A, Ellwood R, Davies R (2001) Comparative investigations of the efficacy of a new toothpaste containing potassium nitrate and triclosan 57 desensitising efficacy of a new dentifrice. J Clin Periodontol 28:1032–1036

    Article  PubMed  Google Scholar 

  29. 29.

    Pereira R, Chava V (2001) Efficacy of a 3% potassium nitrate desensitizing mouthwash in the treatment of dentinal hypersensitivity. J Periodontol 72:1720–1725

    Article  PubMed  Google Scholar 

  30. 30.

    Singal P, Gupta R, Pandit N (2005) 2% sodium fluoride-iontophoresis compared to a commercially available desensitizing agent. J Periodontol 76:351–357

    Article  PubMed  Google Scholar 

  31. 31.

    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 37:510–517. doi:10.1111/j.1600-051X.2010.01558.x

    Article  PubMed  Google Scholar 

  32. 32.

    Earl J, Leary R, Muller K, Langford R, Greenspan D (2011) Physical and chemical characterization of dentin surface following treatment with NovaMin technology. J Clin Dent 22:62–67

    PubMed  Google Scholar 

  33. 33.

    Mason S, Hughes N, Sufi F, Bannon L, Maggio B, North M, Holt J (2010) A comparative clinical study investigating the efficacy of a dentifrice containing 8% strontium acetate and 1040 ppm fluoride in a silica base and a control dentifrice containing 1450 ppm fluoride in a silica base to provide immediate relief of dentine hypersensitivity. J Clin Dent 21:42–48

    PubMed  Google Scholar 

  34. 34.

    Hughes N, Mason S, Jeffery P, Welton H, Tobin M, O’Shea C, Browne M (2010) 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 21:49–55

    PubMed  Google Scholar 

  35. 35.

    Seong J, Macdonald E, Newcombe RG, Davies M, Jones SB, Johnson S, West NX (2013) In situ randomised trial to investigate the occluding properties of two desensitising toothpastes on dentine after subsequent acid challenge. Clin Oral Investig 17:195–203

    Article  PubMed  Google Scholar 

  36. 36.

    Peacock JM, Orchardson R (1995) Effects of potassium ions on action potential conduction in A- and C-fibers of rat spinal nerves. J Dent Res 74:634–641

    Article  PubMed  Google Scholar 

  37. 37.

    Waraaswapati N, Krongnawakul D, Jiraviboon D, Adulyanon S, Karimbux N, Pitiphat W (2005) The effect of a new toothpaste containing potassium nitrate and triclosan on gingival health, plaque formation and dentine hypersensitivity. J Clin Periodontol 32:53–58

    Article  Google Scholar 

  38. 38.

    Kim 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 38:419–428. doi:10.2341/11-504-L

    Article  PubMed  Google Scholar 

  39. 39.

    Frechoso C, Menendez M, Guisasola C, Arregui I, Tejerina J, Sieilsa A (2003) Evaluation of the efficacy of two potassium nitrate bioadhesive gels (5% and 10%) in the treatment of dentinal hypersensitivity: a randomized clinical trail. J Clin Periodontol 30:315–320

    Article  PubMed  Google Scholar 

  40. 40.

    Tschoppe P, Zandim DL, Martus P, Kielbassa AM (2011) Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J Dent 39:430–437. doi:10.1016/j.jdent.2011.03.008

    Article  PubMed  Google Scholar 

  41. 41.

    Sgolastra F, Petrucci A, Gatto R, Monaco A (2011) Effectiveness of laser in dentinal hypersensitivity treatment: a systematic review. J Endod 37:297–303. doi:10.1016/j.joen.2010.11.034

    Article  PubMed  Google Scholar 

  42. 42.

    Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A (2013) Lasers for the treatment of dentin hypersensitivity: a meta-analysis. J Dent Res 92:492–499

    Article  PubMed  Google Scholar 

  43. 43.

    Gillam D, Newman H, Davies E, Bulman J (1992) Clinical efficacy of a low abrasive dentifrice for the relief of cervical dentinal hypersensitivity. J Clin Periodontol 19:197–201

    Article  PubMed  Google Scholar 

  44. 44.

    Walsh T, Worthington HV, Glenny AM, Appelbe P, Marinho VC, Shi X (2010) Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 20:CD007868. doi:10.1002/14651858.CD007868.pub2

    Google Scholar 

  45. 45.

    Sharma D, McGuire JA, Amini P (2013) Randomized trial of the clinical efficacy of a potassium oxalate-containing mouthrinse in rapid relief of dentin sensitivity. J Clin Dent 24:62–67

    PubMed  Google Scholar 

  46. 46.

    Colloca L, Benedetti F (2005) Placebos and painkillers: is mind as real as matter? Nat Rev Neurosci 6:545–552

    Article  PubMed  Google Scholar 

  47. 47.

    Di Blasi Z, Harkness E, Ernst E, Georgiu A, Kleijnen J (2001) Influence of context effect on health outcomes. A systematic review. Lancet 375:757–762

    Article  Google Scholar 

  48. 48.

    Barrett B, Muller D, Rakel D, Rabago D, Marchand L, Scheder JC (2006) Placebo, meaning, and health. Perspect Biol Med 49:178–198

    Article  PubMed  Google Scholar 

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Authors

Corresponding author

Correspondence to P. Usai.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The authors declare that no financial relationships exist regarding any of the products involved in this study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

The protocol and informed consent forms were approved by the ethics committee of the University of Sassari (n° DH 2362CE).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Clinical Relevance

Based on the clinical study results, a daily application of a toothpaste containing nano-hydroxyapatite can effectively reduce dentin hypersensitivity.

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Cite this article

Vano, M., Derchi, G., Barone, A. et al. Reducing dentine hypersensitivity with nano-hydroxyapatite toothpaste: a double-blind randomized controlled trial. Clin Oral Invest 22, 313–320 (2018). https://doi.org/10.1007/s00784-017-2113-3

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Keywords

  • Dentine hypersensitivity
  • Nano-hydroxyapatite
  • Fluoride
  • Desensitizing agents