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

Abstract

Objective

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.

Results

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.

Conclusions

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.

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References

  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. https://doi.org/10.1111/jcpe.12552

    Article  PubMed  Google Scholar 

  2. 2.

    Addy M (1992) Clinical aspects of dentine hypersensitivity. Proc Finn Dent Soc 88(suppl. 1):407–412

    Google 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 148:728–736

    Article  PubMed  Google 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 135:1109–1118

    Article  Google 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. https://doi.org/10.1902/jop.2015.150420

    Article  PubMed  Google Scholar 

  6. 6.

    Brännström M, Astron A (1972) The hydrodynamics of the dentin: its possible relationship to dentinal pain. Int Dent J 22(2):219–227

    PubMed  Google 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. https://doi.org/10.1007/s00784-017-2113-3

  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. https://doi.org/10.1089/pho.2012.3449

    Article  PubMed  Google 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. https://doi.org/10.1177/00220345890680110601

    Article  PubMed  Google 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. https://doi.org/10.1080/00016357.2017.1323348

    Article  Google Scholar 

  11. 11.

    Porto IC, Andrade AK, Montes MA (2009) Diagnosis and treatment of dentinal hypersensitivity. J Oral Sci 51(3):323–332. https://doi.org/10.2334/josnusd.51.323

    Article  PubMed  Google 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 29:219–225

    Article  PubMed  Google Scholar 

  13. 13.

    Miglani S, Aggarwal V, Ahuja B (2010) Dentine hypersensitivity: recent trends in management. J Conserv Dent 13(4):218–224. https://doi.org/10.4103/0972-0707.73385

    Article  PubMed  PubMed Central  Google 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. https://doi.org/10.1111/j.1600-051X.2010.01558.x

    Article  PubMed  Google 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. https://doi.org/10.1034/j.1600-051X.2001.281107.x

    Article  PubMed  Google Scholar 

  16. 16.

    Swift EJ Jr (2004) Causes, prevention, and treatment of dentin hypersensitivity. Compend Contin Educ Dent 25:95–106

    PubMed  Google 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 4

  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 151:264–269

    Article  PubMed  Google 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 7:10

    Article  PubMed  PubMed Central  Google 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 15:7–16

    Google 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:d5928

    Article  Google Scholar 

  22. 22.

    Glass GV (1976) Primary, secondary, and meta-analysis of research. Educ Res 5(10):3–8. https://doi.org/10.3102/0013189X005010003

    Article  Google 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. https://doi.org/10.4103/0970-4388.112403

    Article  PubMed  Google 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. https://doi.org/10.1016/j.dental.2015.11.020

    Article  PubMed  Google Scholar 

  25. 25.

    Han L, Okiji T (2015) Dentin tubule occluding ability of dentin desensitizers. Am J Dent 28:90–94

    PubMed  Google 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. https://doi.org/10.2341/11-504-L

    Article  Google 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. https://doi.org/10.1111/j.1365-2842.2008.01876.x

    Article  PubMed  Google 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. https://doi.org/10.1111/j.1600-051X.1994.tb00307.x

    Article  PubMed  Google 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. https://doi.org/10.4103/0970-9290.66639

    Article  PubMed  Google 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. https://doi.org/10.1016/j.joen.2008.10.001

    Article  PubMed  Google 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. https://doi.org/10.4317/jced.50955

    Article  PubMed  PubMed Central  Google 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. https://doi.org/10.1590/S1806-83242009000300018

    Article  PubMed  Google 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. https://doi.org/10.14219/jada.archive.2013.0116

    Article  PubMed  PubMed Central  Google 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. https://doi.org/10.1111/joor.12109

    Article  PubMed  Google 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. https://doi.org/10.1111/j.1600-051X.2010.01694.x

    Article  Google 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. https://doi.org/10.1007/s10103-009-0685-0

    Article  PubMed  Google 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 144:495–506

    Article  Google 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. https://doi.org/10.3109/00016357.2014.923112

    Article  PubMed  Google 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. https://doi.org/10.1016/j.dental.2015.08.162

    Article  PubMed  Google 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. https://doi.org/10.1111/j.1600-051X.1992.tb00639.x

    Article  PubMed  Google 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. https://doi.org/10.1111/j.1600-051X.1996.tb00526.x

    Article  PubMed  Google 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. https://doi.org/10.1902/jop.2001.72.12.1720

    Article  Google 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 30:315–320

    Article  PubMed  Google 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. https://doi.org/10.1902/jop.2004.75.11.1461

    Article  PubMed  Google 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):1232–1237

    PubMed  Google 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 137:1013–1020

    Article  PubMed  Google 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. https://doi.org/10.2341/08-118

    Article  PubMed  Google 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. https://doi.org/10.1089/pho.2008.2364

    Article  PubMed  Google 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. https://doi.org/10.1902/jop.2010.100172

    Article  PubMed  Google 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. https://doi.org/10.1590/S0103-64402011000200012

    Article  PubMed  Google 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 29:721–725

    Article  PubMed  Google 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 39:249–254

    Article  PubMed  Google 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. https://doi.org/10.1177/0022034510388516

    Article  PubMed  Google 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. https://doi.org/10.1590/S1806-83242012000300013

    Article  PubMed  Google 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. https://doi.org/10.1016/j.dental.2012.01.003

    Article  Google 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. https://doi.org/10.1016/j.jdent.2013.06.003

    Article  PubMed  Google 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. https://doi.org/10.1111/jcpe.12057

    Article  PubMed  PubMed Central  Google 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. https://doi.org/10.1016/S0300-5712(13)70005-8

    Article  PubMed  Google 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. https://doi.org/10.1016/j.jdent.2012.11.011

    Article  PubMed  Google 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 29:61–68

    Article  Google 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 29:45

    PubMed  Google 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. https://doi.org/10.1007/s10103-013-1441-z

    Article  Google 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. https://doi.org/10.2341/15-145-C

    Article  PubMed  Google Scholar 

  64. 64.

    Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Meas 20(1):37–46. https://doi.org/10.1177/001316446002000104

    Article  Google 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. https://doi.org/10.1186/1741-7015-8-18

    Article  PubMed  PubMed Central  Google 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. https://doi.org/10.1016/j.jdent.2014.06.004

    Article  PubMed  Google Scholar 

  67. 67.

    Egger M, Smith GD, Sterne JA (2001) Uses and abuses of meta-analysis. Clin Med 1(6):478–484. https://doi.org/10.7861/clinmedicine.1-6-478

    Article  Google Scholar 

  68. 68.

    Pandis N (2011) The evidence pyramid and introduction to randomized controlled trials. Am J Orthod Dentofac Orthop 140(3):446–447. https://doi.org/10.1016/j.ajodo.2011.04.016

    Article  Google 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. https://doi.org/10.1016/0003-9969(94)90190-2

    Article  PubMed  Google 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. https://doi.org/10.1089/pho.2006.24.358

    Article  PubMed  Google Scholar 

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Acknowledgements

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.

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Correspondence to Vittorio Moraschini.

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Moraschini, V., da Costa, L.S. & dos Santos, G.O. Effectiveness for dentin hypersensitivity treatment of non-carious cervical lesions: a meta-analysis. Clin Oral Invest 22, 617–631 (2018). https://doi.org/10.1007/s00784-017-2330-9

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Keywords

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