Effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) on dental hypersensitivity: A randomized controlled clinical trial

Mariangela Ivette Guanipa Ortiz, Cristiane de Melo Alencar, Brennda Lucy Freitas De Paula, Eliane Bemerguy Alves, Jesuína Lamartine Nogueira Araújo, Cecy Martins Silva, Mariangela Ivette Guanipa Ortiz, Cristiane de Melo Alencar, Brennda Lucy Freitas De Paula, Eliane Bemerguy Alves, Jesuína Lamartine Nogueira Araújo, Cecy Martins Silva

Abstract

Objective: This randomized controlled clinical trial aimed to evaluate the effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH), and the impact of this on the health-related quality of life (HRQL).

Methods: Eighty teeth with DH were randomized into four groups and received three treatment sessions: PLACEBO = placebo + LASER application mimicking; CPP-ACPF = CPP-ACPF + LASER application mimicking; PBM = placebo + LASER active application; CPP-ACPF+PBM = CPP-ACPF + LASER active application. Tactile (exploratory probe) and evaporative (triple syringe) stimuli were used to measure DH and were recorded with the aid of a visual analogue scale (VAS) after the 1st, 2nd and 3rd treatment sessions and one-month follow-up. The HRQL was recorded in the DH experience questionnaire (DHEQ).

Results: The intragroup comparison showed a significant reduction in DH (p < 0.05) with both stimuli after one-month follow-up. The intergroup comparison with the evaporative stimulus showed that CPP-ACPF+PBM significantly reduced DH when compared to the rest of treatments, after one-month follow-up. CPP-ACPF+PBM group statistically differed from the other treatment groups in the DHEQ evaluation after one-month follow-up.

Conclusion: After one-month follow-up, the association of CPP-ACPF with PBM was effective in the reduction of DH and promoted a positive impact on the HRQL of the participants of this study.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flow diagram showing patient recruitment…
Fig 1. Flow diagram showing patient recruitment and follow-up.
Adapted from the CONSORT flow diagram.
Fig 2. DHEQ results, median values before…
Fig 2. DHEQ results, median values before and after one-month follow-up of the desensitizing treatments application.
* Different upper case letters represent significant intragroup statistical difference according to the Wilcoxon Test (p≤0.05); ** Different lowercase letters represent significant intergroup statistical difference according to the Mann-Whitney Test (p≤0.05).

References

    1. West NX, Lussi A, Seong J, Hellwig E. Dentin hypersensitivity: pain mechanisms and etiology of exposed cervical dentin. Clin Oral Investig. 2013;17(1):S9–19.
    1. Machuca C, Vettore M V, Krasuska M, Baker SR, Robinson PG. Using classification and regression tree modelling to investigate response shift patterns in dentine hypersensitivity. BMC Med Res Methodol. 2017;17(1):120 10.1186/s12874-017-0396-3
    1. Canadian Advisory Board on Dentin Hypersensitivity. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc. 2003;69(4):221–226.
    1. Bergamini MR, Bernardi MM, Sufredini IB, Ciaramicoli MT, Kodama RM, Kabadayan F, et al. Dentin hypersensitivity induces anxiety and increases corticosterone serum levels in rats. Life Sci. 2014;98(2):96–102. 10.1016/j.lfs.2014.01.004
    1. Schmidlin PR, Sahrmann P. Current management of dentin hypersensitivity. Clin Oral Investig. 2013;17(1):S55–59. 10.1007/s00784-012-0912-0
    1. Mantzourani M, Sharma D. Dentine sensitivity: past, present, and future. J Dent. 2013;41(4):S3–17. 10.1016/S0300-5712(13)70002-2
    1. Mahajan G, Kaur H, Gautam A. Prevalence of buccal cervical dentine hypersensitivity and related risk factors a cross-sectional study. Int Dent Med J Adv Res. 2017;3:1–5. 10.15713/ins.idmjar.64
    1. Coleman TA, Grippo JO, Kinderknecht KE. Cervical dentin hypersensitivity. Part II: Associations with abfractive lesions. Quintessence Int. 2000;31(7):466–473.
    1. Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Lasers for the treatment of dentin hypersensitivity: a meta-analysis. J Dent Res. 2013;92(6):492–499. 10.1177/0022034513487212
    1. West NX, Seong J, Davies M. Management of dentine hypersensitivity: efficacy of professionally and self-administered agents. J Clin Periodontol. 2015;42(1):S256–302. 10.1111/jcpe.12336
    1. Soares R, De Ataide IDN, Fernandes M, Lambor R. Assessment of enamel remineralisation after treatment with four different remineralising agents: A Scanning Electron Microscopy (SEM) Study. J Clin diagnostic Res. 2017;11(4):ZC136–ZC141. 10.7860/JCDR/2017/23594.9758
    1. Huq NL, Myroforidis H, Cross KJ, Stanton DP, Veith PD, Ward BR, et al. The interactions of CPP-ACP with saliva. Int J Mol Sci. 2016;17(6):E915 10.3390/ijms17060915
    1. Pandeshwar P, Mahesh DR, Reshma D, Shastry SP, Kaul R, Srinivasreddy MB. Photobiomodulation in oral medicine: a review. J Investig Clin Dent. 2016;7(2):114–126. 10.1111/jicd.12148
    1. Umberto R, Claudia R, Gaspare P, Gianluca T, Alessandro del V. Treatment of dentine hypersensitivity by diode laser: a clinical study. Int J Dent. 2012;2012:858–950. 10.1155/2012/858950
    1. Gojkov-Vukelic M, Hadzic S, Zukanovic A, Pasic E, Pavlic V. Application of diode laser in the treatment of dentine hypersensitivity. Med Arch. 2016;70(6):466–469. 10.5455/medarh.2016.70.466-469
    1. Wang L, Magalhães AC, Francisconi-Dos-Rios LF, Calabria MP, Araújo D, Buzalaf M, et al. Treatment of dentin hypersensitivity using nano-hydroxyapatite pastes: a randomized three-month clinical trial. Oper Dent. 2016;41(4):E93–E101. 10.2341/15-145-C
    1. Splieth CH, Tachou A. Epidemiology of dentin hypersensitivity. Clin Oral Investig. 2013;17(l)1:S3–8. 10.1007/s00784-012-0889-8
    1. Douglas-De-Oliveira DW, Vitor GP, Silveira JO, Martins CC, Costa FO, Cota LOM. Effect of dentin hypersensitivity treatment on oral health related quality of life—A systematic review and meta-analysis. J Dent. 2017;71:1–8. 10.1016/j.jdent.2017.12.007
    1. Turner L, Shamseer L, Altman DG, Weeks L, Peters J, Kober T, et al. Consolidated standards of reporting trials (CONSORT) and the completeness of reporting of randomized controlled trials (RCTs) published in medical journals. Cochrane Database Syst Rev. 2012;14(11):MR000030 10.1002/14651858.MR000030.pub2
    1. Calvert M, Brundage M, Jacobsen PB, Schünemann HJ, Efficace F. The CONSORT patient-reported outcome (PRO) extension: implications for clinical trials and practice. Health Qual Life Outcomes. 2013;11:184 10.1186/1477-7525-11-184
    1. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. 10.1001/jama.2013.281053
    1. Smith BG, Knight JK. An index for measuring the wear of teeth. Br Dent J. 1984;156(12):435–438. 10.1038/sj.bdj.4805394
    1. Miller PD. A classification of marginal tissue recession. Int J Periodontics Restorative Dent. 1985;5(2):8–13.
    1. Holland GR, Narhi MN, Addy M, Gangarosa L, Orchardson R. Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. J Clin Periodontol. 1997;24(11):808–813. 10.1111/j.1600-051x.1997.tb01194.x
    1. Boiko OV, Baker SR, Gibson BJ, Locker D, Sufi F, Barlow AP, et al. Construction and validation of the quality of life measure for dentine hypersensitivity (DHEQ). J Clin Periodontol. 2010;37(11):973–980. 10.1111/j.1600-051X.2010.01618.x
    1. Douglas-De-Oliveira DW, Lages FS, Paiva SM, Cromley JG, Robinson PG, Cota LOM. Cross-cultural adaptation of the Brazilian version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15). Braz Oral Res. 2018;32:e37 10.1590/1807-3107bor-2018.vol32.0037
    1. Lopes AO, de Paula Eduardo C, Aranha ACC. Evaluation of different treatment protocols for dentin hypersensitivity: an 18-month randomized clinical trial. Lasers Med Sci. 2017;32(5):1023–1030. 10.1007/s10103-017-2203-0
    1. Cunha-Cruz J, Wataha JC, Heaton LJ, Rothen M, Sobieraj M, Scott J, Berg J, Northwest Practice-based Research Collaborative in Evidence based Dentistry. The prevalence of dentin hypersensitivity in general dental practices in the northwest United States. J Am Dent Assoc. 2013;144(3):288–296. 10.14219/jada.archive.2013.0116
    1. Yoshizaki KT, Francisconi-Dos-Rios LF, Sobral MP, Aranha AC, Mendes FM, Scaramucci T. Clinical features and factors associated with non-carious cervical lesions and dentin hypersensitivity. J Oral Rehabil. 2017;44(2):112–118. 10.1111/joor.12469
    1. Alcântara PM, Barroso NFF, Botelho AM, Douglas-de-Oliveira DW, Gonçalves PF, Flecha OD. Associated factors to cervical dentin hypersensitivity in adults: a transversal study. BMC Oral Health. 2018;18(1):155 10.1186/s12903-018-0616-1
    1. West N, Seong J, Davies M. Dentine hypersensitivity. Monogr Oral Sci. 2014;25:108–22. 10.1159/000360749
    1. Kennedy-Martin T, Curtis S, Faries D, Robinson S, Johnston J. A literature review on the representativeness of randomized controlled trial samples and implications for the external validity of trial results. Trials. 2015;16:495 10.1186/s13063-015-1023-4
    1. Mehta D, Gowda V, Finger WJ, Sasaki K. Randomized, placebo-controlled study of the efficacy of a calcium phosphate containing paste on dentin hypersensitivity. Dent Mater Off Publ Acad Dent Mater. 2015;31(11):1298–1303. 10.1016/j.dental.2015.08.162
    1. Moosavi H, Maleknejad F, Sharifi M, Ahrari F. A randomized clinical trial of the effect of low-level laser therapy before composite placement on postoperative sensitivity in class V restorations. Lasers Med Sci. 2015;30(4):1245–1249. 10.1007/s10103-014-1565-9
    1. Hall C, Mason S, Cooke J. Exploratory randomised controlled clinical study to evaluate the comparative efficacy of two occluding toothpastes—a 5% calcium sodium phosphosilicate toothpaste and an 8% arginine/calcium carbonate toothpaste—for the longer-term relief of dentine hypersensitivity. J Dent. 2017;60:36–43. 10.1016/j.jdent.2017.02.009
    1. Addy M, West NX, Barlow A, Smith S. Dentine hypersensitivity: is there both stimulus and placebo responses in clinical trials?. Int J Dent Hyg. 2007;5(1):53–59. 10.1111/j.1601-5037.2007.00228.x
    1. Wierichs RJ, Stausberg S, Lausch J, Meyer-Lueckel H, Esteves-Oliveira M. Caries-preventive effect of NaF, NaF plus TCP, NaF plus CPP-ACP, and SDF varnishes on sound dentin and artificial dentin caries in vitro. Caries Res. 2018;52(3):199–211. 10.1159/000484483
    1. Reynolds EC, Cai F, Cochrane NJ, Shen P, Walker GD, Morgan MV, et al. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2008;87(4):344–348. 10.1177/154405910808700420
    1. Berkathullah M, Farook MS, Mahmoud O. The effectiveness of remineralizing agents on dentinal permeability. Biomed Res Int. 2018;2018:4072815 10.1155/2018/4072815
    1. Praveen R, Thakur S, Kirthiga M, Narmatha M. Comparative evaluation of a low-level laser and topical desensitizing agent for treating dentinal hypersensitivity: A randomized controlled trial. J Conserv Dent. 2018;21(5):495–499. 10.4103/JCD.JCD_197_18
    1. Arany PR, Cho A, Hunt TD, Sidhu G, Shin K, Hahm E, et al. Photoactivation of endogenous latent transforming growth factor–β1 directs dental stem cell differentiation for regeneration. Sci Transl Med. 2014;6(238):238ra69 10.1126/scitranslmed.3008234
    1. Cochrane NJ, Reynolds EC. Calcium phosphopeptides—mechanisms of action and evidence for clinical efficacy. Adv Dent Res. 2012;24(2):41–47. 10.1177/0022034512454294
    1. Chokshi K, Chokshi A, Konde S, Shetty SR, Chandra KN, Jana S, et al. An in vitro Comparative Evaluation of Three Remineralizing Agents using Confocal Microscopy. J Clin Diagn Res. 2016;10(6):ZC39–ZC42. 10.7860/JCDR/2016/18191.7984
    1. Rahiotis C, Vougiouklakis G. Effect of a CPP-ACP agent on the demineralization and remineralization of dentine in vitro. J Dent. 2007;35(8):695–698. 10.1016/j.jdent.2007.05.008
    1. Fernando JR, Shen P, Sim CPC, Chen YY, Walker GD, Yuan Y, et al. Self-assembly of dental surface nanofilaments and remineralisation by SnF2 and CPP-ACP nanocomplexes. Sci Rep. 2019;9(1):1285 10.1038/s41598-018-37580-w
    1. Kijsamanmith K, Banomyong D, Burrow MF, Kanchanasantikul P, Wipawiwat S, Srikam S, et al. Effect of Conventional and Acid-modified Casein Phosphopeptide-Amorphous Calcium Phosphate Crèmes on Dentin Permeability Before and After Acid Challenge. Oper Dent. 2019;5 [Epub ahead of print]. 10.2341/17-382-L
    1. Bou Chebel F, Zogheib CM, Baba NZ, Corbani KA. Clinical comparative evaluation of Nd: YAG laser and a new varnish containing casein phosphopeptides-amorphous calcium phosphate for the treatment of dentin hypersensitivity: A prospective study. J Prosthodont Off J Am Coll Prosthodont. 2018;27(9):860–867. 10.1111/jopr.12984
    1. Faraoni JJ, Torres Toro CV, de Matos LLM, Palma-Dibb RG. Efficacy of different strategies to treat root dentin eroded by liquid or gaseous hydrochloric acid associated with brushing abrasion. Arch Oral Biol. 2018;89:65–69. 10.1016/j.archoralbio.2018.02.005
    1. Gillam DG. A New Perspective on Dentine Hypersensitivity–Guidelines for General Dental Practice. Dent Update. 2017;44(1):33–6, 39–42. 10.12968/denu.2017.44.1.33
    1. Veitz-Keenan A, Barna JA, Strober B, Matthews AG, Collie D, Vena D, et al. Treatments for hypersensitive noncarious cervical lesions: A Practitioners Engaged in Applied Research and Learning (PEARL) Network randomized clinical effectiveness study. J Am Dent Assoc. 2013;144(5):495–506. 10.14219/jada.archive.2013.0152
    1. Grippo JO, Simring M, Coleman TA. Abfraction, abrasion, biocorrosion, and the enigma of noncarious cervical lesions: a 20-year perspective. J Esthet Restor Dent. 2012;24(1):10–23. 10.1111/j.1708-8240.2011.00487.x

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다