In vitro and in vivo evaluation of the effectiveness of three dentin desensitizing treatment regimens

Purpose: To evaluate the in vitro and in vivo effects of three treatment regimens on dentin permeability and reduction of dentin hypersensitivity (DH). Methods: The desensitization treatments were: Gluma Desensitizer PowerGel (GLU), MS Coat One (MSC), and dentin burnishing with fiber-resin burs (STB). A split-chamber device was used to determine the permeability of dentin slices cut from human molars in vitro. Fluid flow through dentin was recorded with a photochemical method after EDTA cleaning, albumin soaking and desensitization treatment (n=10). 61 study participants with three severely hypersensitive teeth each were enrolled. Sensitivity was determined with an air stimulus before, immediately after treatment, and after 1, 3 and 6 months, using a verbal rating scale. Results: From the 61 study participants enrolled, 52 completed the trial. Permeability at baseline and after albumin soaking was not significantly different. All treatments produced reduced fluid flow through dentin (P> 0.05). All treatments reduced DH significantly (no or moderate sensitivity). Statistical results revealed significant differences among the treatments (P= 0.03). Mann-Whitney comparisons showed GLU, STB< MSC. CLINICAL SIGNIFICANCE: The in vitro test proved to be a valuable screening tool for prediction of initial desensitization of hypersensitive lesions with the tested therapeutic approaches. Both the topical desensitizer applications and the dentin burnishing treatment were effective in reducing dentin hypersensitivity for 6 months. Gluma Desensitizer PowerGel and dentin burnishing with fiber-resin burs showed consistently high reductions in sensitivity whereas teeth treate ith the oxalate containing MS Coat One regained some sensitivity over time.