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      Efficacy of Desensitizers in Reducing Post-preparation Sensitivity Prior to a Fixed Dental Prosthesis: A Randomized Controlled Clinical Trial

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          A BSTRACT

          Aims:

          The aim of this article is to evaluate and compare the effectiveness of Gluma, Shield Force Plus, and Telio CS desensitizers, in reducing pre- and post-cementation sensitivity for complete coverage restorations.

          Materials and Methods:

          The study was a double-blind, randomized, controlled clinical trial in which 56 patients requiring posterior three-unit fixed partial dentures were randomly assigned to four groups, each group with 14 patients ( n = 14): Group C (Control group), Group GL (Gluma group), Group SF (Shield Force Plus group), and Group TC (Telio CS group). In the desensitizer groups, desensitizer application was performed following the manufacturer’s directions immediately after tooth preparation (first visit), before metal restoration try-in (second visit, 2 weeks after the first visit), and before final cementation (third visit, 2 weeks after the second visit). Sensitivity levels were scored and evaluated using a visual analog scale (VAS), using cold test and electric pulp test (EPT) during the three visits before the cementation, and then over the phone 2 weeks after the final cementation. The data were statistically analyzed using one-way analysis of variance (ANOVA) followed by post-hoc Bonferroni and unpaired t-tests.

          Results:

          One-way ANOVA revealed significant differences between the four groups. The post-hoc Bonferroni tests showed a significant decrease in the mean cold test scores from the first to third visit, with a p-value <0.001 for the GL, SF, and TS groups. The mean EPT scores also decreased significantly from the first to third visit ( p< 0.001) for the GL and SF groups, whereas p = 0.023 for the TS group. Most of the subjects did not complain of any sensitivity post-cementation, except for one patient in Group TS.

          Conclusion:

          All three desensitizers were found to be effective in reducing pre- and post-cementation dentin sensitivity, as indicated by the consistent reduction in VAS scores throughout the visits.

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          Most cited references26

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          Dentine hypersensitivity: New perspectives on an old problem

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            Closing of dentinal tubules by Gluma desensitizer.

            Gluma Dentin Bond is an adhesive system, where the primer contains 5% glutaraldehyde and 35% hydroxyethyl methacrylate. Practitioners have reported a strong desensitizing effect of the Gluma system on dentin. This study, thus, sought to evaluate the effect of this system on dentin using various microscopic techniques. 12 non-restored human molars extracted for prosthodontic reasons were used. Prior to extraction the buccal cusps were removed such that a 2 mm x 2 mm wide dentin surface was exposed. The surfaces were treated in 6 ways: (1) application of Gluma 2 cleanser, Gluma 3 primer to which 0.1% w/v fluorescein was added, and Gluma 4 sealer; (2) as in (1) but treatment with H2O/0.1% w/v fluorescein instead of the Gluma 3; (3) as in (1) but without Gluma 2; (4) as in (1) but with application of 5% glutaraldehyde instead of Gluma 3; (5) as in (1) but without Gluma 4; (6) as in (1) but with application of 35% HEMA/0.1% w/v fluorescein instead of Gluma 3. Following extraction, 1 tooth per procedure was prepared for confocal laser scanning microscopy. The remaining teeth were fixed and prepared for SEM and TEM evaluation. In specimens of procedures (1) and (5), tubular occlusions could be seen to a depth of 200 microm. In specimens of procedure (4) tubular occlusions were found only to a depth of 50 microm. Such occlusions were not seen in control specimens (2), in specimens where the smear-layer had not been removed (3), or following application of HEMA alone (6). It is concluded that glutaraldehyde can intrinsically block dentinal tubules. The septa in the tubules may counteract the hydrodynamic mechanism for dentinal sensitivity.
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              Gender is a confounding factor in pain trials: women report more pain than men after arthroscopic surgery.

              A gender difference in the incidence of acute pain may be a confounder in analgesic trials. We have tested the hypothesis that the incidence of acute pain after knee arthroscopic procedures is greater in women than men. We performed three RCTs on intra-articular analgesics in which no postoperative analgesia was given until the need for such treatment was documented by scoring moderate-to-severe pain on a verbal rating scale (VRS 0-4; n=219), and a 0-100 mm visual analogue pain scale (VAS) within 2 h postoperatively. All trials were performed with an intra-articular catheter technique. The design allowed us to study the natural course of pain after arthroscopic surgery until analgesia was required. Women reported more pain of at least moderate intensity than men (84 vs 57%; P<0.0001), indicating that being female is a risk factor for early postoperative pain (RR 1.47, 95% confidence interval from 1.23 to 1.74). The VAS score corresponding to moderate and severe pain is similar in men and women. Only short acting anaesthetics were given in order to minimise carry-over effects. Since previous trials on arthroscopic analgesics neither measured baseline pain nor stratified for gender, a difference between treatment groups could result from an uneven distribution regarding these factors. Our findings have major implications for the interpretation of previously published trials on intra-articular analgesia.
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                Author and article information

                Journal
                J Int Soc Prev Community Dent
                J Int Soc Prev Community Dent
                JISPCD
                Journal of International Society of Preventive & Community Dentistry
                Wolters Kluwer - Medknow (India )
                2231-0762
                2250-1002
                May-Jun 2021
                10 June 2021
                : 11
                : 3
                : 332-339
                Affiliations
                [1 ]Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
                [2 ]Dental Intern, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
                [3 ]Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
                Author notes
                Address for correspondence: Dr Harisha Dewan, Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia. E-mail: harisha.dewan@ 123456yahoo.com
                Article
                JISPCD-11-332
                10.4103/jispcd.JISPCD_31_21
                8257008
                34268196
                bf27c71c-a5c5-48b2-befb-344f553ee7f6
                Copyright: © 2021 Journal of International Society of Preventive and Community Dentistry

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 30 January 2021
                : 04 April 2021
                : 12 April 2021
                Categories
                Original Article

                cementation,dentin desensitizing agents,dentin sensitivity,tooth preparation

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