Evaluation of effectiveness of amorphous calcium phosphate varnish on dentin hyper sensitivity

Dentin hypersensitivity is an important clinical problem affecting a large part of population. Dentin hypersensitivity is characterized by short and dull pain derived from exposed dentin in response to chemical, thermal, tactile or osmotic stimuli which cannot be explained as any other dental defect or pathology. The etiology of dentin exposure is multifactorial. Dentin tubules exposed as a result of attrition, abrasion, erosion lesions or gingival recessions due to incorrect toothbrushing etc. Dentin hypersensitivity may disturb the patient during eating, drinking, brushing and breathing. Clinical examinations demonstrated that the prevalence of dentinal hypersensitivity changes between %4?74. Several theories have been proposed to explain the mechanism while the hydrodynamic theory being currently accepted. According to this theory fluids within the dentinal tubules are disturbed by several stimuli and this fluid changes result in activation of sensory nerves in the pulp/inner dentine region of the tooth. Treatment of dentinal hypersensitivity by occluding exposed dentinal tubules is achieved by several materials and methods. In our study four different materials have been used to occlude exposed dentinal tubules. The aim of this study was to investigate and compare the clinical effectiveness of amorphous calcium phosphate formula varnish. Six men and fourteen women were included to the study. A total of 100 teeth in 20 patients were studied. Hypersensitive teeth were divided into five groups. Gluma desensitizer (Glutaraldehide), Fluor Protector (0,1 fluoride), Enamel Pro varnish (amorphous calcium phosphate formula with 5% fluoride), BisBlock (Oxalic Acid) were applied randomly to teeth and the 5th tooth was assigned as control.viiiFull mouth periodontal parameters including probing depths (PD), gingival index (GI), plaque index (PI), gingival recession (REC) were measured at six sites for each tooth. A visual analogue scale (VAS) was used to determine responses to different stimuli. VAS scores were recorded before and after treatment, first week, fourth week and sixteenth week. According to the results of our study, all materials were effective for the treatment of dentine hypersensitivity. Best results were obtained with Gluma and BisBlock. Enamel Pro Varnish (amorphous calcium phosphate) and Fluor Protector were mildly effective. No complications were recorded for any of the materials. Dentin tubules were partially or fully occluded for Gluma and BisBlock specimens, oxalate crystals were located deeply in the tubules. Dentin tubule openings were narrowed or superficially occluded for Fluor Protector group while limited occlusion was observed for Enamel Pro varnish because the specimens were not stored in saliva. In the limits of this study Gluma and BisBlock were very effective in treating dentinal hypersensitivity while Enamel Pro varnish not effective as thm could be used as an alternative agent. Keywords: Dentin hypersensitivity, amorphous calcium phosphate, scanning electron microscope (SEM)