Skip to main content
NCBI home page
The Journal of the Indian Prosthodontic Society logoLink to The Journal of the Indian Prosthodontic Society
. 2022 Apr 13;22(2):143–151. doi: 10.4103/jips.jips_254_21

Effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing the post vital tooth preparation hypersensitivity: A randomized controlled trial

K Savitha 1,✉, P S Manoharan 1, J Balaji 1, G Ezhumalai 1, B T Pradeep Raja 1, Sanchayita Roy 1
PMCID: PMC9132512  PMID: 36511025

Abstract

Aim:

Hypersensitivity is the most common clinical problem which is encountered by most of dental patients undergoing a vital tooth preparation for a fixed crown prosthesis. The aim of this study is to evaluate the effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing dentinal hypersensitivity following vital tooth preparation.

Settings and Design:

This study is a randomized control trial performed on 119 teeth of 68 patients who are in need of fixed prosthesis treatment.

Materials and Methods:

After a thorough clinical examination, patients were allocated into any of the randomly assigned four groups (Control, silver diamine fluoride, potassium nitrate, and glutaraldehyde) and the level of hypersensitivity was measured by blasting air on the surface of tooth at five different intervals (before preparation, after preparation, after application of desensitizers, before cementation and after a follow up period of about 30 days) and is graded using Schiff 's cumulative hypersensitivity index.

Statistical Analysis Used:

Kruskal wallis test is used to compare the rate of sensitivity between the 4 groups. Friedman and Wilcoxon test is used to compare the rate of sensitivity at 5 different intervals.

Results:

All the desensitizers used in this study reduced the level of hypersensitivity. Among which, silver diamine fluoride was found to be more effective after application, before cementation, and after a follow up period of about 30 days followed by GLUMA and potassium nitrate.

Conclusion:

The results of this study suggest that silver diamine fluoride was found to be more effective after application, before cementation of the definitive prosthesis and after a follow up period of 30 days.

Keywords: Dentinal hypersensitivity, desensitizers, vital tooth preparation

INTRODUCTION

Dentinal hypersensitivity is one of the most common clinical conditions encountered by most of the general practitioners characterized by “short, sharp pain arising from the exposed dentin in response to any stimuli which can be thermal, evaporative, tactile, osmotic or chemical that cannot be ascribed to any other dental defect or pathology.”[1,2,3,4] Different terms have been used to describe dentinal hypersensitivity like cervical/root/cemental/dentine hypersensitivity/dentine sensitivity.[3,4] Dentinal hypersensitivity is a prevalent disorder and is one of the most unbearable conditions among the patients which can lead to both physical and psychological discomfort for the patient having a negative effect on the quality of a person's life, especially with regard to the selection of diet and hygiene maintenance. It has been found to be more prevalent among the population with the incident rate of about 4%–74% with it being more common among the females than in males with the peak of 30–40 years of age in canines followed by premolars being the most commonly affected teeth.[4,5,6]

Several attempts have been made to treat hypersensitivity either by desensitizing the nerve, forming precipitates of protein within the tubules, sealing/plugging the dentinal tubules or by laser therapy.[7] Commonly used desensitizing agents are Potassium Nitrate, Glutaraldehyde, Silver Nitrate, Sodium fluoride, Strontium Chloride, Zinc Chloride, Methyl methacrylate, and Silver diamine fluoride.[8] Potassium nitrate acts by preventing the nerve from getting depolarized and the entrance of sodium ions into the nerve thereby reduces the level of sensitivity[9] Gluma is a combination of glutaraldehyde and hydroxyethyl methacrylate which acts by coagulating the proteins within the dentinal tubules and thereby decreasing the level of sensitivity.[10] Silver diamine fluoride solution is been used as therapeutic agent at a concentration of about 38% for the management of dental caries which has a ph of 8–9.[11] However, its prevalence as a desensitizer following vital tooth preparation is less among the general practitioners as they are not aware of the pros and cons of the material. Application of the solution topically on the exposed dentinal surface resulted in the formation of squamous layer plugging the dentinal tubules, thereby reducing the dentinal hypersensitivity.[12] And so, the primary objective of this study is to evaluate the effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing dentinal hypersensitivity following vital tooth preparation. The secondary objectives of this study are to observe for any incidences of debonding and hypersensitivity following cementation of the definitive prosthesis and after a follow-up period. The null hypothesis is that there is no measurable difference in the reduction of Hypersensitivity following vital tooth preparation on using silver diamine fluoride than potassium nitrate and glutaraldehyde.

MATERIALS AND METHODS

This study was conducted among the patients who were referred to the Department of Prosthodontics, IGIDS for crown and bridge prosthesis in vital tooth during the period of May 2019 to Dec 2020. Ethical approval was obtained from the Institutional Review Board (IRB No: IGIDSIRB2018NRP40PGSAPRI) and Institutional Ethical Committee (IEC No: IGIDSIEC2018NRP40PGSAPRI). Trial was registered in clinical Trials Registry-India (CTRI-REF/2020/01/031226). 119 teeth of 68 patients who met the inclusion criteria participated in the study [Table 1]. Informed consent were obtained from all the participants before the recruitment in the study. The sample size for the study was estimated by a statistician and block randomization was generated using computer software. Patients were allocated and assigned into any of the 4 groups (Control, Silver diamine fluoride, potassium nitrate, and glutaraldehyde). The details of the Materials and equipment used are shown in Table 2.

Table 1.

Inclusion and exclusion criteria for recruitment into the study

Inclusion criteria Exclusion criteria
1. Vital teeth in need of fixed prosthetic restorations 1. Age <25 years
2. Age above 25 years[13] 2. Allergic to desensitizers[14]
3. Absence of restorations/fracture of tooth[16] 3. Pregnant/breast feeding
4. Teeth should be free of decay, pulpal and periodontal pathologies 4. Noncooperative patients
5. Co-operative patients 5. Patients who require antibiotic or steroid therapy[15]
6. Nonvital tooth
7. Amelogenesis imperfecta
8. Dentinogenesis imperfecta
9. Periodontal diseases
10. Carious tooth
11. Pain related to the orofacial region
Open in a new tab

Table 2.

Materials used

Materials used Manufacturer
Silver-diamine fluoride RIVASTAR, dental avenue India private limited (Haryana)
Gluma Heraeus kulzer, (South bend)
Potassium nitrate Himalayan Drug Company, India
Rubber dam GDC fine crafted Dental Pvt Ltd, Punjab
Oro micro applicator tips Reach global India Pvt Limited, Maharastra
Luxatemp provisional material Dental avenue India Pvt Ltd, Haryana
Non eugenol zinc oxide eugenol 3M ESPE, Karnataka
Open in a new tab

METHODOLOY

Patient and site preparation

Rubber dam isolation is done before the preparation and tooth sensitivity to the specific site is checked using Schiff's cumulative index.[17] The level of Sensitivity was determined using air-water syringe of a dental unit. The degree of hypersensitivity on the buccal and occlusal surface of the tooth site is checked by blasting air at a distance of 1 cm for minute and it was graded using Schiff's cumulative index.[18,19,20,21] Schiff's cumulative hypersensitivity index is used to measure the severity of sensitivity and based on the nature of pain, participants grade the degree of hypersensitivity from 0 to 3.(0-no response to stimulus, 1-Responds to air stimulus but does not require removal of the stimulus, 2-Responds to air stimulus and requires removal of the stimulus, 3-Responds to stimulus and found the stimulus to be painful and requires removal of stimulus).

Tooth preparation

Selected teeth were prepared for a definitive prosthesis with a shoulder bevel finish line on the buccal surface and chamfer line on the lingual surface under local anesthesia (Lidocaine 2% and epinephrine 1:100000). Following the loss of anesthetic effect on the pulp (60 min), degree of hypersensitivity is measured for each sample. Based on the random allocation concealment the desensitizing substances (Water-Control, Silver diamine fluoride, 5% potassium nitrate, Glutaraldehyde) were applied onto the randomly assigned prepared teeth [Figure 1-7, Application of the desensitizer - Silver diamine fluoride]. Following preparation and after application of the specific desensitizing agents onto the surface, air is blasted onto the prepared surface using air-water syringe and the degree of hypersensitivity is recorded. Patients were blinded throughout the procedure and is unaware of the type of material used for each abutment tooth.[22]

Figure 1.

Figure 1

Open in a new tab

Rubber dam isolation done and gingival barrier placed in relation to 13 and 15

Figure 7.

Figure 7

Open in a new tab

Apply potassium iodide solution over the previously applied solution until the creamy white precipitate turns clear

Figure 2.

Figure 2

Open in a new tab

Gingival barrier cured with the light cure unit in relation to 13 and 15

Figure 3.

Figure 3

Open in a new tab

RIVASTAR- Silver diamine fluoride and potassium iodide capsules

Figure 4.

Figure 4

Open in a new tab

Pierce the silver foil-silver diamine fluoride

Figure 5.

Figure 5

Open in a new tab

Apply it onto the prepared surface of the tooth and rub it

Figure 6.

Figure 6

Open in a new tab

Pierce the green foil –Potassium iodide

Temporarization

Following vital tooth preparation and impression making, the prepared teeth were protected with temporary crown fabricated with Bis Acryl Methacrylate Composite (Luxa temp/Trantemp provisional restoration material) and is luted with eugenol free Zinc oxide cement (3M ESPE Relyx Temp NE) for a period of about 15 days until the definitive prosthesis is fabricated. During this period, any incidence of hypersensitivity is recorded.[23,24,25,26]

FPD cementation

Porcelain fused metal restorations were fabricated in the laboratory by an experienced technician. Before the cementation of definitive prosthesis, degree of hypersensitivity is again checked by blasting air onto the prepared surface and is graded according to Schiff's cumulative hypersensitivity index and the scores were recorded. The final prosthesis is checked for esthetics, marginal fit, and occlusion and is luted with glass ionomer cement.

Follow-up

Patients were recalled after 30 days to check for any symptoms of hypersensitivity and the values were recorded. There were no incidences of debonding of the definitive prosthesis in any of the samples during the period of the study.

Sensitivity test

Adjacent teeth is isolated with gauze and a blinded examiner evaluated sensitivity and the values were recorded. Hypersensitivity was evaluated by blowing compressed air onto the buccal and the occlusal surface of the tooth at a distance of about 1 cm for 1 min. The degree of hypersensitivity is graded using Schiff's Cumulative index with the values ranging from 0 to 3. Following dentinal stimulation, the sensitivity level is graded by the patients from 0 to 3. The level of sensitivity on the abutment tooth is measured at 5 different intervals (Before preparation, 2 h after preparation as local anesthesia loses its effect, after application of desensitizing agents, prior to cementation of definitive prosthesis and after a follow-up period of about 30 days).

Statistical methods

To compare the rate of sensitivity between the four groups: Silver diamine fluoride, potassium nitrate, GLUMA, and control group, Kruskal–Wallis test was used.

For comparing sensitivity at different times, Friedman statistical test followed by Wilcoxon is used.

RESULTS

The present study is carried out with an aim to evaluate the effect of silver diamine fluoride, potassium nitrate, glutaraldehyde in reducing the post vital tooth preparation dentinal hypersensitivity. For this purpose, a total of 119 vital abutment teeth of 68 patients who are in need of fixed prosthesis in the anterior and posterior regions. Of the 68 patients involved in the study, there were 42 Males and 26 females with 63 anterior teeth and 56 posterior teeth in need of definitive restorations. All the patients participated till the end of the study and there were no dropouts noticed. The mean and standard deviation were calculated from the collected data. The results were statistically analyzed and calculated using the Friedman test between the 5 intervals and overall comparison was statistically analyzed using Kruskal-Wallis test.

Preoperative sensitivity

As per the inclusion criteria, hypersensitivity in all the samples of 4 groups (water, silver diamine fluoride, potassium nitrate, GLUMA) before the preparation was found to be zero.

Postoperative sensitivity

Kruskal–Wallis test is used to compare the rate of sensitivity between the four groups (water, silver diamine fluoride, potassium nitrate, GLUMA). P = 0.000 indicated a highly significant difference between the four groups.

The same statistical method is used to compare the degree of hypersensitivity after the application of desensitizing agents between the four groups (water, silver diamine fluoride, potassium nitrate, and GLUMA) and it is found that P = 0.000 indicated a highly significant difference between the four groups.

Desensitizing agents at 5 different intervals

Friedmann test is used to compare the difference in the group at 5 different intervals (before preparation, after preparation, after application of desensitizing agents, before cementation and after a follow-up period of about 30 days). All the desensitizing agents used showed a highly significant difference (P = 0.000) in the group at 5 different intervals [Table 3].

Table 3.

Comparison of the control group, desensitizers at 5 different intervals

Intervals Sample size Mean SD Minimum Maximum P
Water
 Before preparation 28 0.00 0.000 0 0 0.000
 After preparation 28 2.89 0.315 2 3
 After application of desensitizers 28 2.86 0.356 2 3
 Prior to cementation 28 2.46 0.576 1 3
 Follow up after 30 days 28 0.79 0.738 0 3
Silver diamine fluoride
 Before preparation 32 0.00 0.000 0 0 0.000
 After preparation 32 2.41 0.560 1 3
 After application of desensitizers 32 1.06 0.619 0 2
 Prior to cementation 32 0.44 0.564 0 2
 Follow up after 30 days 32 0.00 0.000 0 0
Potassium nitrate
 Before preparation 25 0.00 0.000 0 0 0.000
 After preparation 25 2.56 0.507 2 3
 After application of desensitizers 25 1.84 0.374 1 2
 Prior to cementation 25 1.40 0.645 0 2
 Follow up after 30 days 25 0.16 0.473 0 0
Gluma
 Before preparation 34 0.00 0.000 0 0 0.000
 After preparation 34 2.24 0.606 1 3
 After application of desensitizers 34 1.41 0.557 0 2
 Prior to cementation 34 0.94 0.694 0 3
 Follow-up after 30 days 34 0.09 0.288 0 1
Open in a new tab

SD: Standard deviation

Silver diamine fluoride

The degree of sensitivity is found to be least before the cementation and after a follow-up period and was most after tooth preparation [Table 3 and Graph 1].

Graph 1.

Graph 1

Open in a new tab

Comparison of the groups at 5 different intervals

Potassium nitrate

The degree of sensitivity is found to be least after the application of the desensitizer and was most after the preparation [Table 3 and Graph 1].

Gluma

Degree of sensitivity is found to be least after a follow-up period and was most after the preparation [Table 3 and Graph 1].

Control

Degree of sensitivity is found to be more after preparation, after the application of the agent and before cementation of the definitive prosthesis and was least after the follow-up period [Table 3 and Graph 1].

Comparison of the desensitizing agents

Kruskal-Wallis test is used to compare the difference between the 4 groups (control, silver diamine fluoride, potassium nitrate, and glutaraldehyde). It was found that the least amount of sensitivity is observed in the silver diamine fluoride group followed by GLUMA and potassium nitrate and was most in the Control group (WATER). A finding of P = 0.000 indicated a highly statistical difference in all the groups [Table 3 and Graph 1].

Comparison of the control versus desensitizing agents

Comparison of the control and the other desensitizing agent groups at 5 different intervals (before preparation, after preparation, After application of the desensitizing agents, before cementation of the definitive prosthesis and after a follow-up period) indicated a highly statistical difference with silver diamine fluoride found to be more effective in reducing the post vital tooth preparation hypersensitivity followed by GLUMA and potassium nitrate [Tables 4-6].

Table 4.

Comparison of the control group versus silver diamine fluoride

Groups Sample size After preparation After applying desensitizing agents Prior to cementation Follow up
Water (control) 28 2.893 2.857 2.464 0.786
Silver diamine fluoride 32 2.406 1.063 0.438 0.000
Open in a new tab

Table 6.

Comparison of the control group versus Gluma

Groups Sample size After preparation After applying desensitizing agents Before cementation Follow up
Water (control) 28 2.893 2.857 2.464 0.786
Gluma 34 2.235 1.412 0.941 0.88
Open in a new tab

Table 5.

Comparison of the control group versus potassium nitrate

Groups Sample size After preparation After applying desensitizing agents Before cementation Follow-up
Water (control) 28 2.893 2.857 2.464 0.786
Potassium nitrate 25 2.406 1.84 1.4 0.16
Open in a new tab

DISCUSSION

Addy et al. defined Hypersensitivity as a transient short and sharp pain which occurred as a result of the exposure of dentinal tubules in response to any stimuli.

In situations, where the vital tooth is prepared to receive a definitive prosthesis, the dentin is exposed and left uncovered for a sufficient period till the provisional crown is fabricated.[27] After the definitive prosthesis is fabricated, the provisional crown and the residual cement remaining on the tooth structure are removed.[28] Definitive prosthesis made of either metal or ceramic material will be tried to check the accuracy of fit, marginal adaptation, proximal contours, and occlusion.[29] All the above-mentioned instances happen in regular clinical practice and the patient is comforted stating that the sensitivity is a transient phenomenon. During cementation of the prosthesis, acidic luting agents may sometimes increase the sensitivity and cause intolerable discomfort to the patient.[30] The entire procedure becomes an uncomfortable experience for the patient. Using desensitizing agents for dentin exposure due to caries and noncarious lesions as already mentioned is very well recorded in literature. Following tooth preparation, many desensitizing agents have been recommended for use.[31] Though hypersensitivity and desensitizing agents are not novel to the dental profession, its use following tooth preparation to handle postpreparation sensitivity does not have enough literature to support. We find many articles in the literature on the use of desensitizing agents to reduce hypersensitivity for conditions like carious and noncarious lesions.[32,33,34,35,36,37,38] Very few evidences exist on the use of various desensitizing agents following vital tooth preparation. In 2009, Jatalian et al. conducted a study to find out the effectiveness of the desensitizers in reducing the post vital tooth preparation dentinal hypersensitivity and found that Potassium nitrate used before cementation reduced postoperative vital tooth preparation sensitivity than GLUMA. The knowledge and practice of such desensitizing agents following vital tooth preparation is less among the general practitioners as there are no much literature evidence. Hence, the aim of this study is to evaluate the effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in the reduction of post vital tooth preparation hypersensitivity.

Comparison of the dentinal hypersensitivity among the four groups (water, silver diamine fluoride, potassium nitrate, glutaraldehyde) showed the same value before preparation indicating that there is no meaningful statistical difference (P = 1.000) between the groups which determined the equality of the characteristics of the groups at the start of the procedure. Furthermore, as per the inclusion criteria, the rate of sensitivity in all the samples of the four groups is found to be before the preparation.

When silver diamine fluoride is used as desensitizer, comparison of the rate of hypersensitivity at five different intervals (before preparation, after preparation, after application of desensitizing agents, before cementation of the definitive prosthesis and after a follow-up period of about 30 days) revealed a highly significant difference (P = 0.000). The least amount of sensitivity is observed before cementation of the definitive prosthesis and marked difference is noted after preparation. No report of sensitivity is observed after the follow-up period (mean = 0.00). Thus, Silver diamine fluoride when used as desensitizer reduced the level of hypersensitivity immediately after application and over time with no sensitivity reported after follow-up period indicating that it has a long-term effect. When using Potassium nitrate as a desensitizer, comparison of the degree of hypersensitivity at 5 different intervals (Before preparation, After preparation, after application of desensitizing agents, before cementation of the definitive prosthesis, and after a follow-up period of about 30 days) showed a highly significant difference (P = 0.000). Least amount of hypersensitivity is observed after a follow-up period of 30 days and most is noted after preparation. Thus, Potassium Nitrate when used as a desensitizer reduced the degree of hypersensitivity immediately after application of the agent and over time indicating that it has a long term effect. When using GLUMA as a desensitizer, comparison of the degree of hypersensitivity at 5 different intervals (Before preparation After preparation, After application of desensitizing agents, before cementation of the definitive prosthesis and after a follow-up period of about 30 days) revelead a highly significant difference (P = 0.000). Least amount of sensitivity was observed after a follow-up period of about 30 days and most was after preparation. Thus, GLUMA as a desensitizer reduced the rate of hypersensitivity immediately after application and over time indicating that it has a long-term effect. Comparing the degree of sensitivity in the control group at 5 different intervals (Before preparation, After preparation, After application of desensitizing agents, prior to cementation of the definitive prosthesis and after a follow up period of about 30 days) showed a significant difference (P = 0.000). Water is applied as a control instead of desensitizing agent and sensitivity on the abutment teeth is measured at different intervals. It was found that least amount of sensitivity is observed after a follow-up period and is most after preparation and application. The reduction in hypersensitivity occurred slowly over time which may be due to the sclerotic dentin formation as a result of constant stimulation. Thus, it can be concluded that there is little reduction in the level of hypersensitivity over time even without the use of desensitizers. When compared to the instantaneous effect of the desensitizers in other groups, the effect seems to be very little and occurs gradually over time. It was found that there is a highly statistically significant difference between the four groups (P = 0.000) after the application of desensitizing agents (silver diamine fluoride, potassium nitrate, GLUMA) and the control group. Comparison of the desensitizing agents and the control group showed that there is the significant reduction in the rate of hypersensitivity after application of desensitizing agents. Least amount of sensitivity after application of the agents is observed in the Silver diamine fluoride group followed by GLUMA and potassium nitrate and higher degree of sensitivity was observed in the control group. Comparison of the degree of sensitivity before cementation of the prosthesis among the four groups (Control, silver diamine fluoride, potassium nitrate and GLUMA) showed a highly significant difference (P = 0.000) between the four groups. The least amount of sensitivity prior to the cementation of the prosthesis was observed in silver diamine fluoride group followed by potassium nitrate and GLUMA and most was observed in Control group. Null hypothesis was rejected as there were significant difference in the reduction of hypersensitvity using silver diamine fluoride than potassium nitrate and glutaraldehyde. To the extent of our knowledge, this was the first report which compared the efficacy of silver diamine fluoride in the reduction of post vital tooth preparation hypersensitivity. In this study, the results showed that silver diamine fluoride was superior to the other desensitizing agents in reducing the pain and discomfort among the patients at four different intervals. The null hypothesis which was stated at the start of the study is rejected as there is highly significant difference on using silver diamine fluoride in reducing the post vital tooth preparation hypersensitivity than the potassium nitrate and GLUMA. However, of the 34 treated with gluma desensitizer 12 of them showed mild pulsating pain which can be considered as one of the side effects of the material. One of the limitations of the current randomized controlled trial is the sample size and a longer follow-up period is needed to evaluate the significant difference between the materials. Further Randomized control studies with longer follow-up period are needed to evaluate the effect of silver diamine fluoride as a desensitizer in reducing the post vital tooth preparation hypersensitivity.

CONCLUSION

Within the limitations of the study, the following conclusions were drawn:

  1. Desensitizers used in this study are effective in desensitizing the prepared vital tooth

  2. Among the desensitizers used, silver diamine fluoride seems to be more effective after application, before cementation of the definitive prosthesis, and after a follow-up period of 30 days

  3. There was no debonding of any definitive prosthesis noted during the period of the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

  • 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;24:808–13. doi: 10.1111/j.1600-051x.1997.tb01194.x. [DOI] [PubMed] [Google Scholar]
  • 2.Porto IC, Andrade AK, Montes MA. Diagnosis and treatment of dentinal hypersensitivity. J Oral Sci. 2009;51:323–32. doi: 10.2334/josnusd.51.323. [DOI] [PubMed] [Google Scholar]
  • 3.Miglani S, Aggarwal V, Ahuja B. Dentin hypersensitivity: Recent trends in management. J Conserv Dent. 2010;13:218–24. doi: 10.4103/0972-0707.73385. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Addy M. Dentine hypersensitivity: New perspectives on an old problem. Int Dent J. 2002;52:367–75. [Google Scholar]
  • 5.Amarasena N, Spencer J, Ou Y, Brennan D. Dentine hypersensitivity in a private practice patient population in Australia. J Oral Rehabil. 2011;38:52–60. doi: 10.1111/j.1365-2842.2010.02132.x. [DOI] [PubMed] [Google Scholar]
  • 6.Jalalian E, Meraji N, Mirzaei M. A comparison of the efficacy of potassium nitrate and gluma desensitizer in the reduction of hypersensitivity in teeth with full-crown preparations. J Contemp Dent Pract. 2009;10:66–73. [PubMed] [Google Scholar]
  • 7.Trushkowsky RD. Etiology and treatment of dentinal hypersensitivity. J Multidiscip Care Decis Dent. 2016;2:21–4. [Google Scholar]
  • 8.Youssef HA. An evaluation of four desensitizing agents for treatment of the post preparation tooth pain: Silver nitrate, potassium nitrate, strontium chloride and ferric oxalate. Egypt Dent J. 1995;41:1485–94. [PubMed] [Google Scholar]
  • 9.Hodosh M. A superior desensitizer – Potassium nitrate. J Am Dent Assoc. 1974;88:831–2. doi: 10.14219/jada.archive.1974.0174. [DOI] [PubMed] [Google Scholar]
  • 10.Al-Qahtani SM. Evaluation and comparison of efficacy of Gluma® and D/Sense® desensitizer in the treatment of root sensitivity induced by non-surgical periodontal therapy. Open Access Maced J Med Sci. 2019;7:1685–90. doi: 10.3889/oamjms.2019.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Mei ML, Lo EC, Chu CH. Clinical use of silver diamine fluoride in dental treatment. Compend Contin Educ Dent. 2016;37:93–8. [PubMed] [Google Scholar]
  • 12.Horst JA, Ellenikiotis H, Milgrom PL. Ucsf protocol for caries arrest using silver diamine fluoride: Rationale, indications and consent. J Calif Dent Assoc. 2016;44:16–28. [PMC free article] [PubMed] [Google Scholar]
  • 13.Canadian Advisory Board on Dentin Hypersensitivity. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc. 2003;69:221–6. [PubMed] [Google Scholar]
  • 14.Hodosh AJ, Hodosh S, Hodosh M. Potassium nitrate-zinc oxide eugenol temporary cement for provisional crowns to diminish postpreparation tooth pain. J Prosthet Dent. 1993;70:493–5. doi: 10.1016/0022-3913(93)90260-u. [DOI] [PubMed] [Google Scholar]
  • 15.Sensat ML, Brackett WW, Meinberg TA, Beatty MW. Clinical evaluation of two adhesive composite cements for the suppression of dentinal cold sensitivity. J Prosthet Dent. 2002;88:50–3. [PubMed] [Google Scholar]
  • 16.Niazy HA. Birmingham: Thesis University of Alabama; 1999. The effect of three desensitizing agents on dentin hypersensitivity in human subjects following routine crown preparation; pp. 1–77. [Google Scholar]
  • 17.Olley RC, Wilson R, Moazzez R, Bartlett D. Validation of a Cumulative Hypersensitivity Index (CHI) for dentine hypersensitivity severity. J Clin Periodontol. 2013;40:942–7. doi: 10.1111/jcpe.12144. [DOI] [PubMed] [Google Scholar]
  • 18.Frechoso SC, Menéndez M, Guisasola C, Arregui I, Tejerina JM, Sicilia A. 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. 2003;30:315–20. doi: 10.1034/j.1600-051x.2003.20077.x. [DOI] [PubMed] [Google Scholar]
  • 19.Nagata T, Ishida H, Shinohara H, Nishikawa S, Kasahara S, Wakano Y, et al. Clinical evaluation of a potassium nitrate dentifrice for the treatment of dentinal hypersensitivity. J Clin Periodontol. 1994;21:217–21. doi: 10.1111/j.1600-051x.1994.tb00307.x. [DOI] [PubMed] [Google Scholar]
  • 20.Madhavan S, Nayak M, Shenoy A, Shetty R, Prasad K. Dentinal hypersensitivity: A comparative clinical evaluation of CPP-ACP F, sodium fluoride, propolis, and placebo. J Conserv Dent. 2012;15:315–8. doi: 10.4103/0972-0707.101882. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Yadav K, Sofat A, Gambhir RS, Galhotra V. Dentin hypersensitivity following tooth preparation: A clinical study in the spectrum of gender. J Nat Sci Biol Med. 2014;5:21–4. doi: 10.4103/0976-9668.127277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Abdollahi A, Jalalian E. Effectiveness of two desensitizer materials, potassium nitrate and fluoride varnish in relieving hypersensitivity after crown preparation. J Contemp Dent Pract. 2019;20:489–93. [PubMed] [Google Scholar]
  • 23.Meyerowitz JM, Rosen M, Cohen J, Becker PJ. The effect of eugenol containing and non-eugenol temporary cements on the resin-enamel bond. J Dent Assoc S Afr. 1994;49:389–92. [PubMed] [Google Scholar]
  • 24.Bohnenkamp DM, Garcia LT. Repair of bis-acryl provisional restorations using flowable composite resin. J Prosthet Dent. 2004;92:500–2. doi: 10.1016/j.prosdent.2004.08.017. [DOI] [PubMed] [Google Scholar]
  • 25.Singh A, Garg S. Comparative evaluation of flexural strength of provisional crown and bridge materials – An in vitro study. J Clin Diagn Res. 2016;10:C72–7. doi: 10.7860/JCDR/2016/19582.8291. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Kozmacs C, Baumann V, Bunz O, Piwowarczyk A. relative clinical success of bis-acryl composite provisional crowns. Compend Contin Educ Dent. 2018;39:e9–12. [PubMed] [Google Scholar]
  • 27.Davis GR, Tayeb RA, Seymour KG, Cherukara GP. Quantification of residual dentine thickness following crown preparation. J Dent. 2012;40:571–6. doi: 10.1016/j.jdent.2012.03.006. [DOI] [PubMed] [Google Scholar]
  • 28.Edelhoff D, Ozcan M. To what extent does the longevity of fixed dental prostheses depend on the function of the cement. Working Group 4 materials: Cementation? Clin Oral Implants Res. 2007;18(Suppl 3):193–204. doi: 10.1111/j.1600-0501.2007.01442.x. [DOI] [PubMed] [Google Scholar]
  • 29.Bartold PM. Dentinal hypersensitivity: A review. Aust Dent J. 2006;51:212–8. [PubMed] [Google Scholar]
  • 30.Haddad MF, Rocha EP, Assunção WG. Cementation of prosthetic restorations: From conventional cementation to dental bonding concept. J Craniofac Surg. 2011;22:952–8. doi: 10.1097/SCS.0b013e31820fe205. [DOI] [PubMed] [Google Scholar]
  • 31.Bannister RD, Roudsari RV, Satterthwaite JD. Film thickness of dentin desensitizing agents on full crown preparations: Influence of product and gravity. Oper Dent. 2014;39:E241–9. doi: 10.2341/13-215-L. [DOI] [PubMed] [Google Scholar]
  • 32.Dababneh RH, Khouri AT, Addy M. Dentine hypersensitivity – An enigma. A review of terminology, mechanisms, aetiology and management? Br Dent J. 1999;187:606–11. doi: 10.1038/sj.bdj.4800345. [DOI] [PubMed] [Google Scholar]
  • 33.Lambrechts P, Van Meerbeek B, Perdigão J, Gladys S, Braem M, Vanherle G. Restorative therapy for erosive lesions. Eur J Oral Sci. 1996;104:229–40. doi: 10.1111/j.1600-0722.1996.tb00072.x. [DOI] [PubMed] [Google Scholar]
  • 34.Levitch LC, Bader JD, Shugars DA, Heymann HO. Non-carious cervical lesions. J Dent. 1994;22:195–207. doi: 10.1016/0300-5712(94)90107-4. [DOI] [PubMed] [Google Scholar]
  • 35.Nascimento MM, Dilbone DA, Pereira PN, Duarte WR, Geraldeli S, Delgado AJ. Abfraction lesions: Etiology, diagnosis, and treatment options. Clin Cosmet Investig Dent. 2016;8:79–87. doi: 10.2147/CCIDE.S63465. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Boston DW, al-bargi H, Bogert M. Abrasion, erosion, and abfraction combined with linear enamel hypoplasia: A case report. Quintessence Int. 1999;30:683–7. [PubMed] [Google Scholar]
  • 37.Satyapal T, Mali R, Mali A, Patil V. Comparative evaluation of a dentifrice containing calcium sodium phosphosilicate to a dentifrice containing potassium nitrate for dentinal hypersensitivity: A clinical study. J Indian Soc Periodontol. 2014;18:581–5. doi: 10.4103/0972-124X.142447. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Nirola A, Gupta M, Singla K, Kaur M. Comparative efficacy of application of three different desensitizing agents with iontophoresis in the treatment of hypersensitive teeth. J Int Clin Dent Res Organ. 2016;8:51. [Google Scholar]

Articles from The Journal of the Indian Prosthodontic Society are provided here courtesy of Wolters Kluwer -- Medknow Publications

RESOURCES