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138]
Letter to Editor
Improved quality of life
in patients with dentin
hypersensitivity
Sir,
Dentin hypersensitivity seems to be a common problem and
still remains an enigma in diagnosis. The discomfort that
arises as a result of dentin hypersensitivity is said to greatly
affect the quality of life of the patients. On reviewing the
literature, the prevalence of dentin hypersensitivity can
range anywhere from 4.8% to 62.3%.[1] The success of
treating dentine hypersensitivity mainly depends on the
long‑term efficiency of treatment modalities. The treatment
modalities include the use of desensitizing chemical agents
and LASER.[2]
To the best of our knowledge, till date, based on the
evidence from clinical trial, the long‑term prognosis
of desensitizing toothpaste has not yet been clearly
identified. Most of the clinical trial evaluated the prognosis
only till the period of 12  weeks; hence, more trial is
necessary. Moreover, some clinical trials were reported
with publication bias. Many company‑sponsored clinical
trials reported the results which favor the benefit of the
company, but the adverse outcome was not addressed.[3,4]
In the recent years, LASER seems to provide promising
results. The mechanism of action differs with the type
of LASER. Low‑power LASER has a biomodulatory
effect; cellular metabolic activity of odontoblast gets
increased thereby blocking the dentinal tubules. Whereas,
high‑power LASER increases the surface temperature and
promotes recrystallization of dentinal surface that results in
blockade of dentinal tubules.[5] The previous report stated
that adhesives like cyanoacrylate have higher efficiency
than LASER.[6] Furthermore, regenerative procedures
such as guided tissue regeneration with a three‑layered
membrane lead to successful results in the management
of hypersensitivity. 8% nanocarbonated hydroxyapatite
collagen/poly (lactic‑co‑glycolic acid) (nCHAC/PLGA)
forms the inner porous membrane, 4% nCHAC/PLGA
forms the middle layer, and PLGA forms nonporous outer
membrane. When placed, it forms highly biocompatible
membrane which helps in tissue regeneration.[7]
In the recent years, dynamic biological agents, namely stem
cells such as stem cells from apical papilla, dental pulp stem
© 2019 Saudi Endodontic Journal | Published by Wolters Kluwer ‑ Medknow 81
cells (DPSC), and scaffold attribute to de novo regeneration
of dentin. However, the challenge is that the functional
regeneration of dentin depends on enamel regeneration.
The availability of Dental Epithelial Stem Cells (DESC)
that is responsible for enamel regeneration is very scarce.[8]
Porcine epithelial rests of Malassez when cultured with
DPSC can differentiate into enamel. The challenge in de
novo enamel regeneration is time frame. It requires many
years to form enamel which is not compatible with our
clinical needs, and even if there is mild disturbance during
the process, it may lead to defective enamel formation.
However, lot of research is still ongoing in achieving the
ultimate goal in the treatment of dentin hypersensitivity
which is the permanent relief of discomfort thereby
improving the patients’ quality of life.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Krishnamachari Janani, P. Ajitha, Raghu Sandhya
Department of Conservative Dentistry and Endodontics, Saveetha
Dental College, Saveetha Institute of Medical and Technical
Sciences, Chennai, Tamil Nadu, India
Address for correspondence: Dr. P. Ajitha,
Department of Conservative Dentistry and Endodontics, Saveetha Dental
College, Saveetha Institute of Medical and Technical Sciences, 162,
Poonamallee High Road, Chennai ‑ 600 077, Tamil Nadu, India.
E‑mail: ajitharijesh@gmail.com
Submission: 20-05-19 Revision: 07-06-19
Acceptance: 25-06-19 Web Publication: 27-12-19
REFERENCES
1. Favaro Zeola  L, Soares  PV, Cunha‑Cruz  J. Prevalence of dentin
hypersensitivity: Systematic review and meta‑analysis. J  Dent
2019;81:1‑6.
2. da Rosa  WL, Lund  RG, Piva  E, da Silva  AF. The effectiveness of
current dentin desensitizing agents used to treat dental hypersensitivity:
A systematic review. Quintessence Int 2013;44:535‑46.
3. Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry
sponsorship and research outcome and quality: Systematic review. BMJ
2003;326:1167‑70.
4. Sismondo S. Pharmaceutical company funding and its consequences:
A qualitative systematic review. Contemp Clin Trials 2008;29:109‑13.
5. Aranha AC, Eduardo Cde P. Effects of Er: YAG and Er, Cr: YSGG
lasers on dentine hypersensitivity. Short‑term clinical evaluation. Lasers
Med Sci 2012;27:813‑8.
6. Biagi R, Cossellu G, Sarcina M, Pizzamiglio IT, Farronato G.
Laser‑assisted treatment of dentinal hypersensitivity: A literature
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Letter to Editor

review. Ann Stomatol (Roma) 2015;6:75‑80.

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7. Bhavikatti SK, Bhardwaj S, Prabhuji ML. Current applications of
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nanotechnology in dentistry: A review. Gen Dent 2014;62:72‑7. Website:
8. Yin Y, Yun S, Fang J, Chen H. Chemical regeneration of human
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tooth enamel under near-physiological conditions. Chemical
Communications 2009:5892-4.
DOI:
10.4103/sej.sej_81_19

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How to cite this article: Janani K, Ajitha P, Sandhya R. Improved quality
of life in patients with dentin hypersensitivity. Saudi Endod J 2020;10:81-2.
© 2019 Saudi Endodontic Journal | Published by Wolters Kluwer ‑ Medknow

82 Saudi Endodontic Journal | Volume 10 | Issue 1 | January-April 2020