Scientific Article Review:

Effect of Commercially Available Nano-Hydroxyapatite Containing Desensitizing Toothpaste and Mouthwash on Dentinal Tubular Occlusion - A SEM Analysis

Published In: Journal of Pharmacy and Bioallied Sciences
Publication Year: 2023

Study Design

This research is an in vitro experimental study aimed at comparing the effectiveness of nano-hydroxyapatite (n-HAP) toothpaste and mouthwash in occluding dentinal tubules over 28 days using scanning electron microscopy (SEM).

Funding Sources

The study reported no financial support or sponsorship and declared no conflicts of interest.

PICO Framework - What Was Studied and How?

Population:
Premolars and canine teeth (extracted, caries-free, and free from attrition, abrasion, or erosion).

Intervention:
Brushing with n-HAP toothpaste twice daily for 2 minutes over 28 days.

Comparison:
Using n-HAP mouthwash twice daily for 1 minute over 28 days.

Outcomes:
The percentage of occluded dentinal tubules measured using SEM at baseline, and on the 7th, 14th, 21st, and 28th days.

In Paragraph Form:
This study examined extracted premolars and canines to compare the effects of n-HAP-containing toothpaste and mouthwash on dentinal tubule occlusion over time. Specimens were treated daily and assessed periodically using SEM to measure occlusion levels.

Inclusion and Exclusion Criteria

Inclusion Criteria:

• Caries-free crown and root.
• Teeth without attrition, abrasion, or erosion.

Exclusion Criteria:

• Teeth with developmental anomalies.
• Endodontically treated teeth.

Demographics and Study Design

The study utilized 10 specimens in total, divided into two groups of five each:

• Toothpaste Group: Brushed for 2 minutes twice daily.
• Mouthwash Group: Soaked for 1 minute twice daily.

Primary Outcome Variables and Results

Outcome: Percentage of occluded dentinal tubules (categorized as unoccluded, partially occluded, or completely occluded).

Results:
The toothpaste group demonstrated superior occlusion rates compared to the mouthwash group at every interval (7th, 14th, 21st, and 28th days). Key findings include:

• Completely Occluded Tubules on Day 28:

  • Toothpaste: 80.84% ± 8.06
  • Mouthwash: 71.03% ± 4.68
  • p-value: <0.001

• Statistical Significance: Toothpaste consistently outperformed mouthwash across all time points (p ≤ 0.05).

Conclusions

Brushing with n-HAP-containing toothpaste twice daily significantly improved dentinal tubule occlusion over 28 days compared to the mouthwash. This suggests that n-HAP toothpaste may be a more effective treatment for dentin hypersensitivity.

Discussion: Strengths and Limitations

Strengths:

• Utilized SEM imaging for precise measurements.
• Standardized specimen preparation and treatment conditions.

Weaknesses:

• Small sample size (n=10).
• Study was conducted in vitro without simulating oral conditions such as acid challenges.

Citation

Gupta I, Chauhan S, Amaranath BJ, Das N, Johnson L, Mehrotra V. Effect of commercially available nano-hydroxyapatite containing desensitizing toothpaste and mouthwash on dentinal tubular occlusion: A SEM analysis. J Pharm Bioall Sci. 2023;15:S1027-S1029. Access here.

Visual Aids

Chart: Comparison of Completely Occluded Tubules (%)