Clinical evaluation of the role of glutardialdehyde in a one-bottle adhesive.
OBJECTIVE
To evaluate clinically whether the addition of glutardialdehyde to the one-bottle enamel-dentin adhesive Gluma Comfort Bond (GCB) has a desensitizing function, as insinuated by the brand name Gluma Comfort Bond+Desensitizer (GCB+D).


METHODS
Two pain studies following identical protocols were conducted in Abu Dhabi (A) and Bologna (B). Each of the 60 and 59 patients selected, respectively, had two sensitive cervical tooth sites, characterized by a score three or higher on a five-step pain scale: 1 (no), 2 (slight), 3 (mild), 4 (severe), 5 (very severe) discomfort upon application of a 2-second cold air stimulus. The buccal sensitive sites treated in A were generally small, in B larger and in most cases extending into the proximal tooth area. The patients indicated their discomfort level according to the pain scale prior to and immediately after topical application of GCB and GCB+D, respectively, and then at recalls after 1 week, 1 (A) or 3 (B) months, and 6 months. The data was statistically analyzed by chi2-tests (P < 0.05).


RESULTS
With the cumulative scores 1 and 2, the following percentage success rates were found for GCB/GCB+D. A: postoperatively 93/98, 1 week and 1 month 98/98, and at 6 months 92/100. In B, the respective decrease in sensitivity was uniformly 43/100 throughout the entire evaluation period, postoperatively through 6 months. The 33 teeth (57%) of GCB with scores 3 and 4 in the B-study received a rescue treatment with Gluma Desensitizer immediately after the 1 week recall. This regimen reduced the sensitivity instantaneously to scores 1 and 2 until the end of the evaluation after 6 months. In the A-study, GCB+D was significantly more effective than GCB after 1 week, 1 month, and 6 months, in the B-study at all recall sessions. It is hypothesized that a thin film of adhesive applied to a sensitive area may not polymerize and seal the dentin surface adequately due to oxygen inhibition. In particular, proximal sensitive tooth sites with poor access for adhesive application are suspected to remain inadequately sealed with a polymer film and thus sensitive. In this latter case however, glutardialdehyde as a component of the adhesive compound will result in coagulation of peripheral tubular liquid protein and thus desensitization, due to hampering of the liquid shift across the tubules upon excitation of a cold stimulus. In conclusion, glutardialdehyde played an active and effective role as a desensitizing agent, when added to the ethanol-water based one-bottle adhesive Gluma Comfort Bond.
Dondi dall'Orologio
Giovanni
G
Department of Conservative Dentistry, Dental School, University of Bologna, Italy.
Lone
Asmat
A
Finger
Werner J
WJ
D000328:Adult; D016009:Chi-Square Distribution; D001840:Dental Bonding / Q000009:adverse effects; D003806:Dentin Permeability; D003807:Dentin Sensitivity / Q000209:etiology / Q000517:prevention & control*; D017220:Dentin-Bonding Agents / Q000627:therapeutic use*; D019234:Dentinal Fluid / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D005976:Glutaral / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement
D017220:Dentin-Bonding Agents; C445021:Gluma Comfort Bond; C445022:Gluma Comfort Bond & Desensitizer; D005976:Glutaral