title: Treatments for hypersensitive noncarious cervical lesions: a Practitioners Engaged in Applied Research and Learning (PEARL) Network randomized clinical effectiveness study.
abstract: BACKGROUND
  The Practitioners Engaged in Applied Research and Learning (PEARL) Network conducted a three-armed randomized clinical study to determine the comparative effectiveness of three treatments for hypersensitive noncarious cervical lesions (NCCLs): use of a potassium nitrate dentifrice for treatment of hypersensitivity, placement of a resin-based composite restoration and placement of a sealant.
  
  
  METHODS
  Seventeen trained practitioner-investigators (P-Is) in the PEARL Network enrolled participants (N = 304) with hypersensitive posterior NCCLs who met enrollment criteria. Participants were assigned to treatments randomly. Evaluations were conducted at baseline and at one, three and six months thereafter. Primary outcomes were the reduction or elimination of hypersensitivity as measured clinically and by means of patient-reported outcomes.
  
  
  RESULTS
  Lesion depth and pretreatment sensitivity (mean, 5.3 on a 0- to 10-point scale) were balanced across treatments, as was sleep bruxism (present in 42.2 percent of participants). The six-month participant recall rate was 99 percent. Treatments significantly reduced mean sensitivity (P < .01), with the sealant and restoration groups displaying a significantly higher reduction (P < .01) than did the dentifrice group. The dentifrice group's mean (standard deviation) sensitivity at six months was 2.1 (2.1); those of the sealant and restoration groups were 1.0 (1.6) and 0.8 (1.4), respectively. Patient-reported sensitivity (to cold being most pronounced) paralleled clinical measurements at each evaluation.
  
  
  CONCLUSIONS
  Sealing and restoration treatments were effective overall in reducing NCCL hypersensitivity. The potassium nitrate dentifrice reduced sensitivity with increasing effectiveness through six months but not to the degree offered by the other treatments. Practical Implications. Sealant or restoration placement is an effective method of immediately reducing NCCL sensitivity. Although a potassium nitrate dentifrice did reduce sensitivity slowly across six months, at no time was the reduction commensurate with that of sealants or restorations.
authors: Oral & Maxillofacial Pathology, Radiology and Medicine, College of Dentistry, New York University, New York City, USA.
authors: Analia
authors: A
authors: Veitz-Keenan
authors: Julie Ann
authors: JA
authors: Barna
authors: Brad
authors: B
authors: Strober
authors: Abigail G
authors: AG
authors: Matthews
authors: Damon
authors: D
authors: Collie
authors: Donald
authors: D
authors: Vena
authors: Frederick A
authors: FA
authors: Curro
authors: Van P
authors: VP
authors: Thompson
mesh_terms: D055812:Community-Based Participatory Research; D003188:Composite Resins / Q000737:chemistry; D003793:Dental Restoration, Permanent / Q000379:methods; D003802:Dentifrices / Q000627:therapeutic use; D057133:Dentin Desensitizing Agents / Q000627:therapeutic use; D003807:Dentin Sensitivity / Q000145:classification / Q000628:therapy*; D017220:Dentin-Bonding Agents / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055115:Light-Curing of Dental Adhesives / Q000379:methods; D008297:Male; D008689:Methacrylates / Q000627:therapeutic use; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D017680:Potassium Compounds / Q000627:therapeutic use; D019279:Resin Cements / Q000737:chemistry; D020186:Sleep Bruxism / Q000145:classification; D019237:Tooth Cervix / Q000187:drug effects / Q000473:pathology*; D057085:Tooth Wear / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: C112274:Clearfil Liner Bond 2; C505694:Clearfil S3 Bond; D003188:Composite Resins; D003802:Dentifrices; D057133:Dentin Desensitizing Agents; D017220:Dentin-Bonding Agents; D008689:Methacrylates; D009566:Nitrates; D010895:Pit and Fissure Sealants; D017680:Potassium Compounds; D019279:Resin Cements; C507210:premise composite resin; C023844:potassium nitrate
keywords: Noncarious cervical lesion; bruxism; dental sealant; dentifrices; dentin-bonding agents; molar; operative dentistry; premolar; resin-based composite; restorative dentistry; root sensitivity
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