title: Calcium sodium phosphosilicate had some benefit on dentine hypersensitivity.
abstract: METHODS
  Medline (via Pubmed), Embase, Web of Science, CENTRAL (The Cochrane Library), and the Chinese Biomedical Literature Database. Search strategy was limited to articles published in English and Chinese. No restriction applied to date of publication and a supplemental manual search was conducted by reviewing the reference lists for related paper and articles. Grey literature was also searched in ClinicalTrials.gov, the National Research Register, OpenGrey and the WHO's international clinical Trial Registry Platform.
  
  
  METHODS
  Randomised controlled trials in humans with DH that compared topical CSPS in any modality and any concentration to a negative (placebo) control. The primary outcome was the DH pain response to routine activities or to thermal, tactile, evaporative or electrical stimuli, and the secondary outcome was the side effect of CSPS use including discomfort, oral hygiene deterioration or dental staining.Data extraction and synthesisStudy selection, data extraction and risk bias assessment were carried out in duplicate by two calibrated reviewers. Any disagreement was resolved via discussion after consulting a third reviewer. Mean differences (MDs) and standard deviations (SDs) were used to summarise data in studies with continuous outcomes. Heterogeneity was assessed using the I(2) test. Meta-analysis was performed when similarities were found among the included studies. The Grading of Recommendations Assessment Development and Evaluation (GRADE) System's Profiler was used to assess the quality of the body of the evidence.
  
  
  RESULTS
  Eleven trials were included comparing CSPS with a negative control. Four articles that focused on post-periodontal therapy were extracted as an independent analysis group. CSPS was used in topical administration with concentrations ranging from 2.5%-15%. Follow-up times ranged from 15 days to eight weeks. DH pain was elicited by tactile, evaporative or thermal stimuli. A 10 cm visual analogue scale (VAS) was the most commonly used for measurements. Five studies revealed a low risk of bias, one study had a high risk of bias and five studies had an unclear risk of bias. Seven of the studies were regarded as having a potential conflict of interest.For the primary outcome (DH) Subjects in the DH group (four studies) showed that toothpaste containing 5% CSPS was favoured compared with a negative control at almost every time point, however one study did not report a significant difference between these treatments at two weeks.The results from the from the grey literature (two studies) did not show significant differences between the CSPS and control groups and the results were not in agreement with the other studies. Another study observed effects of both 2.5% and 7.5% CSPS-containing toothpaste: 7.5% CSPS was more effective at relieving DH than a negative control, whereas no significant difference was found between 2.5% and the negative controls.For the secondary outcome (adverse events): six studies did not observe adverse reactions. The remaining studies reported minor adverse events, although most were not orally related.Toothpaste containing 5% CSPS versus negative control: the 5% CSPS-containing toothpaste showed a better desensitising effect at both two and six weeks regardless of the applied stimuli (evaporative, two weeks: MD = -0.68; 95% CIs = -1.15, -0. 20; I2 = 59%; evaporative, six weeks: MD = -1.69; 95% CIs = -1.86, -1.52; I2 = 42%; thermal, two weeks: MD = -0.59; 95% CIs = -1.33, 0.14; I2 = 84%; and thermal, six weeks: MD = -1.70; 95% CIs = -2.17, -1.23;I2 = 72%). The quality of evidence was categorised as 'moderate'.Prophylaxis paste containing 15% CSPS versus negative control: prophylaxis paste containing 15% CSPS showed a better desensitising effect on post-periodontal therapy DH pain than a negative control, immediately after prophylaxis and at four weeks, as determined using evaporative or tactile stimuli, and the results showed relatively low heterogeneity (evaporative, immediate: MD = -0.87; 95% CIs = -1.23, -0.51; I2 = 0%; evaporative, four weeks: MD = -0.93; 95% CIs = -1.11, -0.75; I2 = 41%; tactile, immediate: MD = -9.59; 95%CIs = -12.17, -7.01; I2 = 55%; and tactile, four weeks: MD = -8.34; 95% CIs = -10.87, -5.80; I2 =0%). The quality of evidence was classified as 'low'.The two studies that assessed patients' self-assessments of dentine sensitivity were not pooled because of clinical heterogeneity.
  
  
  CONCLUSIONS
  The majority of the studies included in the review found that sodium phosphosilicate was more effective than negative control at alleviating dentine hypersensitivity, used either as toothpaste to alleviate DH or as a prophylaxis paste to treat post-periodontal therapy DH. The review found moderate quality of evidence that 5% CSPS-containing toothpaste is effective for use as an at-home treatment to relieve DH. There is low quality evidence that prophylaxis paste containing 15% CSPS is favoured over a negative control at reducing post-periodontal therapy hypersensitivity. It remains unclear whether concentrations of more than 5% CSPS have increased risk of side effects. The results are based on a small number of clinical trials. Seven of the studies were industry or partially industry-sponsored.
authors.affiliation: New York University College of Dentistry, New York, USA.
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Freda
authors.affiliation: New York University College of Dentistry, New York, USA.
authors.forename: Analia
authors.initials: A
authors.lastname: Veitz-Keenan
mesh_terms: D006801:Humans; D057133:Dentin Desensitizing Agents / Q000494:pharmacology; D003807:Dentin Sensitivity / Q000188:drug therapy; D005898:Glass; D014100:Toothpastes / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic; D015201:Meta-Analysis as Topic
chemical_list: D057133:Dentin Desensitizing Agents; D014100:Toothpastes