Clinical efficacy of nano-hydroxyapatite in dentin hypersensitivity: A systematic review and meta-analysis.

OBJECTIVES:

To evaluate the desensitizing effect of nano-hydroxyapatite (n-HAP) on dentine hypersensitivity (DH).

SOURCES:

Seven electronic databases were searched on April 27, 2018.

STUDY SELECTION:

Randomized clinical trials (RCTs) were included based on the PICO strategy: Participants - Humans with DH; Intervention - n-HAP-containing desensitizing; Comparison -n-HAP-free treatments or placebo/negative control; and Outcomes - relief of DH. The risk of bias was classified by the Cochrane guidelines. Five meta-analyses were performed to evaluate the efficacy of n-HAP with regard to pain assessment stimuli (primary outcome); comparison of n-HAP with other treatments or placebo/negative control, and effectiveness of at-home and in-office n-HAP use (secondary outcomes). The quality of the evidence was evaluated using the GRADE.

DATA:

Six RCTs with 4 weeks of follow-up were included in the meta-analysis. For the primary outcome, n-HAP showed a better desensitizing effect for evaporative stimuli (SMD -1.09 [-1.24, -0.94], p < 0.00001) and tactile stimuli (SMD -0.93 [-1.42, -0.43]) than other treatments (p = 0.0002). However, there was no difference between n-HAP and other treatments for the cold stimuli (SMD -0.17 [-0.81, 0.48], p = 0.61). In an overall analysis, n-HAP-containing treatment showing the most significant desensitizing effect (SMD -0.93 [-1.19, -0.68], p < 0.00001) with a high quality of evidence for pooled results. In the secondary outcomes, n-HAP showed the best effect in the overall analysis (p < 0.05) with moderate quality evidence.

CONCLUSIONS:

The n-HAP-containing treatment showed better clinical performance than other treatments for DH relief. However, long-term follow-up RCTs are required in the future before definitive recommendations can be made.

결론: 나노하이드록시 아파타이트 함유 치료는 다른 방법보다 DH(치아지각과민)증상 완화에 더 뛰어난 임상결과를 보여주었다.

CLINICAL SIGNIFICANCE:

Dentin hypersensitivity is a common global condition and its multifactorial etiology has led to the development of several treatments. The n-HAP-containing treatment showed greater DH relief when compared to other desensitizing agents, placebo or negative control.

임상적인 의미: 상아질 지각과민(시린이)는 세계적으로 흔한 질환이다. 나노 하이드록시아파타이트 함유 처치가 기타 다른 지각과민처지재에 비해 월등한 효과를 보여 주었다. 

* 참고: 연구 논문의 신뢰성

체계적 리뷰와 메타분석은 연구 논문중 가장 신뢰할 만한 수준의 논문을 의미합니다.