Comparison of the Clinical Effectiveness of Self Etch Adhesive and Fluoride Varnish in Reducing Dentin Hypersensitivity in Patients With Gingival Recession: Randomized Clinical Trial

Dentin hypersensitivity is a common disorder and is one of the most irritating clinical condition1. It is one of the everyday complaints from patient visiting dental operatory2. Dentin hypersensitivity has been defined as "Short, sharp pain arising from exposed dentin in response to stimuli typically thermal, evaporative , tactile , osmotic or chemical that cannot be related to any other dental defect or pathology"3'4.Prevalance of dentin hypersensitivity in general population is 4% to 57% 5. Adults are normally affected by dentin hypersensitivity mainly in their late 30s however mainly people aged between 29 to 49 years can also suffer from this6.

One of the most well known theory for dentin hypersensitivity is Brannstorm and Astrom's Hydrodynamic theory2'6. According to this theory environmental ,thermal, chemical changes cause the movement of fluid within tubules, which stimulate terminals of pulpal nerve fibers located in tubules, this will lead to acute transient pain6'7.

Dentin is composed of dentinal tubules and dentin is protected by highly mineralized structures i.e enamel covers the dentin in crown portion while root dentin is protected by cementum8.Certain type of physical, chemical, pathological and biological challenges or developing defects can lead to exposure of dentin. Periodontal tissue loss or gingival recession is one of the most predisposing factor because it will lead to exposure of cervical and root dentin2.

A lot of research has been done on treatment of dentin hypersensitivity but still no consensus has been reached on which product is "gold standard" for treatment of dentin hypersensitivity9.Lukomsky suggested that fluoride can be used as topical desensitizing agent for reduction of DH. It has been in use since 1941.Fluoride causes formation of calcium fluoride crystals and varying degree of fluorapatite which will block the transmission of noxious stimuli to pulp. For treatment of dentin hypersensitivity varnishes containing sodium fluoride as an active component are in use for many years9.Some researchers recommended the use of self etch adhesive for reduction of dentin permeability10.Self etch adhesive form acid resistant hybrid layer due to which they show high level of clinical effectiveness. Yu et al showed that one bottle self etch adhesive plays an effective role in alleviating symptoms of dentin hypersensitivity11.

The aim of current clinical study is to compare clinical effectiveness of self etch and fluoride varnish in reducing dentin hypersensitivity in patients with gingival recession.