Comparative evaluation of Calcium sodium phospho silicate dentifrice (CSPS) and Nano-hydroxy apatite dentifrice (NHA) in reducing Dentinal hypersensitivity after Scaling and Root planing.

Dentine hypersensitivity (DH) is characterized by short, sharp pain arising from exposed dentine in response to stimuli, typically thermal, evaporative, tactile, osmotic or chemical and which cannot be ascribed to any other dental defects or pathology. The diagnosis of this disease is often based on the subject’s self report of pain and requires exclusion of other dental and periodontal conditions that might cause pain. The successful treatment of periodontal disease depends on the effective removal of bacterial deposits from the tooth surfaces. This can be accomplished by thorough daily oral hygiene measures achieved by the patient and by professionally performed mechanical debridement. However, the establishment of healthy periodontal conditions by active treatment may often result in receding of the gingival tissues, leaving root surfaces exposed to the oral environment. The iatrogenic denudation of root dentin due to removal of the cementum layer is yet another complication to scaling procedures. The ultimate goal for treating DH is immediate relief with a long-lasting action. The efficacy of desensitizing agent’s that blocks the pain stimulus such as potassium or strontium-containing dentifrices is limited. Therefore, desensitizing agents that can occlude tubules and resist chemical substances and abrasion have been developed. Calcium sodium phosphosilicate, a bioactive glass, reacts when exposed to aqueous media and provides calcium and phosphate ions that form a hydroxyl carbonate, a mineral that is chemically similar to the mineral in enamel and dentin. The chemical reaction initiated by calcium sodium phosphosilicate to promote the formation of a hydroxyl carbonate layer for the treatment of DH is also useful in treating demineralized tooth structure or in preventing further demineralization. Synthetic carbonate hydroxyl-apatite nanocrystals have been shown to produce re-mineralization of the altered enamel surfaces and to be effective in closing dentinal tubules. The mechanism of action is based on occluding the dentinal tubules to block the hydrodynamic mechanism and pain stimulation by depositing a thin coating, or artificial smear layer, on the exposed dentin. Also, remineralizing the exposed dentin surface with deposits or precipitation of fine particles work to occlude the dentinal tubules. Patients will be receiving phase I therapy which includes scaling and root planing and thorough oral hygiene instructions will be given. Patients will be assessed for eligibility after 1 week. Parameters such as Schiff score; visual analog score will be measured at baseline. The dentifrice is applied to the teeth using a rubber cup with a low speed hand piece. Then two consecutive 3- second applications focusing on exposed cementum and dentine will be done. The clinical parameters were re-assessed immediately after the application. The participants were instructed about the home use of their dentifrice. Each participant will be given a new soft toothbrush and a tube of the assigned dentifrice. They will be informed to use only the toothbrush and dentifrice provided for the trial and instructed to not use a mouthwash while participating in this study. The home care instructions will be given, which comprises brushing twice daily using the modified bass technique with a 1-inch strip of the dentifrice for 2 minutes and rinsing one time with water. Patient will be recalled after 2 and 4 weeks parameters will be re-assessed. Follow up will be done at 2 weeks and 4 weeks for parameters.