• N.V. Yanko Ukrainian Medical Stomatological Academy (Poltava)
Keywords: remineralisation, hypersensitivity, desensitisation, enamel, dentin


ремінералізація, гіперчутливість, десенситизація, емаль, дентинRemineralisation agents not only strengthen enamel resistance, but also can occlude dentine tubules, reducing teeth sensitivity. This article provides an overview of various available agents used for enamel remineralisation and dentin hypersensitivity treatment. Conventional fluorides are used in the form of solutions, varnishes, foam, gels, dentifrices, showing low remineralising and desensitising ability as compared to newer fluoride-content products. Deep fluoridation is an effective method for reducing dentin hypersensitivity for a long time; its remineralising potential is used for white spot lesions treatment, caries prevention, and fissure sealing. Most novel fluoride compounds showed higher remineralising and desensitising abilities as compared to conventional fluorides. Deep penetration fluoridation is an effective method for remineralisation and reducing dentin hypersensitivity in long time. Despite of the fact that calcium phosphate systems have demonstrated a benefit over conventional fluorides in remineralisation their desensitising ability was not confirmed by various studies. The use of bioactive glass in remineralisation and desensitisation is quite promising, but further researches need to be undertaken to prove its efficacy. «Curodont» and synthetic nanohydroxyapatite from biomimetic systems showed good results in the above-mentioned treatments, but more researches are required to confirm their clinical efficacy. There is no doubt that iontophoresis with calcium and fluoride substances is still the most effective method in the office remineralisation, however, its potential effect in desensitisation has to be better evaluated. Efficacy of different kinds of lasers alone or in combination with a remineralisation agent has been confirmed mostly in vitro studies, therefore, there is a lack of clinical trials to prove their benefit. In latter studies, dentin sealants and desensitisers occluded dentin tubules were superior to conventional fluorides and synthetic nanohydroxyapatites. Simultaneously, the data about calcium phosphate and deep penetration fluoridation efficacy over such desensitisers as dentin sealants and nerve sensitivity inhibitors are controversial and indicate that additional studies are required to deepen our knowledge of the insufficiently explored area of reducing dentin hypesensitivity. In spite of the new advances, the ideal treatment modality for remineralisation does not exist. Within last decades, dentistry has made significant steps towards the elusive goal of enamel remineralisation and dentin desensitisation, but more long-term сlinical controlled studies are needed to confirm and quantify these findings, as well as to identify additional factors that can potentiate these processes.


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1. Fejerskov O, Kidd EAM. (2008). Dental caries: The disease and its clinical management. Oxford: Blackwell Munksgaard.
2. Cate JMT. In vitro Studies on the Effects of Fluoride on De- and Remineralisation. J Dent Res 1990; 69 (2 suppl): 614–619.
3. Chomenko LO, Shapovalova LI. Deep fluoridation – method of caries prevention. Part 2. Dentin sealing liquid. Preventive and paediatric dentistry 2013; 1(8): 6-10 [in Ukrainian].
4. Philip N. State of the Art Enamel Remineralisation Systems: The Next Frontier in Caries Management. Caries Res 2018; 53(3): 284-295.
5. González-Cabezas C, Fernández CE. Recent Advances in Remineralisation Therapies for Caries Lesions. Adv Dent Res 2018; 29(1): 55–59.
6. Zero DT. Dentifrices, mouthwashes, and remineralization/caries arrestment strategies. BMC Oral Health 2006; 6 Suppl 1(Suppl 1): S9.
7. Pitts NB, Wright JP. Reminova and EAER: keeping enamel whole through caries remineralisation. Adv Dent Res 2018; 29: 48–54.
8. Liu Y, Hsu CY, Teo CM, Teoh SH. Potential mechanism for the laser-fluoride effect on enamel demineralization. J Dent Res 2013; 92(1):71–75.
9. Cunha-Cruz J, Wataha JC, Zhou L, et al. Treating dentin hypersensitivity: therapeutic choices made by dentists of the northwest PRECEDENT network. J Am Dent Assoc 2010;141(9):1097–1105.
10. Derks A, Katsaros C, Frencken JE, et al. Caries-inhibiting effect of preventive measures during orthodontic treatment with fixed appliances. A systematic review. Caries Res 2004; 38: 413–420.
11. Pinto SC, Bandéca MC, Pinheiro MC, et al. Preventive effect of a high fluoride toothpaste and arginine-carbonate toothpaste on dentinal tubules exposure followed by acid challenge: a dentine permeability evaluation. BMC Res Notes 2014; 7: 385.
12. Uraz A, Erol-Şiimşek Ö, Pehliivan S,et al.The efficacy of 8% Arginine-CaCO3 applications on dentine hypersensitivity following periodontal therapy: A clinical and scanning electron microscopic study. Med Oral Patol Oral Cir Bucal 2013; 18(2): e298–e305.
13. Huang X, Exterkate RAM, ten Cate JM. Factors associated with alkali production from arginine in dental biofilms. J Dent Res 2012; 91:1130-1134.
14. Ástvaldsdóttir Á, Naimi-Akbar A, Davidson T, et al. Arginine and Caries Prevention: A Systematic Review. Caries Res 2016; 50:383-393.
15. Marinho VCC, Worthington HV, Walsh T, Clarkson JE. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews 2013; 7: Art. No.: CD002279.
16. Іваницький І. О. Порівняльна характеристика ефективності лікування гіперчутливості зубів із використанням сучасних препаратів: автореф. дис. на здобуття наук. ступеня канд. мед. наук: 14.01.22 спец. «Стоматологія» / І. О. Іваницький. – Полтава, 2010. – 18 с. [Ivanitskiy IO. Comparative characteristic of the efficacy of teeth hypersensitivity treatment with the using of modern medicines: thesis submitted in fulfilment of the requirement regulations for the degree of doctor of philosophy: 14.01.22 speciality «Stomatology» / IO Ivanitskiy. – Poltava, 2010. – 18p].
17. Ярова C.П., Гензицька О.С., Заболотна І.І. Особливості лікування гіперестезії дентину при захворюваннях тканин пародонта. Медицина сьогодні і завтра. – 2011. – №3. – С. 143-146. [Yarova C.P., Genzitska O.S., Zabolotna I.I.. Features of the treatment of dentin hyperesthesia at diseases of periodontal tissues. Medicine today and tomorrow 2011; 3: 143-146].
18. Castillo JL, Rivera S, Aparicio, T, et al. The Short-term Effects of Diamine Silver Fluoride on Tooth Sensitivity: a Randomized Controlled Trial. J Dent Res 2011: 90(2):203–208.
19. Chu CH, Lo EC, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res 2002; 81: 767–770.
20. Knappwost A. Tiefenfluoridie rungdurch mineralische Schmelzversiegelung. LZAKB 1993; 21:232.
21. 21.Meto A, Meto A, Tragaj E, et al. The Use of Tiefenfluorid for Desensitization of Dentinal Hyperesthesia. Balkan Journal of Dental Medicine 2014;18(2): 85-88.
22. Kаськова Л.Ф., Бережна О.Е., Солошенко Ю.І. та ін. Використання препарату Глуфторед у практиці дитячої стоматології // Профілактична та дитяча стоматологія. – 2011. – №1(6). – Р. 36-37 [Kas’kova LF, Berezhna OE, Soloshenko YuI, et al. Use of medicine "Gluftored" in the practice of paediatric dentistry. Preventive and paediatric dentistry 2011; 1 (6): 36-37].
23. Gans C, Klimek J, Gleim A. Qualität von Fissurenversiegelung mit zwei Fluorid freisetzenden. Versieglermaterialien. Dtsch Zahnärztl Z 1999; 54: 108-111.
24. Iafisco M, Esposti DL, Ramírez-Rodríguez GB, et al. Fluoride-doped amorphous calcium phosphate nanoparticles as a promising biomimetic material for dental remineralisation. Scientific Reports 2018; 8(1): [17016].
25. Guclu ZA, Alacam A, Coleman NJ: A 12-week assessment of the treatment of white spot lesions with CPP-ACP paste and/or fluoride varnish. Biomed Res Int 2016; 2016: 8357621.
26. Rosaiah K, ArunaK. Clinical efficacy of amorphous calcium phosphate, G.C. Tooth Mousse and Gluma desensitizer in treating dentin hypersensitivity. Int J Dent Clin 2011; 3 (1):1-4.
27. Pishevar L, Farhad SZ, Mirzakhani M, et al. Comparison the effect of casein phosphopeptide amorphous calcium phosphate and fluoride varnish on dentin hypersensitivity reduction. Caspian J Dent Res 2015; 4(2): 20-26.
28. Torwane NA, Hongal S, Goel P, et al. A clinical efficacy of 30% ethenolic extract of Indian propolis and Recaldent™ in management of dentinal hypersensitivity. A comparative randomized clinical trial. Eur J Dent 2013; 7(4): 461–468.
29. Llena C, Leyda AM, Forner L. CPP-ACP and CPP-ACFP versus fluoride varnish in remineralisation of early caries lesions. A prospective study. Eur J Paediatr Dent 2015; 16(3): 181-186.
30. Madhavan S, Nayak M, Shenoy A, et al. Dentinal hypersensitivity: A comparative clinical evaluation of CPP-ACP F, sodium fluoride, propolis, and placebo. J Conserv Dent 2012;15(4):315–318.
31. Freire IR, Pessan JP, Amaral JG, et al. Anticaries effect of low-fluoride dentifrices with phosphates in children: a randomized controlled trial. J Dent 2016; 50: 37–42.
32. Favretto CO, Delbem ACB, Moraes JCS, et al. Dentinal tubule obliteration using toothpastes containing sodium trimetaphosphate microparticles or nanoparticles. Clin Oral Invest 2018; 22: 3021-3029.
33. Zhou J, Chiba A, Scheffel DLS, et al. Effects of a Dicalcium and Tetracalcium Phosphate-Based desensitizer on in vitro dentin permeability. PLoS One 2016; 11(6): e0158400.
34. Zhu M, Li J, Chen B, et al. The Effect of Calcium Sodium Phosphosilicate on Dentin Hypersensitivity: A Systematic Review and Meta-Analysis. PLoS One 2015; 10(11): e0140176.
35. Golpayegani VM, Sohrabi A, Biria M, et al. Reminelization Effect of Topical NovaMin Versus Sodium Fluoride (1.1%) on Caries-Like Lesions in Permanent Teeth. J Dent (Tehran) 2012; 9(1): 68–75.
36. Han L, Okiji T. Dentin tubule occluding ability of dentin desensitizers. Am J Dent 2015; 28(2): 90-94.
37. Alkilzy M, Santamaria RM, Schmoeckel J, Splieth CH: Treatment of carious lesions using self-assembling peptides. Adv Dent Res 2018; 29: 42-47.
38. Schlee M, Rathe F, Bommer C, et al. Self-assembling peptide matrix for treatment of dentin hypersensitivity: A randomized controlled clinical trial. J periodont 2018; 89 (6): 653-660.
39. Pepla E, Besharat LK, Palaia G, et al. Nano-hydroxyapatite and its applications in preventive, restorative and regenerative dentistry: a review of literature. Ann Stomatol (Roma) 2014; 5: 108; 5:
40. Juntavee N, Juntavee A, Plongniras P. Remineralisation potential of nano-hydroxyapatite on enamel and cementum surrounding margin of computer-aided design and computer-aided manufacturing ceramic restoration. Int J Nanomed 2018; 13: 275513: 27.
41. Pathan AB, Bolla N, Kavuri SR, et al. Ability of three desensitizing agents in dentinal tubule obliteration and durability: An in vitro study. J Conserv Dent. 2016;19(1): 31-36.
42. Orsini G, Procaccini M, Manzoli L, et al. A 3-day randomized clinical trial to investigate the desensitizing properties of three dentifricies. J Periodontal 2013; 84(11): e65–73.
43. Профілактика стоматологічних захворювань: підручник для студентів стоматологічних факультетів закладів вищої медичної освіти / [Л.Ф. Каськова, Л.І.Амосова, О.О. Кулай та ін.]; за ред. проф. Л.Ф.Каськової; УМСА. – 2-ге вид., перероб., доповн. – Полтава: ТОВ «АСМІ», 2018. - 403 с. [Prevention of stomatological diseases: textbook for students of stomatological departments of institutions of higher medical education] [LF Kas`kova, LI Amosova, OO Kulaj, et al.]; LF Kaskova, editor; UMSA, 2d edition. – Poltava: АSMI, 2018. – 403p.].
44. Patil AR, Varma S, Suragimath G, et al. Comparative evaluation of efficacy of iontophoresis with 0.33% sodium fluoride gel and diode laser alone on occlusion of dentinal tubules. J Clin Diagn Res 2017; 11: ZC123–ZC126.
45. Nelson DGA, Wefel JS, Jongebloed WL, Featherstone JD. Morphology, histology and crystallography of human dental enamel treated with pulsed low-energy infrared laser radiation. Caries Res 1987;21(5):411–426.
46. Sgolastra F, Petrucci A, Gatto R, Monaco A. Effectiveness of laser in dentinal hypersensitivity treatment: a systematic review. J Endod 2011; 37:297-303.
47. George VT, Mathew TA, George N, et al. Efficacy of diode laser in the management of dentin hypersensitivity following periodontal surgery. J Int Oral Health 2016; 8(1):103-108.
48. Umberto R, Claudia R, Gaspare P, et al. Treatment of dentine hypersensitivity by diode laser: a clinical study. Int J Dent 2012:858950.
49. Ahrari F, Mohammadipour HS, Hajimomenian L, Fallah-Rastegar A. The effect of diode laser irradiation associated with photoabsorbing agents containing remineralizing materials on microhardness, morphology and chemical structure of early enamel caries. J Clin Exp Dent 2018;10(10): e955–e962.
50. Asl-Aminabadi N, Najafpour E, Samiei M, et al. Laser-Casein phosphopeptide effect on remineralisation of early enamel lesions in primary teeth. J Clin Exp Dent 2015; 7(2): e261–e267.
51. Farmakis ET, Eleftherios-Terry R, et al. In Vitro Evaluation of Dentin Tubule Occlusion by Denshield and Neodymium-doped Yttrium-Aluminum-Garnet Laser Irradiation. J Endodont 2012; 38(5): 662 – 666.
52. Ceballos-Jiménez AY, Rodríguez-Vilchis LE, Contreras-BulnesR, et al. Acid resistance of dental enamel treated with remineralising agents, Er:YAG laser and combined treatments. Dent Med Probl 2018; 55(3): 255–259.
53. Yu C-H, Chang Y-H, Clinical efficacy of the Er:YAG laser treatment on hypersensitive dentin. J Formos Med Assoc 2014; 113 (6): 388-391.
54. Туманова С.А., Рубежова Н.В. Клиническая эффективность некоторых средств, применяемых для лечения и профилактики гиперестезии зубов // Институт Стоматологии. – 2009. – №4(45). – C. 66-67 [Tumanova SA, Rubezhova NV. Clinical efficacy of some medicines used for treatment and prevention of dental hyperesthesia Institute of stomatology 2009; 4(45): 66-67].
55. Kawamura K, Kunimatsu Y, Takafumi Nakano T, et al. Anti-demineralisation effect of desensitizer containing copolymer and sodium fluoride on root dentin – a transverse microradiographic study. Acta Biomater Odontol Scand 2019: 5(1): 38-43.
56. Mosleh A, Niazy M, El-yassaky M. Clinical and Laboratory Evaluation of the Efficacy of Three Different Treatment Modalities in Management of Dentin Hypersensitivity. Al-Azhar Dent J 2018; 5(2): 129-134.
57. Aparna S, Setty S, Thakur S. Comparative efficacy of two treatment modalities for dentinal hypersensitivity: A clinical trial. Indian J Dent Res 2010; 21, 544–548.
58. Konekeri V, Bennadi D, Manjunath M, et al. A Clinical Study to assess the Effectiveness of CPPACP (Casein Phosphopeptide-Amorphous calcium phosphate) versus Potassium-nitrate (KNO3) on cervical dentine hypersensitivity. J Young Pharm 2015; 7(3): 217-224.
59. Walsh LJ. The effects of GC Tooth Mousse on cervical dentinal sensitivity: A controlled clinical trial. Int Dent SA 2010; 12(1): 4-12.
60. Yilmaz NA,, Ertas E, Orucoğl H. Evaluation of Five Different Desensitizers: A comparative dentin permeability and SEM investigation in vitro. Open Dent J 2017; 11: 15–33.
61. Будзинский Н.Э., Сирак А.Г., Арютюнов А.В. Сравнительный анализ эффективности лечения гиперестезии твердых тканей зубов с использованием препаратов на основе соединений фтора и глутаральдегида // Современные проблемы науки и образования. – 2014. – №1. – С. 1-7 [Budzinskiy NE, Sirak AG, Arutyunov AV. Comparative analysis of the effectiveness of the dental hyperesthesia treatment using medicines based on fluorine and glutaraldehyde compounds. Contemporary problems of science and education 2014; 1:1-7].
62. Петрушанко В.М., Павленкова О.В., Павленко С.А. та ін. Аналіз та застосування різних груп десенситайзерів для лікування гіперестезії // Вісник проблем біології і медицини. – 2017. – №2(138). – С.208-210 [Petrushanko V.M., Pavlenkova O.V., Pavlenko S.A., et al. Analysis and application of different groups of desensitisers for treatment of hyperesthesia. Bulletin of problems in biology and medicine 2017; 2 (138): 208–210].
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