Occlusion of Dentinal Tubules by Nanohydroxyapatite and Zinc Carbonate Hydroxyapatite-Based Toothpastes as Desensitizing Agents: An in Vitro Study
Abstract
Objectives: Dentin hypersensitivity (DH), characterized by a short, sharp, and intense pain response to a stimulus, is the most commonly encountered patient complaint. Various in-office and at-home methods including the recently introduced nano-hydroxyapatite (n-HA) and zinc carbonate-hydroxyapatite (Zn-CHA)-based products reduce the DH discomfort. This study compared the effectiveness of commercially available n-HA and Zn-CHA toothpastes for occlusion of dentinal tubules for management of DH.
Materials and Methods: In this in vitro study, 40 tooth samples were randomly assigned to 4 groups (n=10): negative control): brushing without toothpaste,Aclaim n-HA toothpaste,Biorepair Zn-CHA toothpaste, andShyNM calcium sodium phosphosilicate (CSPS) toothpaste. After demineralization with 17% ethylenediaminetetraacetic acid, the mounted specimens were brushed with an electric pressure-sensitive toothbrush and the respective toothpaste. Occlusion of dentinal tubules was subsequently evaluated under a scanning electron microscope (SEM). Elemental composition of the occluding plug was analyzed by energy-dispersive X-ray spectroscopy (EDX).
Results: The test n-HA and Zn-CHAand the positive control (CSPS) groups revealed significantly higher tubular occlusion compared to the negative control group (p= 0.001). The highest tubular occlusion was achieved in n-HA and Zn-CHA groups (80%); while negative control showed no occlusion (0%). Elemental analysis of dentinal plug showed significant differences in carbon, oxygen, calcium, and phosphorus levels among the groups (p<0.05).
Conclusion: The tubular occlusion capacity of Zn-CHA and n-HA were similar to CSPS-based toothpaste, and CHA in Zn-CHA enabled the formation of stable dentinal plugs.
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3. Olley RC, Sehmi H. The rise of dentine hypersensitivity and tooth wear in an ageing population. Br Dent J. 2017 Aug 25;223(4):293-297.
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5. Miglani S, Aggarwal V, Ahuja B. Dentin hypersensitivity: Recent trends in management. J Conserv Dent. 2010 Oct;13(4):218-24.
6. Peacock JM, Orchardson R. Effects of potassium ions on action potential conduction in A- and C-fibers of rat spinal nerves. J Dent Res. 1995 Feb;74(2):634-41.
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11. Roveri N, Battistella E, Foltran I, Foresti E, Iafisco M, Lelli M, Palazzo B, Rimondini L. Synthetic biomimetic carbonate-hydroxyapatite nanocrystals for enamel remineralization. Adv Mater Res. 2008 Jun;47:821-4.
12. Jeevanandam J, Barhoum A, Chan YS, Dufresne A, Danquah MK. Review on nanoparticles and nanostructured materials: history, sources, toxicity and regulations. Beilstein J Nanotechnol. 2018 Apr 3;9:1050-1074.
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14. Thompson VP, Watson TF, Marshall GW Jr, Blackman BR, Stansbury JW, Schadler LS, Pearson RA, Libanori R. Outside-the-(cavity-prep)-box thinking. Adv Dent Res. 2013 Nov;25(1):24-32.
15. Toledano-Osorio M, Osorio E, Aguilera FS, Luis Medina-Castillo A, Toledano M, Osorio R. Improved reactive nanoparticles to treat dentin hypersensitivity. Acta Biomater. 2018 May;72:371-380.
16. Arnold WH, Prange M, Naumova EA. Effectiveness of various toothpastes on dentine tubule occlusion. J Dent. 2015 Apr;43(4):440-9.
17. Al Asmari D, Khan MK. Evaluate Efficacy of Desensitizing Toothpaste Containing Zinc-carbonate Hydroxyapatite Nanocrystals: Non-comparative Eight-week Clinical Study. J Int Soc Prev Community Dent. 2019 Oct 25;9(6):566-570.
18. Tosun S, Culha E, Aydin U, Ozsevik AS. The combined occluding effect of sodium fluoride varnish and Nd:YAG laser irradiation on dentinal tubules-A CLSM and SEM study. Scanning. 2016 Nov;38(6):619-624.
19. Jena A, Kala S, Shashirekha G. Comparing the effectiveness of four desensitizing toothpastes on dentinal tubule occlusion: A scanning electron microscope analysis. J Conserv Dent. 2017 Jul-Aug;20(4):269-272.
20. Chen CL, Parolia A, Pau A, Celerino de Moraes Porto IC. Comparative evaluation of the effectiveness of desensitizing agents in dentine tubule occlusion using scanning electron microscopy. Aust Dent J. 2015 Mar;60(1):65-72.
21. Amaechi BT, Mathews SM, Ramalingam K, Mensinkai PK. Evaluation of nanohydroxyapatite-containing toothpaste for occluding dentin tubules. Am J Dent. 2015 Feb;28(1):33-9.
22. Philip N. State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management. Caries Res. 2019;53(3):284-295.
23. Schäfer F, Beasley T, Abraham P. In vivo delivery of fluoride and calcium from toothpaste containing 2% hydroxyapatite. Int Dent J. 2009 Dec;59(6):321-4.
24. O'Hagan-Wong K, Enax J, Meyer F, Ganss B. The use of hydroxyapatite toothpaste to prevent dental caries. Odontology. 2022 Apr;110(2):223-230.
25. Bajaj M, Poornima P, Praveen S, Nagaveni NB, Roopa KB, Neena IE, Bharath KP. Comparison of CPP-ACP, Tri-Calcium Phosphate and Hydroxyapatite on Remineralization of Artificial Caries Like Lesions on Primary Enamel -An in vitro Study. J Clin Pediatr Dent. 2016;40(5):404-9.
26. Anil A, Ibraheem WI, Meshni AA, Preethanath RS, Anil S. Nano-Hydroxyapatite (nHAp) in the Remineralization of Early Dental Caries: A Scoping Review. Int J Environ Res Public Health. 2022 May 5;19(9):5629.
27. onescu AC, Degli Esposti L, Iafisco M, Brambilla E. Dental tissue remineralization by bioactive calcium phosphate nanoparticles formulations. Sci Rep. 2022 Apr 9;12(1):5994.
28. Andrea B, Carolina M, Gallo S, Pascadopoli M, Quintini M, Lelli M, Tarterini F, Foltran I, Scribante A. Biomimetic Action of Zinc Hydroxyapatite on Remineralization of Enamel and Dentin: A Review. Biomimetics (Basel). 2023 Feb 8;8(1):71.
29. Mocanu A, Cadar O, Frangopol PT, Petean I, Tomoaia G, Paltinean GA, Racz CP, Horovitz O, Tomoaia-Cotisel M. Ion release from hydroxyapatite and substituted hydroxyapatites in different immersion liquids: in vitro experiments and theoretical modelling study. R Soc Open Sci. 2021 Jan 13;8(1):201785.
30. Madupalli H, Pavan B, Tecklenburg MMJ. Carbonate substitution in the mineral component of bone: Discriminating the structural changes, simultaneously imposed by carbonate in A and B sites of apatite. J Solid State Chem. 2017 Nov;255:27-35.
31. Degli Esposti L, Ionescu AC, Brambilla E, Tampieri A, Iafisco M. Characterization of a Toothpaste Containing Bioactive Hydroxyapatites and In Vitro Evaluation of Its Efficacy to Remineralize Enamel and to Occlude Dentinal Tubules. Materials (Basel). 2020 Jun 30;13(13):2928.
32. Toledano-Osorio M, Osorio R, Osorio E, Medina-Castillo AL, Toledano M. Novel Pastes Containing Polymeric Nanoparticles for Dentin Hypersensitivity Treatment: An In Vitro Study. Nanomaterials (Basel). 2021 Nov 22;11(11):3150.
33. Filip DG, Surdu VA, Paduraru AV, Andronescu E. Current Development in Biomaterials-Hydroxyapatite and Bioglass for Applications in Biomedical Field: A Review. J Funct Biomater. 2022 Nov 16;13(4):248.
34. Allaker RP. The Use of Antimicrobial Nanoparticles to Control Oral Infections. Nano-Antimicrobials. 2011 Dec;26:395-425.
35. Gallob J, Ling MR, Amini P, Patil A, Atassi M. Efficacy of a dissolvable strip with calcium sodium phosphosilicate (NovaMin®) in providing rapid dentine hypersensitivity relief. J Dent. 2019;91S:100003.
36. Prasad PS, Pasha MB, Rao RN, Rao PV, Madaboosi N, Özcan M. A Review on Enhancing the Life of Teeth by Toothpaste Containing Bioactive Glass Particles. Curr Oral Health Rep. 2024;11(2):87-94.
37. Burwell AK, Litkowski LJ, Greenspan DC. Calcium sodium phosphosilicate (NovaMin): remineralization potential. Adv Dent Res. 2009;21(1):35-9.
38. Kunam D, Manimaran S, Sampath V, Sekar M. Evaluation of dentinal tubule occlusion and depth of penetration of nano-hydroxyapatite derived from chicken eggshell powder with and without addition of sodium fluoride: An in vitro study. J Conserv Dent. 2016 May-Jun;19(3):239-44.
39. Shamel M, El Banna S. In vitro comparative SEM analysis of nano-hydroxyapatite toothpaste and diode laser: evaluation of efficacy of dentinal tubular occlusion. J Stomatol. 2022 Jan; 75(1):1-6.
40. Silvestrini Biavati A, Gastaldo L, Dessì M, Silvestrini Biavati F, Migliorati M. Manual orthodontic vs. oscillating-rotating electric toothbrush in orthodontic patients: a randomised clinical trial. Eur J Paediatr Dent. 2010 Dec;11(4):200-2.
2. Orchardson R, Gillam DG. Managing dentin hypersensitivity. J Am Dent Assoc. 2006 Jul;137(7):990-8; quiz 1028-9.
3. Olley RC, Sehmi H. The rise of dentine hypersensitivity and tooth wear in an ageing population. Br Dent J. 2017 Aug 25;223(4):293-297.
4. Absi EG, Addy M, Adams D. Dentine hypersensitivity. A study of the patency of dentinal tubules in sensitive and non-sensitive cervical dentine. J Clin Periodontol. 1987 May;14(5):280-4.
5. Miglani S, Aggarwal V, Ahuja B. Dentin hypersensitivity: Recent trends in management. J Conserv Dent. 2010 Oct;13(4):218-24.
6. Peacock JM, Orchardson R. Effects of potassium ions on action potential conduction in A- and C-fibers of rat spinal nerves. J Dent Res. 1995 Feb;74(2):634-41.
7. Amaechi BT, Lemke KC, Saha S, Gelfond J. Clinical Efficacy in Relieving Dentin Hypersensitivity of Nanohydroxyapatite-containing Cream: A Randomized Controlled Trial. Open Dent J. 2018 Aug 31;12:572-585.
8. Wang Z, Jiang T, Sauro S, Pashley DH, Toledano M, Osorio R, Liang S, Xing W, Sa Y, Wang Y. The dentine remineralization activity of a desensitizing bioactive glass-containing toothpaste: an in vitro study. Aust Dent J. 2011 Dec;56(4):372-81.
9. Shah S, Shivakumar AT, Khot O, Patil C, Hosmani N. Efficacy of NovaMin-and Pro-Argin-containing desensitizing dentifrices on occlusion of dentinal tubules. Dent Hypotheses. 2017 Oct;8(4):104-9.
10. Gopinath NM, John J, Nagappan N, Prabhu S, Kumar ES. Evaluation of Dentifrice Containing Nano-hydroxyapatite for Dentinal Hypersensitivity: A Randomized Controlled Trial. J Int Oral Health. 2015 Aug;7(8):118-22.
11. Roveri N, Battistella E, Foltran I, Foresti E, Iafisco M, Lelli M, Palazzo B, Rimondini L. Synthetic biomimetic carbonate-hydroxyapatite nanocrystals for enamel remineralization. Adv Mater Res. 2008 Jun;47:821-4.
12. Jeevanandam J, Barhoum A, Chan YS, Dufresne A, Danquah MK. Review on nanoparticles and nanostructured materials: history, sources, toxicity and regulations. Beilstein J Nanotechnol. 2018 Apr 3;9:1050-1074.
13. Morães RR, Garcia JW, Wilson ND, Lewis SH, Barros MD, Yang B, Pfeifer CS, Stansbury JW. Improved dental adhesive formulations based on reactive nanogel additives. J Dent Res. 2012 Feb;91(2):179-84.
14. Thompson VP, Watson TF, Marshall GW Jr, Blackman BR, Stansbury JW, Schadler LS, Pearson RA, Libanori R. Outside-the-(cavity-prep)-box thinking. Adv Dent Res. 2013 Nov;25(1):24-32.
15. Toledano-Osorio M, Osorio E, Aguilera FS, Luis Medina-Castillo A, Toledano M, Osorio R. Improved reactive nanoparticles to treat dentin hypersensitivity. Acta Biomater. 2018 May;72:371-380.
16. Arnold WH, Prange M, Naumova EA. Effectiveness of various toothpastes on dentine tubule occlusion. J Dent. 2015 Apr;43(4):440-9.
17. Al Asmari D, Khan MK. Evaluate Efficacy of Desensitizing Toothpaste Containing Zinc-carbonate Hydroxyapatite Nanocrystals: Non-comparative Eight-week Clinical Study. J Int Soc Prev Community Dent. 2019 Oct 25;9(6):566-570.
18. Tosun S, Culha E, Aydin U, Ozsevik AS. The combined occluding effect of sodium fluoride varnish and Nd:YAG laser irradiation on dentinal tubules-A CLSM and SEM study. Scanning. 2016 Nov;38(6):619-624.
19. Jena A, Kala S, Shashirekha G. Comparing the effectiveness of four desensitizing toothpastes on dentinal tubule occlusion: A scanning electron microscope analysis. J Conserv Dent. 2017 Jul-Aug;20(4):269-272.
20. Chen CL, Parolia A, Pau A, Celerino de Moraes Porto IC. Comparative evaluation of the effectiveness of desensitizing agents in dentine tubule occlusion using scanning electron microscopy. Aust Dent J. 2015 Mar;60(1):65-72.
21. Amaechi BT, Mathews SM, Ramalingam K, Mensinkai PK. Evaluation of nanohydroxyapatite-containing toothpaste for occluding dentin tubules. Am J Dent. 2015 Feb;28(1):33-9.
22. Philip N. State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management. Caries Res. 2019;53(3):284-295.
23. Schäfer F, Beasley T, Abraham P. In vivo delivery of fluoride and calcium from toothpaste containing 2% hydroxyapatite. Int Dent J. 2009 Dec;59(6):321-4.
24. O'Hagan-Wong K, Enax J, Meyer F, Ganss B. The use of hydroxyapatite toothpaste to prevent dental caries. Odontology. 2022 Apr;110(2):223-230.
25. Bajaj M, Poornima P, Praveen S, Nagaveni NB, Roopa KB, Neena IE, Bharath KP. Comparison of CPP-ACP, Tri-Calcium Phosphate and Hydroxyapatite on Remineralization of Artificial Caries Like Lesions on Primary Enamel -An in vitro Study. J Clin Pediatr Dent. 2016;40(5):404-9.
26. Anil A, Ibraheem WI, Meshni AA, Preethanath RS, Anil S. Nano-Hydroxyapatite (nHAp) in the Remineralization of Early Dental Caries: A Scoping Review. Int J Environ Res Public Health. 2022 May 5;19(9):5629.
27. onescu AC, Degli Esposti L, Iafisco M, Brambilla E. Dental tissue remineralization by bioactive calcium phosphate nanoparticles formulations. Sci Rep. 2022 Apr 9;12(1):5994.
28. Andrea B, Carolina M, Gallo S, Pascadopoli M, Quintini M, Lelli M, Tarterini F, Foltran I, Scribante A. Biomimetic Action of Zinc Hydroxyapatite on Remineralization of Enamel and Dentin: A Review. Biomimetics (Basel). 2023 Feb 8;8(1):71.
29. Mocanu A, Cadar O, Frangopol PT, Petean I, Tomoaia G, Paltinean GA, Racz CP, Horovitz O, Tomoaia-Cotisel M. Ion release from hydroxyapatite and substituted hydroxyapatites in different immersion liquids: in vitro experiments and theoretical modelling study. R Soc Open Sci. 2021 Jan 13;8(1):201785.
30. Madupalli H, Pavan B, Tecklenburg MMJ. Carbonate substitution in the mineral component of bone: Discriminating the structural changes, simultaneously imposed by carbonate in A and B sites of apatite. J Solid State Chem. 2017 Nov;255:27-35.
31. Degli Esposti L, Ionescu AC, Brambilla E, Tampieri A, Iafisco M. Characterization of a Toothpaste Containing Bioactive Hydroxyapatites and In Vitro Evaluation of Its Efficacy to Remineralize Enamel and to Occlude Dentinal Tubules. Materials (Basel). 2020 Jun 30;13(13):2928.
32. Toledano-Osorio M, Osorio R, Osorio E, Medina-Castillo AL, Toledano M. Novel Pastes Containing Polymeric Nanoparticles for Dentin Hypersensitivity Treatment: An In Vitro Study. Nanomaterials (Basel). 2021 Nov 22;11(11):3150.
33. Filip DG, Surdu VA, Paduraru AV, Andronescu E. Current Development in Biomaterials-Hydroxyapatite and Bioglass for Applications in Biomedical Field: A Review. J Funct Biomater. 2022 Nov 16;13(4):248.
34. Allaker RP. The Use of Antimicrobial Nanoparticles to Control Oral Infections. Nano-Antimicrobials. 2011 Dec;26:395-425.
35. Gallob J, Ling MR, Amini P, Patil A, Atassi M. Efficacy of a dissolvable strip with calcium sodium phosphosilicate (NovaMin®) in providing rapid dentine hypersensitivity relief. J Dent. 2019;91S:100003.
36. Prasad PS, Pasha MB, Rao RN, Rao PV, Madaboosi N, Özcan M. A Review on Enhancing the Life of Teeth by Toothpaste Containing Bioactive Glass Particles. Curr Oral Health Rep. 2024;11(2):87-94.
37. Burwell AK, Litkowski LJ, Greenspan DC. Calcium sodium phosphosilicate (NovaMin): remineralization potential. Adv Dent Res. 2009;21(1):35-9.
38. Kunam D, Manimaran S, Sampath V, Sekar M. Evaluation of dentinal tubule occlusion and depth of penetration of nano-hydroxyapatite derived from chicken eggshell powder with and without addition of sodium fluoride: An in vitro study. J Conserv Dent. 2016 May-Jun;19(3):239-44.
39. Shamel M, El Banna S. In vitro comparative SEM analysis of nano-hydroxyapatite toothpaste and diode laser: evaluation of efficacy of dentinal tubular occlusion. J Stomatol. 2022 Jan; 75(1):1-6.
40. Silvestrini Biavati A, Gastaldo L, Dessì M, Silvestrini Biavati F, Migliorati M. Manual orthodontic vs. oscillating-rotating electric toothbrush in orthodontic patients: a randomised clinical trial. Eur J Paediatr Dent. 2010 Dec;11(4):200-2.
| Issue | Vol 22 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v22i54.20714 | |
| Keywords | ||
| Dentin Sensitivity Dentifrices Dentin Desensitizing Agents Hydroxyapatites Metal Nanoparticles Toothpaste | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Mehrotra S, Agnihotri R. Occlusion of Dentinal Tubules by Nanohydroxyapatite and Zinc Carbonate Hydroxyapatite-Based Toothpastes as Desensitizing Agents: An in Vitro Study. Front Dent. 2026;22.
