Treatments for hypersensitive noncarious cervical lesions: A Practitioners Engaged in Applied Research and Learning (PEARL) Network randomized clinical effectiveness study

Analia Veitz-Keenan, Julie Ann Barna, Brad Strober, Abigail G. Matthews, Damon Collie, Donald Vena, Frederick A. Curro, Van P. Thompson

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29 Citations (Scopus)


Background. The Practitioners Engaged in Applied Research and Learning (PEARL) Network conducted a three-armed randomized clinical study to determine the comparative effectiveness of three treatments for hypersensitive noncarious cervical lesions (NCCLs): use of a potassium nitrate dentifrice for treatment of hypersensitivity, placement of a resin-based composite restoration and placement of a sealant.
Methods. Seventeen trained practitioner-investigators (P-Is) in the PEARL Network enrolled participants (N = 304) with hypersensitive posterior NCCLs who met enrollment criteria. Participants were assigned to treatments randomly. Evaluations were conducted at baseline and at one, three and six months thereafter. Primary outcomes were the reduction or elimination of hypersensitivity, as measured clinically and by means of
patient-reported outcomes.
Results. Lesion depth and pretreatment sensitivity (mean, 5.3 on a 0- to 10-point scale) were balanced across treatments, as was sleep bruxism
(present in 42.2 percent of participants). The six-month participant recall rate was 99 percent. Treatments significantly reduced mean sensitivity (P
< .01), with the sealant and restoration groups displaying a significantly higher reduction (P < .01) than did the dentifrice group. The dentifrice
group’s mean (standard deviation) sensitivity at six months was 2.1 (2.1); those of the sealant and restoration groups were 1.0 (1.6) and 0.8 (1.4),
respectively. Patient-reported sensitivity (to cold being most pronounced) paralleled clinical measures at each evaluation.
Conclusions. Sealing and restoration treatments were effective overall in reducing NCCL hypersensitivity. The potassium nitrate dentifrice reduced
sensitivity with increasing efficacy through six months but not to the degree with increasing efficacy through six months but not to the degree
that the other treatments did.
Practical Implications. Sealant or restoration placement is an effective method of immediately reducing NCCL sensitivity. Although a potassium
nitrate dentifrice did reduce sensitivity slowly across six months, at no time was the reduction commensurate with that of sealants or restorations.
Key Words. Noncarious cervical lesion; bruxism; root sensitivity; resinbased composite; dental sealant; dentin bonding agents; dentifrices
Original languageEnglish
Pages (from-to)495-506
Number of pages12
JournalJournal of the American Dental Association (1939)
Issue number5
Publication statusPublished - May 2013

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