Arginine-Containing Desensitizing Toothpaste for Dentine Hypersensitivity: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LI Rui ¹ , TANG Xiaojun ² , LI Yueheng ¹ , WANG Yang ² , CHEN Jiao ¹ , WANG Qinghua ¹ , HUANG Yajing ¹ ,  ZHOU Zhi ¹

1. The Affiliated Hospital of Stomatology, Chongqing Medical University, Chongqing 400012, China; 2. School of Public Health, Chongqing Medical University, Chongqing 400016, China;

Corresponding author：

ZHOU Zhi, Email: zhouzhi_050918@hotmail.com

Keywords：

Arginine-containing toothpastes; Dentine hypersensitivity; Meta analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20110101

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Objective 　To estimate the effect of desensitizing toothpaste containing arginine on dentine hypersensitivity.
Methods 　Such databases as CNKI, PubMed, Web of Science and Cochrane Trials Register (Issue 4, 2008) were retrieved, and Google was used as a supplementary tool to search the information up to March 2010. Randomized controlled trials (RCTs) of treating dentine hypersensitivity with arginine-containing toothpaste were included, and the relevant information was extracted and the quality evaluation was undertaken. Meta-analyses were performed with RevMan 5.0 software.
Results 　Five RCTs with 397 patients were included. The results of meta-analyses showed that at 8 weeks, arginine-containing toothpaste was significantly different from potassium-containing toothpaste in terms of tactile sensitivity test (SMD=1.32, 95%CI 0.68 to 1.96) and air blast test (SMD= –0.77, 95%CI –1.22 to 0.32) with a better therapeutic effect.
Conclusion 　Current literature evidence shows that the arginine-containing toothpaste is effective for the dentine hypersensitivity. However, this study is based on a small number of RCTs and samples, so further studies with high-quality and large-sample RCTs are needed.

Citation： LI Rui,TANG Xiaojun,LI Yueheng,WANG Yang,CHEN Jiao,WANG Qinghua,HUANG Yajing,ZHOU Zhi. Arginine-Containing Desensitizing Toothpaste for Dentine Hypersensitivity: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2011, 11(5): 570-575. doi: 10.7507/1672-2531.20110101 Copy

1.	2 Markowitz K, Pashley DH. Discovering new treatments for sensitive teeth: the long path from biology to therapy. J Oral Rehabil , 2008, 35(4): 300-315.
2.	3 Orchardson R, Gillam DG. Managing dentin hypersensitivity. J Am Dent Assoc , 2006, 137(7), 990-998.
3.	5 Addy M. Dentine hypersensitivity: New perspectives on an old problem. Int Dent J , 2002, 52(Suppl): 367-375.
4.	6 Brännström M, Johnson G. Movements of the dentine and pulp liquids on application of thermal stimuli. Acta Odontol Scand , 1970, 28(1): 59-70.
5.	7 Canadian Advisory Board on Dentin Hypersensitivity. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc , 2003, 69(4): 221-226.
6.	8 Blong MA, Volding B, Thrash WJ, et al . Effects of a gel containing 0.4 percent stannous fluoride on dentinal hypersensitivity. Dent Hyg (Chic) , 1985, 59(11): 489-492.
7.	9 Snyder RA, Beck FM, Horton JE. The efficacy of a 0.4 % stannous fluoride gel on root surface hypersensitivity [abstract]. J Dent Res , 1983, 62(3): 237.
8.	10 Thrash WJ, Dodds MW, Jones DL. The effect of stannous fluoride on dentinal hypersensitivity. Int Dent J , 1994, 44(1Suppl 1): 107-118.
9.	11 Schiff T, Saletta L, Baker RA, et al . Desensitizing effect of a stabilized stannous fluoride/sodium hexametaphosphate dentifrice. Compend Coutin Educ Dent , 2005, 26( 9 Suppl 1): 35-40.
10.	12 Miller S, Truong T, Heu R, et al . Recent advances in stannous fluoride technology: Antibacterial efficacy and mechanism of action towards hypersensitivity. Int Dent J , 1994, 44(1 Suppl 1): 83-98.
11.	13 Walters PA. Dentinal hypersensitivity: A review. J Contemp Dent Pract , 2005, 6(2): 107-117.
12.	14 Cummins D. Dentin Hypersensitivity: From Diagnosis to a Breakthrough Therapy for Everyday Sensitivity Relief. J Clin Dent , 2009, 20(1): 1-9.
13.	15 Ayad F, Ayad N, Zhang YP, et al . Comparing the Efficacy in Reducing Dentin Hypersensitivity of a New Toothpaste Containing 8.0% Arginine, Calcium Carbonate, and 1450 ppm Fluoride to a Commercial Sensitive Toothpaste Containing 2% Potassium ion: An Eight-Week Clinical Study on Canadian Adults. J Clin Den , 2009, 20(1): 10-16.
14.	16 Docimo R, Montesani L, Maturo P, et al . Comparing the Efficacy in Reducing Dentin Hypersensitivity of a New Toothpaste Containing 8.0% Arginine, Calcium Carbonate, and 1450 ppm Fluoride to a Commercial Sensitive Toothpaste Containing 2% Potassium Ion: An Eight-Week Clinical Study in Rome, Italy. J Clin Dent , 2009, 20(1): 17-22.
15.	17 Docimo R, Montesani L, Maturo P, et al . Comparing the efficacy in reducing dentin hypersensitivity of new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a benchmark commercial desensitizing toothpaste containing 2% potassium ion: an eight-week clinical study in Rome, Italy. J Clin Dent , 2009, 20(4): 137-143.
16.	18 Que K, Fu Y, Lin L, et al . Dentin hypersensitivity reduction of a new toothpaste containing 8.0% arginine, a high cleaning calcium carbonate system and 1450ppm fluoride: A 8-week clinical study in Chengdu, China. Am J Dent , 2010, 23 Spec No A: 28A-35A.
17.	19 Panagakos F, Schiff T, Guignon A. Dentin hypersensitivity: Effective treatment with an in-office desensitizing paste containing 8% arginine and calcium carbonate. Am J Dent , 2009, 22 Spec No A: 3A-7A.
18.	20 Cummins D. The efficacy of a new dentifrice containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride in delivering instant and lasting relief of dentin hypersensitivity. J Clin Dent , 2009, 20(4): 109-114.
19.	21 Cummins D. Recent advances in dentin hypersensitivity: Clinical proven treatments for instant and lasting sensitivity relief. Am J Dent , 2010, 23 Spec No A: 3A-13A.
20.	22 Schiff T, Delgado E, Zhang YP, et al . Clinical evaluation of the efficacy of an in-office desensitizing paste containing 8% arginine and calcium carbonate in providing instant and lasting relief of dentin hypersensitivity. Am J Dent , 2009, 22 Spec No A: 8A-15A.
21.	23 Garcia-Godoy F, Garcia-Godoy A, Garcia-Godoy C, et al . Effect of a desensitizing paste containing 8% arginine and calcium carbonate on the surface roughness of dental materials and human dental enamel. Am J Dent , 2009, 22 Spec No A: 21A-24A.
22.	24 Petrou I, Heu R, Stranick M, et al . A Breakthrough Therapy for Dentin Hypersensitivity: How Dental Products Containing 8% Arginine and Calcium Carbonate Work to Deliver Effective Relief of Sensitive Teeth. J Clin Dent , 2009, 20 (1): 23-31.
23.	25 Lavender SA, Petrou I, Heu R, et al . Mode of action studies of a new desensitizing dentifrice containing 8.0% arginine, a high cleaning calcium carbonate system and 1450 ppm fluoride. Am J Dent , 2010, 23 Spec No A: 14A-19A.
24.	26 Parkinson CR, Butler A, Willson RJ. Development of an acid challenge-based in vitro dentin disc occlusion model. J Clin Dent , 2010, 21(2): 31-36.
25.	27 Schiff T, Delgado E, Zhang YP, et al . The clinical effect of a single direct topical application of a dentifrice containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride on dentin hypersensitivity: the use of a cotton swab applicator versus the use of a fingertip. J Clin Dent , 2009, 20(4): 131-136.
26.	28 Yin W, Li X, He S, Ma H, et al . Extrinsic stain removal efficacy of a new desensitizing dentifrice containing 8.0% arginine, calcium carbonate and 1450ppm fluoride. Am J Dent , 2010, 23 Spec No A: 36A-40A.
27.	29 Nathoo S, Delgado E, Zhang YP, et al . Comparing the efficacy in providing instant relief of dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride relative to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste with 1450 ppm fluoride: a three-day clinical study in New Jersey, USA. J Clin Dent , 2009, 20(4): 123-130.
28.	30 Ayad F, Ayad N, Delgado E, et al . Comparing the efficacy in providing instant relief of dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste with 1450 ppm fluoride: a three-day clinical study in Mississauga, Canada. J Clin Dent , 2009, 20(4): 115-122.
29.	31 Fu Y, Li X, Que K, et al . Instant dentin hypersensitivity relief of a new desensitizing dentifrice containing 8.0% arginine , a high cleaning calcium carbonate system and 1450ppm fluoride: A 3-day clinical study in Chengdu, China. Am J Dent , 2010, 23 Spec No A: 20A-27A.
30.	32 Hughes N, Mason S, Jeffery P, et al . A comparative clinical study investigating the efficacy of a test dentifrice containing 8% strontium acetate and 1040 ppm sodium fluoride versus a marketed control dentifrice containing 8% arginine, calcium carbonate, and 1450 ppm sodium monofluorophosphate in reducing dentinal hypersensitivity. J Clin Dent , 2010, 21(2): 49-55.
31.	33 Hamlin D, Williams KP, Delgado E, et al . Clinical evaluation of the efficacy of a desensitizing paste containing 8% arginine and calcium carbonate for the in-office relief of dentin hypersensitivity associated with dental prophylaxis. Am J Dent , 2009, 22 Spec No A: 16A-20A.
32.	34 Orchardson R, Gillam DG. The efficacy of potassium salts as agents for treating dentin hypersensitivity. J Orofac Pain , 2000, 14(1): 9-19.
33.	35 Poulsen S, Errboe M, Lescay Mevil Y, et al . Potassium containing toothpastes for dentine hypersensitivity. The Cochrane Database Syst Rev , 2006, 19(3): CD001476.、.
34.	36 Drisko CH. Dentine hypersensitivity-Dental hygiene and periodontal considerations. Int Dent J , 2002, 52(5): 385-393,.
35.	樊明文, 周学东. 牙体牙髓病学. 第2版. 北京: 人民卫生出版社, 2005: 134-138.
36.	Brannstrom M. A hydrodynamic mechanism in the transmission of pain- produced stimuli through the dentine. In: Anderson DJ, ed. Sensory Mechanisms in Dentine. Oxford: Pergamon, 1962: 73-79.
37.	American Dental Association Council on Scientific Affairs. Acceptance program guidelines: products for the treatment of dentinal hypersensitivity, 2004.

1. 2 Markowitz K, Pashley DH. Discovering new treatments for sensitive teeth: the long path from biology to therapy. J Oral Rehabil , 2008, 35(4): 300-315.
2. 3 Orchardson R, Gillam DG. Managing dentin hypersensitivity. J Am Dent Assoc , 2006, 137(7), 990-998.
3. 5 Addy M. Dentine hypersensitivity: New perspectives on an old problem. Int Dent J , 2002, 52(Suppl): 367-375.
4. 6 Brännström M, Johnson G. Movements of the dentine and pulp liquids on application of thermal stimuli. Acta Odontol Scand , 1970, 28(1): 59-70.
5. 7 Canadian Advisory Board on Dentin Hypersensitivity. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc , 2003, 69(4): 221-226.
6. 8 Blong MA, Volding B, Thrash WJ, et al . Effects of a gel containing 0.4 percent stannous fluoride on dentinal hypersensitivity. Dent Hyg (Chic) , 1985, 59(11): 489-492.
7. 9 Snyder RA, Beck FM, Horton JE. The efficacy of a 0.4 % stannous fluoride gel on root surface hypersensitivity [abstract]. J Dent Res , 1983, 62(3): 237.
8. 10 Thrash WJ, Dodds MW, Jones DL. The effect of stannous fluoride on dentinal hypersensitivity. Int Dent J , 1994, 44(1Suppl 1): 107-118.
9. 11 Schiff T, Saletta L, Baker RA, et al . Desensitizing effect of a stabilized stannous fluoride/sodium hexametaphosphate dentifrice. Compend Coutin Educ Dent , 2005, 26( 9 Suppl 1): 35-40.
10. 12 Miller S, Truong T, Heu R, et al . Recent advances in stannous fluoride technology: Antibacterial efficacy and mechanism of action towards hypersensitivity. Int Dent J , 1994, 44(1 Suppl 1): 83-98.
11. 13 Walters PA. Dentinal hypersensitivity: A review. J Contemp Dent Pract , 2005, 6(2): 107-117.
12. 14 Cummins D. Dentin Hypersensitivity: From Diagnosis to a Breakthrough Therapy for Everyday Sensitivity Relief. J Clin Dent , 2009, 20(1): 1-9.
13. 15 Ayad F, Ayad N, Zhang YP, et al . Comparing the Efficacy in Reducing Dentin Hypersensitivity of a New Toothpaste Containing 8.0% Arginine, Calcium Carbonate, and 1450 ppm Fluoride to a Commercial Sensitive Toothpaste Containing 2% Potassium ion: An Eight-Week Clinical Study on Canadian Adults. J Clin Den , 2009, 20(1): 10-16.
14. 16 Docimo R, Montesani L, Maturo P, et al . Comparing the Efficacy in Reducing Dentin Hypersensitivity of a New Toothpaste Containing 8.0% Arginine, Calcium Carbonate, and 1450 ppm Fluoride to a Commercial Sensitive Toothpaste Containing 2% Potassium Ion: An Eight-Week Clinical Study in Rome, Italy. J Clin Dent , 2009, 20(1): 17-22.
15. 17 Docimo R, Montesani L, Maturo P, et al . Comparing the efficacy in reducing dentin hypersensitivity of new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a benchmark commercial desensitizing toothpaste containing 2% potassium ion: an eight-week clinical study in Rome, Italy. J Clin Dent , 2009, 20(4): 137-143.
16. 18 Que K, Fu Y, Lin L, et al . Dentin hypersensitivity reduction of a new toothpaste containing 8.0% arginine, a high cleaning calcium carbonate system and 1450ppm fluoride: A 8-week clinical study in Chengdu, China. Am J Dent , 2010, 23 Spec No A: 28A-35A.
17. 19 Panagakos F, Schiff T, Guignon A. Dentin hypersensitivity: Effective treatment with an in-office desensitizing paste containing 8% arginine and calcium carbonate. Am J Dent , 2009, 22 Spec No A: 3A-7A.
18. 20 Cummins D. The efficacy of a new dentifrice containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride in delivering instant and lasting relief of dentin hypersensitivity. J Clin Dent , 2009, 20(4): 109-114.
19. 21 Cummins D. Recent advances in dentin hypersensitivity: Clinical proven treatments for instant and lasting sensitivity relief. Am J Dent , 2010, 23 Spec No A: 3A-13A.
20. 22 Schiff T, Delgado E, Zhang YP, et al . Clinical evaluation of the efficacy of an in-office desensitizing paste containing 8% arginine and calcium carbonate in providing instant and lasting relief of dentin hypersensitivity. Am J Dent , 2009, 22 Spec No A: 8A-15A.
21. 23 Garcia-Godoy F, Garcia-Godoy A, Garcia-Godoy C, et al . Effect of a desensitizing paste containing 8% arginine and calcium carbonate on the surface roughness of dental materials and human dental enamel. Am J Dent , 2009, 22 Spec No A: 21A-24A.
22. 24 Petrou I, Heu R, Stranick M, et al . A Breakthrough Therapy for Dentin Hypersensitivity: How Dental Products Containing 8% Arginine and Calcium Carbonate Work to Deliver Effective Relief of Sensitive Teeth. J Clin Dent , 2009, 20 (1): 23-31.
23. 25 Lavender SA, Petrou I, Heu R, et al . Mode of action studies of a new desensitizing dentifrice containing 8.0% arginine, a high cleaning calcium carbonate system and 1450 ppm fluoride. Am J Dent , 2010, 23 Spec No A: 14A-19A.
24. 26 Parkinson CR, Butler A, Willson RJ. Development of an acid challenge-based in vitro dentin disc occlusion model. J Clin Dent , 2010, 21(2): 31-36.
25. 27 Schiff T, Delgado E, Zhang YP, et al . The clinical effect of a single direct topical application of a dentifrice containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride on dentin hypersensitivity: the use of a cotton swab applicator versus the use of a fingertip. J Clin Dent , 2009, 20(4): 131-136.
26. 28 Yin W, Li X, He S, Ma H, et al . Extrinsic stain removal efficacy of a new desensitizing dentifrice containing 8.0% arginine, calcium carbonate and 1450ppm fluoride. Am J Dent , 2010, 23 Spec No A: 36A-40A.
27. 29 Nathoo S, Delgado E, Zhang YP, et al . Comparing the efficacy in providing instant relief of dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride relative to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste with 1450 ppm fluoride: a three-day clinical study in New Jersey, USA. J Clin Dent , 2009, 20(4): 123-130.
28. 30 Ayad F, Ayad N, Delgado E, et al . Comparing the efficacy in providing instant relief of dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste with 1450 ppm fluoride: a three-day clinical study in Mississauga, Canada. J Clin Dent , 2009, 20(4): 115-122.
29. 31 Fu Y, Li X, Que K, et al . Instant dentin hypersensitivity relief of a new desensitizing dentifrice containing 8.0% arginine , a high cleaning calcium carbonate system and 1450ppm fluoride: A 3-day clinical study in Chengdu, China. Am J Dent , 2010, 23 Spec No A: 20A-27A.
30. 32 Hughes N, Mason S, Jeffery P, et al . A comparative clinical study investigating the efficacy of a test dentifrice containing 8% strontium acetate and 1040 ppm sodium fluoride versus a marketed control dentifrice containing 8% arginine, calcium carbonate, and 1450 ppm sodium monofluorophosphate in reducing dentinal hypersensitivity. J Clin Dent , 2010, 21(2): 49-55.
31. 33 Hamlin D, Williams KP, Delgado E, et al . Clinical evaluation of the efficacy of a desensitizing paste containing 8% arginine and calcium carbonate for the in-office relief of dentin hypersensitivity associated with dental prophylaxis. Am J Dent , 2009, 22 Spec No A: 16A-20A.
32. 34 Orchardson R, Gillam DG. The efficacy of potassium salts as agents for treating dentin hypersensitivity. J Orofac Pain , 2000, 14(1): 9-19.
33. 35 Poulsen S, Errboe M, Lescay Mevil Y, et al . Potassium containing toothpastes for dentine hypersensitivity. The Cochrane Database Syst Rev , 2006, 19(3): CD001476.、.
34. 36 Drisko CH. Dentine hypersensitivity-Dental hygiene and periodontal considerations. Int Dent J , 2002, 52(5): 385-393,.
35. 樊明文, 周学东. 牙体牙髓病学. 第2版. 北京: 人民卫生出版社, 2005: 134-138.
36. Brannstrom M. A hydrodynamic mechanism in the transmission of pain- produced stimuli through the dentine. In: Anderson DJ, ed. Sensory Mechanisms in Dentine. Oxford: Pergamon, 1962: 73-79.
37. American Dental Association Council on Scientific Affairs. Acceptance program guidelines: products for the treatment of dentinal hypersensitivity, 2004.

Chinese Journal of Evidence-Based Medicine

Arginine-Containing Desensitizing Toothpaste for Dentine Hypersensitivity: A Meta-analysis

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