In vivo and in situ evaluation of innovative approaches in dentin hypersensitivity treatment

Abstract Background Dentin hypersensitivity (DH) causes transient sharp pain from exposed dentinal tubules, adversely affecting oral health and quality of life. This study compared the efficacy of two innovative treatments against Sodium Fluoride Varnish in reducing DH and occluding dentinal tubules over eight weeks. Methods This randomized, triple-blind, three-parallel-arm clinical and in situ study included a total of 63 participants (age range: 26–46 years), each randomly assigned to one of three treatment groups: PRG Barrier Coat, Embrace varnish, or Duraphat varnish. The clinical trial assessed pain intensity was assessed using Visual Analog Scale (VAS) after tactile, evaporative, and thermal stimuli at baseline, 3 min, 2 weeks, 4 weeks, and 8 weeks. The in-situ phase evaluated dentinal tubules occlusion pre- and post-treatment using scanning electron microscopy (SEM) at 2000× magnification. Statistical Analysis was conducted using Kruskal-Wallis and Friedman tests for intergroup and intragroup comparisons, respectively, and Spearman’s correlation for pain reduction-tubule occlusion relationship (p < 0.05). Results PRG Barrier Coat achieved the highest efficacy with 94.9% pain reduction and 96.9% tubule occlusion. Embrace varnish showed moderate results with 64.3% pain reduction and 69.7% tubule occlusion, while Duraphat varnish provided limited performance with 45.4% pain reduction and 48.3% tubule occlusion. PRG Barrier Coat exhibited the most prolonged effects in reducing dentin hypersensitivity, aligning with its higher tubule occlusion. Embrace varnish demonstrated moderate performance, showing initial pain relief that was less sustained over time. Duraphat varnish provided the least reduction in pain and tubule occlusion, with effects that appeared transient. Conclusions This study demonstrated that PRG Barrier Coat and Embrace varnish effectively reduced pain intensity and promoted dentinal tubule occlusion, with PRG Barrier Coat showing the most sustained effects. These findings highlight the importance of dentinal tubule occlusion in DH management and suggest that treatment selection should consider both immediate pain relief and durability of therapeutic effects. Trial registration ClinicalTrials.gov (NCT04568473) on September 23, 2020.