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    C:\fakepath\erosion C:\fakepath\erosion Presentation Transcript

    • Non caries tooth loss Dental erosion
      Chu CH
      Faculty of Dentistry
      The University of Hong Kong
    • Non caries tooth loss
      • Erosion is the loss of enamel and dentine by chemical means not involving bacteria.
      • Abrasion is the loss of enamel and dentine by wear from surfaces other than teeth (e.g. tooth brushing).
      • Attrition is the loss of enamel and dentine caused by wear of tooth against tooth.
    • Dental erosion
      Dental erosion, or erosive tooth wear, is now recognized as a major cause of tooth wear.
      (Smales and Kaidonis, 2006)
    • Dental erosion
      Effects:
      Enamel thinning with exposure of dentin
      Unsightly appearance of teeth
      Tooth hypersensitivity
      Reduced chewing function.
      5. Pulpal involvement in advanced cases
    • Dental erosion
      Significance:
      Aging population with more elderly retaining their teeth,
      Change in dietary habits (Cola drinks, red or white wine and fruit juices)
    • Dental erosion
      Prevalence
      Limited longitudinal data are available
      5% Finnish (Jarvinen et al., 1991)
      7% Nigerians (Oginni and Olusile, 2002)
      13% Swedish (Lussi et al., 1991)
      15% Norwegian (Myklebust et al., 2003)
      46% Chinese adults (Hou et al., 2005)
      6%Chinese prechildren (Luo et al., 2005)
      No data in Hong Kong
    • Dental erosion
      Questionnaire telephone survey (2008)
      Faculty of Dentistry & Social Science Research Center, University of Hong Kong
      Chinese adults
      Website http://hkupop.hku.hk/
    • Age
      Successful Samples:514
    • 92% Respondents aged 25-45 had symptoms of Dental Erosion
      Successful Samples:570; Age range: 25-45
    • 72% Respondents reported their teeth turned yellow
      Successful Samples:520 (multiple responses)
    • Q: How often would you consume non-water beverage and food like soft drinks, coffee, snacks, fruits, dessert, etc. in a day?
      36%
      Successful Samples:494
      36% Respondents* ate at least 6 times per day (Average 5.4 Times )
    • 68% Respondents had dental check-upat least once every year
      Q: On average, how often do you go for dental check up in a year ?
      Average: 0.92 times
      SD:0.03
      Base:499
      Successful Samples:519
    • Dental erosion
      73% did not know symptoms of erosion
      70% had never heard about erosion
      53% could not differentiate erosion and caries
      This lack of public knowledge about erosion has also been reported in the UK
      (Dugmore and Rock, Community Dent Health; 20:223-7)
    • Dental erosion
      Sources:
      1. endogenous (eg gastric)
      2. exogenous (eg dietary)
    • Dental erosion
      Sources: endogenous
      Bullimia
    • Dental erosion
      Sources: endogenous
      GI reflux
    • Dental erosion
      Sources: exogenous
      Coke Zero over indulgence
    • Dental erosion
      Sources: exogenous
      Red wine drinker
    • Dental erosion
      Sources: exogenous
      Seafood lovers
    • Dental erosion
      Sources: exogenous
      Preserved Snacks
    • Dental erosion
      Sources: exogenous
      GI reflux
    • Dental erosion
      All carbonated drinks, including soda and some energy drinks, contain a lot of acid such as citric, phosphoric and carbonic acids which can rapidly dissolve enamel on teeth.
    • Early erosive tooth wear
      Prevention
      Patient Education
    • Prevention of erosion
      • Dietary acids and drinking habits
      • Reflux and referral to gastroenterologists
      • Preventing erosion
      • Fluoride
      • Dentine bonding agents
      • The relationship between sensitivity and erosion
    • Mild cases of tooth wear
      • Dietary advice
      • Fluoride toothpaste
      • Low abrasive toothpaste
      • Dentine bonding agents
      • Avoid placing restorations
    • Moderate erosion
      • Prevent and Patient education
      • Consider restorations only when concerns for appearance or sensitivity
      Composites, Onlays, Crowns
    • Severe erosion
      Refer to specialist
    • Dental erosion
      Regular Review is important
    • Dentine HypersensitivityOpportunities for an optimized, evidence based management
    • Definition of Dentine Hypersensitivity
      Dentine hypersensitivity is characterized by short, sharp pain arising from exposed dentine in response to external stimuli which cannot be ascribed to any other form of dental defect or disease.
      Correct differential diagnosis is key for management success!
      Addy M.,Int. Dent.J, 2002, Canadian Advisory Board, J of Can.Dent.Assoc., 2003
    • Aetiology - Mechanism of Hypersensitivity
      Explained by Brännström’s Hydrodynamic Theory
      Short sharp pain associated with A-beta and A-delta nerve fibers stimulation
      Two phases* development:
      Lesion Localisation
      Lesion Initiation
      GINGIVAL RECESSION
      LOSS OF ENAMEL
      LESION LOCALISATION
      Exposure of dentine
      LESION INITIATION
      Opening of dentine tubules
      (removal of cementum or smear layer)
      *Dababneh et all. Br Dent J, 1999
    • Aetiology - Mechanism of Hypersensitivity
      GINGIVAL RECESSION
      LOSS OF ENAMEL
      Abrasion
      Attrition
      Abfraction
      Erosion
      Fracture
      Incorrect tooth-brushing or flossing
      Periodontitis
      Periodontal procedures
      Gingival trauma (picking, hard foods)
      Crown preparation
    • Dentine Hypersensitivity treatment options
      Occluding the dentine tubules
      Desensitising the nerves
    • Desensitising of nerves – mechanism and clinical evidence*
      Buffering of membrane potential with potassium (K+) ions
      Symptomatic action
      Potassium salts delivered in at home products (toothpastes)
      Potassium nitrate (5%)
      Potassium citrate (5,5%)
      Potassium chloride (3,75%)
      Reduction in yield sensitivity measures – minimum 2 weeks of 2/day use
      Pain relief - 4-8 weeks of 2/day use
      Equivocal data on actual efficacy
      * Literature review in Cummins, J Clin Dent, 2009
    • Dentine tubule occlusion - mechanism and clinical evidence*
      At home use (Toothpaste) - precipitation of insoluble metal compounds.
      Strontium chloride – reported less effective than potassium salts**
      Stannous fluoride – secondary effects (staining)**
      In office use
      Established desensitisers with HEMA or oxalate seal
      Desensitising pastes with calcium sodium phosphosilicate or CPP-ACP technologies
      High fluoride containing products with sensitivity relief as secondary benefit only (varnishes, toothpastes and gels)
      *Literature review in Orchardson, JADA, 2006; ** Cummins, J Clin Dent 2009
    • Dentine Hypersensitivity treatment options - Current State
      2 widely used mechanisms* **
      desensitising toothpaste recognized as the “first option” recommendation – effective but slow (4-8 weeks) pain relief * **
      In office treatment approached usually for “severe cases”* **
      Stated need for new tested treatment options that should effectively occlude dentine tubules and mimic the natural desensitising process***.
      *Orchardsson, JADA, 2006, ** Cummins, J Clin Dent 2009, ***Markowitz, J of Oral Rehab., 2007
    • Dentine Hypersensitivity treatment options - Current Needs
      Efficacy – fast, reliable action and long term effect
      Action based upon natural process of desensitisation
      Compatible with other active compounds
      No staining or other side effects
      Good taste
      Safe
    • Introducing a new technology
      Over several decades, the State University of New York (SUNY) studied the role of saliva in oral health under the leadership of Dr. Israel Kleinberg.
      Arginine was identified as a key component of saliva and important to oral health
      Ortek Company, in collaboration with SUNY, developed a novel technology for dentine hypersensitivity associating arginine with calcium carbonate
      Colgate acquired the technology from Ortek in July 2007, and further developed the formulation by including sodium fluoride
    • What is the Pro-Argin™ Technology?
      • Pro-Argin™ is a special technology consisting of Arginine and calcium carbonate
      • It is proprietary to Colgate
    • Carbon
      Hydrogen
      Oxygen
      Nitrogen
      What is Arginine?
      Arginine is a natural amino acid and is an essential element in many biological processes
      Arginine is naturally found in saliva
      Arginine is compatible with fluoride
      US Food and Drug Administration has categorised arginine as safe in food.
    • -
      +
      How does Pro-Argin™ Technology work against Dentine Hypersensitivity?
      +
      -
      Arginine
      • Arginine is a bipolar molecule having both positively and negatively charged groups. Arginine ispositively charged at physiological pH
    • How does Pro-Argin™ Technology work against Dentine Hypersensitivity?
      -
      -
      +
      -
      -
      -
      Like most natural surfaces, tooth surface, including the dentine, is negatively charged.
      At physiological pH in saliva, Arginine interacts with the calcium carbonate and adheres to the walls of dentine tubules and the dentine surface.
      -
      +
      Arginine
      -
      Dentine
    • How does Pro-Argin™ Technology work against Dentine Hypersensitivity?
      Arginine promotes precipitation of calcium and phosphate ions to form a calcium-rich layer that plugs and seals the opening of dentine tubules.
      The plug shields dentine fluid from exposure to external stimuli.
      -
      -
      -
      Graphical representation, for illustration purposes only
      Pro-Argin™ Technology thus addresses the cause of dentine hypersensitivity.
    • Pro-Argin™ Technology Documentation
      Mode of Action
      How the technology works
      In vitro tests
      Clinical Efficacy
      Hypersensitivity clinical studies
      Surface roughness study
    • High powered microscope visualization
      Confocal Laser Scanning Microscopy (CLSM)
      Scanning Electron Microscopy (SEM)
      Atomic Force Microscopy (AFM)
      Chemical Analysis
      • Electron Spectroscopy for Chemical Analysis (ESCA)
      • Energy dispersive X-ray spectroscopy (EDX)
      Confocal Dye Binding Experiments
      Acid Resistance
      Hydraulic conductance
      Pro-Argin™ Technology – Mode of Action Documentation – Dentine Occlusion
    • Pro-Argin™ Technology – Mode of Action High powered microscope visualization
      Dentine tubules have diameter ~1 to 5 microns
      High powered microscopes are used to visualize the tubules
      Confocal Laser Scanning Microscope (CLSM)
      Scanning Electron Microscope (SEM)
    • Pro-Argin™ Technology – Mode of Action High powered microscope visualization
      Arginine and CaCO3 are required for efficacy
      Compared occlusion of
      CaCO3
      8% Arginine/CaCO3/1450 ppm MPF
      8% Arginine/Dical/1450 ppm MPF
      8% Arginine/CaCO3
    • Pro-Argin™ Technology – Mode of Action High powered microscope visualization: Confocal LSM
      CaCO3
      8% Arginine/dical/1450 ppm MPF
      8% Arginine/CaCO3
      8% Arginine/CaCO3/1450 ppm MPF
    • Pro-Argin™ Technology – Mode of Action High powered microscope visualization (SEM)
      Dentine Occlusion – 8.0% Arginine/CaCO3
      Treated
      Baseline
      SEM Images – 10,000x Magnification
    • AFM used to evaluate dentine surface
      Untreated dentine shows tubule completely open and helical structure of dentine collagen
      Treated dentine shows no helical structure – sign of protective layer at the surface of dentine
      Collagen
      Open Tubule
      Pro-Argin™ Technology – Mode of Action Atomic Force Microscopy
    • Pro-Argin™ Technology – Mode of Action Atomic Force Microscopy
      Untreated Dentine Multiple Tubules
      Treated dentine Multiple Tubules
      Dentine tubule completely occluded and sealed by 8% Arg/CaCO3
    • Open Tubule
      Untreated Dentine– Single Tubule
      Pro-Argin™ Technology – Mode of Action Atomic Force Microscopy
      Treated Dentine– Single Tubule
    • Pro-Argin™ Technology – Mode of Action Chemical Analysis - ESCA
      ESCA is a surface analysis technique used for obtaining chemical information about the surfaces of solid materials
      Utilizes an x-ray beam to excite a solid sample resulting in the emission of photoelectrons
      Energy analysis of these photoelectrons provides chemical information about a sample surface 
      ESCA has a sampling depth of approximately 30 Å
    • Pro-Argin™ Technology – Mode of Action Chemical Analysis - ESCA
      Elementary analysis (by ESCA) of surface layer showed:
      Before treatment: high levels of carbon, oxygen and nitrogen, and low levels of calcium and phosphorus, consistent with demineralization of dentine and exposure of collagen matrix.
      After treatment: Increase in calcium, phosphorus and carbonate content confirms the composition of occluding layer deposited after application of the Pro-Argin™ Technology
      Decrease in nitrogen is due to coverage of collagen-containing dentine surface by occluding layer
      Increase in silicon is evidence that some silica from Pro-Relief™ Desensitising Polishing paste formula is deposited at the surface of dentine
    • Pro-Argin™Technology– Mode of Action Chemical Analysis - ESCA
      16
      Legend
      14
      Before application
      12
      After application
      10
      Atomic %
      8
      6
      4
      2
      0
      CO3
      Ca
      P
      N
      Silica
      Chemical Analysis of Coating – ESCA = Electron Spectroscopy for Chemical Analysis*
    • After evaluation of tubule occlusion by SEM, samples were analysed by EDX analysis in order to qualitatively determine the elemental composition of the occluding material as the sampling depth is higher than ESCA
      Analysis performed on occluded and a freeze-fractured face of the treated dentine disks
      Pro-Argin™ Technology – Mode of Action Chemical analysis - EDX
    • Pro-Argin™ Technology – Mode of Action Chemical analysis - EDX
      Energy dispersive X-ray spectroscopy
    • Pro-Argin™ Technology – Mode of Action Chemical analysis - EDX
      Energy dispersive X-ray spectroscopy
    • Energy dispersive X-ray spectroscopy
      Pro-Argin™ Technology – Mode of Action Chemical analysis - EDX
      EDX analysis provided qualitative confirmation of the ESCA results
      Tubules occluded with arginine, calcium, carbonate, phosphate and silica
      Increase in silicon is evidence that some silica from Colgate® Sensitive Pro-Relief™ Desensitising Polishing Paste formula is deposited within the occluding layer
    • Confocal Laser Scanning Microscope has two modes of operation
      Reflectance
      Shows hard surfaces
      Fluorescence
      Discloses substrate that binds fluorescent dye
      Used FITC dye that binds to amines
      (Functional group on arginine)
      Pro-Argin™ Technology – Mode of Action Dentine Occlusion
    • Fluorescence
      Overlay
      Reflection
      Dentine Tubules 100% Open – Top view
      Pro-Argin™ Technology – Mode of Action Confocal Dye Binding
      Fluorescein isothiocyanate as dye
    • Open tubules
      Overlay
      Reflection
      Fluorescence
      Dentine Tubules 100% Open – Side view
      Pro-Argin™ Technology – Mode of Action Confocal Dye Binding
    • Pro-Argin™ Technology – Mode of Action Confocal Dye Binding
      Dye concentrated
      In tubule
      Fluorescence
      Reflection
      Overlay
      Treated Dentine – Top view
    • Dye concentrated
      In tubule
      No open tubules
      Overlay
      Fluorescence
      Reflection
      Treated Dentine – Side view
      Pro-Argin™ Technology – Mode of Action Confocal Dye Binding
    • Pro-Argin™ Technology – Mode of Action Confocal Dye Binding – Acid resistance
      Treatment of dentine surfaces with Colgate® Sensitive Pro-Relief™Desensitising Polishing Paste
      Subsequent treatment of occluded dentine samples with acidic soft drink
      Visualisation of dentine surface by 2 methods
      Confocal Laser Scanning Microscopy (CLSM) in reflectance mode
      CLSM using a fluorescent dye that adheres to surfaces, side view
    • Pro-Argin™ Technology – Mode of Action Confocal Dye Binding – Acid resistance
      Before treatment
      Treated with Pro-Argin™ Technology 5xs
      2nd Acid Challenge (24 hours later)
      1 minute Acid Challenge
    • Pro-Argin™ Technology – Mode of Action Confocal Dye Binding – Acid resistance
      Open tubules
      Open tubules
      Overlay
      Reflection
      Fluorescence
    • Pro-Argin™ Technology – Mode of Action Confocal Dye Binding – Acid resistance
      Treated with 8.0% Pro-Argin™ Technology 5x
      Untreated
      Open tubules
      Acid Challenge-
      treated with
      Acidic drink for 1 min
      Second Acid Challenge (24 hours later) - treated with
      Acidic drink for 1 min
      Tubule occlusion by the Pro-Argin™ technology is resistant
      to acid from common beverages
    • Pro-Argin™ Technology – Mode of Action Hydraulic Conductance
      Hydraulic conductance (Pashley et al) is used to measure inhibition of fluid flow in dentine tubules
      Effective occlusion agents reduce flow
      Hydraulic conductance experiments were conducted with Colgate Sensitive Pro-Relief™ Desensitising Polishing Paste (Pro-Argin™ formula)
    • Pro-Argin™ Technology – Mode of Action Hydraulic conductance
      Pro-Argin™ Technology significantly reduced fluid flow in dentine tublules
    • Pro-Argin™ Technology – Mode of Action Summary
      The arginine interacts with the calcium carbonate at physiological pH to form a positively charged agglomerate which is attracted by electrostatic forces to negative surfaces, including dentine
      This agglomerate promotes the formation of a calcium-rich mineral layer on the dentine surface to occlude the tubules.
      The occlusion protects dentinal fluid from exposure to external stimuli, thus stopping fluid movement in the tubules.
      This blocking of the fluid movement addresses the cause of pain and discomfort.
      The occluding layer resists acid attacks, such as provoked by certain acid beverages.
    • Pro-Argin™ Technology Documentation
      Mode of Action
      How the technology works
      In vitro tests
      Clinical Efficacy
      Hypersensitivity clinical studies
      Surface roughness study
    • Pro-Argin™ Technology Clinical Documentation
      Hypersensitivity Measurements Methodology
      In-Office desensitising (Prophylaxis) Paste containing 8% Arginine and Calcium Carbonate
      Colgate supported independent Clinical Documentation
      Ortek Clinical Documentation
      Toothpaste formula containing arginine and 1450 ppm fluoride as MFP in a calcium carbonate base
    • Hypersensitivity Measurements Methodology
      Dentine Hypersensitivity (DHS) improvements for a tested product are usually compared to negative &/or positive controls in order to establish product efficacy.
      Double-blind randomized parallel groups
      DHS is generally may be measured following the application of stimuli of known intensity:
      Tactile
      Air blast
      Thermal
    • Hypersensitivity Measurements Methodology
      Tactile stimulation
      Pressure stimulation based assessment
      Electronic Force Sensing Probe (Yeaple Probe) calibrated once daily
      Explorer tip stroked perpendicular to surface beginning at pre-set force of 10g and increasing by 10g increments until patient expresses discomfort.
      Scored as force (g) required to elicit discomfort
      Non-sensitive if no discomfort upon 50g of force.
    • Hypersensitivity Measurements Methodology
      Air blast stimulation
      Evaporative stimulus-based assessment
      One second of air delivered at 1cm distance from the surface
      From standard dental unit syringe at 60psi (±5) and 70°F(±3)
      Examiner scores subject response using Schiff Cold Air Sensitivity Scale, where:
      “0” No subject response to stimulus
      “1” responds but will continue
      “2” responds and moves or requests discontinuation
      “3” Painful response to stimulus, discontinuation requested
    • Pro-Argin™ Technology Clinical DocumentationHypersensitivity Clinical Research Methodology
      Fully compliant with American Dental Association Acceptance Guidelines for approval of desensitising products
      Reviewed by the US Food and Drug Administration (FDA)
      Also utilized in published research testing the effectiveness of desensitising products
    • Pro-Argin™ Technology Clinical DocumentationHypersensitivity Clinical Research Methodology
      Colgate Sensitive Pro-Relief™ Desensitising Polishing Paste with Pro-Argin™ Technology
      8% arginine in a calcium carbonate/silica prophy base
      No fluoride
      Toothpaste formula containing arginine and 1450 ppm fluoride as MFP in a calcium carbonate base
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      Study design for post-scaling application1
      Objectives
      Compare the efficacy in reducing hypersensitivity after a single post scaling application, as the final polishing step in a dental prophylaxis
      Assess the duration of relief over 4 and 12 weeks.
      Methodology
      Study conducted in San Francisco, California
      68 subjects (50% female)
      Test: Colgate Sensitive Pro-Relief™ Paste n=32
      Negative Control: Nupro n=36
      Mean age 36 years (24-56)
      Double blind, parallel group controlled study
      Tactile and air blast scores at baseline, immediate after product application, at 4 and 12 weeks.
      All used Crest anti cavity toothpaste and soft brush for duration of study.
      1 Schiff T et al , (2009) Am.J of Dent, 22, Special Issue A, 8A-15A
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      Post-scaling application - Tactile results1
      p < 0.05
      p < 0.05
      Yeaple Probe Pressure
      Test product
      Control product
      1 Schiff T et al , (2009) Am.J of Dent, 22, Special Issue A, 8A-15A
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      Post-scaling application - Air Blast Results1
      p < 0.05
      p < 0.05
      Schiff Scores
      Test product
      Control product
      1 Schiff T et al , (2009) Am.J of Dent, 22, Special Issue A, 8A-15A
    • Post-scaling application1
      Conclusions:
      Colgate® Sensitive Pro-Relief™ desensitising paste provides a statistically significant reduction in dentine hypersensitivity as compared to a control prophylaxis paste immediately after a single application following dental scaling. This relief lasts for 4 weeks.
      Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      1 Schiff T et al , (2009) Am.J of Dent, 22, Special Issue A, 8A-15A
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      Study design for pre-scaling application2
      Objective
      Compare the efficacy in reducing hypersensitivity when applied before professional prophylaxis
      Methodology
      Study conducted in Langhorn, Pennsylvania
      45 subjects (33 female)
      Test: Colgate Sensitive Pro-Relief ™ Paste n=22
      Negative Control: Nupro n=23
      Mean age 45 years (23-66)
      Double blind, parallel group controlled study
      Tactile and air blast scores at baseline,
      Two 3 second applications of test or control product with prophy cup
      Reassess sensitivity after completion of scaling and polishing with Nupro prophy paste
      2 Hamlin D et al, (2009) Am J of Dent, 22, Special Issue A, 16A-20A
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      Pre-scaling application - Tactile Results2
      p < 0.05
      Yeaple Probe Pressure
      Test product
      Control product
      2 Hamlin D et al, (2009) Am J of Dent, 22, Special Issue A, 16A-20A
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      Pre-scaling application - Air Blast Results2
      p < 0.05
      Schiff Scores
      Test product
      Control product
      2 Hamlin D et al, (2009) Am J of Dent, 22, Special Issue A, 16A-20A
    • Conclusions:
      When applied prior to a scaling, Colgate® Sensitive Pro-Relief™ desensitising paste with 8 % arginine and calcium carbonate provides a statistically significant reduction in dentine hypersensitivity measured after scaling compared to a control prophylaxis paste.
      Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      Pre-scaling application2
      2 Hamlin D et al, (2009) Am J of Dent, 22, Special Issue A, 16A-20A
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      ORTEK Sponsored Studies
      Immediate Relief
      Negative controlled Study
      Reductions in sensitivity after dental prophylaxis procedure
      Tactile: 53% improvement compared to 2% for the negative control
      Air blast: 37% improvement compared to 6% for the negative control
      Thermal: 37% improvement compared to 13% for the negative control
      2. Immediate and Lasting (28 days) Relief
      Monadic-design Study
      Reductions in sensitivity immediately after dental prophylaxis procedure
      Tactile: 84% improvement from baseline
      Air blast: 72% improvement from baseline
      Reductions in sensitivity 28 days after dental prophylaxis procedure
      Tactile: 88% improvement from baseline
      Air blast: 68% improvement from baseline
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product
      In vitro testing3 of surface roughness
      Composite
      Porcelain
      Amalgam
      Gold
      Enamel
      No significant alteration of surfaces
      3 Garcia-Godoy F et al, (2009) Am J of Dent, 22, Special Issue A, 21A - 24A
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office productConclusions
      Significant immediate and lasting (28 days) tactile and air blast dentine hypersensitivity relief when applied as a single treatment after tooth scaling procedure, as the final polishing step in a dental prophylaxis.
      Significant tactile and air blast dentine hypersensitivity relief when applied as a single treatment before professional prophylaxis (scaling and polishing) procedure.
      No significant effect on surface roughness on the following substrates: resin composite, porcelain, amalgam, gold and human dental enamel.
    • Study design4
      Objectives
      Compare the efficacy in reducing hypersensitivity after brushing application after 2, 4 and 8 weeks.
      Methodology
      Study conducted in private practice, Rome, Italy
      80 patients (24 males, 56 females)
      40 subjects in each group
      mean age of 42.2 y (± 10.6y)
      Test products:
      Test Formula: 8% Arginine/CaCO3/1450 ppm fluoride (as MFP)
      Positive Control: 3.75%KCl / 1450 NaF
      Double blind, parallel group controlled study
      Tactile and air blast scores at baseline, 2, 4 and 8 weeks
      Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula
      4 Docimo R et al (2009) J Clin Dent 20 (Spec Iss): 17-22
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula
      Tactile Stimulation Results4
      p < 0.05
      p < 0.05
      p < 0.05
      Yeaple Probe Pressure
      Test formula
      Control product
      4 Docimo R et al (2009) J Clin Dent 20 (Spec Iss): 17-22
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula
      Air Blast Stimulation Results4
      p < 0.05
      p < 0.05
      Schiff Scores
      p < 0.05
      Test formula
      Control product
      4 Docimo R et al (2009) J Clin Dent 20 (Spec Iss): 17-22
    • Docimo R et al 4
      Conclusions:
      Pro-Argin™ Technology was shown to effectively reduce tactile and air blast hypersensitivity compared to both the baseline values and to a positive control toothpaste* containing 3.75% KCl when used twice daily for two, four and eight weeks.
      Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula
      * Sensodyne Total Care F toothpaste
      4 Docimo R et al (2009) J Clin Dent 20 (Spec Iss): 17-22
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula
      Study Design5
      Objectives
      Compare the efficacy in reducing hypersensitivity after brushing application after 3 days, 2, 4 and 8 weeks.
      Methodology
      Study conducted in clinical research centre, Mississauga, Canada.
      77 patients (25 males, 52 females)
      38 test and 39 control subjects
      mean age of 35.2 y ± 10.6)
      tested products
      Test formula: 8% Arginine /CaCO3/ 1450 ppm Fluoride (MFP)
      Positive Control: 3.75%KCl / 1450 NaF
      Double blind, parallel group controlled study
      Tactile and air blast scores at baseline, 3 days, 2, 4 and 8 weeks
      5 Ayad F et al (2009) J Clin Den (Spec Iss) 10-16.
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula
      Tactile Stimulation Results5
      p < 0.05
      p < 0.05
      p < 0.05
      Yeaple Probe Pressure
      Test formula
      Control product
      5 Ayad F et al (2009) J Clin Den (Spec Iss) 10-16.
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula
      Air Blast Stimulation Results5
      p < 0.05
      p < 0.05
      p < 0.05
      Schiff Scores
      Test formula
      Control product
      5Ayad F et al (2009) J Clin Den (Spec Iss) 10-16.
    • Ayad et al5
      Conclusions:
      Pro-Argin™ Technology was shown to effectively reduce tactile and air blast hypersensitivity compared to both the baseline values and to a positive control toothpaste* containing 3.75% KCl when used twice daily for two, four and eight weeks.
      Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula
      * Sensodyne Total Care F toothpaste
      5 Ayad F et al (2009) J Clin Den (Spec Iss) 10-16.
    • Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula : Summary
      Clinical data from two independent clinical trials showed show that the Pro-Argin™ Technology was shown to effectively deliver a sensitive benefit as compared to a leading desensitising toothpaste containing 2% potassium ion as the desensitising agent.
    • 100
      Pro-Argin™ Technology Conclusions
      Pro-Argin™ Technology is an innovative and proprietary technology combining the key ingredients Arginine, an amino acid, and insoluble calcium carbonate.
      Occludes tubules rapidly and effectively to treat the cause of tooth sensitivity. Tubule occlusion is calcium rich and acid resistant.
      Provides fast relief and long lasting protection from hypersensitivity.
      Is compatible with fluoride and provides no secondary unpleasant effects.
      Provides clinically superior sensitivity relief compared to other leading desensitising technologies (3.75% potassium chloride equivalent to 2% potassium).
      Represents a reliable solution for treatment of dentine hypersensitivity of various aetiology.
    • Colgate Sensitive Pro-Relief Desensitizing In-Office Paste
    • Colgate Sensitive Pro-Relief Desensitizing In-Office Paste
      Clinically proven to deliver instant relief that lasts four weeks after a single application
      Fast and easy application using a rotary cup
    • With
    • With
    • Reduces sensitivity pain for a comfortable dental procedure
      With
    • Fast and easy to use
      Fill a rotary cup with paste.
    • Fill a rotary cup with paste.
      At low to moderate speed polish whole dentition. On sensitive areas apply product for 3 seconds and then repeat.
      Fast and easy to use
    • Proof of clinical efficacy
    • Post-procedure instant and lasting relief study
      Controlled study
      68 male and female subjects (between 24 and 56 years of age) with established dentin hypersensitivity
      Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.
    • Post-procedure instant and lasting relief study
      Controlled study
      68 male and female subjects (between 24 and 56 years of age) with established dentin hypersensitivity
      Products tested
      Pro-ArginTM technology desensitizing paste
      Negative control: pumice prophylaxis paste
      Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.
    • Post-procedure instant and lasting relief study
      Product A or B
      Scaling
      Day 28
      Day 0
      (Immediate)
      Baseline
      Controlled study
      68 male and female subjects (between 24 and 56 years of age) with established dentin hypersensitivity
      Products tested
      Pro-ArginTM technology desensitizing paste
      Negative control: pumice prophylaxis paste
      Product applied after scaling procedure
      Evaluations at baseline, immediately after application, 28 days, 3 months
      Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.
    • Post-procedure instant and lasting relief study
    • Post-procedure instant and lasting relief study
      Effects on dentin hypersensitivity
      Tactile sensitivity scores
      Test paste
      Control paste
      Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.
    • Post-procedure instant and lasting relief study
      Effects on dentin hypersensitivity
      Tactile sensitivity scores
      Air blast sensitivity scores
      Test paste
      Control paste
      Test paste
      Control paste
      Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.
    • Post-procedure instant and lasting relief study
      Effects on dentin hypersensitivity
      Tactile sensitivity scores
      Air blast sensitivity scores
      149.6%
      reduction
      Test paste
      Control paste
      Test paste
      Control paste
      79%
      reduction
      40.6%
      reduction
      34.1%
      reduction
      Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.
    • Plugs and seals open tubules
    • Plugs and seals open tubules
    • Shown to be more effective than the control toothpaste with potassium salt
    • Air blast sensitivity score
      Shown to be more effective than the control toothpaste with potassium salt
      Brushing twice daily over a period of 8 weeks with Colgate® Sensitive Pro-Relief™ Toothpaste with Pro-Argin™ Technology is significantly (p<0.05) more effective in reducing sensitivity than using the control toothpaste (with potassium ions).
      Colgate Sensitive Pro-Relief™ Toothpaste
      Positive control: Toothpaste with 2% potassium ion
      Docimo R et al. J Clin Dent. 2009;20(Spec Iss):17-22.
    • Air blast sensitivity score
      Shown to be more effective than the control toothpaste with potassium salt
      Sensitivity relief
      Brushing twice daily over a period of 8 weeks with Colgate® Sensitive Pro-Relief™ Toothpaste with Pro-Argin™ Technology is significantly (p<0.05) more effective in reducing sensitivity than using the control toothpaste (with potassium ions).
      Colgate Sensitive Pro-Relief™ Toothpaste
      Positive control: Toothpaste with 2% potassium ion
      Docimo R et al. J Clin Dent. 2009;20(Spec Iss):17-22.
    • Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing
    • Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing
      3
      2
      Air blast sensitivity scores
      1
      0
      Baseline
      Immediate
      3-day
      When applied directly to the sensitive tooth with a fingertip and gently massaged for 1 minute, Colgate® Sensitive Pro-Relief™ Toothpaste provides instant sensitivity relief compared to the positive and the negative control. The relief was maintained after 3 days of twice-daily brushing.
      Colgate Sensitive Pro-Relief™ Toothpaste
      Nathoo S et al. J Clin Dent. 2009;20(Spec Iss):123-130.
    • Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing
      3
      2
      Air blast sensitivity scores
      1
      0
      Baseline
      Immediate
      3-day
      When applied directly to the sensitive tooth with a fingertip and gently massaged for 1 minute, Colgate® Sensitive Pro-Relief™ Toothpaste provides instant sensitivity relief compared to the positive and the negative control. The relief was maintained after 3 days of twice-daily brushing.
      Colgate Sensitive Pro-Relief™ Toothpaste
      Positive control: Toothpaste with 2% potassium ion
      Nathoo S et al. J Clin Dent. 2009;20(Spec Iss):123-130.
    • Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing
      3
      2
      Air blast sensitivity scores
      1
      0
      Baseline
      Immediate
      3-day
      When applied directly to the sensitive tooth with a fingertip and gently massaged for 1 minute, Colgate® Sensitive Pro-Relief™ Toothpaste provides instant sensitivity relief compared to the positive and the negative control. The relief was maintained after 3 days of twice-daily brushing.
      Colgate Sensitive Pro-Relief™ Toothpaste
      Positive control: Toothpaste with 2% potassium ion
      Negative control: Toothpaste with 1450 ppm fluoride only
      Nathoo S et al. J Clin Dent. 2009;20(Spec Iss):123-130.
    • Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing
      3
      2
      Air blast sensitivity scores
      Sensitivity relief
      1
      0
      Baseline
      Immediate
      3-day
      When applied directly to the sensitive tooth with a fingertip and gently massaged for 1 minute, Colgate® Sensitive Pro-Relief™ Toothpaste provides instant sensitivity relief compared to the positive and the negative control. The relief was maintained after 3 days of twice-daily brushing.
      Colgate Sensitive Pro-Relief™ Toothpaste
      Positive control: Toothpaste with 2% potassium ion
      Negative control: Toothpaste with 1450 ppm fluoride only
      Nathoo S et al. J Clin Dent. 2009;20(Spec Iss):123-130.
    • Colgate Sensitive Pro-Relief™ Toothpaste
    • Colgate Sensitive Pro-Relief™ Toothpaste
      Colgate Sensitive Pro-Relief™ Toothpaste is the first toothpaste for at-home use and is clinically proven to provide instant and lasting sensitivity relief
    • Colgate Sensitive Pro-Relief™ Toothpaste
      Colgate Sensitive Pro-Relief™ Toothpaste is the first toothpaste for at-home use and is clinically proven to provide instant and lasting sensitivity relief
      Works instantly when applied directly to the sensitive tooth
    • Colgate Sensitive Pro-Relief™ Toothpaste
      Colgate Sensitive Pro-Relief™ Toothpaste is the first toothpaste for at-home use and is clinically proven to provide instant and lasting sensitivity relief
      Works instantly when applied directly to the sensitive tooth
      Contains fluoride for caries prevention
    • A breakthrough in dentin hypersensitivity relief
    • A breakthrough in dentin hypersensitivity relief
      An in-office treatment for instant sensitivity relief in one fast and easy step
    • A breakthrough in dentin hypersensitivity relief
      An in-office treatment for instant sensitivity relief in one fast and easy step
      A daily-use toothpaste as follow-up treatment for long-lasting relief
    • A breakthrough in dentin hypersensitivity relief
      An in-office treatment for instant sensitivity relief in one fast and easy step
      A daily-use toothpaste as follow-up treatment for long-lasting relief
      The first toothpaste to be clinically proven to offer instant relief when applied directly