Influência de agentes obliteradores na eficácia e durabilidade no controle da hipersensibilidade dentinária: um ensaio clínico randomizado, controlado, duplo-cego e com delineamento em boca dividida

Abstract

Cervical dentin hypersensitivity (DH) represents a prevalent and challenging clinical condition, whose acute pain significantly compromises patients’ quality of life. Despite the variety of therapeutic approaches available, there is still no consensus regarding the most effective and long-lasting treatment protocol. This randomized, controlled, double-blind, split-mouth clinical trial aimed to compare the efficacy and durability of three desensitizing protocols applied in a single clinical session for reducing DH associated pain, as well as to evaluate their impact on patients' quality of life. Thirty-three individuals (99 teeth) reporting pain > 3 to air-jet stimulus were randomly assigned to one of the following groups: GLU – 3% potassium nitrate + Gluma (control); GAS – GLU + universal adhesive system; GAR – GAS + bulk-fill flowable resin composite. Pain was assessed using air-jet and tactile stimuli based on the Numerical Rating Scale (NRS) at baseline, immediately after intervention, and at 7, 30, 90, and 180 days. Periodontal parameters: probing depth (PD), gingival recession (GR), bleeding on probing (BOP), visible plaque (VP), probing sensitivity (PS), gingival phenotype, and keratinized mucosa height (KMH) were monitored, and oral health-related quality of life was measured using the OHIP-14 questionnaire at baseline, 90 days, and 180 days of follow-up. Statistical analysis included mixed linear models and appropriate non-parametric tests for repeated measures and categorical data (α=0.05). The results showed that all protocols significantly reduced pain from the first post-intervention evaluation through 180 days, with no statistically significant differences between groups. No changes were observed in periodontal parameters, and quality-of-life scores improved significantly at 90 and 180 days. It is concluded that all tested protocols were effective and safe, and that the addition of the adhesive system and flowable resin composite did not provide additional long-term benefits compared to the control protocol. These findings support the rational selection of therapeutic protocols in clinical practice, especially in public health settings.