精氨酸脫敏牙膏治療牙本質敏感的Meta分析_《中國循證醫學雜志》

作者：

李銳 ¹ , 唐曉君 ² , 李月恒 ¹ , 汪洋 ² , 陳嬌 ¹ , 王勤花 ¹ , 黃雅靜 ¹ ,  周智 ¹

1. 重慶醫科大學口腔醫院（重慶?400012）；2. 重慶醫科大學公共衛生學院（重慶?400016）;

關鍵詞：

精氨酸牙膏牙本質敏感 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20110101

視頻：

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　評價精氨酸脫敏牙膏治療牙本質敏感的療效。
方法　計算機檢索CNKI、PubMed、Web of Science和Cochrane圖書館臨床對照試驗資料庫（2008年第4期），并輔以Google搜索引擎進行檢索（檢索時間截至2010年3月），搜集精氨酸脫敏牙膏治療牙本質敏感的隨機對照試驗（RCT）。對納入文獻進行資料提取和質量評價后，采用RevMan 5.0軟件進行Meta分析。
結果　共納入5個RCT，包括397例患者。Meta分析結果顯示，精氨酸牙膏與含鉀牙膏比較，在第8周觸壓敏感測試［SMD= 1.32，95%CI（0.68，1.96）］及冷空氣噴吹檢測［SMD= –0.77，95%CI（–1.22，–0.32）］上，其差異均有統計學意義，精氨酸牙膏治療牙本質敏感效果更佳。
結論　現有文獻表明，精氨酸牙膏治療牙本質敏感效果優于含鉀牙膏。但因納入RCT數較少，樣本量較小，上述結論尚待更多高質量、大樣本的RCT予以進一步證實。

引用本文： 李銳,唐曉君,李月恒,汪洋,陳嬌,王勤花,黃雅靜,周智. 精氨酸脫敏牙膏治療牙本質敏感的Meta分析. 中國循證醫學雜志, 2011, 11(5): 570-575. doi: 10.7507/1672-2531.20110101 復制

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, 周學東. 牙體牙髓病學. 第2版. 北京: 人民衛生出版社, 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, 周學東. 牙體牙髓病學. 第2版. 北京: 人民衛生出版社, 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.

《中國循證醫學雜志》

精氨酸脫敏牙膏治療牙本質敏感的Meta分析

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《中國循證醫學雜志》

精氨酸脫敏牙膏治療牙本質敏感的Meta分析

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