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Abstract
Background: Dentin hypersensitivity is a common oral health condition characterized by short, sharp pain arising from exposed dentin in response to thermal, tactile, or evaporative stimuli. Fluoride-based products are widely used for its management, while nano-hydroxyapatite (n-HAP) has emerged as a biomimetic alternative with potential dentinal tubule-occluding and remineralizing properties.
Objective: To systematically evaluate the comparative effectiveness of nano-hydroxyapatite and fluoride-based interventions for the management of dentin hypersensitivity.
Methods: This systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, Embase, Cochrane Library, and Web of Science were searched, along with reference-list screening. Eligible studies evaluated hydroxyapatite-containing toothpaste or dentifrice against fluoride-based interventions and reported clinical outcomes related to dentin hypersensitivity or remineralization. Study characteristics and clinical outcomes were extracted, and risk of bias was assessed using the Cochrane RoB 2 tool.
Results: Four randomized clinical trials met the eligibility criteria. Across the included studies, both nano-hydroxyapatite and fluoride-based interventions demonstrated reductions in dentin hypersensitivity. Hydroxyapatite-containing formulations produced clinically meaningful improvements in sensitivity assessed through tactile and air-blast stimulation and patient-reported sensitivity measures. In comparative evaluations, hydroxyapatite demonstrated effects comparable to, and in some outcomes favorable to, fluoride-based interventions. However, differences in hydroxyapatite concentration, formulation, comparator products, assessment methods, and follow-up duration limited direct quantitative comparison. Overall, three studies were judged to have low risk of bias, while one had some concerns related primarily to missing outcome data.
Conclusion: Nano-hydroxyapatite appears to be a promising alternative to fluoride-based interventions for reducing dentin hypersensitivity. However, the limited number of studies and methodological heterogeneity highlight the need for larger, well-designed trials with standardized outcome measures and longer follow-up.