PEARL Non-carious Cervical Lesion RCT Baseline and Sleep Bruxism Findings

Methods: Sixteen PEARL Network Practitioner-Investigators (P-Is) enrolled 225 subjects with NCL lesions (88% premolars, remainder molars) with calibrated air flow Numeric Pain Assessment Scale (0-10) readings ≥3. Subjects were evaluated via criteria (4) for sleep bruxism (American Academy of Sleep Medicine, 2001) and filled out sensitivity and OHIP-14 questionnaires. Following cervical impression lesions were randomized to one of the three treatments and so treated, DBAS and RBC groups were then again air flow tested. Patients were recalled at 1, 3 and 6 months post treatment and impression (3 and 6 m) and all measures repeated.

Results: Subjects were predominately (66%, 148/225) female and overall mean age 46.6 (±10.0) yrs. At baseline patients reported sensitivity scores; cold > sweet > hot >chewing = clenching. Sleep bruxism was found in 43.4%, (95/225) of subjects with 55% of those from 40-47 yrs old. Of those with bruxism >20% exhibit 3 or more signs/symptoms. Recall rate at 6 m (132 evaluated) was 97%. The median (range) pre-treatment hypersensitivity was 5 (3-10), 1 m post-treatment 1 (0-8), 3 m 1 (0-9) and 6 m 0 (0-8). Mean pre-treatment hypersensitivity was 5.4 ± 1.8 and baseline post-treatment significantly (p<0.05) less 1.4 ± 1.7 for the combined DBAS and RBC subjects.

Conclusions: PEARL P-I successfully enrolled subjects and randomized patients with a high 6 month recall percentage. Dentin bonding agent followed by sealant and resin based composite restoration significantly lowered baseline air sensitivity. Sleep bruxism appears to be a cofactor in non-carious cervical lesion patients. Supported by NIDCR U01-DE016755.