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O z o n e t r e a t m e n t f o r d e n t i n a l h y p e r s e n s i t i v i t y In the paint group, a significant reduction in NRS values was observed (p < 0.000 between T0 and T1) before treatment (T0) and immediately after the application (T1). A significant reduction in NRS values was not observed prior to treatment and at the end of the follow-up for all of the patients (p < 0.003 between T0 and FU6). In the ozone group, a significant reduction in NRS values was observed before treatment and after the fourth session of ozone therapy (p < 0.000 between T0 and T4). A significant reduction in NRS values was registered prior to treatment and at the end of follow-up for all of the patients (p < 0.000 between T0 and FU6). Concerning the six-month follow-up, a signifi- cant difference in NRS values (p < 0.05 between T0 and FU7) was observed. A significant decrease in NRS values was registered (p < 0.000 according to the Mann– Whitney test) in the paint group. The raw data revealed a progressive decrease in NRS values in patients treated with ozone. Moreover, the follow-ups revealed a further maintenance of the results regarding NRS values at six months. Discussion The present study takes into consideration the possibility of extending the use of ozone thera- py in the dental field to the treatment of dentin- al hypersensitivity. The purpose of the research was to evaluate the effectiveness of ozone in the reduction of pain due to hypersensitivity. From the results obtained, the desensitizing treatment with paint was proven effective in terms of im- mediate results, attributable to the paint’s abil- ity to form a protective layer, a mechanical bar- rier on the affected surface. The provisional barrier seals the dentinal tubules, preventing the flow of the dentinal fluid and therefore inter- rupting nerve stimulation and the consequent perception of pain. The six-month follow-up, however, did not find significant maintenance of the results. This may be due to the inability of adhesive agents to withstand the stress of the oral environment and their undergoing a progressive dissolution that causes the resto- ration of the initial sensitivity values, as observed by Jain et al.11 In the present study, no significant difference was reported after six months from the first application, but this was probably due to the insufficient sample sizes of patients. Therefore, the use of paint-on desensitizers, whose effec- tiveness is well established and well document- ed in the literature, may not be a definitive treat- ment and may require repeated applications throughout the patient’s life. Duke et al. ob- served that the action of paint can still be effec- tive up to five months.12 In the ozone group, a progressive reduction in NRS values was observed; this can be attributed to the beneficial action of the ozone itself on the tooth surface. In contrast to what was observed by Azarpazooh et al.,13 one application of ozone was not sufficient to resolve the pain symptoms linked to dentinal hypersensitivity; the results appeared more evident from the second applica- tion on, instead. As observed by Bocci et al., the increase in patency of the tubules caused by the application of ozone on the dental surface may facilitate the entry of minerals in the saliva and desensitizing agents.10 In this way, the sealing of the dentinal tubules would be continuous owing to the mineral salts contained in the saliva (mainly calcium and fluoride). According to this theory, it can be assumed that the action of ozone causes a sort of repair of the dentin by modifying its in- ternal structure and therefore leading to long- term effects. The long-term maintenance of the beneficial effect of ozone therapy, as well as the reduction of pain, seems more evident if com- pared with the use of paint, despite the small numeric sample. Considering that ozone does not occlude the dentinal tubules, its action could be enhanced by the concomitant use of fluoride- based products or amorphous calcium phosphate to create a smear plug in the tubules. In fact, as noted by another study,14 there is a synergy be- tween ozone and fluoride that does not occur with other desensitizers, such as oxalates. For this reason, ozone therapy could be associated with fluoride products in both professional application and at-home care. Conclusion Both therapies proved to be effective. The paint demonstrated an immediate desensitizing action, which was not observed in the treatment with ozone. However, in the longer term, the paint did not ensure a significant reduction in NRS values. Treatment with ozone proved to be more effective in the maintenance of long-term results. It can therefore be said that ozone therapy in the man- agement of dentinal hypersensitivity represents an innovative and effective technique, with good maintenance of long-term results. 22 Volume 3 | Issue 2/2017 Journal of Oral Science & Rehabilitation