In-office treatment for dentin hypersensitivity: a systematic review and network meta-analysis
Po-Yen Lin
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Search for more papers by this authorYa-Wen Cheng
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorChia-Yi Chu
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Search for more papers by this authorKuo-Liong Chien
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorChun-Pin Lin
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Yu-Kang Tu
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
Address:
Yu-Kang Tu
Institute of Epidemiology and Preventive Medicine
College of Public Health, National Taiwan University
Room 539, 17 Xu-Zhou Road
Taipei
Taiwan
E-mail: [email protected]
Search for more papers by this authorPo-Yen Lin
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Search for more papers by this authorYa-Wen Cheng
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorChia-Yi Chu
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Search for more papers by this authorKuo-Liong Chien
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorChun-Pin Lin
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Yu-Kang Tu
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
Address:
Yu-Kang Tu
Institute of Epidemiology and Preventive Medicine
College of Public Health, National Taiwan University
Room 539, 17 Xu-Zhou Road
Taipei
Taiwan
E-mail: [email protected]
Search for more papers by this authorConflict of interest and sources of funding statement
No external funding, apart from the support of the authors' institution, was available for this study. The authors declare that there are no conflicts of interest in this study.
Abstract
Aim
Dentin hypersensitivity, caused by the exposure and patency of dentinal tubules, can affect patients' quality of life. The aim of this study was to undertake a systematic review and a network meta-analysis, comparing the effectiveness in resolving dentin hypersensitivity among different in-office desensitizing treatments.
Materials and Methods
A literature search was performed with electronic databases and by hand until December 2011. The included trials were divided into six treatment groups as placebo, physical occlusion, chemical occlusion, nerve desensitization, laser therapy and combined treatments. The treatment effects between groups were estimated with standardized mean differences by using a Bayesian network meta-analysis.
Results
Forty studies were included. The standardized mean difference between placebo and physical occlusion was −2.57 [95% credible interval (CI): −4.24 to −0.94]; placebo versus chemical occlusion was −2.33 (95% CI: −3.65 to −1.04); placebo versus nerve desensitization was −1.72 (95% CI: −4.00 to 0.52); placebo versus laser therapy was −2.81 (95% CI: −4.41 to −1.24); placebo versus combined treatment was −3.47 (95% CI: −5.99 to −0.96). The comparisons of the five active treatments showed no significant differences.
Conclusions
The results from network meta-analysis showed that most active treatment options had significantly better treatment outcome than placebo.
Supporting Information
Filename | Description |
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jcpe12011-sup-0001-AppendixS1.docxWord document, 63.7 KB | Appendix S1. Quality assessment of the included articles for network meta-analysis. |
jcpe12011-sup-0002-AppendixS2.docxWord document, 13.4 KB | Appendix S2. Results of network and standard meta-analysis. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
References
- Al-Sabbagh, M., Brown, A. & Thomas, M. V. (2009) In-office treatment of dentinal hypersensitivity. Dental Clinics of North America 53, 47–60, viii.
- Aranha, A. C. & De Paula Eduardo, C. (2012) Effects of Er:YAG and Er,Cr:YSGG lasers on dentine hypersensitivity short-term clinical evaluation. Lasers in Medical Science 27, 813–818.
- Assis, J. S., Rodrigues, L. K., Fonteles, C. S., Colares, R. C., Souza, A. M. & Santiago, S. L. (2011) Dentin hypersensitivity after treatment with desensitizing agents: a randomized, double-blind, split-mouth clinical trial. Braz Dent J 22, 157–161.
- Azarpazhooh, A., Limeback, H., Lawrence, H. P. & Fillery, E. D. (2009) Evaluating the effect of an ozone delivery system on the reversal of dentin hypersensitivity: a randomized, double-blinded clinical trial. Journal of Endodontics 35, 1–9.
- Banerjee, A., Hajatdoost-Sani, M., Farrell, S. & Thompson, I. (2010) A clinical evaluation and comparison of bioactive glass and sodium bicarbonate air-polishing powders. Journal of Dentistry 38, 475–479.
- Brannstrom, M. (1963) Dentin sensitivity and aspiration of odontoblasts. Journal of the American Dental Association 66, 366–370.
- Canadian Advisory Board on Dentin Hypersensitivity (2003) Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. Journal/Canadian Dental Association 69, 221–226.
- Castillo, J. L., Rivera, S., Aparicio, T., Lazo, R., Aw, T. C., Mancl, L. L. & Milgrom, P. (2011) The short-term effects of diammine silver fluoride on tooth sensitivity: a randomized controlled trial. Journal of Dental Research 90, 203–208.
- Corona, S. A., Nascimento, T. N., Catirse, A. B., Lizarelli, R. F., Dinelli, W. & Palma-Dibb, R. G. (2003) Clinical evaluation of low-level laser therapy and fluoride varnish for treating cervical dentinal hypersensitivity. Journal of Oral Rehabilitation 30, 1183–1189.
- Cunha-Cruz, J., Stout, J. R., Heaton, L. J. & Wataha, J. C. (2011) Dentin hypersensitivity and oxalates: a systematic review. Journal of Dental Research 90, 304–310.
- Dababneh, R. H., Khouri, A. T. & Addy, M. (1999) Dentine hypersensitivity – an enigma? A review of terminology, mechanisms, aetiology and management British Dental Journal 187, 606–611; discussion 603.
- Dilsiz, A., Aydin, T., Canakci, V. & Gungormus, M. (2010a) Clinical evaluation of Er:YAG, Nd:YAG, and diode laser therapy for desensitization of teeth with gingival recession. Photomedicine and Laser Surgery 28(Suppl. 2), S11–S17.
- Dilsiz, A., Aydin, T. & Emrem, G. (2010b) Effects of the combined desensitizing dentifrice and diode laser therapy in the treatment of desensitization of teeth with gingival recession. Photomedicine and Laser Surgery 28(Suppl. 2), S69–S74.
- Dilsiz, A., Canakci, V., Ozdemir, A. & Kaya, Y. (2009) Clinical evaluation of Nd:YAG and 685-nm diode laser therapy for desensitization of teeth with gingival recession. Photomedicine and Laser Surgery 27, 843–848.
- Dondi dall'Orologio, G. & Malferrari, S. (1993) Desensitizing effects of Gluma and Gluma 2000 on hypersensitive dentin. American Journal of Dentistry 6, 283–286.
- Dunne, S. M. & Hannington-Kiff, J. G. (1993) The use of topical guanethidine in the relief of dentine hypersensitivity: a controlled study. Pain 54, 165–168.
- Duran, I. & Sengun, A. (2004) The long-term effectiveness of five current desensitizing products on cervical dentine sensitivity. Journal of Oral Rehabilitation 31, 351–356.
- Eitner, S., Bittner, C., Wichmann, M., Nickenig, H. J. & Sokol, B. (2010) Comparison of conventional therapies for dentin hypersensitivity versus medical hypnosis. International Journal of Clinical and Experimental Hypnosis 58, 457–475.
- Erdemir, U., Yildiz, E., Kilic, I., Yucel, T. & Ozel, S. (2010) The efficacy of three desensitizing agents used to treat dentin hypersensitivity. Journal of the American Dental Association 141, 285–296.
- Fiocchi, M. F., Moretti, A. J., Powers, J. M. & Rives, T. (2007) Treatment of root sensitivity after periodontal therapy. American Journal of Dentistry 20, 217–220.
- Frechoso, S. C., Menendez, M., Guisasola, C., Arregui, I., Tejerina, J. M. & Sicilia, A. (2003) Evaluation of the efficacy of two potassium nitrate bioadhesive gels (5% and 10%) in the treatment of dentine hypersensitivity. A randomised clinical trial. Journal of Clinical Periodontology 30, 315–320.
- Gentile, L. C. & Greghi, S. L. (2004) Clinical evaluation of dentin hypersensitivity treatment with the low intensity Gallium-Aluminum-Arsenide laser – AsGaAl. Journal of Applied Oral Science 12, 267–272.
- Gerschman, J. A., Ruben, J. & Gebart-Eaglemont, J. (1994) Low level laser therapy for dentinal tooth hypersensitivity. Australian Dental Journal 39, 353–357.
- Gillam, D. G., Newman, H. N., Davies, E. H., Bulman, J. S., Troullos, E. S. & Curro, F. A. (2004) Clinical evaluation of ferric oxalate in relieving dentine hypersensitivity. Journal of Oral Rehabilitation 31, 245–250.
- Glass, G. V. (1976) Primary, secondary, and meta-analysis of research. Educational Researcher 5, 3–8.
10.3102/0013189X005010003 Google Scholar
- Grossman, L. I. (1935) A systematic method for the treatment of hypersensitive dentin. Journal of American Dental Association 22, 11.
- Hamlin, D., Williams, K. P., Delgado, E., Zhang, Y. P., Devizio, W. & Mateo, L. R. (2009) 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. American Journal of Dentistry 22(Spec No A), 16A–20A.
- He, S., Wang, Y., Li, X. & Hu, D. (2011) Effectiveness of laser therapy and topical desensitising agents in treating dentine hypersensitivity: a systematic review. Journal of Oral Rehabilitation 38, 348–358.
- Hoaglin, D. C., Hawkins, N., Jansen, J. P., Scott, D. A., Itzler, R., Cappelleri, J. C., Boersma, C., Thompson, D., Larholt, K. M., Diaz, M. & Barrett, A. (2011) Conducting indirect-treatment-comparison and network-meta-analysis studies: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 2. Value Health 14, 429–437.
- Holland, G. R., Narhi, M. N., Addy, M., Gangarosa, L. & Orchardson, R. (1997) Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. Journal of Clinical Periodontology 24, 808–813.
- Ide, M., Morel, A. D., Wilson, R. F. & Ashley, F. P. (1998) The role of a dentine-bonding agent in reducing cervical dentine sensitivity. Journal of Clinical Periodontology 25, 286–290.
- Ipci, S. D., Cakar, G., Kuru, B. & Yilmaz, S. (2009) Clinical evaluation of lasers and sodium fluoride gel in the treatment of dentine hypersensitivity. Photomedicine and Laser Surgery 27, 85–91.
- Ishihata, H., Kanehira, M., Finger, W. J., Shimauchi, H. & Komatsu, M. (2012) Effects of applying glutaraldehyde-containing desensitizer formulations on reducing dentin permeability. Journal of Dental Sciences 7, 105–110.
- Jalali, Y. & Lindh, L. (2010) A randomized prospective clinical evaluation of two desensitizing agents on cervical dentine sensitivity. A pilot study. Swedish Dental Journal 34, 79–86.
- Jansen, J. P., Fleurence, R., Devine, B., Itzler, R., Barrett, A., Hawkins, N., Lee, K., Boersma, C., Annemans, L. & Cappelleri, J. C. (2011) Interpreting indirect treatment comparisons and network meta-analysis for health-care decision making: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 1. Value Health 14, 417–428.
- Kakaboura, A., Rahiotis, C., Thomaidis, S. & Doukoudakis, S. (2005) Clinical effectiveness of two agents on the treatment of tooth cervical hypersensitivity. American Journal of Dentistry 18, 291–295.
- Kara, C. & Orbak, R. (2009) Comparative evaluation of Nd:YAG laser and fluoride varnish for the treatment of dentinal hypersensitivity. Journal of Endodontics 35, 971–974.
- Kielbassa, A. M., Attin, T., Hellwig, E. & Schade-Brittinger, C. (1997) In vivo study on the effectiveness of a lacquer containing CaF2/NaF in treating dentine hypersensitivity. Clinical Oral Investigations 1, 95–99.
- Launay, Y., Mordon, S., Cornil, A., Brunetaud, J. M. & Moschetto, Y. (1987) Thermal effects of lasers on dental tissues. Lasers in Surgery and Medicine 7, 473–477.
- Lier, B. B., Rosing, C. K., Aass, A. M. & Gjermo, P. (2002) Treatment of dentin hypersensitivity by Nd:YAG laser. Journal of Clinical Periodontology 29, 501–506.
- Liu, H. C., Lan, W. H. & Hsieh, C. C. (1998) Prevalence and distribution of cervical dentin hypersensitivity in a population in Taipei, Taiwan. Journal of Endodontics 24, 45–47.
- Marsilio, A. L., Rodrigues, J. R. & Borges, A. B. (2003) Effect of the clinical application of the GaAlAs laser in the treatment of dentine hypersensitivity. Journal of Clinical Laser Medicine and Surgery 21, 291–296.
- McBride, M. A., Gilpatrick, R. O. & Fowler, W. L. (1991) The effectiveness of sodium fluoride iontophoresis in patients with sensitive teeth. Quintessence International 22, 637–640.
- Merika, K., Heftitarthur, F. & Preshaw, P. M. (2006) Comparison of two topical treatments for dentine sensitivity. The European Journal of Prosthodontics and Restorative Dentistry 14, 38–41.
- Morris, M. F., Davis, R. D. & Richardson, B. W. (1999) Clinical efficacy of two dentin desensitizing agents. American Journal of Dentistry 12, 72–76.
- Olusile, A. O., Bamise, C. T., Oginni, A. O. & Dosumu, O. O. (2008) Short-term clinical evaluation of four desensitizing agents. Journal of Contemporary Dental Practice 9, 22–29.
- Orchardson, R. & Collins, W. J. (1987) Clinical features of hypersensitive teeth. British Dental Journal 162, 253–256.
- Orchardson, R. & Gillam, D. G. (2006) Managing dentin hypersensitivity. Journal of the American Dental Association 137, 990–998; quiz 1028–1029.
- Orhan, K., Aksoy, U., Can-Karabulut, D. C. & Kalender, A. (2011) Low-level laser therapy of dentin hypersensitivity: a short-term clinical trial. Lasers in Medical Science 26, 591–598.
- Orsini, G., Procaccini, M., Manzoli, L., Giuliodori, F., Lorenzini, A. & Putignano, A. (2010) A double-blind randomized-controlled trial comparing the desensitizing efficacy of a new dentifrice containing carbonate/hydroxyapatite nanocrystals and a sodium fluoride/potassium nitrate dentifrice. Journal of Clinical Periodontology 37, 510–517.
- Ozen, T., Orhan, K., Avsever, H., Tunca, Y. M., Ulker, A. E. & Akyol, M. (2009) Dentin hypersensitivity: a randomized clinical comparison of three different agents in a short-term treatment period. Operative Dentistry 34, 392–398.
- Pamir, T., Ozyazici, M., Baloglu, E. & Onal, B. (2005) The efficacy of three desensitizing agents in treatment of dentine hypersensitivity. Journal of Clinical Pharmacy and Therapeutics 30, 73–76.
- Polderman, R. N. & Frencken, J. E. (2007) Comparison between effectiveness of a low-viscosity glass ionomer and a resin-based glutaraldehyde containing primer in treating dentine hypersensitivity–a 25.2-month evaluation. Journal of Dentistry 35, 144–149.
- Porto, I. C., Andrade, A. K. & Montes, M. A. (2009) Diagnosis and treatment of dentinal hypersensitivity. Journal of Oral Science 51, 323–332.
- Poulsen, S., Errboe, M., Lescay Mevil, Y. & Glenny, A. M. (2006) Potassium containing toothpastes for dentine hypersensitivity. Cochrane Database Systematic Review 3, CD001476.
- Prati, C., Cervellati, F., Sanasi, V. & Montebugnoli, L. (2001) Treatment of cervical dentin hypersensitivity with resin adhesives: 4-week evaluation. American Journal of Dentistry 14, 378–382.
- Que, K., Ruan, J., Fan, X., Liang, X. & Hu, D. (2010) A multi-centre and cross-sectional study of dentine hypersensitivity in China. Journal of Clinical Periodontology 37, 631–637.
- Rees, J. S. & Addy, M. (2004) A cross-sectional study of buccal cervical sensitivity in UK general dental practice and a summary review of prevalence studies. International Journal of Dental Hygiene 2, 64–69.
- Rees, J. S., Jin, L. J., Lam, S., Kudanowska, I. & Vowles, R. (2003) The prevalence of dentine hypersensitivity in a hospital clinic population in Hong Kong. Journal of Dentistry 31, 453–461.
- Ritter, A. V., De, L. D. W., Miguez, P., Caplan, D. J. & Swift, E. J. Jr (2006) Treating cervical dentin hypersensitivity with fluoride varnish: a randomized clinical study. Journal of the American Dental Association 137, 1013.1020; quiz 1029.
- Schiff, T., Delgado, E., Zhang, Y. P., Cummins, D., Devizio, W. & Mateo, L. R. (2009) 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. American Journal of Dentistry 22(Spec No A), 8A–15A.
- Schwarz, F., Aoki, A., Becker, J. & Sculean, A. (2008) Laser application in non-surgical periodontal therapy: a systematic review. Journal of Clinical Periodontology 35, 29–44.
- Schwarz, F., Arweiler, N., Georg, T. & Reich, E. (2002) Desensitizing effects of an Er:YAG laser on hypersensitive dentine. Journal of Clinical Periodontology 29, 211–215.
- Scott, J. & Huskisson, E. C. (1976) Graphic representation of pain. Pain 2, 175–184.
- Sethna, G. D., Prabhuji, M. L. & Karthikeyan, B. V. (2011) Comparison of two different forms of varnishes in the treatment of dentine hypersensitivity: a subject-blind randomised clinical study. Oral Health & Preventive Dentistry 9, 143–150.
- Sgolastra, F., Petrucci, A., Gatto, R. & Monaco, A. (2011) Effectiveness of laser in dentinal hypersensitivity treatment: a systematic review. Journal of Endodontics 37, 297–303.
- Shen, S. Y., Tsai, C. H., Yang, L. C. & Chang, Y. C. (2009) Clinical efficacy of toothpaste containing potassium citrate in treating dentin hypersensitivity. Journal of Dental Sciences 4, 173–177.
- Shetty, S., Kohad, R. & Yeltiwar, R. (2010) Hydroxyapatite as an in-office agent for tooth hypersensitivity: a clinical and scanning electron microscopic study. Journal of Periodontology 81, 1781–1789.
- Sicilia, A., Cuesta-Frechoso, S., Suarez, A., Angulo, J., Pordomingo, A. & De Juan, P. (2009) Immediate efficacy of diode laser application in the treatment of dentine hypersensitivity in periodontal maintenance patients: a randomized clinical trial. Journal of Clinical Periodontology 36, 650–660.
- Singal, P., Gupta, R. & Pandit, N. (2005) Two percent sodium fluoride-iontophoresis compared to a commercially available desensitizing agent. Journal of Periodontology 76, 351–357.
- Sowinski, J., Ayad, F., Petrone, M., Devizio, W., Volpe, A., Ellwood, R. & Davies, R. (2001) Comparative investigations of the desensitising efficacy of a new dentifrice. Journal of Clinical Periodontology 28, 1032–1036.
- Taani, S. D. & Awartani, F. (2002) Clinical evaluation of cervical dentin sensitivity (CDS) in patients attending general dental clinics (GDC) and periodontal specialty clinics (PSC). Journal of Clinical Periodontology 29, 118–122.
- Tarbet, W. J., Silverman, G., Stolman, J. M. & Fratarcangelo, P. A. (1979) An evaluation of two methods for the quantitation of dentinal hypersensitivity. Journal of the American Dental Association 98, 914–918.
- Tengrungsun, T. & Sangkla, W. (2008) Comparative study in desensitizing efficacy using the GaAlAs laser and dentin bonding agent. Journal of Dentistry 36, 392–395.
- Tu, Y. K., Baelum, V. & Gilthorpe, M. S. (2005) The problem of analysing the relationship between change and initial value in oral health research. European Journal of Oral Sciences 113, 271–278.
- Tu, Y. K., Needleman, I., Chambrone, L., LU, H. K. & Faggion, C. M. Jr (2012) A bayesian network meta-analysis on comparisons of enamel matrix derivatives, guided tissue regeneration and their combination therapies. Journal of Clinical Periodontology 39, 303–14.
- Tu, Y. K., Woolston, A. & Faggion, C. M. Jr (2010) Do bone grafts or barrier membranes provide additional treatment effects for infrabony lesions treated with enamel matrix derivatives? A network meta-analysis of randomized-controlled trials. Journal of Clinical Periodontology 37, 59–79.
- Vieira, A. H., Passos, V. F., De Assis, J. S., Mendonca, J. S. & Santiago, S. L. (2009) Clinical evaluation of a 3% potassium oxalate gel and a GaAlAs laser for the treatment of dentinal hypersensitivity. Photomedicine and Laser Surgery 27, 807–812.
- West, N. X. (2008) Dentine hypersensitivity: preventive and therapeutic approaches to treatment. Periodontology 2000 48, 31–41.
- Yates, R., Owens, J., Jackson, R., Newcombe, R. G. & Addy, M. (1998) A split-mouth placebo-controlled study to determine the effect of amorphous calcium phosphate in the treatment of dentine hypersensitivity. Journal of Clinical Periodontology 25, 687–692.
- Yilmaz, H. G., Cengiz, E., Kurtulmus-Yilmaz, S. & Leblebicioglu, B. (2011a) Effectiveness of Er,Cr:YSGG laser on dentine hypersensitivity: a controlled clinical trial. Journal of Clinical Periodontology 38, 341–346.
- Yilmaz, H. G., Kurtulmus-Yilmaz, S. & Cengiz, E. (2011b) Long-term effect of diode laser irradiation compared to sodium fluoride varnish in the treatment of dentine hypersensitivity in periodontal maintenance patients: a randomized controlled clinical study. Photomedicine and Laser Surgery 29, 721–725.
- Yilmaz, H. G., Kurtulmus-Yilmaz, S., Cengiz, E., Bayindir, H. & Aykac, Y. (2011c) Clinical evaluation of Er,Cr:YSGG and GaAlAs laser therapy for treating dentine hypersensitivity: A randomized controlled clinical trial. Journal of Dentistry 39, 249–254.
- Zantner, C., Popescu, O., Martus, P. & Kielbassa, A. M. (2006) Randomized clinical study on the efficacy of a new lacquer for dentine hypersensitivity. Schweizer Monatsschrift fur Zahnmedizin 116, 1232–1237.
- Zhang, D. (2003) Clinical study on primer and sealer on different position to treat dentin hypersensitiveness. Acta Academiae Medicinae Wannan 22, 53–55.