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Dentine hypersensitivity: New perspectives on an old problem

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Abstract

Dentine hypersensitivity is a prevalent, painful condition of the teeth. Despite the fact that the accuracy of the terminology is questionable and other terms have been proposed, 'dentine hypersensitivity' has been in long-term use and is, therefore, the preferred term. In dentine hypersensitiv-ity, lesions exhibit patent tubules at the exposed dentine surface and appropriate stimuli trigger pulpal nerves via a hydrodynamic mechanorecep-tor mechanism to produce a typically short, sharp, painful response. This accepted definition of the condition indicates the need to consider a differential diagnosis. This review will consider evidence that dentine hyper-sensitivity is a tooth-wear phenomenon characterised predominantly by erosion, which both exposes dentine and, more importantly, initiates the lesions. Abrasion caused by brushing teeth with toothpaste appears to be a secondary aggravating factor, which may even act in synergy with erosion. Gingival recession probably accounts for most dentine exposure at the gingival margin, but the process is poorly understood. Management strate-gies, which take into account aetiological and predisposing factors, rather than treatment alone, should be considered. There is little clinical research on many aspects of the aetiology and particularly on the management of the condition. In 1982, dentine hypersensitivity was described as an enigma, because it was frequently encountered yet poorly understood 1 . Some 20 years later, it is worthwhile reconsidering the statement, as the title of a recent article seems to suggest 2 . This review will discuss the terminology, definition, epidemiology, mecha-nisms, anatomy, aetiology and management of the condition. It is hoped that it will demonstrate that, although dentine hypersensitivity is not the enigma it once was, there is still much to be discovered about the condition, its prevention and its management.

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... 5,46 When the ages of the patients in this study were analyzed, the mean age of the participants was 39.5-42.6 years in these groups, in accordance with the literature. 60 Similar to other studies, 46,61,62 our sample size contained more female than male subjects. Although women reported higher DH than was reported by men in these studies, 46,[61][62][63][64] other studies have shown higher DH levels in the male population. ...
... In addition, DH is observed mostly in the buccal cervical margins of canine and premolar teeth. 60 Canine and premolar teeth are the most frequently brushed and are thus the most exposed to the abrasives in toothpastes. 6,67,68 Moreover, it has been shown in clinical trials that brushing teeth aggressively and improperly increases gingival recession. ...
... The incisors are the next most commonly affected after the canines and premolars. 60 In this study, subjects complained of DH in canines, premolars, and incisors (Table 3). ...
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Objective: The aim of this study was to evaluate the clinical efficacy of widely used dentindesensitizing agents (DDAs) (Teethmate Desensitizer, Clinpro White Varnish, Shield Force Plus, and Gluma) in the treatment of dentin hypersensitivity (DH) according to different evaluation parameters over a four-week follow-up period.Methods and Materials: This study was a randomized, single-center, controlled, parallel group study involving 144 teeth in 40 subjects. The baseline DH levels of the subjects were determined using different evaluation parameters. Daily life hypersensitivity and evaporative air stimulus hypersensitivity scores were recorded using a visual analog scale (VAS), and tactile hypersensitivity scores were recorded using a Yeaple probe and measured in grams and on the VAS. Subjects who experienced evaporative air stimulus DH (30-80 mm on the VAS) and tactile hypersensitivity (10-50 g with the Yeaple probe) were included in the study. After application of the DDAs, these evaluation parameters were recorded throughout the follow-up period (immediately after application and at one day and two and four weeks post-application).Results: All four DDAs demonstrated clinical dentin-desensitizing effects throughout the follow-up period according to evaporative air hypersensitivity, tactile sensitivity (g-VAS), and daily life hypersensitivity scores (p<0.05). Only Clinpro White Varnish had tactile sensitivity (g) scores that were similar at baseline and the one-day follow-up (p>0.05). A comparison of DH-reducing effects among the DDAs revealed that they yielded different results immediately after application and at the one-day follow-up time point, depending on which evaluation parameter was used. However, all DDAs showed similar DH-reducing effects at the two- and four-week follow-up time points.Conclusions: Teethmate Desensitizer, Clinpro White Varnish, Shield Force Plus, and Gluma DH showed clinical efficacy for four weeks. DDAs may produce inconsistent clinical evaluation scores not only across different evaluation parameters but also between early and later follow-up time points.
... Patients with hypersensitivity experience short-term acute pain in response to thermal, mechanical, osmotic, or chemical stimuli or dehydration of dentin [5], lasting until the moment the stimulus is discontinued [6]. The most common factor causing pain is cold (about 75% of respondents) [3,5]. ...
... The most common factor causing pain is cold (about 75% of respondents) [3,5]. The main cause of this type of pain, which cannot be attributed to any other dental pathology, is open dentinal tubules [3,[6][7][8]. ...
... We offer a growing number of preparations relieving hypersensitivity, characterized by various levels of effectiveness and mechanisms of action. Most methods of treatment used in dentists' offices and at home by the patient function by closing the dentinal tubules and reducing the flow of dentinal tubular fluid [6,10]. Available chemical and physical agents induce a smear layer or block the dentinal tubules. ...
Article
Introduction: Dentin hypersensitivity is a painful clinical condition. The frequency of its occurrence varies from 8 to 57%, depending on tested group and different methods of investigations. Recommended desensitizing agents have different mechanism of action and effectiveness. We are still looking for solutions that will improve their effectiveness and simultaneously allow for wider use of e.g. as a base material, counteracting postoperative hypersensitivity, reducing marginal microleakage. The aim of the study was to assess the effect of a selected desensitizing agent occluding dentin tubules with calcium hydroxyapatite on marginal microleakage formation of a class V composite restorations subjected to thermocycles. Materials and methods: In study it was used 40 molars and premolars, which were alternately assigned into two groups. In both groups standardized cavities were prepared. In the study group (study group - SG) before application of bonding agent Teethmate Desensitizer (f. Kuraray, Noritake Dental Inc., Okayama, Japan) was used. In the control group (control group - CG) OptiBond All-in-one (f. Kerr, Bioggio, Switzerland) bonding agent was used and cavities were filled using composite material Gradia Direct (f. GC Europe N.V., Leuven, Belgium). After storage in saline, teeth were subjected to 600 thermocycles, passive dye penetration test was done, teeth were cut in the area of filling, according to its long axis. Under light microscope magnification value of microleakage was measured and marginal microleakage rate (M) was counted. The results of the tests were statistically analyzed using the package STATISTICA 12.0 (StatSoft, USA). Results: The average value of M for the SG group was 0.46 (min 0.05, max 0.76, SD 0.226) and for CG was 0.22 (min 0, max 0.74, SD 0.235). The differences between M values were statistically significant (p = 0.0094). Conclusion: A reduction in the number of retention sites for the bonding system, facilitates the formation of microleakage in the experimental conditions and reduces the degree of adhesion of the composite material to the hard tissues of the tooth.
... from improper tooth brushing or periodontal disease progression and its treatment (Addy, 2002;Canadian Advisory Board on Dentin Hypersensitivity, 2003;Markowitz & Pashley, 2008). Dentin hypersensitivity is a common complaint of individuals seeking dental treatment with a clinical prevalence ranging from 3%-57% (Addy, 2002;Cummins, 2010), whereas, the prevalence rises, ranging from 62.5%-90%, following non-surgical periodontal therapy (Lin & Gillam, 2012). ...
... from improper tooth brushing or periodontal disease progression and its treatment (Addy, 2002;Canadian Advisory Board on Dentin Hypersensitivity, 2003;Markowitz & Pashley, 2008). Dentin hypersensitivity is a common complaint of individuals seeking dental treatment with a clinical prevalence ranging from 3%-57% (Addy, 2002;Cummins, 2010), whereas, the prevalence rises, ranging from 62.5%-90%, following non-surgical periodontal therapy (Lin & Gillam, 2012). ...
... The hydrodynamic theory (Brännström, 1966) suggests that dentin hypersensitivity is caused by the outward flow of dentinal fluid in exposed tubules that subsequently activates intra-pulpal nerve fibers (Addy, 2002;West, 2006). The greater number and wider diameter of open dentinal tubules observed in hypersensitive teeth suggest the possibility of elevated fluid flow that in turn increases dentin hypersensitivity (Absi et al., 1987(Absi et al., , 1989. ...
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Objectives To compare the efficacy of calcium sodium phosphosilicate (CSPS) and arginine dentifrices on dentin permeability and acid tolerance. Material and Methods Sixty dentin discs were randomly assigned into 3 groups, then brushed for 1 min with CSPS, arginine, or fluoride (control) dentifrices. To test acid tolerance, each disc was soaked in 6% citric acid for 1 min. Dentin permeability was measured before, following brushing, and acid challenge. Ten discs per group were similarly treated and evaluated for tubule occlusion following a single dentifrice application, while other five discs per group were employed in an acid tolerance assay. Results The percentage reduction in dentin permeability was 39.26%, 32.27%, and 21.71% in the arginine, CSPS, and control groups, respectively. The differences in dentin permeability reduction between the arginine and CSPS groups following brushing and acid challenge were not significant (p = 0.398 and p = 0.211, respectively). The arginine dentifrice demonstrated a significant reduction in permeability compared with the control (p = 0.011). In addition, the occlusion exhibited by the arginine and CSPS dentifrices was more resistant to acid challenge compared with that of the control (p < 0.001). From SEM analysis, dentinal tubule occlusion was observed after a single application in all groups. Some open dentinal tubules were detected in the test groups, while almost all of the orifices were open in the fluoride group following acid challenge. Conclusions There is no significant difference between arginine and CSPS dentifrices in reducing dentin permeability following a single application and acid challenge. Following acid challenge, the reduced permeability generated by arginine and CSPS was more stable compared with the fluoride dentifrice.
... Studies conducted on periodontal patients show figures in the range of 72-98%. 3 Various causes have been attributed to DH including occlusal wear and tear, aggressive toothbrushing leading to abrasion, parafunctional habits like bruxism, erosion from acidic beverages, and exposure of root surfaces due to gingival recession. 4 Many theories have been proposed to explain the sensitivity of dentin. ...
... Therefore, dentinal hypersensitivity depends on the presence of open dentinal tubules and a vital pulp, although it is still unclear how flow of fluid in the dentinal tubules stimulates the nerve endings. 3 Studies show the presence of a greater number and wider tubules on hypersensitive dentin compared to normal dentin. The difference in diameter may be the more important factor since the dynamic fluid flow in the tubules is proportional to the radius. ...
... This plays an important role in the therapeutic strategies. 3 The primary aim of managing DH is the control of pain and discomfort. This can be achieved by two means: Occluding the open dentinal tubules or interfering with the nerve impulse transmission. ...
... Patients often experience transient mild to moderate Root Sensitivity (RS) following non-surgical periodontal therapy which subside or disappear within the subsequent weeks. The term root sensitivity or root-dentine hypersensitivity was suggested by the European Federation of Periodontology to describe sensitivity arising from periodontal disease and its treatment (1). gILLAM & ORCHARDSON (2) postulated that the sensitivity following periodontal therapy is a distinct condition from that of dentine hypersensitivity (DH) occurring after hydrodynamic stimulation. ...
... In this study, the incidence of post scaling RS was higher in females (58.8%) than male. This, however, was not statistically significant though females have been reported to be more proned to hypersensitivity than men (1,9). It has been hypothesized that this is because females seek dental services more frequently and perform more extensive home oral hygiene care in comparison to males (9). ...
Article
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Aim: Patients often experience transient mild to moderate Root Sensitivity (RS) following scaling and root planing which subside or disappear within the subsequent weeks. However, there is a dearth of data on the incidence and intensity of post-scaling root hypersensitivity in our environment. This study investigated the incidence of RS among patients requiring non-surgical periodontal treatment. Materials and methods: Eighty patients requiring non-surgical periodontal treatment at the perio-dontal clinic of University of Port Harcourt Teaching Hospital were recruited for this study. Data were collected through self administered questionnaire after which oral hygiene instruction followed by supra-and subgingival scaling/root planing by hand and ultrasonic instrumentation was done. Post-scaling pain intensity was graded by the patient on a 0-10 Visual Analogue Scale (VAS). Results: Participants age ranged from 17 to 82 years with a mean age of 39.9 ± 16.5 years and a male 39(48.7%) to female 41(51.3%) ratio of 1:1.1. The incidence of post-scaling root sensitivity was 21.3% (17/80) with a mean VAS of 4.7±1.9. Most of the patients with post scaling RS (70.6%, 12/17) were within 21-50 years age bracket and 76.5% (13/17) have tertiary level of education. Post scaling RS was higher in females (58.8%) than males (41.2%). However, there were no significant differences with age, gender, level of education, occupation and oral hygiene practices. Conclusion: In this study, the incidence of post scaling root sensitivity was 21.3% with moderate intensity and it was more frequent in the young and middle age group. We recommend that patients should be made aware of the potential for root sensitivity prior to periodontal treatment.
... The activation of intrapulp nerve fibres is thought to result from the displacement of the content of dentinal tubules following a mechanical, thermal or osmotic stimulus [5][6][7]. Two conditions need to be met for this to occur: the dentin has to be exposed and the dentin tubular system has to be open so as to allow the release of a neural response in the pulp through the fluid movement [7,8]. The dentin tubule could be exposed by multifactorial interactions including erosion, abrasion, saliva, and biofilm/pellicle/plaque, all of which influence whether demineralization occurs or not [7]. ...
... Symptoms of DH can sometimes resemble those of other painful oral diseases and diagnosis is mainly based on a search for predisposing factors, the identification of wear lesions and the elimination of other dental diseases such as caries or periodontal diseases [1,8]. DH may affect the quality of life. ...
Article
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Background: As far as we know, little data, whether obtained from self-administered questionnaires or upon dental clinical examination, has been published on the prevalence of sensitive teeth (ST) in the French adult population. The objectives of the present work were to estimate ST prevalence and characteristics in the general population of France and to explore the associated factors. Method: A multicentre cross-sectional study was conducted between November 2011 and March 2013 in six French cities. Adult passers-by in public places were invited to answer an electronic questionnaire on a tablet computer. Only people who declared having at least one natural tooth were included in the study. A logistic regression model was used for the multivariate analysis. Results: The prevalence of ST during the previous 12 months reported by the sample of 2413 participants was 42.2% [95% CI: 40.2-44.1%]. The final logistic regression model showed significant statistical associations between ST and female gender, use of tobacco, consumption of soft drinks, limited access to oral care and poor oral hygiene habits (p < 0.05). Conclusions: This study provides prevalence data on ST in a general population in France, which seems to remain high despite the existence of many therapies. It should alert professionals to a clinical manifestation that is becoming increasingly prevalent and that they will have to take into consideration to help reduce the discomfort arising from it.
... Dentine sensitivity (DH) is a common condition that's frequently encountered in dental practice [1,2] DH is universally defined as a short, sharp pain arising from exposed dentine in response to thermal, evaporative, tactile, osmotic, or chemical stimuli which cannot be ascribed to any other form of dental defect, pathology or disease [3]. The definition emphasizes the importance of a differential diagnosis as DH may be confused with that of fractured teeth, carious teeth or marginal leakage of restorations [4]. Previous studies showcase that the majority of patients with DH are usually in the 30-40 years age group [4,5] with the frequency of DH being more in females than in males [6,7]; commonly affecting the incisors and premolars [8][9][10][11][12][13] and to some extent the first molars on the buccal aspect of the cervical area [8,10,14]. ...
... The definition emphasizes the importance of a differential diagnosis as DH may be confused with that of fractured teeth, carious teeth or marginal leakage of restorations [4]. Previous studies showcase that the majority of patients with DH are usually in the 30-40 years age group [4,5] with the frequency of DH being more in females than in males [6,7]; commonly affecting the incisors and premolars [8][9][10][11][12][13] and to some extent the first molars on the buccal aspect of the cervical area [8,10,14]. Personal behavioral habits including consumption of highly acidic drinks or food; overzealous dental hygiene and previous dental procedures such as periodontal therapy have been found to be associated with DH [15]. ...
... The conditions share a number of aetiology and prevention strategies. DH has been defined as a short, sharp pain arising from exposed dentine in response to stimuli which cannot be ascribed to any other form of dental defect or pathology [1,2]. The reported prevalence of DH varies from 4 to 74 % of the general population [3], and has been reported to be as high as 98 % in periodontal patients [4]. ...
... The reported prevalence of DH varies from 4 to 74 % of the general population [3], and has been reported to be as high as 98 % in periodontal patients [4]. DH occurs most commonly in the cervical areas of canines and first bicuspids on the buccal surfaces [1] where dentine is exposed through either loss of enamel on the crown of the tooth or gingival recession exposing the root [5]. Gingival recession is caused by anatomical, physiological and pathological factors such as traumatic toothbrushing, periodontal diseases and treatment, and smoking [6,7]. ...
Article
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Objectives To compare the effect of bioavailable gluconate-chelated stannous fluoride (SnF2) toothpaste with control toothpastes for treatment of dentine hypersensitivity (DH) and enamel erosion. Data and sources A Procter & Gamble Oral Care archive of clinical studies was reviewed from 2000 to 2020. Eligible studies were Randomised Controlled Trials (RCTs) investigating bioavailable gluconate-chelated SnF2 toothpaste efficacy compared to controls in adult participants measured following tactile (Yeaple force) and/or evaporative stimuli (Schiff score) in-vivo, duration <2 months (DH); or by erosive toothwear (profilometry) from in-situ samples, duration 10-15 days. Two authors independently assessed eligibility and resolved disagreements by discussion. A meta-analysis was undertaken and Risk of Bias (RoB) assessed using the Cochrane collaboration RoB tool for randomized parallel-group and cross-over trials. Results Fourteen RCTs (1287 participants) assessed DH relief and Six RCTs (184 participants) enamel erosion protection. For DH SnF2 toothpastes provided a 57% (evaporative air) and 142% (tactile) benefit versus negative controls (sodium fluoride/monofluorophosphate, 8 studies; p < 0.001). Compared to positive controls (potassium nitrate or arginine, 6 studies), a 22% advantage (p = 0.036) was seen for evaporative air. In erosion studies, SnF2 toothpastes provided an 83% benefit versus control toothpastes (arginine or sodium fluoride; p < 0.001) with a change (95%CI) in average surface profilometry level (µm) of -2.02(-2.85, -1.20). Conclusions The use of these bioavailable SnF2 toothpastes, as part of a daily oral hygiene regimen, will provide patients with enamel erosion protection, combined with alleviation of DH pain when present, improving quality of life.
... През 60-те години на двадесети век Бренстрьом предлага като възможен механизъм "хидродинамичната теория" (5,6). Алтернативи, представени от други автори, са в последствие отхвърлени (4,20). През 80-те години на миналия век е предложен терминът "дентинна свръхчувствителност" (13,18). ...
... Третият механизъм е свързан с локалното понижаване на рН от образуване на киселини. Кариесогенните микроорганизми в зъбната плака, в резултат на метаболитни процеси, акумулират киселини и снижават рН (4,. Най-податливи са шиечните области заради структурната нееднородност и хетерогенност на зъбния емайл там. ...
... Dentin hypersensitivity (DH) [1] also known as dentine sensitivity [2] or cervical sensitivity/hypersensitivity [3] is characterized by "pain derived from exposed dentin in response to chemical, thermal tactile or osmotic stimuli which cannot be explained as arising from any other dental defect or disease" [4]. It has been demonstrated as a common problem in clinical dentistry [5,6] and is likely to become more frequent in the future because of expected increases in longevity of the natural dentition [7]. ...
... Prevalence of affected teeth by DH in this study can be explained by the consumption of abrasive foods unlike in developed countries where most types of foods are processed. Studies have demonstrated that acidic foods and drinks can soften enamel leading to significant tooth wear, particularly when combined with mechanical cleaning [3] and in line with other studies [37] findings from this study report that persons without tooth wear are less likely to have DH. In addition, similar to findings of this study, another study [38] reported that participants without gingival recession are less likely to have DH. ...
... Typically, the pain is short and sharp, and occurs in response to certain stimuli applied to exposed dentin. 1 It is clinically described as an exaggerated response application of a stimulus to exposed dentin, regardless of its location. 2,3 Dentinal hypersensitivity is characterized by short sharp pain arising from exposed dentin in response to stimuli typically thermal, evaporative, tactile, osmotic or chemical and which cannot be ascribed to any other form of dental defect or pathology. ...
... This practice resulted in a significant number of permutations to describe the apparently same condition (Table 1). 1 Despite the existence of these various terms, several authors prefer the term DH, commonly used and accepted for many decades, to describe a specific painful condition of teeth, which is distinct from others types of dentinal pain having different etiologies. ...
Article
Tooth sensitivity is a very common clinical presentation which can cause considerable concern for patients. Dentin hypersensitivity (DH) is characterized by short sharp pain arising from exposed dentin in response to stimuli. The most widely accepted theory of how the pain occurs is Brannstrom's hydrodynamic theory, fluid movement within the dentinal tubules. The condition generally involves the facial surfaces of teeth near the cervical aspect and is very common in premolars and canines. This condition is frequently encountered by dentists, periodontists, hygienists and dental therapists. Some dental professionals lack confidence in treating DH. The management of this condition requires a good understanding of the complexity of the problem, as well as the variety of treatments available. This review considers the etiopathogenesis, incidence, diagnosis, prevention and management of dentinal hypersensitivity. DH is diagnosed after elimination of other possible causes of the pain. Any treatment plan for DH should include identifying and eliminating predisposing etiologic factors. Professionals should appreciate the role causative factors play in localizing and initiating hypersensitive lesions. It is important to identify these factors so that prevention can be included in the treatment plan. Treatments can be self-administered by the patient at home or be applied by a dental professional in the dental office. At-home methods tend to be simple and inexpensive and can treat simultaneously generalized DH affecting many teeth. Desensitizing treatment should be delivered systematically, beginning with prevention and at-home treatments. The latter may be supplemented with in-office modalities.
... This gives nHA higher functional properties such as high bioactivity, osteoconductivity and crystallanity. There is an increase in the surface area and better ingress of the ions into tubules leading to better occlusion [28]. ...
Article
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Background and aim: Dentinal hypersensitivity is a significant clinical problem encountered in daily dental practice. The management of this condition requires a good understanding of the complexity of the problem, as well as the variety of treatments currently available. The treatment approaches can be either home care products or professionally applied desensitizing agents. The present in-vitro study was designed to investigate the dentinal tubule occluding ability of commercially available nano HA containing mouthwash using FESEM analysis. Methods: In the present in vitro study, 15 human premolars and canines were taken and sectioned mesiodistally. A total of 30 dentinal samples were obtained. All the dentinal discs were etched with 6% citric acid for 2 minutes. The treated samples were washed thoroughly with distilled water for 30 seconds. Samples were divided in two groups of 15 each. The specimens in Group I were shaken vigorously in the Vitis Sensitive mouthwash for 2 min twice daily for 14 days. After this intervention samples were placed in distilled water. Group II specimens were immersed in distilled water. Samples were subjected to FESEM to analyze for tubular occlusion. Results: In group I nearly complete dentinal surface occlusion was present on the 7th and 14th day and precipitates were seen covering a large part of the dentinal surface. In group II no dentinal tubular occlusion was observed. Conclusion: The results of the present study support the ability of nHA containing Vitis sensitive mouthwash to occlude the dentinal tubules and thus it may demonstrate a significant reduction in dentinal hypersensitivity when used clinically.
... Hipersensitivitas dentin ditandai sebagai rasa nyeri akibat dentin yang terbuka jika diberikan stimulus termal, taktil, osmotik dan mekanis, seperti menyikat gigi, makan makanan manis dan asam, dan minuman dingin atau panas. Hal ini menyebabkan pasien merasa nyeri tajam yang singkat yang dikenal dengan hipersensitivitas dentin dan tidak berasal dari kelainan atau patologi gigi (Addy, 2002). Prevalensi hipersensitivitas dentinbervariasi dari terendah 4,5 % sampai tertinggi 57 %. ...
Article
Background : Dentinal hypersensitivity (DH) is a painful clinical condition and is characterized by pain arising from exposed dentin in response to various stimuli. Various treatment modalities are available to treat dentinal hypersensitivity which include at-home and in-office treatment. At home treatment generally consists of a variety of dentrifices containing different constituents like strontium chloride and bioactive glass (Novamin). These agents cause occlusion of dentinal tubules thereby reducing hypersensitivity.Purpose: This study was to evaluate the effects of different desensitizing dentifrices on dentinal tubule occlusion by scanning electron microscopy (SEM) of strontium chloride and bioactive glass (Novamin) pastes in the treatment of dentinehypersensitivity (DH) Methods: sixteen extractedspecimens from bovine incisors teeth with randomized into 2 groups (n=8). The crowns were removed from the root and the crown were sectioned longitudinally into two parts (in a mesiodistaldirection). The cervical toothwere resulting in two samples per tooth.Dentinal tubules were exposedand thesamples provided a 4 mm x 4 mm area of exposed dentinal tubules.Group 1 (treated with strontium chloride), Group 2 (treated with bioactive glass (novamin))After each treatment for seven days, tubule occlusion on dentin were analyzed by scanning electron microscopy (SEM).The data were analyzed using “mann-whitneytest” (p<0.05).Result: Groups bioactive glass (novamin) showed tubule occlusion highest when compared with groups strontium chloride.Conclusion: bioactive glass (novamin) paste showed tubule occlusion highest with strontium chloride
... Several teeth in one area of the mouth or only one specific tooth can be affected (Que et al. , Amarasena et al. 2011. Careful diagnosis of such condition necessitates precise differentiation of its signs and symptoms from the other causes of tooth sensitivity, which may be resulted from dental caries, micro leakage, cracked tooth or fractured restoration (Addy 2002). With the innovation and the development of the sciences, the concept of the prevention becomes more important than curing. ...
... In the case of a thermal, a tactile, or a chemical irritation, a fluid flow in the dentine tubules occurs and pulpal pain receptors are stimulated. While more and wider opened dentine tubules are found in hypersensitive teeth, the same is found after periodontal therapy [14]. Our hypothesis was that dentine-hypersensitivity mouth-rinses offer a simple solution to enable patients to reduce procedural pain or discomfort during PMPR. ...
Article
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Objectives Pain is affecting acceptance of supportive periodontal therapy and primary periodontitis prevention. Our objective was to evaluate the efficacy of a 1-week pre-treatment use of dentinal-hypersensitivity-reducing mouth-rinses (DHM) in periodontal maintenance (SPT) or dental prophylaxis patients. Material and methods One hundred fifty-five participants attending for professional mechanical plaque removal (PMPR) were randomly assigned to use a mouth-rinse twice daily for 1 week prior to their next PMPR. Rinses were containing either potassium oxalate (n = 52), arginine (n = 52), or herbal extracts (n = 51). At baseline and reassessment, procedural pain was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). Self-reported efficacy was documented. Results No inter-group differences were estimated between both test groups and the control for baseline and reassessment means (VAS, VRS). In the SPT group, VAS reduction and self-reported efficacy were found (p < 0.05). Conclusion The 1-week use of DHM failed to show a predictable effect on discomfort during PMPR overall. Around 20% of the patients showed a quantifiable benefit from both test mouth-rinses, whereas more than 50% reported a subjective pain reduction. Focusing patients undergoing supportive periodontal therapy, quantifiable effects were found for both test groups. From a patient’s point of view, DHM might be a suitable adjunct to enhance procedural comfort, especially in patients with a history of periodontitis. Clinical relevance The 1-week use of the dentinal-hypersensitivity-reducing mouth-rinses prior to professional-mechanical-plaque-removal showed to be a suitable adjunct to enhance procedural comfort during instrumentation, especially in patients undergoing supportive periodontal therapy. Registration number: DRKS00010811
... Dentinal hypersensitivity is a significant dental health problem, characterized by short, sharp, pain arising from exposed dentine in response to stimuli typically thermal, evaporative, tactile, osmotic, or chemical which cannot be ascribed to any other form of dental defect or pathology. [1][2][3] Dentinal hypersensitivity being an episodic pain condition, is likely to become a more frequent dental complaint in the future due to the increase in longevity of the dentition and the rise in tooth wear [4] . Dentinal hypersensitivity has multiple causative factors. ...
Article
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Introduction: Toothpaste is a paste or gel dentifrice used with a toothbrush to clean and maintain the aesthetics and health of gingiva and teeth. It serves as an abrasive that aids in removing dental plaque and food from the teeth. In the last decade, many consumers have switched over to herbal toothpastes in order to avoid synthetic and artificial flavors commonly found in regular toothpastes. Aim: To check the correlation of dental hypersensitivity with herbal and non-herbal toothpastes. Methods: The study population of survey consisted of n=83 patients 25-65 years visiting the outpatient, Department of Periodontics, A.B Shetty Memorial Institute of Dental Sciences. Self-administered questionnaire elicited information on systemic and oral health status, type of toothpaste used, duration of use, brushing habits and presence of dentinal hypersensitivity. Results: A total of n=83 patients were investigated, out of which 44.5% used herbal toothpaste while the rest used non-herbal toothpaste. The prevalence of dentinal hypersensitivity was n=22 (26.5%) among the participants and there was no significant correlation found between the herbal toothpaste and dentinal hypersensitivity (p= 0.272). There is no significant difference in usage of herbal toothpaste and non-herbal toothpaste and their duration of use with dentinal sensitivity (p = 0.4380). There is no significant difference between dentinal hypersensitivity and brushing techniques. (p = 0.546). Conclusion: The prevalence of dentinal hypersensitivity was low. This shows that the use of herbal/non-herbal toothpaste does not have significant effect on dental hypersensitivity. It can be concluded that herbal toothpastes and dental hypersensitivity are not correlated.
... According to international studies [1][2][3][4], dentin hypersensitivity (DH) is a complex condition with multi-factorial etiology and high prevalence in all age groups, which may severely affect quality of life [5]. ...
Article
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Dentin hypersensitivity (DH) is a common medical condition with underreported prevalence and it is difficult to quantify. This study aimed to investigate whether assessing dental pulp vascular micro-dynamics by laser-Doppler flowmetry (LDF) would be functional for therapeutic evaluation, in contrast to a verbal rating scale (VRS). A split-mouth single-blind randomized study was conducted on seven patients and a total of 36 teeth. Two DH therapeutic methods were employed: (i) fluoride gel; (ii) Nd:YAG radiation combined with fluoride gel. For each tooth, five consecutive LDF determinations of pulp blood flow were made (before and immediately after desensitizing treatment, then after 24 h, 7 days, and 1 month), and the VRS was applied each time. Spearman’s correlation was applied for concurrent validation. Two-way (treatment and patient) repeated measures ANOVA full factorial was applied, followed by Tukey’s post-hoc comparisons and Pillai’s trace multivariate statistic. While VRS scores had moderate reliability, LDF could objectively estimate treatment effects. Based on partial eta-squared values, treatment and patient characteristics were estimated to explain about 84% and 50% of the variability, respectively. In conclusion, LDF is an objective technique that can quantitatively assess DH evolution, and it is effective in reliably monitoring oral health therapeutic interventions.
... [1][2][3][4] Several therapies including home-and office-applied agents have been prescribed for the treatment of dentinal hypersensitivity, with varying degrees of success. [5][6][7][8][9] Over the past decade, the use of lasers in dentistry has become commonplace. [10][11][12] They have been used alone or in combination with an active desensitizing agent in the treatment of dentinal hypersensitivity. ...
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Context: Several studies have recommended the use of lasers in treatment of dentinal hypersensitivity. These materials have been used alone or in combination with an active desensitizing agent. Aims: The present study aimed to evaluate the use of 1.23% acidulated phosphate fluoride (APF) gel and 810 nm diode laser when used alone and when used together on exposed dentinal tubules. Settings and design: Sixty-one extracted teeth were sectioned with a diamond saw and dentin slices were prepared. They were then treated with 37% orthophosphoric acid to remove the smear layer. Materials and methods: One of the 61 sections was left as an untreated control, whereas the remaining sixty sections were divided into three groups of twenty sections each. The first set of sections (Group 1) was treated with laser alone, whereas the second set (Group 2) was treated with APF alone. A third set of sections (Group 3) was treated with a combination of laser and APF. The sectioned teeth were then evaluated using field emission scanning electron microscopy, and the percentage of dentinal tubule occlusion was observed. Statistical analysis: The Shapiro-Wilk normality test was performed to check for the normal distribution of data, whereas the Kruskal-Wallis test was used to compare the mean percentage of dentinal tubule occlusion between the three groups. The Chi-square test was used to compare the number of images with complete tubular occlusion between the three groups. Results: A total of 96 images were processed from the sixty sectioned samples. It was seen that the sections in Group 3 showed the highest percentage of dentinal tubule occlusion. Group 3 also showed the highest number of samples with complete dentinal tubule occlusion. Significantly lesser levels of dentinal tubule occlusion were seen in Groups 1 and 2. Conclusions: Diode lasers were effective in occluding dentinal tubules. The addition of 1.23% APF significantly increased the efficacy and thoroughness of dentinal tubule occlusion. Significantly lesser levels of dentinal tubule occlusion were seen in the sections treated with laser alone and APF alone.
... females. Our data shows that women are more vulnerable to hypersensitivity of dentine .A hypothesis was given that female visits the dentists more often and follow hygiene instructions more often than males 12,13 . In our study age of the patients ranges from 20-60 years and the average was 37.4 ±8.38 years. ...
Article
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Objective: To compare the mean reduction in pain scores between Bonding agent (GLUMA® Comfort® Bond+ Desensitizer, and Fluoride varnish.
... Существенным и важным заслоном всем патогенным микробам является гигиена рта и те профилактические добавки, которые входят в состав зубных паст и ополаскивателей. Именно поэтому так важно, как каждая из этих паст действует на патогенную микрофлору, на ткани полости рта [12][13][14][15][16][17][18][19]. ...
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Aim. To describe features of formation and carrying-out of an individual hygiene program of stomatologic conditions prevention in ophthalmologic patients. Methods. The formation of hygiene program of prevention. Results. Action tendency and procedure of the program stages conduct with consideration for patients status are stated. Peculiarities of professional and individual oral hygiene during pre-op and post-op periods are reflected. Conclusions. It is necessary to take into account physical characteristics of oral hygiene products (vibration, sound, ultrasound, etc.) concerning subsequent ophthalmic procedures and special aspects of post-op period course.
... depolarization of nerve receptors and reduce the conductivity. A second approach is by mechanical occlusion of the lumen of open dentinal tubules and then, the formation of insoluble precipitates with the participation of calcium, fluoride, strontium, arginine, the adhesive resins or lasers [9,21,25,40,[42][43][44][45][46][47][48]. ...
Article
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Vital abutments presents different degree of dentinal sensitivity (DS) after their preparation. Protective methods of dentinal wound have the purpose to fill up the dentinal tubules. The objective of the study was to assess the efficacy of three different desensitization methods applied to reduce the postoperative sensitivity of prepared vital abutments. The clinical trial included 65 patients with 251 vital abutments, divided into three groups: in the first group of 21 patients (82 vital abutments) the protection method was carried out by a desensitizer agent containing hydroxyethyl methacrylate and glutaraldehyde; in the second group of 22 patients (85 vital abutments), diode laser therapy was used; in the third group of 22 patients (84 vital abutments), associated protection method was applied, by using the same desensitizer agent and laser therapy. During the study, all selected patients used the same toothpaste for at-home desensitization, containing 5% calcium sodium phosphosilicate (CSPS). The evaluation of the painful intensity of DS in vital abutments after desensitization was realized by using a Visual Analogue Scales (VAS) and by evaluating the failure rate. The results of study showed that after desensitisation, the DS of vital abutments has decreased in all three groups, but the highest desensitization rate with the most reduced rate of failures was found in the third group of patients, with associated therapies. The efficiency of the applied desensitization methods have been confirmed.
... The tubules are filled with dentinal fluid and pass from the pulp chamber to the interfaces between the dentin-enamel junction (DEJ) and dentin-cementum junction (DCJ). When the tubules are exposed, external stimuli are able to affect the nerves in the pulp, in this case people can experience a short, sharp pain [2,3]. This is known as dentin hypersensitivity, and it often requires treatment to avoid further irritation and pain. ...
Article
X-ray MicroCT Imaging of Dentin Tubules in a Human Tooth - Carley Goodwin, Stephen Boona, Buwei Chen, Oliver Hesmondhalgh, Shaz Khan, David McComb
... [2,3] Individuals suffering from periodontal disease frequently have exposed radicular dentin as do the healthy individuals, for example, overzealous tooth brushing and trauma to the gingival marginal tissues, with subsequent wear of dentin. [4] Frequent symptoms of these patients include sensitivity and unesthetic appearance of the affected teeth. This, in turn, can have a negative impact on their quality of life, especially with regards to dietary selection, maintaining optimal dental hygiene and esthetics. ...
Article
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The composition of smile architecture includes pink gingiva and white tooth structure which gives an esthetic appearance. As age advances, gingival recession is seen which contributes to dentinal hypersensitivity and unsightly smile esthetics. Due to this, increasing number of patients are seeking dentists for the absence of pink-colored gingiva. Pink composites are gingival-colored composites that help to create a lifelike tooth easily by reconstructing the red-white boundary with superior esthetics. This material provides long-lasting, high esthetic restorations with low abrasive values and high compressive and transverse strength. This shares a case report on how pink composites help in reconstructing the red-white boundary.
... The proper diagnosis is essential to the establishment of adequate treatment. 1 2 Brännström's hydrodynamic theory is the most widely accepted for explaining mechanisms that involve the triggering of pain sensations in DH. According to this theory, sensitivity is the result of the rapid movement of the fluid contained in the interior of the dentinal tubules. ...
Article
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Introduction Dentin hypersensitivity (DH) is defined as high sensitivity of the vital dentin when exposed to thermal, chemical or tactile stimuli. Two mechanisms are required for the occurrence of DH: (1) the dentin must be exposed and (2) the dentinal tubules must be open and connected to the pulp. Molar–incisor hypomineralisation (MIH) is a qualitative abnormality of a genetic origin that affects tooth enamel and, in most cases, is accompanied by DH. The control of tooth sensitivity is fundamental to the successful treatment of MIH. The aim of the proposed randomised, controlled, clinical trial is to evaluate the effectiveness of different protocols for the control of DH in patients with teeth affected by MIH. Methods and analysis One hundred and forty patients who meet the inclusion criteria will be allocated to four groups. Group 1 will be the control group (placebo). In Group 2, sensitive teeth will be sealed with PermaSeal (Ultradent). In Group 3, sensitive teeth will receive low-level laser (LLL, AsGaAl) at a wavelength of 780 nm (Laser XT Therapy, DMC, São Carlos, Brazil). In Group 4, sensitive teeth will be treated with both LLL and PermaSeal (Ultradent). DH will be evaluated 15 min after the application of the treatments and the patients will be reevaluated 1 week, 1 month, 3 months and 6 months after the treatments. The primary outcome of this study is change in pain/sensitivity, when evaluated through a Visual Analogue Scale, to determine the effectiveness of the proposed treatments, as well as differences among the evaluation times for each proposed treatment. Ethics and dissemination This protocol has been ethically approved by the local medical ethical committee (protocol number: 4.020.261). Results will be submitted to international peer-reviewed journals and presented at international conferences. Trial registration number NCT04407702 .
... It has also been shown that changes in the surface properties of materials are not attributable to abrasives in the paste alone. Detergents (e.g., sodium lauryl sulfate) in toothpastes and their pH values are also thought to affect the surface properties of restorative materials [31]. ...
Article
Purpose: The aim of this study was to investigate and compare the effects of some whitening toothpastes on the surface roughness and coloration susceptibility of a composite resin, as well as their whitening effectiveness. Methods: This study was carried out in two different stages. In experiment A, samples were divided into 7 subgroups to compare the surface roughness and coloration susceptibility of the composite resin: distilled water, conventional toothpaste, and 5 different whitening toothpastes. In experiment B, samples were divided into 8 subgroups to compare the whitening effectiveness of the whitening toothpastes: conventional toothpaste, 5 other whitening toothpastes, and two bleaching groups. After toothbrushing simulation, the color and surface roughness of the samples were measured. Data were subjected to one-way analysis of variance, paired t-test and Tukey post-hoc test (α = 0.05). Results: There were no statistically significant differences among the surface roughness values for the groups for any period before and after brushing (P > 0.05). In terms of the coloration susceptibility of the composite resin and the whitening effects of the toothpastes, no statistically significant differences were evident among the groups for any period before and after brushing (P > 0.05). Conclusion: The results of this study indicate that effective toothbrushing is more important than the type of toothpaste employed.
... Yapılan çalışmalarda hassas dentinde, hassas olmayan dentine göre daha geniş ve daha fazla sayıda açık dentin tübülü olduğu saptanmıştır. Ayrıca dentin içerisindeki açığa çıkmış tübül sayısı pulpaya yaklaştıkça artmaktadır [19]. ...
... These teeth are usually subjected to hypersensitized responses which can limit effective plaque control. [3] Loss of enamel, cementum, and/or gingival tissue recession usually leads to exposed dentin, that will cause sensitivity characterised by sharp pain right after mechanical, chemical, or osmotic stimulation [4,5] . Some dental treatments, like removing of dental deposits and debridement of root surfaces in scaling and root planing will facilitate elimination of necrotic cementum and result in exposure of huge number of dental tubules to the stimuli of oral environment. ...
... Addy has defined hypersensitivity as a transient short and sharp pain which arises from the exposure to dentin in response to tactile, thermal, chemical, or osmotic stimulus that cannot be explained by any other category of diseases. [3][4][5] It was not mentioned in the literature as a condition which requires immediate intervention or treatment. However, it was mentioned that there would be an apparent discomfort due to hypersensitivity which was treated by themselves most of the time with over-the-counter drugs. ...
... Dental hypersensitivity is caused due to non-noxious stimuli. The prevalence of hypersensitive in India is about 20.06%, which is more commoner in the females, however, symptoms may reduce later in life, due to age related dentin and pulpal changes (25) . The agents such as potassium nitrate, calcium compound are practiced for its management. ...
Article
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Background: Iontophoresis is a technique of transferring ions into the tissues through the skin by using direct current. It can serve as a substitute for chemical enhancer, eliminates toxicity and adverse reaction formulation problems associated with chemical enhancer. Purpose: The purpose of this literature is to review the studies to see the effectiveness of Fentanyl Iontophoresis in the post operative acute pain and also to find out whether it helps in facilitating the physiotherapy in the post operative acute phase. Methods and Materials: The database literature search was carried out in the electronic database - Medline, and Research gate. Iontophoresis, Post-operative acute pain, Fentanyl Iontophoresis were the key words used to search in the electronic database. Randomized control trials, systematic review, meta-analysis, and case studies included into the review. Conclusion: Fentanyl iontophoresis system offers safety advantages in terms of opioid related drug adverse events (ORADEs) compared with morphine (iv) patient controlled analgesia for the management of acute postoperative pain. Fentanyl iontophoresis is highly potent and capable in relieving the post operative acute pain. This system of transferring ions into the tissues through the skin can play important role in initiating early physiotherapy and improve the mobility and functional limitations of the patient. Key words: Iontophoresis, Post-operative acute pain, Fentanyl Iontophoretic System.
... ds vèkhu Fks A bUgs a pkj lew gks a ih-okboS Dl ldkjkRed] ih-Qs Ylhis je ldkjkRed] udkjkRed vkS j nks uks a ldkjkRed ¼ih-okboS Dl vkS j ih-Qs Ylhis je½ es a foHkkftr fd;k x;kA blds vykok jks fx;ks a dks ;knfPNdrk ls nks lew gks a lew g&A ¼;w fue&152½ vkS j lew g&AA ¼;w fue&158½ es a foHkkftr fd;k x;kA Ikz R;s d lew g es a 34 jks fx;ks a dks ia thdr fd;k x;kA jks fx;ks a dks iz frfnu rhu dS Ilw y fn;s x;s vkS j rhljs ] ika pos a ] lkroa s a rFkk nlos a fnu ij tka p dh xbZ A vU; y{k.kks a es a jkgr ds lkFk&lkFk lew g&A ¼;w fue&152½ ds jks fx;ks a ds rkieku es a lew g&AA ¼;w fue&158½ dh rq yuk es a mYys [kuh; deh ns [kh xbZ A bl vè;;u ls ;g fu"d"kZ fudyrk gS fd ;w fue&152 vkS j ;w fue&158 dk mi;ks x cq [k+ kj vkS j gq Eek vtkfe;k ¼eys fj;k½ ls tq M+ s vU; y{k.kks a ls jkgr ds fy, fd;k tk ldrk gS A 'kCndq a th% gq Eek vtkfu;k] lkbVks dkbUl] fgeks ykbfll] eys fj;k] ijthoh y{k.k] ;w fue&152] ;w fue&158Gingival recession (receding gums) is the exposure of the roots of teeth caused by a loss of gum tissue or retraction of the gingival margin from the crown of teeth. Gum recession is a common problem in adults over the age of 40 years, but it may also occur among teens(Addy, 2002;Bal and Kundalgurkhe, 1999;Curro, 1990;Orchardson and Collins, 1987;Nagata, et al. 1994;Rees and Addy, 2002) ...
... The problem of DH has been a subject of discussion over the years. It occupies an important place in dental diseases, with its continuously increasing incidence [38][39][40]. It has been established that the dentinal fluid can move inside the dentin tubules toward the inside of the pulp or the outside of dentin. ...
Article
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Hyperesthesia is related to increased sensitivity of dental tissues to mechanical, chemical and thermal stimuli. The aim of this prospective clinical trial was to compare the effectiveness of a calcium-fluoride-forming agent (Tiefenfluorid®, Humanchemie GmbH, Alfeld, Germany) with that of a fluoride varnish (EnamelastTM, Ultradent Inc., Cologne, Germany) in the treatment of dental hyperesthesia in adult patients. In total, 176 individuals (106 females and 70 males, aged 18–59 years old) diagnosed with dental hyperesthesia (DH) were enrolled. The main clinical symptoms were hyperesthesia from coldness and sweetness during chewing; the types of clinical lesions were also determined and recorded. The patients were selected randomly and divided into two groups: (i) the first group of 96 patients was treated with Tiefenfluorid® applied in three appointments at 7-day intervals; (ii) the second group of 80 patients was treated with EnamelastTM, applied seven times at 7-day intervals. All the patients were recalled 7 days, 14 days, 1 month, 3 months, and 6 months from the last application. At the baseline and during every follow-up visit, the DH was measured with a pulp tester. A random intercept/random slope model was used to evaluate the effect of the treatment, at various times with respect to the initial diagnosis. Within the limits of the present study, Tiefenfluorid® was more effective than EnamelastTM against DH in that it provided long-lasting results, with a significant improvement still detected at the latest 6-month follow-up.
... Women constitute 81.2% of the patients we included in the study. It may be due to the fact that female patients are more eager for treatment due to DH or that the rate of getting professional help in cases such as pain and illness is higher than men [2]. There are studies reporting higher prevalence of dentin sensitivity in women compared to men, as well as studies reporting that there is no statistically significant difference [29,30]. ...
... Enamel cracks are difficult to visualize and are often overlooked. They can subsequently lead to the appearance of dental hypersensitivity and pain when chewing, symptoms that dissipate when the stimulus is removed (37,38). The demineralization of the adjacent enamel caused by fixed appliances is an undesirable complication of orthodontic treatment, particularly if it is not detected at an early stage and no remedial action is taken (39). ...
Article
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Optical coherence tomography (OCT) is a modern imaging method with applicability in orthodontics. In recent years, there has been an increasing trend in the use of ceramic brackets. The aim of the present study was to investigate the effects of bonding metallic and ceramic brackets on tooth enamel, using optical coherence tomography. For this purpose, 20 permanent teeth we bonded and were subsequently debonded using a side cutter or anterior bracket removal pliers. Using the OCT technique, the enamel, the amount of adhesive remaining and the bracket fragments remaining on the tooth surface were analyzed following the debonding procedure. It was demonstrated that enamel cracks were present only in the samples bonded with ceramic brackets. At the same time, it was noted that the type of pliers did not affect the incidence and extent of damage to the enamel. The type of debonding technique (using the side cutter or the anterior removal pliers) used did not markedly affect the amount of adhesive remaining on the teeth. Thus, as demonstrated herein, by analyzing the enamel structure through the use of OCT, the quality of the processes and the materials used for manufacturing brackets can be increased.
... The Colgate Sensitive Pro-Relief Toothpaste, providing statistically significant improvements after four weeks of twice-daily brushing (32.8667 ±1.53644, 4.8000±.44934). This finding was in agreement with that reported by researcher in patients from Rome and Italy (25,26). Desensitizing dentifrices represent a treatment option that, given regimen compliance, may be efficacious for most individuals (2,12,13,42). ...
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The aim of this research is to evaluate clinically the effect of Colgate sensitive pro-relief tooth paste containing 8% arginine-calcium carbonate on Dentin hypersensitivity in group of Iraqi patient. Material and Method: Fifty volunteered subjects male and female with mean age between 20-40 years suffering from dentin hypersensitivity from at least two teeth on cold and hot stimuli and not due to dental caries were agreed to participate in this study. At home brushing instruction consisted of brushing their teeth for one minute, twice daily using only the tooth paste provided and to refrain from any other oral hygiene products and procedures throughout the duration of the study. Assessment of the dentin hypersensitivity were carried out with air blast and repeated by the same examiner using the same methods. Record was taken according to Colgate sensitivity visual analog scale graduated from 0 to 10. Records were taken on day zero and after four weeks for each patient on the same visual scale. Results Statistical analysis of the total sample demonstrated a highly significant difference between before (32.8667 ±1.53644) and after four weeks (4.8000±.44934) of twice daily use of the product (p =0.001), The percentage of changes was slightly higher in males (6l7.12%) than females (66.12%). Conclusion: Colgate sensitive pro-relief tooth paste contains 8% arginine and calcium carbonate used twice daily for four weeks significantly reduces dentin hypersensitivity. It offers significant relief of dentin hypersensitivity in Iraqi patients. [Nidhal A. Ali, Mohammed Q. Mahmood Fahmi, Fouad H. Al-Bayaty. Effect of long lasting self-applied colgate sensitive pro-relief tooth paste in dentin hypersensitivity in group of Iraqi patients. Life Sci J 2014;11(9):747-751]. (ISSN:1097-8135). http://www.lifesciencesite.com. 113
Article
The data of the World Health Organization say that caries is the most widespread infectious disease in the world: 85–90% of the adult population of the planet suffer from this disease, and in Russia this figure reaches 95%. The leading link in the prevention of caries is oral hygiene, individual and professional. First of all, the means of individual oral hygiene include toothpastes. Toothpastes, depending on their composition, can be divided into hygienic and therapeutic and prophylactic. Anti-caries pastes, belonging to the group of thera-peutic and prophylactic, and they are aimed at strengthening the mineral tissues of the tooth by increasing the concentration of these elements in them. Fluoride toothpastes also have anti-caries effect. To date, a large number of these tooth-pastes are presented on the dental market. The aim of the work was a clinical assessment of the anti-carious efficacy of two commercial samples of toothpastes «President Classic» and «Paradontax Comprehensive Protection» in the presence of restorations in the oral cavity in patients. Materials and methods. In the course of the study (for 6 months), a group of students (40 people) aged 18 to 25 years with a high intensity of caries (KPU from 5 to 8) and not having bad habits were observed, who, depending on the group, were used different fluorine-containing toothpastes (President Classic (mass fraction of fluoride F=1450 ppm) and Parodontax Complex protection (mass fraction of fluoride F=1450 ppm). Results. Studies have shown that an individually prescribed oral care system for patients with multiple caries using directional oral hygiene products reduces the prevalence and intensity of caries and normalizes the cariogenic situation in the oral cavity: improves the hygienic state of the oral cavity, increases enamel resistance to acidic dissolution. In patients who used President Classic toothpaste at home, the average increase in the intensity of caries was reduced by 94%. Conclusion. Thus, the studied studies have shown that an individual cavity care system for patients with multiple caries with the use of an oral hygiene of an aimed action, reduces the prevalence and intensity of caries and normalizes the calculation of the caries-beacon in the oral cavity.
Article
Aim: Hypersensitivity is the most common clinical problem which is encountered by most of dental patients undergoing a vital tooth preparation for a fixed crown prosthesis. The aim of this study is to evaluate the effect of silver diamine fluoride, potassium nitrate, and glutaraldehyde in reducing dentinal hypersensitivity following vital tooth preparation. Settings and Design: This study is a randomized control trial performed on 119 teeth of 68 patients who are in need of fixed prosthesis treatment. Materials and Methods: After a thorough clinical examination, patients were allocated into any of the randomly assigned four groups (Control, silver diamine fluoride, potassium nitrate, and glutaraldehyde) and the level of hypersensitivity was measured by blasting air on the surface of tooth at five different intervals (before preparation, after preparation, after application of desensitizers, before cementation and after a follow up period of about 30 days) and is graded using Schiff 's cumulative hypersensitivity index. Statistical Analysis Used: Kruskal wallis test is used to compare the rate of sensitivity between the 4 groups. Friedman and Wilcoxon test is used to compare the rate of sensitivity at 5 different intervals. Results: All the desensitizers used in this study reduced the level of hypersensitivity. Among which, silver diamine fluoride was found to be more effective after application, before cementation, and after a follow up period of about 30 days followed by GLUMA and potassium nitrate. Conclusion: The results of this study suggest that silver diamine fluoride was found to be more effective after application, before cementation of the definitive prosthesis and after a follow up period of 30 days.
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The objective of this study was to characterise apatite formation ability of a tetra calcium phosphate (TTCP) and dicalcium phosphate anhydrous (DCPA) based desensitising product, TeethmateTM (TM). Methods: Cylindrical samples of TM were produced and immersed in TRIS buffer and artificial saliva (AS) for selected time periods. This was followed by characterisation of the phases formed using 31 P Magic Angle - Nuclear Magnetic Resonance Spectroscopy, X-ray powder diffraction and Fourier-transform infrared spectroscopy. Dentine discs treated with the material were analysed by scanning electron microscopy (SEM) to evaluate crystal shape and tubules occlusion. Results: SEM analysis showed the formation of plate-like crystals occluding the dentinal tubules. Solid-state characterisation analyses showed that TM cement samples immersed in TRIS-buffer (pH: 7.3) formed hydroxyapatite phases within approximately six hours of immersion. HA formation was less rapid for the samples stored in AS (pH: 6.5). Conclusions: This study shows that a TTCP-DCPA based desensitising product (TM) converts to HA in vitro and provides an effective option for the treatment of dentine hypersensitivity.
Article
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Allogeneic hematopoietic stem cell transplantation (alloHSCT) is one of the most commonly performed transplantation procedures nowadays. Despite the significant progress made in the treatment, alloHSCT is still associated with numerous complications also affecting the oral cavity. One of them is dentin hypersensitivity (DH)—a sharp, short-term pain that occurs when stimuli act on exposed dentin. Various authors point out that DH may result in a significantly lower quality of life, among other things by impeding the consumption of food as well as causing difficulties in daily oral hygiene. The aim of the study was a preliminary analysis of the incidence rate and severity of DH pain in adult patients during late period after alloHSCT. The impact of chronic graft-versus-host disease (cGvHD) and time after alloHCT were also considered. A total of 80 patients were examined. cGvHD was identified in 52 participants. The incidence rate and severity of DH pain was assessed on the basis of a questionnaire and a clinical examination. DH pain appeared a serious problem in late period after alloHSCT regardless of post-transplant time. DH primarily affected cGvHD patients. The prevention-treatment protocol for DH should be developed for this group.
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The objective of this study was to characterise apatite formation ability of a tetra calcium phosphate (TTCP) and dicalcium phosphate anhydrous (DCPA) based desensitising product, Teethmate ™ (TM). Methods: Cylindrical samples of TM were produced and immersed in TRIS buffer and artificial saliva (AS) for selected time periods. This was followed by characterisation of the phases formed using ³¹ P Magic Angle - Nuclear Magnetic Resonance Spectroscopy, X-ray powder diffraction and Fourier-transform infrared spectroscopy. Dentine discs treated with the material were analysed by scanning electron microscopy (SEM) to evaluate crystal shape and tubules occlusion. Results: SEM analysis showed the formation of plate-like crystals occluding the dentinal tubules. Solid-state characterisation analyses showed that TM cement samples immersed in TRIS-buffer (pH: 7.3) formed hydroxyapatite phases within approximately six hours of immersion. HA formation was less rapid for the samples stored in AS (pH: 6.5). Conclusions: This study shows that a TTCP-DCPA based desensitising product (TM) converts to HA in vitro and provides an effective option for the treatment of dentine hypersensitivity.
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O tratamento de defeitos estéticos e da hipersensibilidade dentinária cervical (HDC) são as principais indicações para o recobrimento de uma superfície radicular exposta por recessão gengival. Este trabalho descreve o tratamento de uma HDC utilizando a técnica do “envelope” para recobrimento radicular em um dente com sensibilidade exacerbada devido à presença de recessão gengival classe I de Miller, na superfície vestibular do segundo pré-molar inferior esquerdo (35). O tratamento cirúrgico periodontal proposto foi de recobrimento radicular por meio de enxerto de tecido conjuntivo subepitelial pela técnica do “envelope” na região vestibular do 35. Após nove meses foi possível observar o recobrimento da recessão, aumento da faixa de tecido ceratinizado e ausência de HDC. Diante da resolução do caso clínico apresentado, a técnica do enxerto de tecido conjuntivo subepitelial em envelope, quando bem indicada e realizada, pode ser empregada com sucesso em casos de hipersensibilidade dentinária cervical.
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The effectiveness of using «Asepta plus remineralization» special toothpaste, combination of the same toothpaste and «Asepta parodontal fresh» rinse or «Asepta remineralizing gel» (Vertex CJSC, St. Petersburg, Russia) using analysis technique of the structure and severity of the interior disease sight based on psychosensorial-anatomy-functional desadaptation syndrome. It was established that patients who used «Asepta plus remineralization» toothpaste and «Asepta remineralizing gel» on day 3 showed adaptation to the conditions of their existence. Among the patients using «Asepta plus remineralization» toothpaste and «Asepta parodontal fresh» rinse, despite the positive clinical effect of their use on day 3, there was a violation of adaptability to living conditions. In case of the isolated using of «Asepta plus remineralization» toothpaste for oral hygiene, adaptation to their conditions of existence occurred by 7 days of patient observation. The obtained information is important for planning secondary prevention events for dental hyperesthesia, which allows recommending oral care products to patients taking into account the peculiarities of the clinical course of this pathology.
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Background/Aim. Dentine hypersensitivity (DH) is a commonly encountered clinical problem, characterized by short, sharp pain arising from exposed dentine. The aim of this study was to estimate the frequency of cervical DH in an adult population sample of city of Pancevo, Serbia, to evaluate correlation between DH and severity of cervical tooth wear, as well as to investigate the impact of certain etiological factors. Methods. The study included 394 subjects, who were clinically examined and interviewed about potential etiological factors using specially designed questionnaire. Presence of cervical DH was evaluated using cold air stimulation and Schiff ordinal scale. Severity of cervical tooth wear was evaluated using Basic Erosive Wear Examination-BEWE. Results were analyzed using chi-square tests and logistic regression at significance level of p?0.05. Results. The presence of cervical DH was recorded in 32.9% from total number of subjects. Chi-square analysis showed significant association between clinically elicited and questionnaire declared DH (p
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Background: Dentine hypersensitivity (DH) is a frequent clinical problem that represents a long-term painful discomfort for the patients, and for the dentists, it represents a diagnostic and therapeutic challenge. Objective: The aim of the research is to verify the effect of the treatment with diode laser SiroLaser Blue (660nm) of DH alone or in combination with different impregnating agents. Methods: Fifty patients were included in this research, separated into five groups. All the patients have been asked to define the level of dentine hypersensitivity using VAS (0-10). The first group was treated with Fluor Protector, the second group after the application of Fluor Protector has undergone irradiation with SiroLaser Blue (660nm), the third group was treated with impregnating agent Vivasens, the fourth group, after the application of impregnating agent Vivasens, has had SiroLaser Blue (660nm) irradiation. The fifth group has just been treated with SiroLaser Blue (660nm). The efficiency of the treatment was checked using VAS for every group immediately after the conducted treatment, after 7 days and 1 month. Results: Our results showed that all of the desensitizing agents used in the research alone or in combination with a diode laser (660nm) have shown a reduction of DH. The difference has been proven statistically significant in mean values by groups and examinations. Vivasens and diode laser irradiation have provided the best results in the review of mean values after the first examination and one month after the treatment of DH (p<0,05). In our research, the application of diode laser alone has not proven superior to other treatment methods that have been used in the research. Conclusion: Vivasens plus diode laser irradiation has provided the best results even after one month since the treatment of DH.
Article
Objective: All soft and solid surfaces exposed to the oral cavity are covered by an acquired pellicle. While the pellicle adsorbed on enamel is well researched, only limited data are available on the dentin pellicle. The purpose of the present review is to summarize studies considering the composition, structure and properties of the dentin pellicle and compare them with the current state of research on enamel pellicle. Methods: The literature search was conducted using Medline database and Google Scholar, including checking reference lists of journal articles by handsearching. Thereby, 19 studies were included in the present review. Results and conclusion: The dentin pellicle has a similar ultrastructure to the enamel pellicle, which is up to 1 µm thick depending on pellicle formation time and localization in the oral cavity. In contrast, due to the lack of studies on the dentin pellicle regarding its composition and properties, a comparison to the enamel pellicle is difficult. So far, only one study showed anti-abrasive properties and data on anti-erosive properties were controversial. Despite becoming more and more clinically relevant due to the increasing frequency of dentin exposure, the dentin pellicle is largely unexplored. For further investigations it is not only necessary to standardize dentin specimens, but also to assess fundamental research on dentin itself, as its complex morphology and composition may have a crucial influence on pellicle formation. Furthermore, a more detailed knowledge of the dentin pellicle may also reveal target sites for modification in favor of its protective properties.
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Background: Dentinal hypersensitivity is characterized by short, sharp pain from exposed dentine that occurs in response to external stimuli such as cold, heat, osmotic, tactile or chemicals, and cannot be explained by any other form of dental defect or pathology. Laser therapy has become a commonly used intervention and might be effective for dentinal hypersensitivity. Objectives: To assess the effects of in-office employed lasers versus placebo laser, placebo agents or no treatment for relieving pain of dentinal hypersensitivity. Search methods: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 October 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2020, Issue 9), MEDLINE Ovid (1946 to 20 October 2020), Embase Ovid (1980 to 20 October 2020), CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 20 October 2020), and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; from 1982 to 20 October 2020). Conference proceedings were searched via the ISI Web of Science and ZETOC, and OpenGrey was searched for grey literature. The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection criteria: Randomized controlled trials (RCTs) in which in-office lasers were compared to placebo or no treatment on patients aged above 12 years with tooth hypersensitivity. Data collection and analysis: Two review authors independently and in duplicate screened the search results, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. For continuous outcomes, we used mean differences (MD) and 95% confidence intervals (CI). We conducted meta-analyses only with studies of similar comparisons reporting the same outcome measures. We assessed the overall certainty of the evidence using GRADE. Main results: We included a total of 23 studies with 936 participants and 2296 teeth. We assessed five studies at overall low risk of bias, 13 at unclear, and five at high risk of bias. 17 studies contributed data to the meta-analyses. We divided the studies into six subgroups based on the type of laser and the primary outcome measure. We assessed the change in intensity of pain using quantitative pain scale (visual analogue scale (VAS) of 0 to 10 (no pain to worst possible pain)) when tested through air blast and tactile stimuli in three categories of short (0 to 24 hours), medium (more than 24 hours to 2 months), and long term (more than 2 months). Results demonstrated that compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through air blast stimuli at short term (MD -2.24, 95% CI -3.55 to -0.93; P = 0.0008; 13 studies, 978 teeth; low-certainty evidence), medium term (MD -2.46, 95% CI -3.57 to -1.35; P < 0.0001; 11 studies, 1007 teeth; very low-certainty evidence), and long term (MD -2.60, 95% CI -4.47 to -0.73; P = 0.006; 5 studies, 564 teeth; very low-certainty evidence). Similarly, compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through tactile stimuli at short term (MD -0.67, 95% CI -1.31 to -0.03; P = 0.04; 8 studies, 506 teeth; low-certainty evidence) and medium term (MD -1.73, 95% CI -3.17 to -0.30; P = 0.02; 9 studies, 591 teeth; very low-certainty evidence). However, there was insufficient evidence of a difference in pain intensity for all types of lasers when tested through tactile stimuli in the long term (MD -3.52, 95% CI -10.37 to 3.33; P = 0.31; 2 studies, 184 teeth; very low-certainty evidence). Most included studies assessed adverse events and reported that no obvious adverse events were observed during the trials. No studies investigated the impact of laser treatment on participants' quality of life. Authors' conclusions: Limited and uncertain evidence from meta-analyses suggests that the application of laser overall may improve pain intensity when tested through air blast or tactile stimuli at short, medium, or long term when compared to placebo/no treatment. Overall, laser therapy appears to be safe. Future studies including well-designed double-blinded RCTs are necessary to further investigate the clinical efficacy of lasers as well as their cost-effectiveness.
Article
Background: There is no report concerning calcium sodium phosphosilicate (CSPS) and arginine dentifrices in reducing dentine hypersensitivity (DH) in patients undergoing non-surgical periodontal therapy. The aim of the study was to compare the efficacy of a dentifrice containing bioactive glass, 5% CSPS, and 8% arginine dentifrice in relieving DH in patients undergoing non-surgical therapy. Methods: Using a double-blind randomized controlled trial, 45 volunteers with DH following non-surgical therapy were immediately applied with one of three dentifrices containing: 5% CSPS, 8% arginine, or control on DH teeth. The participants then continued to brush twice daily for 8 weeks. DH was assessed using the Schiff cold air sensitivity scale and tactile tests at baseline, immediately after application, and up to 8 weeks. Results: The Schiff analysis revealed that the CSPS dentifrice significantly reduced DH immediately and declined through week 8. The arginine group demonstrated reduced DH through week 2. In contrast, DH reduction in the control began later at week 1. The visual analog scale analysis demonstrated that only CSPS had a significantly reduced percentage DH at the immediate, 2, 4, and 8 weeks compared with the baseline. The percentage of patients with DH (Schiff score ≥ 2) in the CSPS and arginine groups reduced to approximately 50% after the in-office application. The number of DH patients treated with CSPS then decreased to 9% at the 2-week evaluation. Conclusion: The CSPS and arginine dentifrices were beneficial in reducing periodontitis patient's discomfort, immediately and in the first two weeks following non-surgical periodontal therapy. This article is protected by copyright. All rights reserved.
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Pathological tooth wear is an increasing problem affecting a significant proportion of the population. Although different wear mechanisms have been described, most reports in the literature concentrate on cases in which the predominant mechanisms were erosion and attrition. This article presents an unusual case of abrasive tooth wear caused by a sand eating habit which the patient had adopted as a child. Different causes of "abrasive" wear are discussed and the difficulties in management of this case are also presented.
Article
Objectives: To review current knowledge with respect to the epidemiology of abrasive lesions and the evidence for the role of toothpastes and toothbrushes in their aetiology. Materials and methods: ‘Medline’ databases for the period 1966 to the present day were searched electronically, while the dental literature prior to 1966 was searched manually. In both cases, the key words: tooth abrasion, toothpaste and toothbrush were used. Conclusions: Studies in vitro demonstrate that tooth brushing with abrasive toothpastes produces wear to dentine. Extrapolation of these data to effects in vivo is difficult, but suggests that, under normal use, tooth brushing with toothpaste will cause limited wear of dentine in a lifetime's use. Negligible damage to dentine occurs with a toothbrush alone. Most toothpastes have low relative enamel abrasivity values and, alone, have little or no effect on enamel. Abuse and/or interaction with erosion can increase wear of dentine to pathological levels. Enamel softened by erosive agents is easily removed by any mechanical action.
Article
Abstract The reported prevalence of cervical dentine sensitivity (CDS) ranges from 8 to 35%. Detailed epidemiology of the condition, particularly with regard to possible causal factors, is lacking. In particular, no published data appear to exist on its prevalence in periodontal patients. The aim of the present study was therefore to determine the prevalence, distribution and severity of CDS in a population of patients referred to a Periodontology Department of a specialist postgraduate hospital. 507 patients (181 M: 326F, mean age 44.2 (SD 10.31) years) attending a periodontal clinic were assessed for CDS by a questionnaire. The results demonstrated a prevalence of CDS of 84% with no significant gender difference. 71.1% of patients perceived cold as the most common cause of discomfort. A higher prevalence of self-reported discomfort was observed between 40 and 49 years. Of the patients with a reported history of periodontal surgery (34.7%), those treated within 6 months prior to assessment appeared to be more at risk to CDS. Of the patients who received hygienist treatment (88.2%). only 10.5% reported discomfort persisting ≥3 days after treatment. Generally, patients who complained of varying degrees of discomfort over time (84.5%) did not perceive the condition as severe and consequently did not seek treatment. The prevalence of CDS in these referred patients was very high, suggesting that periodontal diseases and/or treatment effects play a role in its aetiology.
Article
Due to the stresses resulting from biomechanical loading forces exerted on the teeth (static, as in swallowing and clenching or cyclic, as in chewing), both enamel and dentin can chip or break away. This loss of tooth substance, which shall be termed Abfraction, is dependent on the magnitude, duration, direction, frequency, and location of the forces. These abfractive lesions are caused by flexure and ultimate material fatigue of susceptible teeth at locations away from the point of loading. Clinical observation of a variety of enamel and dentin lesions due to the shapes, sizes, loci, and frequency warrants a new and distinct classification.
One hundred teeth, experimentally treated with Class V amalgam and silicate restorations and extracted 7 days later, were used to study the correlation between clinical symptoms of thermal sensitivity and histologic signs of pulpal hyperemia and inflammation. The number of teeth sensitive to both cold and heat increased significantly in the presence of hyperemia. As pulpal inflammation increased in severity, the number of teeth sensitive to heat also increased. No correlation was found between the degree of inflammation and sensitivity to cold. These results are discussed in the light of current knowledge concerning the meaning of clinical symptoms and histologic changes in the pulp.
The clinical data indicate that Thermodent toothpaste is of considerable value as an aid in treating sensitive teeth. Local areas of hypersensitivity caused by erosions, abrasions, or attrition have responded most favorably. Although excellent symptomatic relief is provided, it is important that every effort be made to identify and correct the basic causes of the hypersensitivity.
Article
The clinical aspects, epidemiology, etiology and pathogenesis of dental erosions in man and experimental animals are reviewed. Abrasion of enamel, softened in orange juice for 3 minutes and brushed with various dentifrices, was studied with Knoop hardness measurements and scanning electron microscopy. Knoop indentations made on softened enamel surfaces were almost totally removed by 2-minute brushings with highly abrasive tooth pastes. Brushing without dentifrices only slightly changed the distinctness of the indentation outlines. Recommendations for primary and secondary prevention of erosions are given.
Article
The prevalence, distribution and possible causal factors of cervical dentine hypersensitivity were studied in a population from a Marine Dental Clinic in the city of Rio de Janeiro, Brazil. A total of 635 patients were examined for the presence of cervical dentine hypersensitivity by means of a questionnaire and intraoral tests (air and probe stimuli). There were 157 patients (25%) reporting to have hypersensitive teeth, but only 108 patients (17%) were diagnosed as having cervical dentine hypersensitivity. The prevalence of hypersensitivity was higher among females than males, but this difference was not statistically significant. Most females with hypersensitivity were aged 20-49 and most males were aged 40-59. Incisors and premolars had the highest prevalence of dentine hypersensitivity to air and probe stimuli, while molars had the lowest. The presence and history of dentine hypersensitivity were positively correlated with previous exposure to periodontal treatment. Only a few of the patients who claimed to have dentine hypersensitivity had tried treatment with desensitizing toothpastes or sought professional help.
Article
Dentine hypersensitivity occurs when dentinal tubules are open on the dentine surface and patent to a vital pulp. There has been limited interest in the aetiology of dentine hypersensitivity. In particular, little is known about agents that remove the dentine smear layer to expose tubules. Toothbrushing certainly may expose dentine, but whether a toothbrush per se has the effect of opening tubules has not been established. The aim of this study in vitro was to determine whether a toothbrush could remove or create a smear layer. In addition, the combined effects of toothbrushing with dietary fluids on dentine was assessed. Toothbrushing was observed, by scanning electron microscopy, both to remove and to recreate a smear layer on dentine specimens. However, the processes took a considerable time, and under conditions of normal toothbrushing it is unlikely that the latter plays a direct aetiological role in opening tubules. Indeed, together with toothpaste it is more likely that brushing has a therapeutic action by mechanically forming a smear layer. Conversely, and importantly, toothbrushing in the presence of dietary acids enhanced smear layer removal. This finding raises the question of whether the dental profession should be advising that teeth be brushed before meals rather than after, as is often the case.
Article
Dentine hypersensitivity is caused by a change in fluid flow in the dentinal tubules, which excites nerve endings located in the dentinal tubules and at the pulp-dentine border area. Traumatic oral hygiene procedures, excessive use of acid containing dietary fluids and certain dental treatments have been implicated in the occurrence of dentine hypersensitivity. Initial treatment relies on a positive doctor-patient relationship and the use of a desensitizing toothpaste containing strontium chloride, potassium nitrate or sodium citrate. If no relief is obtained, further treatment attempts need to be undertaken by the dentist--application of fluoride varnishes, potassium oxalate, resins or adhesives.
Article
The effect of cement and stone dust on teeth was explored in a cross-sectional study, using blind dental examinations. The sample consisted of 36 workers who had been exposed to to the dust and 62 control workers. Tooth surface loss was observed in 72.2 per cent of the exposed workers and in 48.4 per cent of the controls (P less than 0.03). In both the maxillae (P less than 0.001) and the mandible (P less than 0.02) the amount of tooth surface loss was greater in the exposed workers than in the controls. Both anterior and posterior teeth were affected. These findings indicate that tooth surface loss caused by work-related dust should be considered an occupational hazard.
Article
Exposed dentine may be sensitive to stimuli depending on the patency of the dentinal tubules. Most abrasive elements tend to produce a smear layer which obturates the dentinal tubules. This layer is easily removed by a number of erosive agents, particularly dietary acids. Mouthwashes are increasingly used and largely investigated for possible benefits to dental health. Rarely do studies assess potential detrimental activity. The aim of the present study was to examine effects of mouthwashes on dentine. Smear layers artificially produced on dentine sections were exposed, for time periods ranging from 3 to 300 min, to mouthrinses alone, or with subsequent brushing for 2 min using water or a fluoride toothpaste. Assessments were made by scanning electron microscopy. Of the nine rinses tested, six produced no consistently observable changes compared to water treated controls at any time period with or without brushing. A hexetidine rinse and a fluoride/antiseptic rinse both exposed tubules after exposure times of 2 h and longer, an effect enhanced by post-treatment brushing. A phenolic antiseptic rinse consistently removed the smear layer from specimens, an effect enhanced by brushing such that after 10 min exposure and 2 min brushing many tubules were open at the surface. The results indicate that the use of some mouthrinses could predispose to excessive tooth substance loss and dentine hypersensitivity, particularly if used prior to toothbrushing. There is a need to determine whether the intermittent use of some mouthrinses produces cumulative effects on dentine.
Article
Reported toothbrushing frequency and the effect of toothbrushing frequency, toothbrushing hand, sex and social class on the incidence of plaque and periodontal disease in a group of 720 adolescents examined at age 11-12 years and again at 15-16 years is presented. At 11-12 years, the mean toothbrushing frequency was 11.5 times per week. By age 15-16 years, it had risen to 13.3 times per week. Children from social class I were less likely to brush once per day or less and more likely to brush twice daily than those from social class V. At both examinations, consistently low negative correlations were seen between reported toothbrushing frequency and the mean scores for buccal and lingual plaque, buccal, mesial and total bleeding. Few significant differences were seen between left- and right-handed toothbrushers at age 11-12 years. These were almost entirely due to differences between the boys. By age 15-16 years, no significant differences existed between the two groups. At both examinations, the boys had higher plaque, bleeding and pocketing scores than did the girls. At 15-16 years of age, all social classes exhibited lower mean total pocketing scores than at age 11-12 years. At 11-12 years of age, the social class differences were mainly contributed by the girls, while at re-examination plaque and bleeding scores for both sexes showed an overall trend to increase from social class I through to social class V. At 11-12 years of age, the boys showed a trend for pocketing to increase from social class I through to social class V. This was absent at 15-16 years of age. The girls showed no such trend at 11-12, but it had emerged by age 15-16. The results again demonstrate the influence of social class and sex rather than toothbrushing frequency and handedness on oral hygiene and gingival health. However, in view of the high number of statistical tests employed, some caution must be exercised in the interpretation of differences significant at the 5 per cent level.
Article
In conclusion, if dentine hypersensitivity is to be prevented or more effectively managed, greater consideration must be given to the etiology of the condition than has been the norm to date. In established cases of dentine hypersensitivity, exclusion of other possible causes of pain is essential by considering a differential diagnosis. Management requires the determination of etiologic factors and predisposing influences, and where possible, their control or modification. In particular, the presence of erosive elements should be identified and separated from abrasive influences such as toothbrushing. To ensure the successful management of the clinical implications of dentine hypersensitivity, a careful assessment of the etiologic factors must be considered in evaluating the dental patient presenting with these symptoms.
Article
This article reviews dentin sensitivity from a mechanistic perspective beginning with short treatments of pulpal innervation, the hydrodynamic considerations of dentin, and how various stimuli may cause pain. Speculation is raised about the contribution of bacteria and their products on dentin sensitivity and how dentin might become truly hypersensitive, especially following periodontal therapy. Wherever possible, the clinical considerations of basic research is stressed.
Article
The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.
Article
Studies of extracted teeth have shown that teeth exhibiting dentine hypersensitivity have larger numbers of widened dentinal tubules at the dentine surface compared to non-sensitive teeth. Many compounds used in the treatment of dentine hypersensitivity are thought to achieve therapeutic benefit by tubule occlusion, but there has been almost no attempt to prove such action in vivo. These studies systematically determined whether the dentine surface could be evaluated non-invasively, by a scanning electron microscopic replica technique. Employing a silicone rubber impression method in vitro, the surface detail of dentine could be accurately replicated, with surface scratches, tubules and intratubular structures on the original reproduced on the replica. With attention to method, similar accuracy was achieved in vivo, particularly when tubules were open on the dentine surfaces of the original. The method would appear useful for the study of the dentine surface in cases of dentine hypersensitivity and could prove the first objective method of studying the effects of treatment agents used in the treatment of this painful condition.
Article
The clinician must frequently make treatment decisions with limited knowledge of the appropriateness and consequences of the different options. Patients have specific expectations: that the treatment they receive is the usual one, that they have been informed of the alternatives and the consequences, and most importantly that the treatment has a reasonable chance of success. In TMJ therapy, as with most treatments, the patient's improvement is closely connected to a proper diagnosis based on sound physiologic principles. This investigation will review four basic splint types and discuss their success in the resolution of various temporomandibular disorders. Since the position of the condyle-disc-fossa, the occlusal contact pattern and the masticatory muscle dynamics are interrelated, this study will focus on the physiologic changes splints may cause with modification of this tooth, joint and muscle relationship. Hopefully, selection of a specific splint design appropriate to the patient's disorder will be facilitated by better understanding of its physiologic and therapeutic effects.
Article
In this study the viability and the distribution of bacteria within the radicular dentin and pulp of periodontally diseased caries-free teeth were studied. Healthy teeth served as controls. Samples were obtained from the pulp tissue and from the radicular dentin. Dentin samples were taken from the interdental surfaces in the subgingival area. Starting from the pulpal side, three to five successive dentin layers of approximately 1 mm thickness were sampled. The samples were processed and cultured using an anaerobic technique. Bacterial growth was detected in 87% of the periodontally diseased teeth. In 83% of the teeth, bacteria were present in at least one of the dentin layers. Fifty-nine percent of the diseased teeth, from which the pulp tissue was cultured, contained bacteria in the pulp samples. The mean bacterial concentrations in the pulp and dentin layers ranged from 1,399 to 16,537 colony-forming units (CFU) per mg of tissue. These concentrations were 259 to 7,190 times greater than concentrations found in healthy teeth. It is suggested that the roots of periodontally diseased teeth could act as bacterial reservoirs from which recolonization of mechanically treated root surfaces can occur, as well as infection of the dental pulp. These findings might change current concepts concerning root surface debridement in periodontal therapy.
Article
Evidence indicates that teeth exhibiting cervical dentine hypersensitivity have open dentinal tubules at the dentine surface. The identification of factors which render dentine exposed and tubules open is important both to the prevention and management of dentine hypersensitivity. In this study, recently extracted teeth were root planed or burred to expose the root dentine. Specimens were horizontally sectioned and then using the apical portion as control, the coronal portions placed in a variety of strong and weak acids and dietary fluids. Examination under the scanning electron microscope revealed a smear layer covering completely underlying tubules on the control root planed or burred portions. Test portions exposed to strong and weak acids showed loss of the smear layer and exposure of large numbers of tubules. Formic and tannic acids produced no changes. Some dietary fluids, in particular red and white wine, citrus fruit juices, apple juice and yogurt produced similar etching effects to the acids. The low pH carbonated drink, coca-cola, and a blackcurrent cordial produced no effects. The results of this study in vitro cannot necessarily be extrapolated to the clinical situation, but suggest that certain dietary factors could play a rôle in the aetiology of dentine hypersensitivity. Dietary advice to patients may prove important in the management of this often recurrent condition.
Article
Based on the hydrodynamic theory for stimulus transmission across dentine, it would be logical to conclude that teeth exhibiting the clinical symptoms referred to as dentine hypersensitivity should have dentinal tubules open at the root surface and patent to the pulp. With the exception of studies on cut dentine, there is little direct evidence to support this conclusion. In this study, caries-free teeth with exposed cervical root areas scheduled for extraction which were classified as non-sensitive or hypersensitive after suitable stimulation were examined by scanning electron microscopy. Hypersensitive teeth showed highly significantly increased numbers of tubules per unit area (approximately 8 X) compared with non-sensitive teeth. Tubule diameters were significantly wider (approximately 2 X) in hypersensitive compared to non-sensitive teeth. The number of teeth showing the penetration of methylene blue through the zone of exposed cervical dentine was larger and the depth of penetration greater in hypersensitive teeth compared to non-sensitive teeth. The results provide further evidence that stimulus transmission across dentine in hypersensitive teeth is mediated by a hydrodynamic mechanism. An understanding of factors which open dentinal tubules would seem important if attempts to prevent or treat dentine hypersensitivity are to be successful.
Article
Numerous factors may affect the distribution of plaque and gingivitis in any individuals mouth. Of considerable importance must be the oral hygiene habits of each person, which will be influenced by compliance and dexterity with tooth cleaning methods. The pattern of gingivitis seen at a young age may, with time, reflect the eventual distribution of attachment loss. This in part, could explain the considerable variation in chronic periodontal disease seen between individuals and at different sites within the same mouth. This study reports the baseline data for the distribution of plaque and gingivitis in 1105, 11-12-year-old children in South Wales. The children were selected by disproportionate stratified random sampling and examined by a multidisciplinary group with the long-term aim of evaluating the importance of malocclusion to dental health and psychosocial variables. Toothbrushing frequency had a very low but significant correlation with the distribution of plaque and gingivitis, accounting therefore for only a small % of the variance in the group. For the total group and right-handed toothbrushers, buccal plaque and gingivitis was significantly increased on right contralateral teeth. No specific pattern for plaque and gingivitis distribution by side was seen for 100 left-handed toothbrushers. Plaque and gingivitis also showed significant differences dependent upon arch, tooth number, and surface. The population is being followed at 4-year intervals to monitor the pattern of periodontal disease with time and correlate changes with these baseline findings.
Article
The features of dentine hypersensitivity have been presented largely in descriptive form and there is only limited information on the intraoral distribution of the condition. Additionally, there have been conflicting reports of both high and low plaque accumulation at sites of hypersensitivity. This study investigates the distribution of recession, sensitivity and plaque in a group of 92 patients diagnosed as suffering moderate to severe dentine hypersensitivity affecting several teeth. The group was relatively homogeneous and there was no significant variation in recession, sensitivity or plaque scores between subjects. Tooth number (1–28) highly significantly influenced all parameters. In three-way analyses of variance to identify the effects of jaw, side and tooth number in a segment (1–7) almost all parameters were significantly influenced, however: 1.1. The dominant factors affecting degree of recession were side and tooth number.2.2. The dominant factor affecting sensitivity was side.3.3. The dominant factors affecting buccal plaque were side and tooth number.4.4. The dominant factor affecting lingual plaque was jaw.Two- and three-way interactions were, for the most part, also significant. The correlation matrix revealed significant positive correlations for recession with sensitivity and significant negative correlations for recession and sensitivity with buccal plaque. The findings indicate that the intraoral distribution of recession, sensitivity and plaque in this selected population is complex, being partly fitted by a main-effects model, and suggest that tooth cleaning is one of several major factors which influence the occurrence and distribution of dentine hypersensitivity.
Article
The incidence of ‘hypersensitive’ teeth was investigated in 369 patients by means of a questionnaire and intraoral testing with a cold-water mouthrinse (CWMR) and a sharp probe. Patients' subjective evaluations were found to be unreliable. Of the 103 patients who thought they had ‘sensitive’ teeth, only 62 responded positively to the intraoral tests. Around 29 per cent of patients reported discomfort with the CWMR, but when those with obvious causes for the pain (e.g., caries, cracked enamel) were excluded, the incidence of sensitivity to the CWMR was found to be 18 per cent. The incidence of sensitivity to CWMR and probing was 8·7 per cent. More females than males had sensitive teeth, but the differences were not statistically significant.
Article
It has been established that there is a relationship between osmotic pressure and pain-producing power when CaCl2 solutions in the range 200-2800 atm are applied to dentine (Anderson and Ronning, 1962). Experiments have been performed in an attempt to explain previous failure to confirm this relationship with other solutions. The experiments fell into two groups: those with solutions in the range 25-700 atm and those in the range 200-2800 atm. A decline in sensitivity during an experiment was observed as previously but was found to be caused only by solutions in the high range of osmotic pressure. Because of this decline in sensitivity, only the first results of every sequence of stimulations with the high range of osmotic pressures is comparable with results from the low range of osmotic pressures. Comparable data over the entire range of osmotic pressures 25-2800 atm was obtained by selecting only the first results of every series in the high range and using all the results in the low range of osmotic pressures. When this selection was made, the points on a graph of pain-producing power and log osmotic pressure fell on a sigmoid curve. This curve can be considered to represent the distribution of pain thresholds within the group of subjects, defined in units of log osmotic pressures. Probit transformation has shown that this distribution is normal (Gaussian). Osmotic pressure can therefore be taken as the effective stimulus common to all the solutions used in evoking pain from dentine.
Article
Hydrostatic pressures were applied to human teeth to investigate the development across the dentin of electric potentials which might be involved in excitation of sensory receptors. Electric potentials were measured, and an attempt was made to explain the phenomenon on the basis of the Helmholtz-Smoluchowski equation.
Article
象牙質知覚過敏症は, 日常の臨床でしばしば遭遇する疾患であり, しかもその病理ならびに処置法はまだ十分に明らかにされていない為, 著者は, 知覚過敏症の本態を知り, 同時に適確な処置法を知る目的で, その特徴的症状 (自発痛の欠如と誘発痛の持続性が短いこと) を中心に臨床的ならびに組織学的検索を行なった。その結果, 知覚過敏状態は露出象牙質全面に起るものでなく, 知覚過敏部は点状または小帯状 (Spot or Area) をなして局在することを知った。その知覚過敏部と歯髄・口腔粘膜の電気抵抗値を測定すると多くの場合15kΩから50kΩであり, 知覚過敏の訴えのない象牙質露出部の800kΩとに明かな差がみられた。象牙質知覚過敏を訴えるin situの歯牙の象牙質露出面に銀イオン導入を行うと, 銀イオンが歯髄面まで運ばれている所, 象牙質壁の途中までで輸送が留まっている所, 全く導入が起らない所がみられた。銀イオンの輸送は, その部位を流れる電流の大きさに比例し, 象牙質の抵抗に反比例するので, 銀イオンが歯髄面まで運ばれている所は, 電気抵抗値の小さい所, すなわち, 知覚の鋭敏な場所にあたる。この知覚過敏部位と連なる歯髄面の象牙芽細胞には減数, 消失がみられ, 知覚過敏の訴えのない部位には第2象牙質の添加があった。知覚過敏の特徴的痛みは, この変化した象牙細管を介して速やかに外来刺激が歯髄内の知覚神経に伝わることにより惹起されるものと考えられた。
Article
The exposure of cervical dentine has a multifactorial aetiology and pain may frequently be elicited by a number of stimuli. Management of the condition, dentine hypersensitivity, tends to be empirical because of the lack of knowledge concerning the mechanism of pain transmission through dentine. The pulpal changes associated with the condition and any modulating effect on symptoms are by no means clearly established. Evidence suggests that exposed dentine which is sensitive exhibits patent tubules. The question of how pain is initiated across the dentine has received considerable attention but still remains somewhat debatable. The literature reviewed indicates that, at most, nerve fibres only penetrate a limited distance along some dentinal tubules. The theories that either the odontoblasts and their processes act as dentinal receptors or the nerves in the pulp are the pain receptors, are discussed. Evidence for the stimulation of pulp nerve fibres by a hydrodynamic mechanism would appear the most likely mechanism. Nevertheless, whichever theory proves to be correct, occlusion of dentinal tubules would appear an essential prerequisite for an effective desensitising agent.
Article
This paper reviews the factors, anatomical, pathological and physiological, which have been implicated in the aetiology of gingival recession. Changes in the root surface when exposed to the oral fluids are also reviewed, a possible mechanism for the perpetuation of recession with increase in age is suggested.
Article
The object of the investigation was to test the value of the 3M Brand Electro-Ionizing Toothbrush in the treatment of dentinal hypersensitivity. Eighty-eight volunteers were divided into three groups, each using different methods: (I) stannous fluoride dentifrice and 3M brush without a battery; (II) stannous fluoride dentifrice and 3M brush with a 1 1/2 volt battery; and (III) strontium chloride dentifrice and 3M brush without a battery. The volunteers brushed their teeth for 3 minutes twice a day for 12 weeks using one of the three test agents. The subjects were tested at weeks 0, 2, 4, 8 and 12 by means of a cold water spray quantitated by a temperature probe. All three groups experienced improvement and by week 12 Groups II and III displayed much less sensitivity than did Group I. At the end of the 12 weeks the subjects were questioned as to benefit of treatment. The questionnaire revealed that stannous fluoride with the ionizing brush provided significantly greater relief than did the stannous fluoride alone.
Article
Evidence is presented that the rate of inward diffusion of chemicals through exposed dentine is affected by the rate of outward flow of fluid through the dentinal tubules. Such a flow has been demonstrated in cats. The flow rate appears to depend upon the pulpal tissue-fluid pressure; flow increased during pulp vasodilatation and decreased, even reversing in direction, during vasoconstriction. Pulp vasodilatation can be produced by stimulating intradental afferent nerves, including some of those that seem to be excited by displacement of tubule contents (i.e. by a hydrodynamic mechanism). Thus, when dentine is exposed and these afferents are stimulated they will help to protect the pulp by producing reflex vasodilatation, which will decrease the rate of diffusion of toxins from the mouth into the pulp. The relation between the rate of flow through dentine and the discharge evoked in intradental nerves was investigated in cats. Single fibres were more sensitive to outward than to inward flow. The flow rates required to excite the pulp afferents were greater than those observed during even maximal pulpal vasodilatation.
Article
The buccal surfaces of premolar teeth are common sites of gingival recession, generally attributed to overzealous oral hygiene. Scanning electron microscopy (SEM) of replicas made from dental impressions was applied to document the micromorphology of the buccocervical region of all premolar teeth in 27 dentally healthy, young adults. The SEM observations were correlated with clinical examination. Of the 216 sites, one-third, predominantly the maxillary first premolars, had gingival recession, but fewer than 50% were clinically discernible. The exposed roots were devoid of cementum, and the dentinal surface was smear-like or dotted with tubular apertures from which droplets of fluid extruded. SEM of replicas of gingiva, recorded as clinically healthy, frequently showed signs of inflammation: fluid exudate and distortion of gingival contour by swelling. The cervical enamel of healthy and affected sites showed characteristic periodic fissure-like cracks, probably enamel tufts. The high frequency of subclinical gingival recession, exposed cervical dentin, and gingival inflammation in dentally healthy young adults, in the absence of abrasion of hard or soft tissues, indicates the need to review conventional concepts of initiation of buccal recession and root exposure.
Article
Stimulus transmission across dentine, in conditions such as dentine hypersensitivity, is considered to occur via a hydrodynamic mechanism. This fluid flow in dentine may then induce a mechanoreceptor response in pulpal nerves. However, when fluid flows through a porous structure electrical potentials are also generated. The aim of this study was to develop a reproducible model system to measure streaming potential across dentine and hydroxyapatite and determine the influence of pressure. Using an acrylic cell, with silver electrodes, streaming potentials were recorded across dimensionally standardized dentine and hydroxyapatite specimens, over a pressure range of 1-6 atmospheres. Streaming potentials were found to be directly proportional to pressure and dependent on the electrical conductivity of the saline used in the cell. The results confirm the limited existing data on streaming potentials across dentine and indicate that at these low pressures excitation of pulpal nerves would not occur. However, if, as may be the case, stimuli applied to dentine create very high pressures, the resultant potentials generated could indeed evoke a neural response. The model system is worthy of further use to study this phenomenon and the factors which may influence it.
Article
Gingival recession (GR) is an intriguing condition. This brief communication, after proposing a definition for GR, considers the possible relevance of anatomical, physiological, pathological and traumatic factors in its etiology. It is probable that no one factor in isolation leads to the development of GR. Because of the possible influence of several factors, not necessarily acting synchronously, the occurrence of GR at a given site may be difficult to explain fully, and any subsequent changes may be hard to predict. The importance of the CEJ (or other fixed point) in assessment of GR severity is discussed. A new two-figure Index of Recession (IR) (e.g., F2-4asterisk) is also described, in which the 1st digit relates to the proportional evaluation of the horizontal extent of GR at the level of CEJ, and the 2nd digit is the vertical extent of GR from CEJ in millimetres; the asterisk denotes involvement of the MGJ. The prefixed F (or L) denotes whether GR is facial (or lingual) to the involved root.
Article
Clinical trials on dentine hypersensitivity have been numerous and protocols varied. To date there is little consensus as to the conduct of studies on this poorly-understood yet common and painful dental condition. A committee of interested persons from academia and industry was convened to discuss the subject of clinical trials on dentine hypersensitivity and a consensus report is presented. A double-blind randomized parallel groups design is recommended, although cross-over designs may be used for the preliminary screening of agents. Subjects may have multiple sites scored. Sample size will be determined by estimating the variability in the study population, the effect to be detected and the power of the statistical test to be used. Subject selection is based on a clinical diagnosis of dentine hypersensitivity, excluding those with conflicting characteristics such as currently-active medical or dental therapy. The vestibular surfaces of incisors, cuspids and bicuspids are preferred as sites to be tested. A range of sensitivity levels should be included. Tactile, cold and evaporative air stimuli should be applied. Negative and benchmark controls should be incorporated. Most trials should last 8 weeks. Sensitivity may be assessed either in terms of the stimulus intensity required to evoke pain or the subjective evaluation of pain produced by a stimulus using a visual analog or other appropriate scale. The subject's overall assessment may be determined by questionnaire. Outcomes should be expressed in terms of clinically significant changes in symptoms. Follow-up evaluation is required to determine the persistence of changes. At least 2 independent trials should be conducted before a product receives approval.
Article
The prevalence, distribution, and possible causal factors of cervical dentin hypersensitivity were studied in a population attending the Health Examination Center of National Taiwan University Hospital. A total of 780 patients were examined for the presence of cervical dentin hypersensitivity by means of a questionnaire and intraoral tests. There were 253 patients (32%) who claimed to have hypersensitive teeth at present and 90 patients (12%) who reported a history of hypersensitive teeth. The intraoral distribution of hypersensitivity showed that premolars and molars were the most common teeth sensitive to the air and probe stimuli, while the incisors were the least sensitive ones. The presence and history of dentin hypersensitivity were positively correlated with previous tooth-brushing and periodontal disease. Only a few of the patients who claimed to have dentin hypersensitivity had tried treatment with desensitizing tooth-pastes (11%) or sought professional help (5%).
Article
The aim of this study was to determine, by questionnaire, the reported levels of dentine hypersensitivity in adult patients attending general dental practice. A total of 250 subjects (88 males, aged 40 +/- 14.3 years; 162 females aged 37 +/- 11.6 years), were recruited to the study in 5 dental practices. The prevalence of reported sensitivity was 57.2%, most frequently occurring in the 30-39 year age group. In the vast majority of cases (89.3%) cold was the major stimulus for pain, other commonly reported causes being toothbrushing (38.6%), hot (37.9%) and sweet (25%) stimuli. Desensitising toothpastes were used by 67.9% of those reporting sensitivity, the majority of these (72.6%) reporting a beneficial effect. Professional treatment had been sought by 32% of subjects, almost all (91%) reporting an improvement post-treatment. There was no significant correlation in the level of reported sensitivity and previous periodontal treatment. The majority of subjects with sensitivity also smoked (67.6%), although this relationship did not reach statistical significance (p = 0.07). Visual analogue scales indicated that perceived pain levels with dentine sensitivity were relatively low. It was concluded that the prevalence of dentine sensitivity found in this study was much higher than previously reported, suggesting an increase in the levels of sensitivity within the general population.