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PubMedDate not supplied

The effect of propolis on dentinal hypersensitivity and level of satisfaction among patients from a university hospital Riyadh, Saudi Arabia.

Propolis has been used since ancient times in folk medicine for its beneficial effects. It is a mixture of resin, essential oils and waxes mixed with bee glue; also it contains amino acid, minerals, ethanol, vitamin A, B Complex, E, Pollen and highly active ingredient known as Bioflavenoid (Simon Martin 1991). To date, there have been no studies done on desensitizing effect of Propolis in vivo. So, the aims of this study are to evaluate the effect of Propolis in a clinical trial on subjects with dentinal hypersensitivity, and to assess the level of satisfaction among subjects after they have used the Propolis. Twenty six Saudi female subjects at King Saud University, College of Dentistry, Riyadh, Saudi Arabia, age ranged from 16-40 yr. (mean = 23 yrs.), were included in the study over a period of four weeks. The Cervical Dentinal Sensitivity (C.D.S.) was assessed by two methods: 1--cold air stimuli. 2--Subjective reporting of pain, with a modified questionnaire (Gillam 1997) and a numerical scale 0-10 (Downie et al 1978). The patients were followed up for four weeks after using Propolis, there were two recalls, and the first recall was after one week and the second recall after four weeks of the base line. The results between the base line findings and after four weeks were statistically significant. Eighty five percent of the subjects were found highly satisfied; the Propolis had significant effect on dentinal hypersensitivity during the study period. Further research is needed with double blind clinical trial on a large sample size.

Adolescent↗

PubMed2003

The assessment of an intra-oral video camera as an aid to occlusal caries detection.

AIMS: To investigate the use of intra-oral video cameras (IOVCs) for occlusal caries detection. DESIGN: Eighty premolars and molars set-up to simulate clinical conditions were examined by six examiners using three techniques: visual examination (EX), an IOVC (CAM) and by watching a video that was recorded using an intra-oral video camera (VID). The teeth were then sectioned for histological validation. RESULTS: 30 surfaces had lesions limited to enamel and 39 had lesions extending into dentine. Sensitivity scores at the D1 threshold (enamel and dentine lesions) were 43% (EX), 68% (CAM) and 77% (VID) whilst the specificity scores were 92% (EX), 64% (CAM) and 60% (VID). Corresponding results at the D3 threshold (caries extending into dentine) were 27%, 42%, 60%, 97%, 99% and 77%. CONCLUSIONS: Compared to unaided vision, the use of an IOVC significantly increases the number of occlusal lesions detected, however, there is a rise in false positive scores at the D1 threshold. The use of the video technique also significantly increases the number of occlusal lesions detected but with a concurrent rise in false positive scores at both thresholds.

Bicuspid↗

PubMed2002

Diagnosis and dental treatment of a young adult patient with gastroesophageal reflux: a case report with 2-year follow-up.

A young adult who complained of extreme dentin sensitivity to tactile and thermal stimuli exhibited severe, generalized tooth erosion and an associated parafunctional habit. The diagnosis of the underlying general disease and treatment of its dental sequelae are presented, together with a 2-year follow up. Patients who are suspected of having gastroesophageal reflux should be referred to a gastroenterologist or other health professionals to ensure early diagnosis and treatment of the underlying disorder, thus minimizing the destruction of the patient's dentition and improving the patient's general health. Dental treatment should be adjusted to fit the characteristics of each case.

Adult↗

PubMed1998

Pulpal injury: pathology, diagnosis and periodontal reactions.

Diagnosis of pulpal disease can be difficult due to the lack of diagnostic signs and symptoms available to the practitioner. An understanding of the possible underlying pathological processes, combined with an exact assessment of the pain history, and appropriate clinical tests, should aid the practitioner in determining the nature of pulpal inflammation, and differentiating it from dentine sensitivity and cracked teeth. The responses of the pulp to traumatic injury to the periodontal membrane (PDM) require special consideration, particularly with respect to the assessment of pulp vitality, and the determination of cases requiring pulp extirpation in order to avoid inflammatory root resorption. Although the pulp is relatively isolated from the rest of the dentoalveolar complex by a dentine/cementum barrier, it is important to remember that it can communicate with the PDM through apical and lateral foramina, and areas of damaged cementum. Hence, it is a priority to both preserve the integrity of the cemental layer in cases of traumatic injury and periodontal disease, and to prevent the inflammation and resorption associated with periapical lesions by accurate diagnosis of irreversible pulpitis and pulp necrosis, followed by appropriate endodontic debridement procedures.

Cracked Tooth Syndrome↗

PubMed1977

A new desensitizing dentifrice: preliminary report.

Dentin sensitivity is one of the most painful, ubiquitous, and least satisfactorily treated chronic problems of the teeth. The purpose of this clinical trial was to test the sensitivity-reducing effectiveness of five dentifrices over a six-week period. For the study, 176 adults, ages 18 to 63, exhibiting a total of 486 hypersensitive surfaces, were randomly allocated to five experimental groups to use one of the following: a strontium chloride dentifrice, a 0.4% stannous fluoride gel, a pluronic F-127-sodium citrate gel, a pluronic F-127 gel, or a control dentifrice. No specific instructions were provided as to the frequency or method of toothbrushing; thus, the participants brushed their teeth in their usual manner. The analysis of the data was limited to 168 persons who complied with study procedures. Chi-square analysis examined the statistical differences between the four test agents and the control formulation. The desensitizing effect of the pluronic plus sodium citrate gel was highly significant, and the plain pluronic F-127 preparation was effective to a lesser degree. Patients using the strontium chloride or stannous-fluoride-containing dentifrices did not exhibit a significant improvement over the control group. This study demonstrated that a pluronic polyol gel containing sodium citrate is highly effective in controlling tooth hypersensitivity.

Adult↗

PubMed2002

Some effects of enamel matrix proteins on wound healing in the dento-gingival region.

OBJECTIVE: The aim of the present study was to evaluate by clinical means the effect of enamel matrix proteins on the healing of a soft tissue wound produced by periodontal pocket instrumentation. MATERIAL AND METHODS: The study was performed as an intra-individual, longitudinal trial of 3 weeks duration with a double-masked, split-mouth, placebo-controlled and randomized design. The patient material was comprised of 28 subjects with moderately advanced, chronic periodontitis. Each patient presented with 3 sites in each of 2 jaw quadrants with a probing pocket depth (PPD) of >or=5 mm and bleeding following pocket probing (BoP). Baseline examination, including assessments of plaque, gingival inflammation, PPD, BoP and root dentin sensitivity, was carried out one week after oral hygiene instruction and careful self-performed plaque control. All experimental sites were scaled and root planed, and the soft tissue wall of the pocket was curetted to remove the pocket epithelium and adjacent granulation tissue. The site was carefully irrigated with saline. When the bleeding from the pocket had ceased, a 24% EDTA gel was applied in the site and retained for 2 min. This was followed by careful irrigation with saline. Left and right jaw quadrants were then randomized to subgingival application of enamel matrix derivative (Emdogain) or vehicle-control. All sites were re-examined after 1, 2 and 3 weeks. In addition, a visual analogue scale (VAS) was used to score the degree of post-treatment discomfort. The primary endpoints of treatment success were defined as (i) pocket closure (PPD <or=4 mm), (ii) no bleeding following pocket probing, (iii) no sign of gingival inflammation (GI score =0) and (iv) low degree of post-treatment discomfort (VAS <or=20). Statistical analyzes of intra-individual differences between the test and control treatments were performed by the use of Wilcoxon signed rank test. For comparison of the proportions of sites reaching the defined endpoints of treatment success, a site-based analysis was performed using 2x2 tables and the Fisher exact test. RESULTS: The endpoint "GI score =0" was reached at 16% of the sites subjected to application of Emdogain at 1 week and at 2% of the control sites (p=0.001). At 2 weeks, the corresponding figures were 25% versus 12% (p =0.028). Absence of BoP was at 1 week 57% for the Emdogain treated sites compared to 35% for the control sites (p=0.003). At 2 weeks, this endpoint was reached in 73% and 59% of the test and control sites, respectively (p=0.051). In terms of the endpoint defined for probing pocket depth, PPD <or=4 mm, no differences between test and control sites were found. At 1 week, the proportion of patients reporting a VAS score <or=20 was significantly higher for the Emdogain treated quadrants than for controls (p=0.002). CONCLUSION: The results indicated that Emdogain topically applied in instrumented pockets enhance the early healing of periodontal soft tissue wounds.

Administration, Topical↗

PubMed1993

Inhibition of serum albumin flux across exposed dentine following conditioning with GLUMA primer, glutaraldehyde or potassium oxalates.

A variety of medicaments used on dentine in various treatment procedures may cause a reduction in dentine permeability. By observing the flow of endogenous serum albumin across exposed dentine, agents known to promote dentine bonding of restorative resins or retard dentine sensitivity were assessed regarding their capacity to arrest dentinal fluid flow. Experiments were conducted in young adult macaque monkeys employing Class V cavity preparations in incisors and canines. A diffusion-in-gel-enzyme-linked-immunosorbent-assay (DIG-ELISA) was used to quantitate serum albumin in effluents from these cavities at various time periods following either no treatment or topical application with GLUMA primer, glutaraldehyde or potassium oxalates. While in untreated cavities serum albumin continued to flow even after a period of 1 week, a substantial reduction or complete cessation of serum albumin flux was seen following topical application of the agents tested, suggesting a durable effect on dentinal fluid flow. No difference between agents was observed. Further cutting of the cavity bottom a few tenths of a millimetre resulted in renewed flow of serum albumin. Data suggest that the solutions tested are capable of reducing dentinal fluid flow onto exposed dentine surfaces.

Acid Etching, Dental↗

PubMed1990

[Treatment of dentin hypersensitivity: a retrospective and comparative study of two therapeutic approaches].

Stimulation on exposed dentine at the enamo-dentinal junction is often painful and uncomfortable for the affected patient. Two hundred and forty-four subjects suffering from dentinal sensitivity, aged from 18 to 48 years old, were treated with two types of desensitizing agent. In this study, we used sodium fluoride (Duraflor) and calcium hydroxide (Dycal catalyst). The desensitizing agent is first applied on the exposed dentine and then burnished, without local anaesthesia, until all sensitivity has disappeared. After the first session, 100% of the subjects were desensitized. All subjects were seen 1, 2, 3, 6, 13 and 26 weeks after the first application. After 6 months, 94% of the subjects treated with calcium hydroxide (Dycal) and 87% of those treated with sodium fluoride (Duraflor) were still desensitized. This difference is statistically significant at alpha = 0.01 (Anova test). In conclusion, our study reveals that both calcium hydroxide (Dycal) and sodium fluoride (Duraflor) are effective in the treatment of dentinal hypersensitivity. A slight significant advantage in using calcium hydroxide is also noted.

Adolescent↗

PubMed2006

Immediate dentin sealing using an antibacterial self-etching bonding system.

The pathway to the dental pulp through the cut dentin can lead to pulpal pathology following a crown preparation. While eugenol temporary cements can occasionally reduce dentin sensitivity following tooth preparation, this material can be problematic due to its unfavorable reactivity with composite resin cements. To protect the prepared substrate prior to its definitive restoration and to minimize post-operative sensitivity attributed to thermal changes or bacterial invasion of the dentin tubules, a treatment option that is more effective biologically and chemically is required. This article demonstrates the clinical application of an antibacterial self-etching bonding system.

Anti-Bacterial Agents↗

PubMed1994

[The application of temporary crown and bridge for fixed prosthetic restorations]

The preparation of teeth for fixed prosthetic restoration needs the temporary restoration for various reasons.Once the enamel has been removed,a vital tooth of the sensitive dentin is exposed to the oral environment. If left unprotected teeth,the patient would experience a significant amount of sensitivity to the various stimulations to which the tooth is exposed.In addition,exposed dentin is much more susceptible to caries than enamel is.The prepared tooth is also lacking contact mesiodistall as well as occlusally with its counterparts in the dentition.It is not uncommon for the prepared tooth to drift mesially or distally or to extrued in an occlusal direction.This movement would,of course,cause problems in seating the final restoration.Temporization also allows for the testing of both the esthetic and functional design of the final restoration.The paper showed some fabrication methods for temporary crown and bridge and discussed the effect on the temporary crown and bridge and its needs for design.

Journal Article↗

PubMed1984

Effects of air-drying in vitro on human dentine permeability.

The effects of evaporation produced by air blasts of 0, 0.5, 2 or 5 min to dentine in vitro were evaluated by measuring dentine hydraulic conductance before and after each trial. When the tubules were filled with water, even prolonged evaporation had no effect on dentine permeability. Tubules filled with physiological salt solution produced a time-dependent decrease in dentine permeability. Tubules filled with 1.5 per cent albumin in water gave the largest reductions in dentine permeability. These effects were more marked in unetched as opposed to acid-etched dentine. The results suggest that part of the reduction in dentine sensitivity produced clinically by prolonged air blasts may be due to precipitation of organic and inorganic constituents of dentinal fluid at the surface.

Acid Etching, Dental↗

PubMed1992

Effect of serotonin (5-HT) and calcitonin gene-related peptide (CGRP) on the function of intradental nerves in the dog.

Several inflammatory mediators including serotonin (5-HT) have been indicated to play a role in the sensitization of intradental nerves. In the present investigation, using the single fibre recording technique, the effect of locally applied 5-HT (1 mg/ml) and calcitonin gene-related peptide (rat CGRP 2 micrograms/microliters) on the function of intradental nerves in the dog was studied. The effect of these substances on the pulpal blood flow was also investigated to check their effective diffusion into the dental pulp. 5-HT induced a low-frequency background firing in 11 out of 30 nerve fibres. The number of fibres responding to probing, air blast and osmotic stimulation was increased significantly after 5-HT application. Three fibres responded to cold stimulation after 5-HT application; no responses were induced before. After CGRP application, a continuous low-frequency firing was induced only in 1 fibre out of 11 and 1 fibre which before did not respond to osmotic stimulation gave responses to saturated glucose. The responses to probing and air blasts were qualitatively unchanged. Local application of either of the substances induced a change in pulpal blood flow. It is suggested that while 5-HT is able to sensitize intradental nerves to various hydrodynamic stimuli, CGRP seems to be less effective. Pulpal inflammation with the release of inflammatory mediators may significantly affect the degree of dentine sensitivity.

Animals↗

PubMed1999

Pulpal ischemia in man: effects on detection threshold, A-delta neural response and sharp dental pain.

Preferential blocks of peripheral nerves have shown that myelinated nerves are more susceptible to local compression and less resistant to asphyxia than unmyelinated fibers. Since two groups of functionally different nociceptors exist in the dental pulp, it is of theoretical and clinical interest to determine the influence of ischemia on the sensitivity of human dental pulp, using standard means for testing tooth vitality and at the same time investigating the intensity coding in one pathway of the afferent trigeminal system. Adrenaline was used to study the differential effect of adrenaline-induced ischemia on intradental A-delta nerve activity (INA) and the concomitant sharp pain, as well as on the detection threshold for monopolar electrical stimulation. Cold (ethyl chloride) and heat (heated gutta-percha) stimulation was applied to the tooth surface. In accordance with the hydrodynamic theory of dentin sensitivity the rapid fluid flow induced in the dentinal tubuli by these thermal stimuli is an adequate stimulus for selectively activating the A-delta nerves in healthy pulps. Consistency plots of the magnitude of the perceptual experience of sharp pain against the neural population response in linear coordinates yielded a high product-moment correlation, implying linearity for the intensity coding relationship. In contrast to the significant reduction of INA and its perceptual correlate of sharp pain after adrenaline administration, the electrical detection threshold remained constant during the full test period, suggesting that electrical threshold measurements have their limitations as a diagnostic tool or criterion for assessing the sensitivity of the dental pulp. The absence of A-delta activity was parallelled by no sensation of sharp pain. These findings suggested that the integrated neural A-delta activity constituted the underlying peripheral neurophysiological mechanism of the sensory intensity of sharp dental pain.

Adult↗

PubMed1994

The neurophysiological basis and the role of inflammatory reactions in dentine hypersensitivity.

Recent studies indicate that intradental A-type nerve fibres are responsible for the sensitivity of dentine and are activated by fluid movements in dentinal tubules (hydrodynamic mechanism). The patency of the tubules affects dentine sensitivity to a great extent. Both A delta- and A beta-type nerve fibres respond to dentinal (hydrodynamic) stimulation in a similar way. Only a few studies have been made on the regional sensitivity of dentine or the receptive areas of intradental nerve fibres. The results indicate that the fibres innervating different parts of coronal dentine are equally sensitive to dentinal stimulation but those in the cervical area may be less responsive. Inflammation in the pulp can considerably alter dentine sensitivity. In dog teeth with chronically exposed dentine, nerve responses to hydrodynamic stimulation were reduced although other functional changes indicated nerve sensitization. This may be due to spontaneously occurring changes in the exposed dentine that block the tubules. In acute experiments on cat and dog teeth with open dentinal tubules, certain inflammatory mediators increase the sensitivity of the responding nerve fibres. It seems that intradental C-fibres do not respond to hydrodynamic stimulation of dentine. They are polymodal and activated when external stimuli reach the pulp proper. They could perhaps mediate the dull pain connected with pulpitis. However, they might also have an important modifying effect on dentine sensitivity because they can release neuropeptides, which function in the inflammatory reactions.

Animals↗

PubMed1990

[Test of an electronic fissure caries detector].

The reliability of an electronic detector for caries in pits and fissures was tested by means of physical measurements, histological sections and clinical evaluation. The device measures the ohmic resistance of the tooth, technical data are given. First we compared measurements and histological sections of teeth due for extraction. The results indicated a high sensitivity of the device for caries, false positive diagnoses did not occur. Based on this, a clinical evaluation on 179 teeth was performed. Under practical conditions the sensitivity of the electronic detector (0.77) was lower than in the first part of the study; conventional diagnosis revealed more carious lesions in dentine (sensitivity: 0.82).

Dental Fissures↗

PubMed1980

In vivo resin impregnation of dentinal tubules.

This study investigated the in vivo resin impregnation of dentinal tubules on exposed dentin surfaces with transversely cut tubules and examined the effect of different pretreatment on impregnation of the dentin. The results have lead to the following conclusions: 1. There is no sound reason to routinely etch and impregnate the dentin with resin on cavity walls. 2. It is possible to impregnate flat areas of exposed dentin which are not close to the pulp and which have transversely sectioned dentinal tubules. This may block dentin sensitivity, preventing infection and irritation of the pulp. 3. The etching time with 37% phosphoric acid should be limited to 5 seconds. This is sufficient to open and enlarge the dentinal tubules at the surface. 4. The desiccation should be performed with the air nozzle near, and almost parallel to, a flat surface for at least 15 seconds. An uneven surface results in uneven impregnation of the dentinal tubules due to incomplete desiccation. Therefore, the compressed air should be applied from different directions. Better results are obtained if the dentin surface is smooth. This may be achieved by planing with a smooth fissure bur. 5. To obtain satisfactory desiccation of dentin walls in cavities, an air nozzle should be reduced in diameter enough to allow it to enter the cavity. It should be kept in motion while continuously air drying the cavity surface.

Acid Etching, Dental↗

PubMed2005

Immediate dentin sealing: a fundamental procedure for indirect bonded restorations.

UNLABELLED: The purpose of this article is to review evidence-based principles that could help optimize dentin bonding for indirect composite and porcelain restorations. More than 30 articles were reviewed, most of them addressing the specific situation of dentin bonding for indirect restorations. It appears that the combined results of this data plus clinical experience suggest the need for a revision in the dentin bonding procedure. Immediate application and polymerization of the dentin bonding agent to the freshly cut dentin, prior to impression taking, is recommended. This new application procedure, the so-called immediate dentin sealing (IDS), appears to achieve improved bond strength, fewer gap formations, decreased bacterial leakage, and reduced dentin sensitivity. The use of filled adhesive resins (low elastic modulus liner) facilitates the clinical and technical aspects of IDS. This rational approach to adhesion also has a positive influence on tooth structure preservation, patient comfort, and long-term survival of indirect bonded restorations. CLINICAL SIGNIFICANCE: Tooth preparation for indirect bonded restorations (eg, composite/ceramic inlays, onlays, and veneers) can generate significant dentin exposures. It is recommended to seal these freshly cut dentin surfaces with a dentin bonding agent (DBA) immediately following tooth preparation, before taking impression. A three-step total-etch DBA with a filled adhesive resin is recommended for this specific purpose. The major advantages, as well as the technical challenges of this procedure, are presented in detail.

Dental Bonding↗

PubMed1992

Smear layer: overview of structure and function.

Smear layers are created on hard tissues whenever they are cut with hand or rotary instruments. This thin (1-2 microns) layer of denatured cutting debris is very tenacious and, in fact, is often the surface to which restorative materials are luted. The solubility characteristics, chemical reactivity and the structure-function relationships of this layer have not yet been well-defined. During creation of the smear layer, cutting debris is forced variable distances into dentinal tubules. These so-called smear plugs, together with the smear layer decrease dentin permeability, dentin sensitivity and surface wetness. Bonding adhesive resins to smear layers appears to limit the theoretical bond strength unless the smear layers are loosened or partially removed. Future research in this area will include the use of surface analytical techniques such as Auger electron spectroscopy and ESCA. These techniques are required because of the thinness of the smear layer. It is clear that the nature of this critical interface between dental materials and cut hard tissues remains largely unknown. This field will provide fertile ground for future research.

Animals↗