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PubMed1990

Historic review of the management of tooth hypersensitivity.

For well over a century, there has been cognizance that sensitivity is a serious problem, that it arises when the dentin and cementum are exposed, that fluid movement within the dentinal tubules acts as a provocative stimulus, that tubules can be sealed off (apparently in most instances) without damage to the tooth or the dental pulp, and that the problem can also be at least partially resolved by suppressing nerve firing within the pulp. Most of the therapies proposed to date for treatment rely on one of two major suppressive mechanisms, that is, sealing off the dentinal tubules or dampening neural impulses, even though at the time of their development and use they have been mostly empiric in nature. At present, there appear to be a number of effective therapies, although admittedly none meet all of the hypothetic requirements proposed by Grossman over 50 years ago. Included among the agents with reasonable documentation of effectiveness and little in the way of negatives are fluorides, strontium chloride, potassium nitrate, potassium oxalate, sodium citrate, surface sealing agents (varnishes, resins, cyanoacrylate), calcium hydroxide, and others. There are many dedicated workers who are still concerned with achieving better insight into the problem and methods to resolve it.

Animals↗
PubMed1998

The clinical longevity of porcelain veneers: a 48-month clinical evaluation.

The authors evaluated the clinical longevity of a brand of porcelain veneers and the accompanying cementation system. Fifty-nine porcelain veneers were prepared and placed in 12 patients by one practitioner and evaluated by two evaluators using modified Ryge criteria at baseline and 12 months. Fifty-three veneers were evaluated similarly at 48 months. Plaque index and gingival index scores were recorded as well. At 48 months, the veneers had stable color, all margins were clinically acceptable, there was no secondary caries and the patients reported no sensitivity.

Adhesives↗
PubMed2001

Aesthetic and adhesive cementation for contemporary porcelain crowns.

The evolution of aesthetic restorative materials has led to the development of new preparation designs and cementation protocols. While conventional cements were able to provide mechanical and macromechanical retention for restorations with limited aesthetic expectations, resin cements with micromechanical retention have been formulated as aesthetic alternatives. The objective of the present article is to establish the differences between conventional and adhesive crown cementation techniques, as well as to provide guidelines for reducing postoperative sensitivity and improving aesthetic and functional results.

Cementation↗
PubMed1995

Effect of Amalgambond on cervical sensitivity.

PURPOSE: To evaluate in vivo the feasibility of utilizing Amalgambond adhesive agent alone for the treatment of cervical sensitivity on teeth that did not require a restoration. MATERIALS AND METHODS: Nineteen subjects were selected from a group of patients reporting sensitivity at the cervical region of anterior or posterior teeth. The degree of sensitivity was determined by tactile sense (scraping an explorer over the surface area) or "fluid-shift" sensitivity determined by an air-blast from a syringe for 5 seconds. Patient reactions to stimuli were qualified as : (1) none; (2) slight; (3) moderate; and (4) severe. Only patients with at least two teeth experiencing moderate or severe sensitivity were used. Each of the patients had at least one sensitive tooth treated with Amalgambond and at least one untreated sensitive tooth to act as control. Results were recorded at 24 hours, 7 days, 1 and 6 months. RESULTS: At 6 months, 18 of 19 treated teeth recalled showed decreased sensitivity with 15 showing no sensitivity, and only one remained as sensitive as at baseline. All control teeth remained unchanged from original sensitivity ratings. The teeth with cervical sensitivity treated with Amalgambond adhesive alone had a high probability of decrease or complete loss of sensitivity immediately and the decrease was sustained for at least 6 months (P<0.001).

Dentin Sensitivity↗
PubMed1999

Using a new condensable composite for posterior restorations.

This article discusses the properties of condensable composites and how their filler particles are continually being improved to create an updated, advanced tooth-colored material that can be packed with the same clinical success as amalgam in posterior restorations. Many dental companies are now addressing the major concerns of shrinkage, polishability, and discoloration that inundated previous composites by introducing the next generation of condensable composites. With increased filler content and the addition of special additives to the resin phase, Prodigy Condensable allows clinicians to follow the same protocol for placing amalgam restorations while being assured of improved wear-resistance, strength, longevity, postoperative sensitivity, and esthetics.

Acid Etching, Dental↗
PubMed1998

Digital radiography and caries diagnosis.

Direct digital acquisition of intra-oral radiographs has been possible only in the last decade. Several studies have shown that, theoretically, there are a number of advantages of direct digital radiography compared with conventional film. Laboratory as well as controlled clinical studies are needed to determine whether new digital imaging systems alter diagnosis, treatment and prognosis compared with conventional methods. Most studies so far have evaluated their diagnostic performance only in laboratory settings. This review concentrates on what evidence we have for the diagnostic efficacy of digital systems for caries detection. Digital systems are compared with film and those studies which have evaluated the effects on diagnostic accuracy of contrast and edge enhancement, image size, variations in radiation dose and image compression are reviewed together with the use of automated image analysis for caries diagnosis. Digital intra-oral radiographic systems seem to be as accurate as the currently available dental films for the detection of caries. Sensitivities are relatively high (0.6-0.8) for detection of occlusal lesions into dentine with false positive fractions of 5-10%. A radiolucency in dentine is recognised as a good predictor for demineralisation. Radiography is of no value for the detection of initial (enamel) occlusal lesions. For detection of approximal dentinal lesions, sensitivities, specificities as well as the predictive values are fair, but are very poor for lesions known to be confined to enamel. Very little documented information exists, however, on the utilization of digital systems in the clinic. It is not known whether dose is actually reduced with the storage phosphor system, or whether collimator size is adjusted to fit sensor size in the CCD-based systems. There is no evidence that the number of retakes have been reduced. It is not known how many images are needed with the various CCD systems when compared with a conventional bitewing, nor how stable these systems are in the daily clinical use or whether proper cross-infection control can be maintained in relation to scanning the storage phosphor plates and the sensors and the cable. There is only sparse evidence that the enhancement facilities are used when interpreting images, and none that this has changed working practices or treatment decisions. The economic consequences for the patient, dentist and society require examination.

Contrast Media↗
PubMed1994

Etiology, mechanisms, and management of dentine hypersensitivity.

Dentine hypersensitivity is a common painful condition of the teeth for which little is known of the etiology and predisposing factors. This tends to compromise management, and recurrence of the condition is frequent. Abrasive and erosive factors, by their effects on enamel and gingiva, are important in localizing sites of exposed dentine. Erosive agents are probably responsible for initiating sensitivity by opening dentinal tubules. Management should not only be treatment based. First, a differential diagnosis should be considered. Then, etiologic and predisposing factors should be identified and where possible removed, reduced, or modified. Treatments are largely aimed at blocking the hydrodynamic mechanism for stimulus transmission across dentine by occluding dentinal tubules. There is a need for further research into understanding the condition itself, its etiology, and the mode of action of the large number of varied but apparently effective therapeutic agents.

Dentin↗
PubMed2003

Treatment of cervical sensitivity with a root sealant.

PURPOSE: To assess a novel root sealant for cervical sensitivity. MATERIALS AND METHODS: Clinical assessments, impressions and modified USPHS criteria (n = 24) were carried out at baseline, 3, 6 and 19 months. Plaque samplings were performed at baseline and after 3 and 19 months. RESULTS: At 19 months, 20 patients completed the clinical trial. There was a significant reduction for the sensitivity scores. The log10 of total colony-forming units (cfu + 1) from overlying plaque significantly reduced. The percentage of mutans streptococci reduced after 3 months (P < 0.01) and yeasts also reduced after 19 months (P < 0.01). The mean overall wear (+/- SD) (microm) on the sealant was 78.8 +/- 21.3 at 3 months; 95.4 +/- 7.3 after 6 months and 136.5 +/- 9.8 after 19 months. In conclusion, this sealant was capable of reducing sensitivity. Further wear on the cervical surface was prevented as the mean sealant thickness was 65.3 +/- 3.3 after 19 months.

Adult↗
PubMed2000

Two-year evaluation of class II resin-modified glass ionomer cement/composite open sandwich and composite restorations.

Restorations made of a combination of resin modified glass ionomer cement (RMGIC) and composite resin (CR)--open sandwich fillings--have been recommended for use in proximal boxes of molar cavities. The aim of this study was to compare the clinical behaviour over time of RMGIC/CR sandwich restorations versus CR restorations in Class II molar cavities. During a period of 2 years, a total of 220 restorations were placed in 118 patients by one operator (VV). A random block allocation was used to allocate cavities to one of the two restorative techniques. Bitewing radiographs and photographs were taken at baseline and at annual recall appointments. At present, a total of 210 restorations have been evaluated after 1 year and 141 restorations after 2 years. All restorations were evaluated using a modification of USPHS criteria. A total of three RMGIC/CR and two CR restorations (2.8%) were rated as failures caused by endodontic complications or major fractures. Twenty-eight teeth were reported to have postoperative sensitivity at the baseline evaluation 1 week following placement. Nine RMGIC/CR (8.5%) and four CR (4.9%) restorations with minor fractures were rated Charlie but were still acceptable. Bitewing radiographs revealed progression of carious lesions in proximal surfaces of originally intact or restored teeth adjacent to five (5.9%). RMGIC/CR restorations and eight (10.9%) CR restorations. No statistically significant differences between the two types of restoration were observed with respect to marginal adaptation, discoloration and caries progression. However, a higher number of large CR filling exhibited postoperative sensitivity at baseline compared to moderate CR or extensive and moderate RMGIC/CR restorations.

Adolescent↗
PubMed1998

Short-term clinical evaluation of post-operative sensitivity with bonded amalgams.

PURPOSE: To compare the in vivo short-term post-operative sensitivity of teeth restored with amalgam using a bonded resin liner vs. teeth restored using a copal varnish liner. MATERIALS AND METHODS: 20 patients received Class I or Class II contralaterally paired restorations which were placed at the same appointment. All restorations were placed by the same operator using an identical technique except that, in each randomized pair, one was lined with an adhesive resin (Scotchbond Multi-Purpose Plus) while the other was lined with copal varnish. (Plastodent) Patients were provided visual analog scale response forms, instructed in their use, and requested to complete and return a form reporting their degree of sensitivity at baseline and on days 1, 3, 7, 14, and 30 post-operatively. Data from the response forms were analyzed for differences using a paired t-test. RESULTS: A response rate of 90% (18/20) was achieved for the complete 30-day assessment. Increases in thermal sensitivity beyond baseline were seen in 13 of the 18 subjects involving 12 restorations lined with copal varnish and 10 lined with adhesive resin. Typically, sensitivity peaked on day 1 or day 3 and diminished to pre-operative levels by day 30. Only three subjects reported greater sensitivity at day 30 than at baseline. No significant difference in post-operative sensitivity was found between the two cavity lining materials at any post-operative interval.

Chi-Square Distribution↗
PubMed2000

Creating a reliable bond. An all-in-one system.

This paper explains the reasons why a new adhesion concept was developed, how it was conceived and what properties and test results were achieved with the product Prompt L-Pop that follows this new concept. Therefore, a short historical introduction into the development of adhesive materials is given followed by a summary of today's state-of-the-art techniques. The requirements for the new adhesion concept are pointed out and the outcome of the effort in the development is explained in more detail. In vitro and in vivo test results of Prompt L-Pop support the new concept by revealing excellent bond strength values in combination with good marginal adaptation and a significantly reduced post operative sensitivity. Finally, further developments regarding the new concept are discussed, such as the use of Prompt L-Pop in combination with plasma curing lights or indirect restorations.

Chemical Phenomena↗
PubMed1997

Reduction of postoperative pain: a double-blind, randomized clinical trial.

The authors investigated the capability of two commonly used basing techniques to reduce postoperative sensitivity. The authors measured the time it took the subjects to respond to a standardized stimulus of cold water (cold response measure, or CRM) at baseline and one week after treatment. The authors found no significant reduction in the mean CRM for the group receiving Amalgambond Plus (Parkell), but they did find a significant decrease in the mean CRM for the group receiving Copalite (Harry J. Bosworth Co.) with or without Vitrebond (3M). The authors concluded that the subjects in the Amalgambond Plus group experienced no more sensitivity to cold at one week postoperative than they did at baseline, while the subjects in the Copalite/Vitrebond group did.

Adolescent↗