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PubMed1991

Dentine hypersensitivity--effects of some proprietary mouthwashes on the dentine smear layer: a SEM study.

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.

Benzoates↗
PubMed1999

The importance of technique in preventing postoperative sensitivity when placing bonded restorations.

This article has focused on what are thought to be some of the common causes of postoperative sensitivity following placement of adhesive restorations. Of course, there can be many other factors. There are an infinite number of roads or combinations of roads that won't get dentists where they want to go. However, there is a specific road or roads, when taken carefully in the proper sequence, that will predictably get dentists to their destinations. The same is true for bonding. Adhesive dentistry is by no means difficult, but it is exacting. If the rules are understood and followed precisely, dentists will find the results are well worth the effort.

Dental Bonding↗
PubMed2001

The performance of bonded vs. pin-retained complex amalgam restorations: a five-year clinical evaluation.

BACKGROUND: The authors compared the clinical performance of complex amalgam restorations, replacing at least one cusp--retained either mechanically with self-threading pins or bonded--with a filled, 4-methacryloxyethyl trimellitate anhydride, or 4-META-based resin designed for amalgam bonding. METHODS: The authors placed 60 amalgam restorations (28 pin-retained and 32 bonded), each restoration replacing at least one cusp. They used self-threading stainless steel pins in the pin-retained group and a filled, 4-META-based bonding resin in the bonded group. For both groups, the authors left in place any retention form remaining after removal of an old restoration but did not enhance it. RESULTS: At four years, six restorations had failed. At five years, of the 40 restorations available for evaluation, three had failed, for a total of nine failed restorations; seven of those were pin-retained and two were bonded. Using the Fisher exact test to compare the groups at five years, the authors found no significant difference in failure rate, marginal adaptation, marginal discoloration, secondary caries, tooth sensitivity or tooth vitality. CONCLUSIONS: At five years, there was no difference in the performance of pin-retained amalgam restorations and bonded amalgam restorations. This study will be continued for at least a sixth year. CLINICAL IMPLICATIONS: Bonding with a filled, 4-META-based bonding resin appears to be a satisfactory method of retaining large amalgam restorations replacing cusps.

Acrylic Resins↗
PubMedDate not supplied

The effectiveness of bonded composite restorations in the treatment of painful, cracked teeth: six-month clinical evaluation.

This study investigated the clinical efficacy of a bonded resin composite restoration with and without cuspal coverage for the treatment of painful, cracked teeth. Patients in a private dental practice who presented with complaints were selected. Inclusion criteria were sensitivity to cold, biting and a clinically-visible crack after removal of the existing restoration. All 40 teeth were restored with a three-step total etch system (Phosphoric acid/Clearfil SA primer/PhotoBond), 20 with cuspal coverage and 20 without. Patients were interviewed at one week, five weeks and six months regarding the presence of pain. In addition, the teeth were clinically examined after six months to reveal any sensitivity. At one week, patients reported that 12 teeth (30%) were free of pain and 28 teeth (70%) still had symptoms. At five weeks, patients reported that 25 teeth (62.5%) were free of pain and 13 teeth (32.5%) still had symptoms. Two teeth (5%) needed endodontic treatment after two and five weeks. At six months, patients reported that 30 teeth (75%) were functioning without any complaints. Upon clinical examination, only 20 teeth (50%) were free of symptoms. No statistically significant difference between the results of the teeth treated with and without cuspal coverage could be shown (Fischer's exact test at p<0.05).

Adult↗
PubMed2003

Practical posterior composites. Efficient placement and predictable results.

Certainly, we could spend more time matching shades, applying characterizations, placing secondary anatomy, and even finishing. However, if posterior composite restorations are to be a viable alternative to amalgam in appropriate cases, we must accomplish efficient and predictable placement so that fees for the two types of restorations are somewhat in line. Contact must be solid, sensitivity must be kept to a minimum, and placement and finishing must be fairly simple and organized. If the problems with posterior composites aren't kept to a minimum, all of dentistry will suffer. Our contacts are excellent most of the time, but occasionally we need to redo a "light" one. Our best estimate is that about one in 100 fillings that had no preoperative symptoms needed some postoperative care after restoring. Usually these complaints are corrected by occlusal adjustment, and very rarely by replacing the restoration. We have not yet made a perfect restoration in our practice--we are still trying.

Bicuspid↗
PubMed2000

Clinical evaluation of polyacid-modified resin composite posterior restorations: one-year results.

OBJECTIVE: The aim of this investigation was to evaluate the clinical performance of a new compomer restorative system, Dyract AP, placed in combination with Non-Rinse Conditioner and Prime & Bond NT in permanent posterior teeth. METHOD AND MATERIALS: Fifty Class II and 41 Class I restorations were placed in 39 patients by 1 dentist. The restorations were evaluated directly, with modified US Public Health Service criteria, and indirectly, with color slides and polyvinyl siloxane impressions, at baseline and 6 months and 1 year after placement. Preoperative and 1-year postoperative bitewing radiographs were also taken. RESULTS: All 82 restorations available for 1-year evaluation were in situ. No postoperative sensitivity or pulpal problems were reported. Four Class II restorations (4.9%) failed because of partial fracture or recurrent caries. The percentages of Alfa score for each criterion were color match, 95.1%; marginal discoloration, 57.3%; marginal integrity, 35.4%; anatomic form, 98.8%; and surface texture, 91.5%. The average wear rate of Dyract AP was low (18.5 +/- 11.7 microns at 6 months and 35.7 +/- 13.6 microns at 12 months). CONCLUSION: The excellent handling characteristics, the good clinical performance, and the improved wear resistance suggest that this compomer will provide reliable direct tooth-colored restorations in stress-bearing areas.

Acid Etching, Dental↗
PubMed2006

Two-year clinical evaluation of ormocer and nanofill composite with and without a flowable liner.

PURPOSE: The aim of this clinical follow-up study was to determine the clinical performance of ormocer and a new nanofill composite material, lined or not lined with flowable composites, after 2 years. MATERIALS AND METHODS: Occlusal restorations (n = 108) were placed in 54 patients with two symmetric restorations per patient. In one of the two restorations in each patient, cavities were first lined with the flowable composite material Admira Flow or Filtek Flow after applying the two-step total-etch one-bottle adhesive (Admira Bond) or single bond adhesive (Single Bond). Admira or Filtek Supreme was then applied. Restorations were examined using the USPHS modified Ryge criteria for retention, color matching, cavosurface marginal discoloration, anatomic form, marginal adaptation, surface texture, and secondary caries by two previously calibrated dentists. The overall performance of the restorations was evaluated by Wilcoxon signed ranks test. The chi-square test was used to determine differences in the performance of the restorations in which the flowable composite was applied first. RESULTS: There was no secondary caries or postoperative sensitivity in any of the restorations at the 6-month, 1-year, and 2-year follow-up examinations. After 2 years, only one Admira restoration had failed; all other restorations were available for evaluation. There were no statistically significant differences among the materials regardless of the prior use of flowable material (p > 0.05). There was no statistically significant difference between the restorations with and without the prior application of flowable materials (p > 0.05). CONCLUSION: The clinical performance of occlusal restorations using ormocer or nanofill composite did not benefit from the additional use of the flowable composite. Both of the restorative materials exhibited ideal clinical performance.

Adolescent↗
PubMed2005

Clinical effectiveness of two agents on the treatment of tooth cervical hypersensitivity.

PURPOSE: To investigate the desensitizing ability of a one-bottle bonding agent and a glutaraldehyde-based HEMA formulation on sensitive tooth cervical areas for a period up to 9 months. METHODS: The sample consisted of 40 patients with cervical hypersensitivity. Three sensitive teeth per patient were treated; one received One-Step (one-bottle bonding agent), the other Gluma Desensitizer (glutaraldehyde-based agent) and the third distilled water (control group). The hypersensitivity level was determined before, immediately after the desensitizing session, at 8 weeks, and 9 months post-treatment. Measurements of sensitivity were determined by the patient's response to tactile and air-blast stimuli. A verbal rating scale was used and scored as follows: 0, no discomfort; 1, discomfort but no severe pain; 2, severe pain during simulation; 3, severe pain after simulation. The results were subjected to statistical analysis by Kruskal-Wallis test (a=0.05). RESULTS: Both treatment procedures resulted in reduction of hypersensitivity to both stimuli, for up to 9 months. No significant differences were recorded between One-Step and Gluma Desensitizer at immediate and 8-week examinations, whereas Gluma Desensitizer produced lower hypersensitivity than One-Step at the 9-month assessment. In general, a lower level of reduction was found for the 9-month interval compared to the 8-week hypersensitivity score for both agents tested. A placebo effect was observed with water treatment, ranging from 4.7 to 27.5% reduction of hypersensitivity.

Adult↗
PubMed1994

Measurement of tooth hypersensitivity and oral factors involved in its development.

The various methods of measurement of dentinal hypersensitivity are based upon the types of stimuli used to elicit a pain response in teeth, which include thermal, tactile, evaporative, electrical and osmotic. Pulpal inflammation in its early stages reduce the threshold of pain response to these stimuli but electrical stimulation may make it possible to assess the possible contribution of such inflammation to sensitivity determinations. Although the magnitude of each stimulus is quantifiable, patient response is subjective, which necessarily makes measurements of dentinal sensitivity semisubjective. Various methods of testing dentinal sensitivity are discussed, along with their advantages and disadvantages. The teeth most suited for measurement in clinical studies are the canines and premolars. This is because approx. 80% of the sensitivity lesions are associated with these teeth, which have similar thicknesses of root dentine. Data from several studies involving the same subjects indicate that individual measurements readily return to baseline and that the commonly seen placebo effect is probably due to some as yet unidentified factor in desensitizing formulations. Possible roles of salivary and plaque environmental factors in the development of dentinal sensitivity are discussed, as well as methods for their measurement.

Beverages↗
PubMed2001

Six-month clinical evaluation of two dentin adhesives applied on dry vs moist dentin.

PURPOSE: Acid-etched dentin has been described to easily collapse when it is dried with air after being rinsed with water under laboratorial "ideal" conditions. Manufacturers of modern dentin adhesives recommend leaving dentin moist, regardless of the solvent used in their proprietary dentin adhesives. Nevertheless, many clinicians still dry the cavity preparation after rinsing off the etching gel to check for the enamel frosted aspect. The null hypothesis to be tested in this clinical study was that drying dentin with air upon rinsing off the acid would not result in lower short-term retention rates than when the cavity was left visibly moist. MATERIALS AND METHODS: Upon Internal Review Board approval, thirty-five patients were enrolled in this study. A total of 128 restorations divided into four groups were inserted and evaluated at baseline: (A) Prime & Bond NT, an acetone-based adhesive, applied on moist dentin; (B) Prime & Bond NT applied on dentin dried with air for 3 to 4 s; (C) Single Bond, an ethanol- and water-based adhesive, applied on moist dentin; (D) Single Bond applied on dentin dried with air for 3 to 4 s. A microfilled composite resin was used for all restorations. RESULTS: At 6 months after initial placement, 119 restorations (a 93% recall rate) were re-evaluated. Retention rates at 6 months were 97% (one failure) for Single Bond/moist dentin and 100% for the remaining three groups; however, they were not significantly different (retention rate vs dentin adhesive; retention rate vs moisture). CONCLUSION: Dentin substrate in noncarious lesions may be less sensitive to variations in dentin moisture than the "ideal" dentin substrate used under laboratory conditions.

Acetone↗
PubMed2006

Clinical effectiveness of dentin sealer in treating dental root sensitivity following periodontal surgery.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a commercially available light-cured, resin-based dentin sealer in the treatment of postoperative sensitivity of roots with gingival recession of different extent. MATERIALS AND METHODS: The study was a case control, randomized, blind design. A total of 62 patients with the presence of chronic periodontitis, who required periodontal surgery, participated in this study. All recipients underwent flap operation. After the periodontal surgery 641 teeth were selected for the study. The pain intensity was determined by using visual analogue scale (VAS). The extent of gingival recession was measured using William's periodontal probe. After recording the initial baseline VAS scores, the patients were randomly divided into two groups according to the materials used in the study. The resin-based dentin sealer in the test group was applied following the manufacture's recommendations. Water was used in the control (placebo) group. Hypersensitivity measurements on VAS were repeated 5 minutes, 7 and 30 days after the application of the materials. RESULTS: It was observed that the efficacy of the desensitizing material differed from placebo. The dentin sealer effectively reduced the root sensitivity. The statistically significant (p<0.001) decrease in the intensity of root sensitivity after the application of materials was noted in test and control groups. However, the difference in the reduction of pain intensity between the groups was significant and remained such throughout the study period. The root sensitivity on the day 7 and 30 in both groups showed little change compared to the measurements made right after the application of the materials. No significant difference in measurements of pain intensity in the presence of different extent of gingival recession was noted in none of the groups. CONCLUSION: The results of the study showed that dentin sealer used provided quick and effective reduction in root sensitivity after the surgery and its desensitizing effect lasted beyond 30 days.

Adult↗