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At least 127 records · Page 7Linked to original sources
PubMed1981

The effects of desensitizing agents on the hydraulic conductance of human dentin in vitro.

The hydrodynamic theory of dentin sensitivity states that a stimulus applied at the orifice of exposed dentinal tubules causes movement of tubular fluid which stimulates nerve receptors. The fluid should obey principles of fluid movement through capillary tubes. Any decrease in the functional radius of the dentinal tubules should greatly reduce the rate of fluid flow, thus reducing dentinal sensitivity. The purpose of this study was to evaluate the ability of agents that have been used previously for clinical dentin desensitization to reduce the rate of fluid flow through dentin in vitro. Dentin discs prepared from extracted human third molars were treated with 50% citric acid to remove debris from tubular orifices. After placing the discs in a split chamber device, the rate at which buffer solution could filter across the dentin under 240 cm of water pressure was measured. The occlusal side of the disc was then treated with an agent thought to desensitize dentin to determine if it reduced fluid flow rate. Discs that had more than a 50% reduction in flow rate were examined by scanning electron microscopy to determine if those agents that decreased fluid flow also partially occluded tubular orifices. This in vitro model provided a useful quantitative method for screening a host of preparations that have been used in the past to decrease dentin sensitivity.

Adolescent↗
PubMed2006

Clinical evaluation of a resin-modified glass-ionomer liner for cervical dentin hypersensitivity treatment.

PURPOSE: To evaluate the effectiveness of two agents for treating cervical dentin sensitivity associated with gingival recession or noncarious cervical lesions. METHODS: 44 patients with at least mild sensitivity affecting cervical dentin were enrolled in a longitudinal randomized clinical trial. A resin-based desensitizer or an experimental glass-ionomer was assigned to treat at most two teeth from each side of the mouth. Sensitivity was assessed by tactile and cold tests, measured with a Visual Analogue Scale at baseline, after treatment, and at 1 week, 1, 3, 6, and 12 months after treatment. Other noteworthy clinical observations were recorded. RESULTS: Both treatments effectively reduced dentin sensitivity (mixed linear model analysis). Sensitivity score for the glass-ionomer was significantly lower than for the resin-based desensitizer after treatment and at all follow-up periods (P < 0.0001). Some overhanging margins were observed in the glass-ionomer group, which could accumulate plaque and cause gingivitis. Despite material loss from some teeth treated with the glass-ionomer, the follow-up sensitivity scores were still lower than baseline scores.

Adult↗
PubMed1995

Titaniumtetrafluoride for treatment of hypersensitive dentine.

Dentine hypersensitivity in cervical areas and severe dentine sensitivity in teeth prepared for restorations were treated with a titaniumtetrafluoride solution. Patients included in the study complained spontaneously about the sensitivity in intact dentine surfaces. Thirty patients with at least one tooth on each side of the maxilla and/or mandible experiencing moderate or severe sensitivity in cervical areas participated. The degree of sensitivity was determined by scraping an explorer over the dentine surface and by air blast. At least one sensitive tooth on one side of the jaw was treated with titaniumtetrafluoride, and one on the contralateral side with a placebo solution. Results were recorded after one month, four, eight and twelve months, using the explorer and the air blast. A total of 102 teeth, of which 51 were controls, were treated. About 80% responded to the treatment with the titaniumtetrafluoride solution after one month and 55-84% thereafter. No response occurred in any of the placebo-treated teeth. Twenty patients with severe sensitivity in dentine of teeth prepared for crowns were also treated with the titaniumtetrafluoride solution when trying casts and crowns and before cementation. A total of 52 teeth were treated. Desensitizing effects occurred in 75% of the patients, with 36 of the 52 prepared teeth.

Adult↗
PubMed1991

[Dentin hypersensitivity: etiology and methods of treatment].

This work presents review on etiology of dentinal hypersensitivity and mechanisms of dentin desensitization. The main theories on dentin sensitivity are discussed in details. Particularly are stressed hydrodynamic and transducer theories. Two main approaches to the dentin desensitization by tubule occlusion and blocking pulpal nerve activity by altering the sensory nerves excitability are presented. The aim of dentin desensitization is to apply various agents that occlude dentinal tubules and so decrease dentin sensitivity or to apply agents that reduce nerve excitability. Between many different agents in use the most wide use and best results in decreasing dentin sensitivity have topical application of oxalate salts and application of unfilled resins. Different toothpaste with strontium chloride or potassium nitrate as active ingredients have been commonly used as very effective desensitizing agents.

Dentin↗
PubMed2004

Dentine hypersensitivity: development and evaluation ofamodel in situ to study tubulepatency.

BACKGROUND AND AIMS: Lesions of dentine hypersensitivity have numerous tubules open at the dentine surface as opposed to non-sensitive dentine where tubules are mostly covered by a smear layer. The present two studies were designed to model both states in situ and evaluate the effects of agents on the model. METHOD: Etched (sensitive) and smeared (non-sensitive) dentine specimens prepared from human third molar teeth were retained in lower buccal acrylic appliances. The results of Study 1 led to the development of a method to ensure tubules were sectioned at right angles. Study 1 was a 5-day period, seven treatment regimens randomised, part blind cross over design involving five subjects. Treatments were 2x day application of a desensitising (SA) or non-desensitising toothpastes (F) or chlorhexidine (CHX) mouthwash with or without drinking orange juice (OJ)(1 l/day). A no treatment group (P) allowed plaque to accumulate. The evaluation of effects was observational by scanning electron microscopy (SEM). Study 2 involved 1 subject, 4 treatments applied once and studied after 0, 6, and 12 h by SEM with image analysis. The 12 h groups were studied with and without imbibing water or OJ. Treatments were two desensitising (SA & SC) and one non-desensitising (F) toothpastes and an in office product (DS). RESULTS: Study 1: Treatment SA resulted in occlusion of tubules an outcome little changed by OJ. Treatment P produced a bio-film, which covered the dentine surface. CHX produced some tubule occlusion in three of the five subjects. F+/-OJ and CHX+OJ had little effect and tubules remained open. For smeared specimens toothpastes and OJ removed the smear layer but SA+/-OJ blocked tubules. P and CHX had no effect on the smear layer. Study 2: At 0 h, tubule occlusion was in order of magnitude DS>or=SA>SC>F. After 6 and 12 h with SA, SC and F some loss of occlusion occurred but not DS. Water and OJ by 12 h decreased occlusion for SA, SC and particularly F. Water and OJ removed virtually all of DS. CONCLUSIONS: The aims of Study 1 were achieved and effect of treatments was not inconsistent with data in vitro. The need for more standardisation of specimens was appreciated and applied in Study 2 to allow image analysis to quantitatively record data. Further use of the model in randomised controlled clinical trials is envisaged.

Acid Etching, Dental↗
PubMed1999

Clinical evaluation of a one-bottle bonding system for desensitizing exposed roots.

PURPOSE: To evaluate the effectiveness of a one-bottle adhesive system as a desensitizing treatment, with or without a prior phosphoric acid-etch step. MATERIALS AND METHODS: Two different clinical procedures using a one-bottle adhesive bonding system were tested for its efficacy on desensitizing exposed roots. Thirty subjects with a history of dentin hypersensitivity were selected and 60 exposed sensitive teeth were divided into two groups (n = 30). In Group 1 samples, Scotchbond 1 bonding system (Single Bond in USA) was applied without a prior acid-etching, while in those of Group 2, the exposed sensitive roots were acid-etched with 35% phosphoric acid for 15 seconds, prior to application of bonding agents. The sensitivity was evaluated at 0, 1, 2, 4 weeks and 3 months using cold air blast stimuli, and recorded using a visual-analogue scale. The scores were analyzed as non-parametric data by means of the Mann-Whitney and Sign tests. Five samples from each group were randomly selected in order to make scanning electron microscope observations of the sensitive dentin surfaces at baseline and at each recall using the replica technique. RESULTS: At baseline, after both desensitizing procedures all the patients reported distinct reductions in dentin sensitivity. At 1- and 2-week recalls, 20 teeth of Group 1 and 17 teeth in Group 2 exhibited a return of sensitivity, and in five teeth in each group, the sensitivity score was between 5-8. During the first recall (1-2 weeks), the sensitive teeth were retreated and showed an immediate reduction of sensitivity. At the 1-month recall, eight teeth in Group 1 and four teeth in Group 2 showed a return of some sensitivity, and in six teeth in Group 1 and in three teeth in Group 2, old amalgam restorations were replaced and this procedure almost completely resolved the sensitivity. At the 3-month recall, only five teeth from each group showed residual mild sensitivity (score 1-2). For both Groups 1 and 2 there was a statistically significant (P < 0.0005) reduction in sensitivity levels between the baseline pain scores and immediately after treatment, and between the first recall pre-treatment pain scores and the last recall pain scores. Overall, the two methods of treatment demonstrated a general decrease in sensitivity in both groups over the 3-month study period, adequately solving the clinical and patients' perception of the discomfort of sensitivity. The SEM observations of the replicas showed a progressive loss of the adhesive resin from the treated surfaces. This fact was more evident in the non-etched samples (Group 2) than in those in Group 1. The results of this study showed that exposed root dentin sealed with Scotchbond 1, with or without prior acid-etching, did not show spontaneous sensitivity after 3 months.

Acid Etching, Dental↗
PubMed1999

Scanning electron microscopy (SEM) investigation of selected desensitizing agents in the dentine disc model.

Dentine sensitivity is a painful clinical conditions that can affect up to 35% of the population at any one time. Both professionally available (in-office) or commercially available (over-the-counter) products have been used to treat dentine sensitivity. The aim of the present study was to investigate whether selected in-office desensitizing agents occluded dentine tubules in the dentine disc model. Both surface effects and tubule penetration of the five selected test products were examined by scanning electron microscopy. The results of the present study appeared to demonstrate that all of the applied desensitizing agents produced some occlusion of the tubules although the level of coverage and occlusion varied between the products. Of all the agents tested, ferric oxalate, the active ingredient of Sensodyne Sealant, produced crystal-like structures which occluded a higher proportion of the tubules across the dentine disc surface. ALL-BOND 2 and One-Step (both light-cured primer systems) produced similar crystal-like structures and, although coverage was not uniform across the disc surface, there was some reduction in tubule diameter. These three products, however, appeared to be more effective than either Butler Protect (potassium oxalate) or Oxa-gel (potassium oxalate in a gel) where there was a marked decrease in both the level of coverage and tubule occlusion. Both quantitative and functional studies are required in order to determine the effects of these agents on dentine permeability (fluid flow) as well as clinical studies to determine their effectiveness over time in reducing pain arising from dentine sensitivity.

Dentifrices↗
PubMed1994

Aetiological, predisposing and environmental factors in dentine hypersensitivity.

If the hydrodynamic theory of stimulus transmission across dentine is valid, sensitive dentine has tubules open at the surface and patent to the pulp. Direct and indirect evidence supports this supposition. Factors that result in dentine exposure remove the covering enamel or periodontal tissues (gingival recession). Epidemiological and clinical data for the distribution of exposed cervical dentine indicate that chronic trauma from physical and chemical factors is the most significant aetiological factor. Brushing with a toothpaste may not open dentinal tubules. It is more likely that toothpaste ingredients, when brushed on dentine, would create a smear layer. Exposure of tubules by erosion is probably the major initiator of sensitivity. An increase in our understanding of the aetiological factors involved in dentine hypersensitivity is essential if a sound approach to its management is to evolve. Such information could emanate from epidemiological studies, clinical investigations and laboratory experiments.

Beverages↗
PubMed1995

Effects of toothbrushing prior and/or subsequent to dietary acid application on smear layer formation and the patency of dentinal tubules: an SEM study.

Dentine sensitivity is a quite common condition, associated with open dentinal tubules patent all the way to the pulp. The purpose of this in vitro study was to assess the effects of toothbrushing preceded and/or followed by dietary acid application on the patency of dentinal tubules. Dentine sections were prepared from recently extracted human molars and, after removal of the smear layer, were treated as follows: 1) toothbrushing alone; 2) toothbrushing followed by exposure to orange juice; and 3) toothbrushing subsequent to orange juice exposure. All specimens were observed in the scanning electron microscope (SEM) at a standard magnification and the patency of the dentinal tubules estimated. Results showed that toothbrushing alone was the most effective in occluding the tubules, followed by toothbrushing subsequent to dietary acid application, and then by toothbrushing prior to dietary acid application. From the results of this study it may be that in cases of dentine sensitivity toothbrushing should not precede or follow dietary acid application but be separate from mealtimes. Clinical research is required to confirm the findings of this in vitro study.

Analysis of Variance↗
PubMed1992

Neurophysiological mechanisms of dentin hypersensitivity.

In hypersensitive teeth pain is typically induced by cold and hot fluids or foods brought to contact with the sensitive dentin or by osmotic and mechanical stimuli. The results of animal experiments indicate that intradental A-type nerve fibres are responsible for the sensitivity of dentin. They are most probably activated by the hydrodynamic mechanism. Thus, their activation is to a great extent dependent on the condition of dentin with either open or blocked dentinal tubules. Blocking of the tubules effectively prevents the nerve activation. Correspondingly, in human experiments, the condition of the dentinal tubules greatly affects dentin sensitivity. In clinical studies significantly more open tubules are found in sensitive compared to non-sensitive areas. However, hypersensitivity may sometimes persist despite of effective blocking of the tubules. This may indicate that some other mechanisms may operate in the nerve activation instead of, or in addition to the hydrodynamic one. Inflammation may sensitize the nerve endings to such an extent that smaller fluid shifts would be sufficient for nerve activation or, for example, thermal stimulation may activate the nerves by a direct effect. On the other hand, spontaneously occurring changes in the exposed dentin, which in many cases seem to block the tubules may reduce the responses to hydrodynamic stimulation and, thus, have an opposite effect on dentin sensitivity. The results of animal experiments indicate that functional changes of this kind may occur. These results also indicate that real dentin hypersensitivity can develop as a result of inflammation induced sensitization of the nerves in the pulp-dentin border in teeth with open dentinal tubules.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Desensitization of exposed root surfaces using a semilunar coronally positioned flap.

A definitive treatment is described for cervical dentinal sensitivity, featuring a semilunar coronally positioned flap to cover the denuded root surface. Many patients who complain of having sensitive teeth from exposed dentin secondary to gingival recession can be easily and conservatively treated with a semilunar flap procedure.

Adult↗
PubMed1998

Treating hypersensitivity with fluoride varnishes.

Dentinal hypersensitivity results when stimulation causes the fluid in open dentinal tubules to undergo pressure changes, which activates mechanoreceptor nerves and results in pain. Treatment with fluoride varnish forms a protective layer of calcium fluoride that prevents this fluid flow, thereby reducing dentinal sensitivity.

Administration, Topical↗
PubMed1991

Clinical correlations of dentin structure and function.

Dentin, a porous, fluid-filled mineralized tissue, may provide critical mechanical support to overlying enamel. Once the enamel or cementum surface seals are lost by disease or trauma, the same organization that provided critical mechanical support then becomes a liability, offering millions of fluid-filled diffusion channels from the periphery directly to the pulp. If restorative materials placed in cavities do not seal the dentin, there is a fluid-filled continuum from the cavosurface margins, around gaps between the restorative material and the tooth, to dentin surfaces, then through dentin via its tubules to the pulp. Under most conditions these channels permit bidirectional diffusion of exogenous and endogenous substances across dentin. Occasionally, hydrodynamic stimuli will produce transient, rapid movement of dentinal fluid that will induce pain. The tubules are sometimes so close together in deep dentin that their intrinsic wetness interferes with the bonding of adhesive resins. This permits the formation of gaps, microleakage, dentin sensitivity, and, occasionally, pulpal irritation. Many clinical problems such as poor dentin bonding, microleakage, dentin sensitivity, and pulpal irritation have a common denominator in the structure and function of dentin.

Dental Materials↗
PubMed1993

Air blast-induced evaporative water loss from human dentine, in vitro.

Short air blasts are commonly used to test for dentine sensitivity but their mechanism of action is poorly understood. In this study, evaporative water loss of teeth in vitro was measured under spontaneous conditions and during air blasts from three-way dental air syringes. Air blasts induced a 15-30-fold increase in evaporative water loss, which varied inversely with distance from the tooth and directly with air temperature. As water evaporation occurs readily across smear layers, which greatly impede bulk fluid movement, the use of air blasts may overestimate dentine sensitivity. Sustained air blasts may remove enough fluid from the pulp-dentine complex to cause disruption of odontoblasts and changes in pulpal blood flow.

Acid Etching, Dental↗
PubMed1990

Bond strengths of luting cements to potassium oxalate-treated dentin.

Potassium oxalate is gaining popularity as a dentin treatment to prevent the development of dentin sensitivity. Because treated dentin surfaces are covered with calcium oxalate crystals, the bond strength of cements to oxalate-treated dentin required investigation. This study determined the tensile bond strengths of glass-ionomer, polycarboxylate, and zinc phosphate cements used to cement castings to dentin treated with either water or potassium oxalate. The results indicate that oxalate-treated dentin did not affect the bond strength of glass-ionomer or polycarboxylate cements, but produced a large decrease in the bond strength of zinc phosphate cement.

Dental Bonding↗