Influence of the combined effect of desensitizing dentifrices and universal adhesives on dentin bond strength under erosive conditions

Abstract Objective This study aimed to evaluate whether the use of desensitizing dentifrices containing obliterating agents can affect bond strength of eroded/abraded dentin. Methodology A total of 100 dentin samples were obtained from human molars. The teeth were cut into 3 mm-thickness discs and allocated in five groups (n=20), according to the toothpaste used: WoF - abrasion with fluoride-free toothpaste (Cocoricó); Arg - toothpaste containing arginine (Colgate Sensitive Pro-Relief); Nov - calcium sodium phosphosilicate toothpaste (Sensodyne Repair and Protect); SnF - fluoride-containing toothpaste (AmF/SnCl2/SnF2 - Elmex Erosion); and Control (no erosive/abrasive process). The erosive/abrasive cycle consisted of immersion in citric acid (1%, pH 2.6, 5 min, 4×/day) and abrasion (2×/day, 120-20 sec abrasion, 100 sec immersion) with each toothpaste. During intervals, samples were immersed in artificial saliva. This cycle was performed for five days. Two resin cylinders (2 mm in diameter) were constructed on each sample for the shear bond strength test using a universal adhesive system. The self-etch and etch-and-rinse (Scotchbond Universal) strategies were employed, each in half of the total sample (n=10). Bond strength (MPa) was measured in a shear test and failure modes were assessed with a stereomicroscope. Statistical analysis was performed using the two-way analysis of variance (ANOVA) and Tukey tests (p<0.05). Results A statistically significant difference was found between the adhesive strategies tested (p<0.001), with the self-etching form showing higher values than the etch-and-rinse. Moreover, no significant differences were observed between the tested toothpastes (p=0.750) and interactions (p=0.438). Conclusion The use of toothpaste containing obliterating agents does not affect bond strength to dentin subjected to erosive/abrasive conditions when a universal adhesive is used. However, the self-etch strategy might be preferred for eroded/abraded dentin.

Sodium Fluoride Varnish in Management of Dentin Hypersensitivity Associated with Gingival Recession

ABSTRACT@#Using laser for treatment of dentin hypersensitivity (DH) have recently shown promising results and better immediate reduction in pain scores. However, its efficacy and mechanism of action is controversial. Thus, this study aimed to evaluate the effectiveness of diode laser compared with sodium fluoride varnish in treating DH in patients with gingival recession. Eighteen patients with Miller’s class I and class II gingival recession and hypersensitivity in at least two non-adjacent teeth were included in the study. Test surfaces (n = 25) were treated with diode laser, whilst control surfaces (n = 23) were treated with 5% sodium fluoride varnish. Visual Analogue Scale (VAS) scores were recorded for air and tactile stimulus for both groups at baseline, 15 min, 1 month and 3 months post-treatment. Results showed significant (p < 0.05) reduction in VAS scores at 15 min, 1 month and 3 months compared with baseline in both test and control surfaces, with no significant intergroup differences. However, the percentage reduction in DH was more in laser at all evaluation periods. The use of diode laser and sodium fluoride varnish showed good immediate and prolonged results. Further studies are needed to come up with more effective treatment methods.

In vitro dentin permeability and tubule occlusion of in-office desensitizing materials / Permeabilidade da dentina e oclusão tubular in vitro de materiais dessensibilizantes de consultório

Objetivo: O objetivo desse estudo foi investigar a permeabilidade dentinária e a oclusão tubular de materiais dessensibilizantes de uso em consultório. Métodos: Blocos de dentina bovina foram obtidos e imersos em EDTA 0,5 M para promover a abertura dos túbulos dentinários. Os materiais testados foram: verniz placebo (PLA); verniz fluoretado (FLU); verniz de NaF 5% + 5% trimetafosfato de sódio nanoparticulado (TMP); sistema adesivo universal (SBU); verniz contendo partículas S-PRG (SPRG); solução de Biosilicato (BIOS) e solução de amelotina (AMTN). Os materiais foram aplicados e os espécimes submetidos ao desafio erosivo-abrasivo. A permeabilidade dentinária foi avaliada em T0 (inicial), T1 (após a aplicação dos materiais) e T2 (após o desafio erosivo-abrasivo). As imagens confocais foram usadas para avaliar o comprimento e o número dos túbulos ocluídos e as imagens de microscopia eletrônica de varredura (MEV) para avaliar o número de tubulos abertos. Os dados de permeabilidade e MEV foram analisadas pelo teste ANOVA duas medidas repetidas e pós teste de Tukey. O comprimento e número de túbulos dentinários ocluídos foram analisadas pelo teste ANOVA um critério e pós teste de Tukey, Kruskal-Wallis e pós teste de Dunn's, respectivamente. Os testes de correlação de Spearman e Pearson também foram realizados. O nível de significância foi de 5%. Resultados: O grupo AMTN mostrou os menores valores de permeabilidade em T1 e a seguinte ordem decrescente ocorreu em T2: AMTN=SBU>BIOS=SPRG>TMP>FLU>PLA. O grupo SBU teve o maior comprimento médio de túbulos dentinários ocluídos. O grupo AMTN teve maior número de túbulos dentinários ocluídos do que PLA e FLU e os menores valores de túbulos dentinários abertos foram observados para os grupos AMTN e SBU. Uma correlação significativa foi encontrada entre as análises realizadas. Significância: O sistema adesivo universal e a proteína amelotina foram mais efetivos em reduzir a permeabilidade dentinária através da oclusão dos túbulos dentinários(AU)

Objectives: The aim of this study was to investigate the dentin permeability and tubule occlusion of in-office desensitizing materials. Methods: Bovine dentin blocks were obtained and immersed in 0.5 M EDTA to open dentinal tubules. The materials tested were: placebo varnish (PLA); fluoride varnish (FLU); NaF 5% + 5% nanoparticulate sodium trimetaphosphate varnish (TMP); universal adhesive system (SBU); S-PRG filler-containing varnish (SPRG); Biosilicate solution (BIOS) and amelotin solution (AMTN). The materials were applied, and specimens were submitted to an erosive-abrasive challenge. Dentin permeability was evaluated at T0 (initial), T1 (after application of materials) and T2 (after erosive-abrasive challenge). Confocal images were used to evaluate length and number of dentinal tubules occluded and images from scanning electron microscopy (SEM) to evaluate opened dentinal tubules. Permeability and SEM data were evaluated by two-way repeated measures ANOVA and Tukey tests. The length and number of dentinal tubules occluded were evaluated by one-way ANOVA and Tukey, Kruskal-Wallis and Dunn's tests, respectively. Spearman and Pearson correlation tests were also used. The significance level was 5%. Results: AMTN group showed the lowest permeability value in T1 and the following decreasing order occurred in T2: AMTN=SBU>BIOS=SPRG>TMP>FLU>PLA. SBU group had the highest mean value of dentinal tubules occluded lengths. AMTN group had greater number of dentinal tubules occluded than PLA and FLU and the lowest values of opened dentin tubules were observed for AMTN and SBU groups. A significant negative correlation was found between the analysis. Significance: Universal adhesive system and the AMTN solution were more effective to reduce dentin permeability by occluding dentin tubules(AU)

Dentinal tubule occlusion using Er:YAG Laser: an in vitro study

Abstract Objectives We analyzed the effects of the Er:YAG laser used with different parameters on dentinal tubule (DT) occlusion, intrapulpal temperature and pulp tissue morphology in order to determine the optimal parameters for treating dentin hypersensitivity. Methodology Dentin specimens prepared from 36 extracted human third molars were randomized into six groups according to the treatment method (n=6 each): control (A); Gluma desensitizer (B); and Er:YAG laser treatment at 0.5 W , 167 J/cm2 (50 mJ, 10 Hz) (C), 1 W , 334 J/cm2 (50 mJ, 20 Hz) (D), 2 W , 668 J/cm2 (100 mJ, 20 Hz) (E), and 4 W and 1336 J/cm2 (200 mJ, 20 Hz) (F). Treatment-induced morphological changes of the dentin surfaces were assessed using scanning electron microscopy (SEM) to find parameters showing optimal dentin tubule occluding efficacy. To further verify the safety of these parameters (0.5 W, 167 J/cm2), intrapulpal temperature changes were recorded during laser irradiation, and morphological alterations of the dental pulp tissue were observed with an upright microscope. Results Er:YAG laser irradiation at 0.5 W (167 J/cm2) were found to be superior in DT occlusion, with an exposure rate significantly lower than those in the other groups (P<0.05). Intrapulpal temperature changes induced by Er:YAG laser irradiation at 0.5 W (167 J/cm2) with (G) and without (H) water and air cooling were demonstrated to be below the threshold. Also, no significant morphological alterations of the pulp and odontoblasts were observed after irradiation. Conclusion Therefore, 0.5 W (167 J/cm2) is a suitable parameter for Er:YAG laser to occlude DTs, and it is safe to the pulp tissue.

Association of Nd: YAG laser and calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion

Abstract Objective To evaluate the efficacy of Nd:YAG laser associated with calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion after erosive/abrasive challenges. Methodology Dentin specimens were exposed to 17% ethylene diamine tetra-acetic acid (EDTA) solution for 5 min and randomly allocated into five groups: G1, control (no treatment); G2, Nd:YAG laser (1 W, 10 Hz, 100 mJ, 85 J/cm2); G3, Laser + TeethmateTM Desensitizer; G4, Laser + Desensibilize Nano P; and G5, Laser+Nupro®. Specimens underwent a 5-day erosion-abrasion cycling. Hydraulic conductance was measured post-EDTA, post-treatment, and post-cycling. Post-treatment and post-cycling permeability (%Lp) was calculated based on post-EDTA measurements, considered 100%. Open dentin tubules (ODT) were calculated at the abovementioned experimental moments using scanning electron microscopy and ImageJ software (n=10). Data were analyzed using two-way repeated measures ANOVA and Tukey's test (α=0.05). Results G1 presented the highest %Lp post-treatment of all groups (p<0.05), without significantly differences among them. At post-cycling, %Lp significantly decreased in G1, showed no significant differences from post-treatment in G3 and G4, and increased in G2 and G5, without significant differences from G1 (p>0.05). We found no significant differences in ODT among groups (p>0.05) post-EDTA. At post-treatment, treated groups did not differ from each other, but presented lower ODT than G1 (p<0.001). As for post-cycling, we verified no differences among groups (p>0.05), although ODT was significantly lower for all groups when compared to post-EDTA values (p<0.001). Conclusion All treatments effectively reduced dentin permeability and promoted tubule occlusion after application. Combining Nd YAG laser with calcium-phosphate pastes did not improve the laser effect. After erosive-abrasive challenges, treatments presented no differences when compared to the control.

Scales for pain assessment in cervical dentin hypersensitivity: a comparative study / Escalas para avaliação da dor na hipersensibilidade dentinária cervical: um estudo comparativo

Abstract Background Currently, different pain scales are used extensively to measure clinical pain, especially in dental practice. Objective This study aims to compare pain scales used in clinical research and dental practice, identifying the easiest to understand by patients with Cervical Dentin Hypersensitivity. Method Seventy-four patients with Cervical Dentin Hypersensitivity were stimulated by a thermic test of the sensitive tooth, followed by application of different pain measurement scales (Visual Analogue Scale, Faces Pain Scales, Numeric Rating Scale, and Verbal Rating Scale) and by a questionnaire to evaluate the patient's perception regarding the ease of understanding scales. The statistic tests used were the Wilcoxon, Spearman correlation, and Chi-Square tests. Results The results founded a strong positive correlation between the scales (r = 0.798 to 0.960 p <0.001). The was easiest scale to understand according to the patients was the Verbal Rating Scale (52.7%). Conclusion The pain measurement scales evaluated provide similar information about pain reported in the Cervical Dentin Hypersensitivity allowing the comparison between studies that used them to measure pain. The affinity of the patient with the pain scale can guide the clinical dental practice in the different levels of health care.

Resumo Introdução Atualmente, diferentes escalas têm sido utilizadas para medir a dor no contexto clínico, especialmente na prática odontológica. Objetivo O objetivo deste estudo foi comparar as escalas de dor comumente utilizadas em pesquisas clínicas e na prática clínica odontológica, identificando as mais fáceis de serem compreendidas pelos pacientes com hipersensibilidade dentinária cervical. Método Setenta e quatro pacientes com hipersensibilidade dentinária cervical foram estimulados por um teste térmico para avaliação do dente sensível, seguido pela aplicação de diferentes escalas para avaliação de dor (Escala Visual Analógica, Faces de Dor, Escala Numérica e Escala Verbal) e de um questionário complementar para avaliar a percepção do paciente em relação à facilidade de compreensão das escalas. Os resultados foram submetidos aos testes de correlação de Wilcoxon, Spearman e Qui-Quadrado. Resultados Uma forte correlação positiva foi encontrada entre as quatro escalas avaliadas (r = 0,798 a 0,960; p < 0,001). De acordo com os pacientes, a escala de mais fácil compreensão foi a Escala Verbal (52,7%). Conclusão As escalas para mensuração da dor fornecem informações semelhantes sobre a dor relatada na hipersensibilidade dentinária cervical. A afinidade do paciente pela escala de dor pode direcionar a escolha da escala a ser utilizada na prática clínica odontológica nos diversos níveis de atenção à saúde.

Effect of nanohydroxyapatite on surface mineralization in acid-etched dentinal tubules and adsorption of lead ions / 南方医科大学学报

OBJECTIVE@#To study the effect of nanohydroxyapatite (nHA) for promoting surface mineralization of demineralized dentin discs and adsorption of lead ions in simulated sewage water.@*METHODS@#Sixty dentin disks were prepared from freshly extracted teeth with intact crown (including 30 premolars and 30 molars) and treated with 10% citric acid for 2 min to simulate dentinal tubules with dentin hypersensitivity. The etched dentin discs were brushed with distilled water, 0.2 g HA or 0.2 g nHA for 2 min twice a day for 7 consecutive days, after which scanning electron microscopy (SEM) was performed and calcium and phosphorus contents in the dentin discs were detected using EDS. Lead ion adsorption capacities of HA and nHA were tested by mixing 1 mL serial concentrations of HA and nHA suspensions with 50 mL lead ion solutions (1.0 mg/L). After 24 h, the residual lead ion concentration in the supernatant was measured using ICP to calculate lead ion adsorption rate and adsorption capacity of the materials.@*RESULTS@#SEM showed a smooth surface and empty dentin tubules in the acid- etched dentin dics. The dentin dics treated with HA were covered with masses of particles that loosely attached to the surface, and the diameter of the dentin tubules was reduced. In nHA group, the dentin discs showed a fine and homogeneous surface clogging with a tight attachment, and the dentin tubule diameter was obviously reduced. Daily brushing with HA and nHA, especially the latter, significantly increased calcium and phosphorus contents on the surface of the dentin dics ( < 0.000). In lead ion adsorption experiment, the lead ion adsorption rate of HA decreased as its concentration increased with the highest adsorption rate of 83.01%; the adsorption rate of nHA increased with its concentration until the adsorption equilibrium was reached, and its highest adsorption rate was 98.79%. A good liner relationship was found between the adsorption ability and concentration of HA.@*CONCLUSIONS@#Compared with HA, nHA has a better capacity for surface mineralization of acid-etched dentin discs and also a better ability of lead ion adsorption.

Effect of nano-hydroxyapatite containing desensitizers on dentin bonding performance of self-etch adhesive / 西安交通大学学报(医学版)

Objective: To evaluate the dentinal tubular occlusion of nano-hydroxyapatite (nHAp) containing desensitizers and their influence on the dentin bonding performance of self-etch adhesive. Methods: Mid-coronal dentin specimens were prepared from 48 intact human third molars. They were immersed in 10 g/L of citric acid for 20 s to simulate sensitive teeth, and randomly divided into four groups. The control group received no desensitizing treatment. Three experimental groups were treated with two commercial nHAp containing desensitizing toothpastes (Biorepair and Dontodent) and an experimental pure nHAp paste, respectively. The effect of desensitizers on dentinal tubular occlusion was observed by the field-emission scanning electron microscope (FESEM). Each group was further bonded with Futurabond NR. The micro-tensile bond strength was tested and failure mode distribution was analyzed. Moreover, resin infiltration of the adhesive was evaluated under confocal laser scanning microscopy (CLSM). Results: FESEM revealed that all the desensitizers noticeably occluded the dentinal tubules. After application for 7 days, the penetration depth of desensitizing particles was obviously increased and the extent of occlusion was completer. The micro-tensile bond strength test showed no significant differences in bonding strength among the three desensitization groups and control group (P>0.05). CLSM demonstrated the similar morphology of resin tags was produced in the desensitized groups and control group. Conclusion: Nano-hydroxyapatite containing desensitizers could occlude dentinal tubules effectively. Meanwhile, the application of these nHAp desensitizers has no adverse effect on resin infiltration and dentin bond strength of Futurabond NR self-etch adhesive

Prevalencia e intensidad de sensibilidad posoperatoria durante el tratamiento de prótesis fija / Prevalence and intensity of postoperative hypersensitivity during fixed prosthodontic treatment

RESUMEN Introducción: Durante la realización de prótesis fijas, el paciente puede presentar sensibilidad posoperatoria. Se ha descrito en la literatura diferentes prevalencias de esta sensibilidad, las cuales varían ampliamente, entre 3 por ciento y 34 por ciento. Objetivo: Determinar la prevalencia e intensidad de sensibilidad posoperatoria en el tratamiento de prótesis fija sobre diente vital. Métodos: se realizó un estudio clínico piloto descriptivo. La muestra fue de 35 dientes tratados de 20 pacientes. Esta fue conformada por pacientes atendidos por alumnos del Centro Odontológico de la Universidad de Los Andes, a los cuales se les realizó un tratamiento en base a prótesis fija sobre diente vital, desde el mes de abril hasta octubre del año 2015. Se registró la sensibilidad durante el tratamiento por medio la escala visual análoga a través de un diario completado por el paciente y por la escala verbal numérica aplicada por el investigador en distintas etapas clínicas. Resultados: Se observó una prevalencia del 31,4 por ciento con una intensidad de 0,62 ± 0,49 según la escala visual análoga y de 0 según la escala verbal numérica. Conclusiones: la prevalencia de la sensibilidad posoperatoria se aproximó al rango más alto descrito en la literatura. La intensidad de la sensibilidad observada fue leve a imperceptible clínicamente(AU)

ABSTRACT Introduction: During fixed prosthodontic treatment, patients may present postoperative hypersensitivity. The prevalence rates contained in the literature on the topic range from a mere 3 percent to 34 percent. Objective: Determine the prevalence and intensity of postoperative hypersensitivity during fixed prosthodontic treatment of vital teeth. Methods: A pilot descriptive clinical study was conducted. The sample was 35 treated teeth from 20 patients. These patients had been treated by students from the Dental Center at the University of Los Andes, and had undergone fixed prosthodontic treatment on vital teeth from April to October 2015. Hypersensitivity during the treatment was recorded with the visual analog scale based on a diary kept by patients and on the verbal numerical rating scale as applied by the researcher at the various clinical stages. Results: Prevalence was 31.4 percent with an intensity of 0.62 ± 0.49 by the visual analog scale and of 0 by the verbal numerical rating scale. Conclusions: The prevalence of postoperative hypersensitivity approached the highest range described in the literature, whereas the intensity of hypersensitivity ranged from mild to clinically imperceptible(AU)

To Estimate and Compare the Incidence of Dentin Hypersensitivity Among Men and Women Before and After Tooth Preparation

Dentin hypersensitivity following tooth preparation is a frequently encountered oral health problem. The present study was conducted to estimate and compare the incidence of dentin hypersensitivity among men and women in an adult population sample who required replacement of missing tooth/teeth with a fixed partial prosthesis. Methods: The present study was conducted among 32 participants in which 16 were male and 16 were females who want replacement of missing tooth/teeth with a fixed partial prosthesis. The informed consent of all the participants who participated in this study was obtained. Detailed clinical and radiographic investigations were performed on all participants to exclude conditions of teeth, which might have caused pain similar to dentin hypersensitivity. There was at least one vital abutment tooth in each FPD. Each abutment tooth received two stimuli: tactile stimulus and thermal stimulus. Sensitive teeth were identified with an explorer passed cervically over the abutment tooth. Immediately following stimulation, the participants were asked to grade their overall sensitivity using a 10 cm Visual Analogue Scale (VAS). After the VAS was recorded before tooth preparation, the subjects underwent tooth preparation of the abutment teeth for the fixed partial denture. The VAS was recorded immediately after tooth preparation. The data was compiled and subjected to statistical analysis. Statistical analysis was done by using SPSS, version 22 (SPSS, Inc., Chicago, IL) and p<0.05 was considered statistically significant. Results: In the present study; total participants were 32, out of which 16 were male and 16 were females. The comparison of dentin hypersensitivity between men and women in which women reported more dentin hypersensitivity than men, although results were statistically non-significant. Conclusion: It was concluded that women reported more dentin hypersensitivity than men before and after tooth preparation

Update on dentin hypersensitivity: with the focus on hydrodynamic theory and mechanosensitive ion channels

Dentin hypersensitivity is an abrupt intense pain caused by innocuous stimuli to exposed dentinal tubules. Mechanosensitive ion channels have been assessed in dental primary afferent neurons and odontoblasts to explain dentin hypersensitivity. Dentinal fluid dynamics evoked by various stimuli to exposed dentin cause mechanical stress to the structures underlying dentin. This review briefly discusses three hypotheses regarding dentin hypersensitivity and introduces recent findings on mechanosensitive ion channels expressed in the dental sensory system and discusses how the activation of these ion channels is involved in dentin hypersensitivity.

Guideline for diagnosis, prevention and treatment of dentin hypersensitivity / 中华口腔医学杂志

Dentin hypersensitivity is a common oral condition with a high prevalence rate. As part of the Chinese dental clinicians have some uncertainties on the prevention, diagnosis and treatment of dentin hypersensitivity, a task force was formed under the supervision of the Section of Preventive Dentistry, Chinese Association of Stomatology to develop the present clinical guide on diagnosis and management of dentin hypersensitivity according to the evidence-based dentistry. The evidence is based on systematic and narrative reviews published during the past 10 years (2009-2018) in the Medline database. The present guildlines consist of the definition, epidemiology, etiology and mechanisms, contributing factors, diagnosis and prevention of dentin hypersensitivity, the clinical treatment of dentin hypersensitivity was also recommened.

Guideline for diagnosis, prevention and treatment of dentin hypersensitivity / 中华口腔医学杂志

Dentin hypersensitivity is a common oral condition with a high prevalence rate. As part of the Chinese dental clinicians have some uncertainties on the prevention, diagnosis and treatment of dentin hypersensitivity, a task force was formed under the supervision of the Section of Preventive Dentistry, Chinese Association of Stomatology to develop the present clinical guide on diagnosis and management of dentin hypersensitivity according to the evidence-based dentistry. The evidence is based on systematic and narrative reviews published during the past 10 years (2009-2018) in the Medline database. The present guildlines consist of the definition, epidemiology, etiology and mechanisms, contributing factors, diagnosis and prevention of dentin hypersensitivity, the clinical treatment of dentin hypersensitivity was also recommened.

Lesões cervicais não cariosas: uma abordagem no controle da dor e tratamento

Objetivo: o objetivo deste trabalho é relatar um caso clínico de hipersensibilidade severa associada a múltiplas lesões cervicais não cariosas, entender o mecanismo de ação e a eficácia dos agentes dessensibilizantes. Relato de caso: paciente do gênero masculino, 38 anos de idade, compareceu à clínica da Faculdade Morgana Potrich com um quadro de hipersensibilidade em vários elementos, bem como, a presença de lesão cervical não cariosa em alguns desses elementos. Durante a anamnese o paciente relatou o hábito de escovar os dentes várias vezes ao dia logo após se alimentar, exercendo muita força durante o ato, relatou também fazer consumo diário de cerveja que possui um pH ácido. Ao realizar análise da oclusão notou-se um desequilíbrio oclusal e contato prematuro nos dentes 24 e 34. O tratamento de escolha para esse caso foi o ajuste oclusal seguido do uso de dessensibilizantes e restaurações em resina composta nos dentes que havia a presença de lesões cervicais não cariosas com perda de estrutura dentária. Considerações finais: após esse tratamento, realizado em várias sessões, foi possível devolver ao paciente a função e eliminar a dor provocada pela hipersensibilidade, proporcionando uma melhor qualidade de vida para esse paciente.

Objective: This study aims to report a clinical case of severe hypersensitivity associated with multiple non-carious cervical lesions and to understand the mechanism of action and the efficacy of desensitizing agents. Case report: A 38-year-old male patient attended the clinic at Faculdade Morgana Potrich with the hypersensitivity of several elements and the presence of non-carious cervical lesion in some of these elements. During anamnesis, the patient reported the habit of toothbrushing several times a day soon after eating, exerting a lot of force in such activity; he also reported the daily consumption of beer, which has an acidic pH. The occlusal analysis showed occlusal disorder and premature contact in teeth 24 and 34. The treatment of choice for this case was the occlusal adjustment followed by the use of desensitizers and composite resin restorations on the teeth with non-carious cervical lesions with loss of dental structure. Final considerations: After this treatment, which was performed in several sessions, it was possible to return function to the patient and eliminate the pain caused by hypersensitivity, providing a better quality of life for this patient.(au)

The applications of Nd：YAG laser and Er：YAG laser in endodontics / 口腔疾病防治

@#With the gradual maturity of laser technology, it has become widely considered a new method for disease treatment. Nd：YAG laser and Er：YAG laser are two representative solid-state lasers. These lasers are easy to use, comfortable and safe, and thus, they have recently become a research hotspot in dental treatment. Nd：YAG laser and Er：YAG laser have been used for the treatment of dentin hypersensitivity and dental caries, root canal therapy, pulp preservation and apical surgery. They are effective adjuvant methods for the treatment of dental pulp diseases and provide new avenues for clinical treatment. In this paper, the application of Nd：YAG laser and Er：YAG laser in the treatment of dental pulp disease is described to provide a reference for clinical treatment options.

Research progress in laser treatment of dentin hypersensitivity / 口腔疾病防治

@#Dentin hypersensitivity is mainly associated with abrasion, wear, acid etching, cracking, wedge-shaped defects, enamel hypoplasia, caries, a lack of neck enamel, and cementum coverage accompanied by gingival recession, resulting in direct exposure of dentin tubules to the oral environment. Dentin hypersensitivity is mainly treated by sealing the exposed dentin tubules and reducing the excitability of the pulpal nerves. Laser therapy, as a safe, fast and convenient treatment measure, has achieved good results both alone and in combination with other medicines and has attracted increasing attention. This paper reviews the research progress in the treatment of dentin hypersensitivity using several common laser therapy mechanisms with parameter selections in various scopes of application. A review of the literature shows that the Nd:YAG laser has a strong penetrating power and a large thermal effect and can denature and coagulate proteins in dentin tubules in a very short time; while the CO2 laser causes little damage to the dental pulp and has an obvious immediate curative effect by high absorption of water molecules in hydroxyapatite and the dentin surface is melted and recrystallized; the Er:YAG laser has high water absorption and a large thermal effect and can block the tubules by evaporating the fluid in the tubules and depositing salts; Er, Cr:YSGG laser energy can be fully absorbed by hydroxyapatite and water and result in desensitization by cutting hard tissues and melting periodontal dentin of the tube simultaneously; The Ga-Al-As semiconductor laser and He:Ne laser are low energy. The laser dosage mainly changes the permeability of nerve fibers to potassium and sodium ions and depolarizes the nerve fibers, producing an analgesic effect. The combination of a laser with a desensitizer can improve the clinical efficacy of treating dentin hypersensitivity.

Recesión gingival y su efecto en la hipersensibilidad dentinaria / Gingival recession and its effect on dentin hypersensitivity

La exposición de dentina radicular asociada a una recesión gingival puede producir dolor ante distintos estímulos, situación que puede difi cultar la vida cotidiana de los pacientes que lo padecen, además de presentar complicaciones estéticas que pueden afectar la autoestima. La hipersensibilidad dentinaria tiene una etiología asociada a múltiples factores, siendo el principal factor de riesgo la recesión gingival, situación clínica común que se observa en gran parte de la población. El propósito de esta revisión es reunir distintos conceptos que expliquen la asociación que mantienen estas dos patologías, sus etiologías, el cuadro clínico que presenta la hipersensibilidad dentinaria para poder realizar un diagnóstico diferencial y las distintas opciones de tratamiento para realizar un adecuado manejo de esta condición que incluyen desde recursos terapéuticos que buscan resolver la sintomatología hasta procedimientos quirúrgicos que resultan más invasivos y que se enfocan en tratar el factor predisponente como es la recesión gingival misma (AU)

Dentin exposure level periodontal tissues can cause pain to diff erent stimuli, a situation which can hinder the daily lives of patients who suff er, in addition to having aesthetic complications that can damage self-esteem. Dental hypersensitivity has a multifactorial etiology associated being the main risk factor gingival recession, the common clinical situation observed in much of the population. The purpose of this review is to bring together various concepts that explain the association that maintain these two pathologies, their etiologies, clinical picture presented dentine hypersensitivity to perform a diff erential diagnosis and treatment options for proper management of this condition ranging from therapeutic procedure seeking to resolve the symptoms to surgical procedures that are more invasive and that focus on treating the predisposing factor such as the gingival recession itself (AU)

Uso de dentífricos y colutorios para el control de la hipersensibilidad dentinaria en adultos: una revisión narrativa / Use of toothpastes and mouthwashes for the control of dentin hypersensitivity in adults: a narrative review

RESUMEN: Objetivo: Describir la efectividad del uso de los distintos agentes desensibilizantes contenidos en dentífricos y colutorios para el control de la hipersensibilidad dentinaria en adultos. Método: Se realizó una búsqueda electrónica de la evidencia científica en las bases de datos PubMed, Epistemónikos, EBSCO, BEIC y Cochrane Library; utilizando una estrategia de búsqueda que incluye las palabras clave. Para cada artículo encontrado se analizó el nivel y calidad de evidencia, riesgo de sesgo y ética. Resultados: En total 36 artículos fueron incluidos, 29 ensayos clínicos controlados aleatorizados y 7 revisiones sistemáticas. De los ensayos clínicos encontrados, cinco probaron la eficacia de colutorios, dos realizaron una comparación con dentífricos y colutorios y 22 evaluaron sólo el uso de dentífricos. Los agentes desensibilizantes testeados principalmente encontrados fueron sales de potasio, arginina, nano-hidroxiapatita, fosfosilicato de calcio y sodio (CSFS) y sales de estroncio. Sólo los primeros dos agentes fueron evaluados en presentación dentífrico y colutorio. Todos los ensayos clínicos demostraron reducir la hipersensibilidad dentinaria con alguno de los agentes utilizados en comparación a la medición inicial. Conclusión: Se podría recomendar el uso de nitrato y citrato de potasio, arginina, fosfosilicato de calcio y sodio y nano-hidroxiapatita en dentífricos para el tratamiento de la hipersensibilidad.

ABSTRACT: Objectives: Describe the effectiveness of the use of different desensitizing agents contained in dentifrices and mouthwashes for the control of dentin hypersensitivity in adults. Method: An electronic search of the scientific evidence available was made in PubMed, Epistemónikos, EBSCO, BEIC and Cochrane Library; using a search strategy that included the key words. For each article found the level and quality of evidence, risk of bias and ethics were analyzed. Results: A total of 36 articles were included, 29 randomized controlled clinical trials and 7 systematic reviews. Of the clinical trials, five tested the efficacy of mouthwashes, two made a comparison using dentifrices and mouthwashes and 22 tested only the use of dentifrices. The desensitizing agents mainly found were potassium salts, arginine, nano-hydroxiapatite, calcium sodium phosphosilicate (CSPS) and strontium salts. Only the first two were tested in both presentations. All the clinical trials demonstrated a reduction in dentin hypersensitivity with the use of an agent in comparison to the initial measurement. Conclusions: The use of nitrate and citrate potassium, arginine, calcium sodium phosphosilicate and nano-hydroxyapatite in dentifrices for the treatment of hypersensitivity may be recommended.

Laserterapia de baixa potência no tratamento da hipersensibilidade dentinária / Low-level laser therapy in the treatment of dentin hypersensitivity

Objetivos: avaliar, por meio de métodos clínicos, a eficáciada laserterapia de baixa potência no tratamentoda hipersensibilidade dentinária, orientar os tipos detratamento aos pacientes e proporcionar melhor qualidadede vida, interferindo diretamente no bem-estardiário, uma vez que a sensibilidade se mostra comouma das complicações mais dolorosas e resistentes.Métodos: foram selecionados 72 dentes de 23 pacientessob dois testes: táctil e térmico evaporativo. Os dentesforam posteriormente divididos aleatoriamente emdois grupos: o grupo placebo (36 dentes) e o grupo laser(36 dentes), submetidos à terapia com laser de baixapotência, em que foram realizadas quatro sessões deaplicações, uma vez por semana. Resultados: o grupolaser apresentou diferença estatisticamente significante(p>0,05) na redução da sensibilidade dolorosa quandocomparado ao grupo placebo tanto no teste táctil comono teste térmico evaporativo. Conclusão: a terapia comlaser de baixa potência é eficaz e mostra-se muito promissorapara. (AU)

Objective: to assess, through clinical methods the efficacy of low-level laser therapy on the treatment of dentin hypersensitivity, to instruct patients on the types of treatment, and to provide an improved quality of life, thus affecting directly daily well-being considering that sensitivity is one of the most painful and resistant complications. Methods: a total of 72 teeth were selected from 23 patients by means of two tests: tactical and thermal evaporation. The teeth were later divided randomly into two groups: a placebo group (36 teeth) and a laser group (36 teeth), which were subjected to four sessions of low-level laser therapy once a week. Results: the laser group has presented significant statistical difference (p>0.05) in the reduction of painful sensitivity when compared to the placebo group, in both the tactical and thermal evaporation tests. Conclusion: the low-level laser therapy was effective and it has been shown as a promising treatment for dentin hypersensitivity. (AU)

The effect of three desensitizing agents on dentin hypersensitivity: A randomized, split-mouth clinical trial

This randomized clinical trial tested the effect of three different desensitizing agents on reduction of pain due to hypersensitive cervical dentin lesions. Materials and Methods: Twenty-eight individuals with 84 teeth diagnosed with cervical dentin hypersensitivity (DH) in at least one tooth in any three of the four quadrants were selected. Patients exhibiting pain scores of two or more on the visual analog scale (VAS) were included in the study. Each quadrant in an individual was randomly assigned to one of the three treatment groups based on computer-generated random number. The desensitizing agents used were Profluorid Varnish (Voco: Cuxhaven Germany), Admira Protect (Voco: Cuxhaven Germany), and PRG-Barrier Coat (Shofu: japan). One operator recorded the baseline sensitivity scores after evaporative and tactile stimuli by visual analog score system. The second operator who was not aware of the baseline values applied the desensitizing agents and recorded the sensitivity scores. VAS scores for both the stimuli were noted immediately after application, 1 week, and after 1 month. The data were analyzed using repeated measure ANOVA and post hoc Tukey's multiple comparison tests (P < 0.05 was considered statistically significant). Results: There was a significant reduction in VAS scores from baseline in all the three groups at all the time intervals (P < 0.001). Admira Protect showed significant reduction of hypersensitivity scores at 1 month compared to other groups (P < 0.001). Conclusion: Admira Protect was proved to be better in reducing pain due to DH than PRG-Barrier Coat and Profluorid Varnish after 1 month of application.