Evaluation of Dentine Hypersensitivity in Adult Population with Chronic Periodontitis Visiting Government Dental College & Hospital, Srinagar

Background: A working knowledge of the prevalence of hypersensitivity in chronic periodontitis patients, is imperative to adequate prognostication, treatment planning and outcome. The present study, is a primary report of the prevalence of dentinal hypersensitivity, in relation to various patient characteristics (demographic and clinical) in chronic periodontitis patients visiting Government Dental College and Hospital, Srinagar, J&K.Material & Methods:A cross-sectional study design was used to evaluate 100 male and 100 female patients diagnosed with chronic periodontitis both by questionnaire and clinical test for the presence of dentinal hypersensitivity, in relation to various features.Results:An overall prevalence of 34% was found for self-reported and 42 % for actual dentinal hypersensitivity in chronic periodontitis patients. It was highest in females, undergraduates, rural subjects and canine teeth. The most common provoking stimulus was cold, and duration of hypersensitivity was less than 6 months. Clinical attachment loss was found to be more often associated with hypersensitivity than clinical gingival recession.76% of the patients reporting hypersensitivity also reported the use of desensitizing toothpaste.The reported prevalence of hypersensitivity was in concordance with other reports from dental college clinics. The particular geo-social background of the study location could have contributed to the observed difference in precipitating factors, effect of diet, and treatment seeking behaviour. Conclusion: The prevalence of dentine hypersensitivity in chronic periodontitis patients was 34% according to questionnaire and 42% according to the results of clinical test. Periodontal attachment loss was found to be could be an earlier indicator or a possible risk factor of DH, indicating the need for clinical initiative in the management of hypersensitivity in chronic periodontitis patients.

Occluding dentin tubules with monetite paste / 华西口腔医学杂志

OBJECTIVES@#This study was performed to evaluate the occlusion of monetite paste on dentine tubule and provide a new potential method for treating dentine hypersensitivity.@*METHODS@#Calcium oxide, strontium chloride, and polyethylene glycol phosphate were mixed in a certain proportion and ground in a planetary ball mill. The reaction was carried out by adjusting the pH to obtain monetite and hydroxyapatite paste. The morphological characteristics of the paste were observed through scanning electron microscope (SEM). The structure and composition were analyzed through X-ray diffraction (XRD) and Fourier transform infrared spectrometer (FTIR). The extracted third molar was selected to undergo demineralization to establish the @*RESULTS@#XRD and FTIR showed that the composition of the paste was mainly monetite, and the composition of hydroxyapatite paste was mainly composed of hydroxyapatite. SEM revealed that the size of the crystal particles of the synthesized paste was tens to hundreds of nanometers. Monetite and hydroxyapatite paste could produce a thicker mineralization layer on the dentin surface, and the mineralization of the dentin tubules of monetite was deeper than that of hydroxyapatite paste. The microhardness of the monetite paste group was significantly less than those of the hydroxyapatite paste groups (@*CONCLUSIONS@#Monetite paste could effectively block the exposed dentin tubules and be used for treating dentin hypersensitivity.

To Assess the Knowledge of Dentists Regarding Dentinal Hypersensitivity in a Tertiary Dental Care Hospital in Bangalore City - A Cross Sectional Survey

Dental pain is most commonly associated with the carious destruction leading to inflammation of the pulp or can also be pain present post operatively; however, much of the dental pain can be attributed to dentinal hypersensitivity (DH). The prevalence of DH is high enough (72.5 % to 98 %) to warrant the development of effective treatment. Surveys among dental professionals worldwide suggest that many lack adequate knowledge about this condition and its management. This study aims to assess the knowledge and awareness of postgraduates and faculty regarding dentinal hypersensitivity in a tertiary dental care hospital in Bangalore. METHODSA descriptive cross-sectional survey was carried out among the staff and post graduate students at Rajarajeswari Dental College & Hospital, Bangalore during October 2019. Ethical clearance was obtained from the Institutional Ethical committee. All the staff and post graduate students who were present on the day of study were included in the study. Informed consent was obtained from all the study participants before the study and participation was entirely voluntary. RESULTSMajority of the participants routinely checked for the signs of DH (F - 77.2 % PG - 77 %) and considered DH as a serious problem (F - 87.5 % PG - 87 %). Participants also thought that DH has to be treated with an interdisciplinary approach (F - 75 % PG - 67.7 %). CONCLUSIONSThe study concludes that even though the knowledge and awareness of Dentinal Hypersensitivity was good, there existed uncertainty concerning diagnosis and management of the same.

Treatment of dentinal hypersensitivity using propolis varnish: A scanning electron microscope study

Background: Dentin hypersensitivity (DH) affects all age groups in a population and is perceived as pain to any stimuli. From time immemorial, researchers have sought herbal or natural solutions to treat hypersensitivity. Propolis is one such natural, nontoxic resinous substance produced by honey bees, which is useful in various applications in dentistry and effective in treating dentinal hypersensitivity. Aim: The aim of this in vitro study is to assess the effect of propolis varnish on occlusion of dentinal tubules thus aiding in the treatment of dentinal hypersensitivity. The objective is to evaluate the effectiveness of the proposed treatment using scanning electron microscope (SEM) imaging. Materials and Methods: Twenty naturally extracted teeth were collected and stored until in vitro assessment. Discs obtained from each tooth were divided into two groups of 20 each – I (test) and II (control), with each tooth acting as its own control. Propolis varnish was applied only to the acid-etched surface of the exposed dentin of discs in the test group, whereas all the discs were subjected to SEM imaging. Results: Statistical analysis showed a significant reduction in open tubules (P < 0.001) from 160 ± 6.97 before treatment to 61.20 ± 9.10 after propolis varnish application in the test group. Conclusion: This study showed the promise of propolis varnish as a natural treatment modality for DH.

Clinical efficacy of four interventions in the reduction of dentinal hypersensitivity: A 2-month study.

Background and Aim: Dentinal hypersensitivity is a relatively common problem experienced in clinical dental practice and is characterized by short, sharp pain in response to stimuli such as tactile, thermal, evaporative, osmotic, or chemical. Several agents and treatment modalities have been used in the treatment of this condition. This study was conducted to compare the efficacy of four commercially available toothpastes in the reduction of dentinal hypersensitivity (DH), based on the hypothesis that calcium sodium phosphosilicate (CSPS) group had a better efficacy of the four. Settings and Design: This study design was a prospective, single-blind, randomized, parallel clinical design. Subjects and Methods: A total of 160 cases (93 males and 67 females; aged 20-60 years) were randomly divided into four groups: Group 1 - toothpaste containing 5% potassium nitrate; Group 2 - toothpaste containing 5% CSPS (NovaMin); Group 3 - toothpaste containing 10% strontium chloride; and Group 4 - a herbal formulation. The patients' DH scores for tactile, thermal, and evaporative stimuli were recorded on a visual analog scale at baseline, 2 weeks, 1 month, and 2 months. Statistical Analysis Used: The data were analyzed with Wilcoxon signed-rank test, Kruskal-Wallis test, and Mann-Whitney U-test (P < 0.05). Results: The four desensitizing kinds of toothpaste containing different active agents were effective in relieving dentinal hypersensitivity. However, CSPS group showed a better clinical response at the end of 2 months. Conclusions: The CSPS group showed a better reduction in the symptoms of DH.

Evaluation of three different agents for in‑office treatment of dentinal hypersensitivity: A controlled clinical study.

Context: Dentin desensitizers are used for in‑office treatment of dentinal hypersensitivity. They block the open tubules and bring about a reduction in hypersensitivity. Aim: The aim was to evaluate and compare the clinical effectiveness of a dentin desensitizer, a combination of a dentin desensitizer + adhesive and one‑bottle self‑etching adhesive for in‑office treatment of dentin hypersensitivity. Settings and Design: Institutional, prospective double-blind parallel clinical design. Subjects and Methods: A total of 54 teeth in 20 patients were randomly allocated to one of the three study groups, with 18 teeth in each group as follows: Group A‑Gluma Desensitizer (GD), Group B‑Gluma Comfort Bond + Desensitizer (GCBD), Group C‑Single Bond Universal (SBU). The patients’ dentinal hypersensitivity scores for tactile (hand‑held scratch device), thermal (cold), and evaporative (dental unit air syringe) stimuli were recorded on a visual analog scale. The parameters were recorded at baseline, immediately after application of the agent, 3‑ and 6‑week posttreatment. Statistical Analysis Used: The data were analyzed with Friedman’s test, Wilcoxon signed ranks test, Kruskal–Wallis test, and Mann–Whitney‑U‑test (P < 0.05). Results: All three groups showed a significant reduction in dentinal hypersensitivity (P < 0.05) compared to baseline at all time intervals. Statistically, significant differences were noted between GD and SBU; between GCBD and SBU in all testing parameters. Between GD and GCBD no significant difference was noted. Conclusions: GD and GCBD showed a greater reduction in dentin hypersensitivity than SBU.

Dentinal Hypersensitivity: pre-hybridization as an alternative treatment / Hipersensibilidade dentinária: pré-hibridização como um tratamento alternativo

A hipersensibilidade dentinária pode ocorrer quando há exposição da dentina após preparos dentários para restaurações indiretas. Para evitar ou minimizar desconfortos pós-operatórios, os adesivos dentinários têm sido utilizados para proteger a dentina exposta. Esta técnica é denominada pré-hibridização. Apesar da utilização clínica, ainda existem controvérsias sobre a eficácia, o material e o protocolo mais adequado para realizá-la. Objetivo: Esta revisão tem como objetivo discutir os conceitos que envolvem a pré-hibridização, baseando-se nos artigos mais relevantes publicados (2002 até a data atual), indexados nas bases de dados da SciELO, MEDLINE e Pubmed. Método: Para a pesquisa foram utilizadas as seguintes palavras-chave: pré-hibridização, hipersensibilidade dental e variáveis (ex.: pré-hibridização dentinária, hipersensibilidade dentinária, tratamento de hipersensibilidade). Foram selecionadas as referências do tipo revisão e artigos de pesquisa originais. Foram feitos esforços para identificar estudos sobre tratamentos clínicos comparativos, controlados e estudos de meta-análise sobre a hipersensibilidade e a pré-hibridização dentinária. Resultado: Baseado na revisão realizada é possível destacar os adesivos autocondicionantes como a primeira escolha para os procedimentos de pré-hibridização. Conclusão: Porém, a literatura ainda não apresenta um protocolo consolidado e as pesquisas clínicas que estudam a eficiência desta técnica são limitadas.

Dentinal hypersensitivity may occur after the dentine exposure because of indirect restoration preparations. Either to avoid or decrease postoperative discomfort, dentinal adhesives have been used to protect the exposed dentine. This technique is called pre-hybridization. Notwithstanding, despite of the clinical use, there still exist controversies on its efficacy and the most adequate material and protocol to execute it. Objective:This review study aimed to discuss the concepts involving the pre-hybridization based on the most important papers published from 2002 to date, indexed at the following databases: SciELO, MEDLINE and Pubmed. Methods: The following keywords were applied in the searching: pre-hybridization, tooth hypersensitivity and their possibilities (e.g.: dentinal pre-hybridization, dentinal hypersensitivity, hypersensitivity treatment). Only review and original research studies were selected. Efforts to identify comparative, controlled clinical studies as well as meta-analysis studies on hypersensitivity and dentinal pre-hybridization were made. Results: Based on the review conducted, it was possible to highlight that the self-conditioning adhesives have been the first choice for pre-hybridization procedures. Conclusion: However, the literature still lacks on determining a consolidated protocol and the clinical effectiveness of this procedure.

Clinical assessment on application of Er:Cr:YSGG laser in dentinal hypersensitivity reduction / 대한구강보건학회지

OBJECTIVES: We aimed to evaluate the effectiveness of Er:Cr:YSGG laser therapy on the reduction of dentinal hypersensitivity while taking into account the length and depth of the cervical abrasion. METHODS: We included adults (age, 20-60 years) with at least 2 hypersensitive teeth. The hypersensitive teeth were stimulated with a pressure-indicating probe and an air syringe. The response of the subjects to this stimulation was quantified using a visual analog scale (VAS) and Schiff air sensitivity score. The patients were treated at baseline, immediately after laser treatment, and at 1, 2, and 4 weeks after the Er:Cr:YSGG laser therapy. The results were analyzed by repeated measure analysis of variance (ANOVA) and Bonferroni's post hoc test. RESULTS: The values of tactile test and air blast test showed statistically significant differences between the following time points: baseline and immediately after laser treatment, baseline and first week after treatment, and immediately after laser treatment and first week after treatment (P0.05). The depth and width of the cervical abrasion was not statistically significant in dentinal hypersensitivity reduction (P>0.05). CONCLUSIONS: The use of Er:Cr:YSGG laser therapy reduced dentinal hypersensitivity, especially immediately after laser treatment. The depth and width of the cervical abrasion is not statistically significant in dentinal hypersensitivity reduction.

Comparative evaluation of two commercially available desensitizing agents for the treatment of dentinal hypersensitivity.

Aims: A randomized clinical trail was designed to compare the efficacy of two commercially available desensitizing agents (fluoride varnish containing 6% sodium fluoride and 6% calcium fluoride and a gel containing 6% potassium nitrate and 0.11% fluoride ions) in the treatment of dentinal hypersensitivity. Settings and Design: Randomized clinical trial. Materials and Methods: Twenty-one patients were selected. Subjects were evaluated using three different stimuli, i.e., tactile test, air blast test and cold water test. They were then randomly divided into two groups. Patients in group I were treated with fluoride varnish and group II patients were treated with gel containing 6% potassium nitrate and 0.11% fluoride ions. The patients were examined at baseline, immediately after application of the agent, at 1 week, 1 month and 3 months interval. Statistical Analysis: Statistical analysis was done using unpaired "t" test, paired "t" test and Chi-square test with Yate's correction. Results: The results were analyzed; it was seen that patients treated in group I showed significantly better results compared to group II patients at 1 month and 3 months interval. Teeth which required repeat dose and those which did not require repeat dose were comparable in number. Conclusions: Both the agents showed significant reduction in sensitivity at all time intervals compared to baseline. A comparatively significant reduction in sensitivity score was seen in patients treated with fluoride varnish and it appeared to be more effective in providing long-term relief against all the three test stimuli. Teeth with initial high sensitivity score required repeat doses, which was comparable for both the groups.

Evaluation of the efficacy of a 5% calcium sodium phosphosilicate (Novamin®) containing dentifrice for the relief of dentinal hypersensitivity: A clinical study.

Context: Dentinal hypersensitivity (DH) is a commonly encountered problem. Several products are used in management of DH with varying results. Need is felt in dentistry for a material that chemically reacts, physically occludes and adheres intimately to dentinal tubules to reduce the possibility of its recurrence. One such material is calcium sodium phosphosilicate-Novamin ® . Aim: To evaluate an efficacy of a 5% calcium sodium phosphosilicate (Novamin ® SHY NM TM ) containing dentifrice compared to placebo for the relief of DH. Settings and Design: Outpatients visiting Dept of Periodontics, Yenepoya Dental College with DH were deemed eligible for this case-control clinical trial after an informed consent. Materials and Methods: 30 patients having at least 2 sensitive teeth with a VAS (Visual Analogue Scale) of >3 cm after air blast stimulation, qualified to participate in the study. Test (SHY NM TM toothpaste containing 5% calcium sodium phosphosilicate) and control (Pepsodent toothpaste without a desensitizing agent) groups, each containing 15 participants, were subjected to cold water and air blast stimulation for an assessment of DH at baseline, 6 th and 8 th week using VAS. Statistical analysis used: Unpaired t-test and repeated measures ANOVA. Results: 5% Novamin ® containing dentifrice significantly reduced DH within 6 th and 8 th week of usage when compared to a placebo dentifrice. Conclusions: A Novamin ® containing dentifrice significantly reduced DH when compared to a placebo dentifrice.

Prevalence of dentine hypersensitivity among adult patients attending a dental hospital clinic in Turkey / Prevalencia de la hipersensibilidad dentinaria entre los pacientes adultos que asisten a la clínica del hospital dental en Turquía

OBJECTIVES: The aim of this study is to determine the prevalence of dentine hypersensitivity (DH) and to examine some associated factors such as the initiating stimuli among adult patients attending the Restorative Clinic of the Kirikkale University Dental Faculty, Turkey. METHODS: Questionnaires for 1169 patients, 678 men and 491 women, were completed and necessary clinical examinations performed during a one-year period and patients who were diagnosed with DH were questioned further about their occupation and smoking habits. Patients with at least two different quadrants which had sensitive teeth with sound exposed cervical dentine on the facial surface, were included in the study. The amount ofcervical lesions, buccal gingival recession and initiating factors associated with the sensitive teeth were also recorded. RESULTS: Of the 1169 patients examined, 89 were diagnosed as having dentine hypersensitivity, giving a prevalence of 7.6%. The commonest teeth affected were the upper premolars and the commonest initiating factor was cold drinks. CONCLUSIONS: The prevalence of dentine hypersensitivity in a postgraduate clinic in Turkey was 7.6%. The commonest teeth affected were the upper premolar and the commonest initiating factor was cold drinks.

OBJETIVOS: El objetivo de este estudio fue determinar la prevalencia de la hipersensibilidad dentinaria (HD) y examinar algunos factores asociados con ella, tales como los estímulos iniciadores entre los pacientes adultos que asisten a la Clínica Restaurativa la Facultad Dental Universitaria de Kirikkale, Turquía. MÉTODOS: Cuestionarios entregados a 1169 pacientes, 678 hombres y 491 mujeres, fueron respondidos, y se realizaron los exámenes clínicos necesarios por espacio de un ano. Los pacientes que fueron diagnosticados con HD, fueron interrogados ulteriormente acerca de su ocupación y el hábito defumar. Los pacientes con al menos dos cuadrantes diferentes, que tenían dientes sensibles con exposición de dentina cervical sana sobre la superficie facial, fueron incluidos en este estudio. También se registró la cantidad de lesiones cervicales, la recesión gingival bucal y los factores iniciadores asociados con la sensibilidad de los dientes. RESULTADOS: De los 1169 pacientes examinados, 89 se diagnosticaron con hipersensibilidad de la dentina, para una cifra de prevalencia de 7.6%. Los dientes más comúnmente afectados fueron los premolares superiores y los factores iniciadores más comunes fueron las bebidas frías. CONCLUSIONES: La prevalencia de la hipersensibilidad dentinaria en una clínica postgraduada en Turquía fue de 7.6%. Los dientes más comúnmente afectados fueron los premolares superiores y el facgor iniciador más común fueron las bebidas frías.

Efficacy of two commercially available dentifrices in reducing dentinal hypersensitivity.

Objective: A parallel design clinical study evaluated reduction in hypersensitivity after brushing for 12 weeks with Anchor toothpaste (containing potassium citrate, zinc citrate, triclosan and sodium monofluorophosphate) (test) and Colgate Total (sodium fluoride, silica, triclosan and copolymer) (control) dentifrices. Materials and Methods: Sixty adults with sensitivity to hot and cold stimulus in at least two tooth surfaces were stratified at the baseline examination by tactile, hot and cold stimuli scores in two balanced groups. Subjects were randomly allocated the test and control dentifrices and evaluated after 6 and 12 weeks of dentifrice use for hypersensitivity. Results: The two teeth that were selected in each patient were designated as two different sets. The 12 th -week scores as compared to baseline scores for tactile, heat and cold tests in the test group showed a reduction in tooth hypersensitivity by 36.67% (P < 0.01), 20.35% (P < 0.01) and 53.64 % (P < 0.01), respectively, in the first set of teeth and 43.75% (P < 0.01), 24.48% (P < 0.01) and 59.78% (P < 0.01), respectively, in the second set of teeth. The 12 th -week scores as compared to baseline scores for tactile, heat and cold tests in the control group showed a reduction in tooth hypersensitivity by 42.86% (P < 0.01), 13.02% (P < 0.01) and 45.14% (P < 0.01), respectively, in the first set of teeth and 40% (P < 0.01), 16.59% (P < 0.01) and 44.16% (P < 0.01), respectively, in the second set of teeth. Conclusions: Both the products reduced dentinal hypersensitivity in the study subjects at the end of the 12-week period. However, there was no statistically significant difference in reduction in hypersensitivity between the two products.

Comparative evaluation of different strengths of electrical current in the management of dentinal hypersensitivity.

Background : Dentinal hypersensitivity is a commonly occurring but less understood and poorly managed problem of the teeth. Iontophoresis is a technique wherein desensitizing agents can be transferred under electrical pressure into the tooth structure to manage hypersensitivity. Aim : The purpose of present study is to compare the effect of different strengths of electrical current used for varying lengths of time, keeping the electrical dosage constant with the iontophoretic unit in the management of dentinal hypersensitivity. Materials and Methods : This study was conducted among the patients attending the Periodontal Department of the Government Dental College and Hospital, Patiala, Punjab, specifically complaining of tooth hypersensitivity. The Verbal Rating Scale (VRS) was used to record scores pre-, during, and post-treatment. Ten percent SrCl2 solution was applied with an iontophoretic unit. Three applications were performed at weekly intervals, up to the second week, using the same electric current dosage. The data compiled was statistically analyzed. Results : A remarkable reduction in dentinal hypersensitivity to both air blast and cold water stimuli was noted at the end of two months after iontophoresis with each current group / method, namely, I (0.25 mA for 4 minutes), II (0.5 mA for 2 minutes), and III (1 mA for 1 minute). However, the differences in effectiveness / improvement within the three current groups during the entire duration of the study were found to be statistically insignificant. Conclusion : Within the limits of this study, it could be implied that for relieving hypersensitivity, iontophoresis for all three current groups was almost equally effective, and it was found that repeated applications (up to three) gave good relief. Iontophoresis was found to be effective and safe.

Study on the Changes of Dentinal Hypersensitivity and Surface Characteristics Following the Various Root Treatment / 대한치주과학회지

Exposure of the root surface due t o gingival recession after periodontal surgery, elicit pain response when exposed to mechanical, heat, chemical o r osmotic irritation. Especially patients treated with periodontal surgery, show high frequency. There have been reports that the 1 out of 7 patients complains of dentinal hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentinal hypersensitivity. The purposes of this study were to evaluate die effect of sodium chloride and potassium oxalate and to observe the relationship between the dentinal hypersensitivity and surface characteristics such as dentinal tubule size and number. This study included 20 teeth which were scheduled for extraction and had no pulpal disease. These teeth were divided into Root planing group, EDTA group, NaCl group and Oxalate group. Dentinal hypersensitivity is measured by tactile, pressured air and cold water using NRS (Numerical Rating Scales). Teeth were extracted under local anesthesia and each specimen was sectioned to a size about 3 X 5 mm and was examined under the scanning electron microscope (X2,000) The results were as follows, 1. The EDTA group exhibited significantly increased dentinal hypersensitivity comparing with the other groups. 2. The NaCl and Oxalate groups showed significantly reduced dentinal hypersensitivity comparing with the EDTA group. 3. As a method for dentinal hypersensitivity measurement, it was presumed that tactile sensitivity test was not sensitive method but air blast test and cold water test were adequate method. 4. In a SEM study, the root planing group exhibited amorphous smear layer and showed no dentinal tubule orifice, but the EDTA group showed the large number of dentinal tubules. On the other hand, the NaCl and Oxalate groups did not show exposed dentinal tubules. The NaCl group showed more rough root surface than the EDTA group, anti the Oxalate group showed many participates to be presumed as calcium oxalate particle. As the results from this study, root planing couldn't expose the dentinal tubule and NaCl and potassium oxalate occluded exposed dentinal tubule effectively. Dentinal hypersensitivity has close relationship with the exposure of dentinal tubules, especially with it's size and number.