Cross-cultural adaptation of the Brazilian version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15)

Abstract The dentine hypersensitivity (DH) is able to impair the oral health related quality of life (OHRQoL). However, there isn't any specific validated questionnaire to be used in Brazil. The objective was to adapt and to validate the English version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) for use in Brazil. DHEQ-15 was cross-culturally adapted into the Brazilian-Portuguese language and then validated in a cross-sectional study with 100 participants recruited at a University clinic. Study sample comprised 2 groups: 100 individuals with DH, and 100 individuals without. The instrument was self-administered twice 7 to 10 days apart. The participants answered a global rating of oral health. The psychometric properties of the Brazilian version of DHEQ-15 were verified through internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient - ICC), convergent (Spearman correlation) and discriminant (Mann-Whitney test) validity. The significance threshold was set at p<0.05. Sample comprised 69 men and 131 women, of mean age 30.4y. The Brazilian DHEQ-15 demonstrated very good internal consistency (α = 0.945). Test-retest reliability revealed excellent reproducibility (ICC = 0.959, p < 0.001). There was statistically significant correlation between the scores obtained on all DHEQ-15 domains and the global rating of oral health (p<0.001). Participants with DH scored significantly higher than those without DH (p<0.001). This study provides evidence supporting the cross-cultural validity of the Brazilian version of DHEQ-15 for use in Brazil.

Effect of commercially available and experimental potassium oxalate-based dentin desensitizing agents in dentin permeability: influence of time and filtration system

This study evaluated the influence of time after application of oxalate solutions in reducing dentin hydraulic conductance. Fifty dentin discs were obtained from extracted human third molars and assigned to 5 groups (n=10), according to the desensitizing agent used: Group I: OxaGel; Group II: experimental agent DD-1: Group III: experimental agent DD-2. In Groups IV and V, a placebo gel and deionized water were used as control, respectively. The agents were applied for 3 min, washed out and the hydraulic conductance was measured immediately and at 5-, 15- and 30-min intervals, and after acid etching. Data were analyzed statistically by two-way ANOVA and Duncan's test at 5 percent significance level. Groups I, II and III did not differ significantly from each other in any of the time intervals (p>0.05). Likewise, Groups IV and V were statistically similar to each other (p>0.05). The active agents reduced significantly dentin permeability in comparison to control groups (p<0.05). Dentin permeability measured in vitro decreased significantly with time regardless of the agent applied (either active or control agents). The results of Group V, in which no dentin desensitizing agent was employed, indicates that the assessment of dentin permeability by this method must be interpreted with caution.

O objetivo deste estudo in vitro foi avaliar a influência do tempo pós-aplicação de agentes anti-hiperestésicos comercial e experimentais na permeabilidade dentinária por meio da medição da condutibilidade hidráulica da dentina, utilizando-se o método de discos de dentina. Cinqüenta discos de dentina obtidos a partir de terceiros molares humanos recém extraídos foram divididos em 5 grupos (n=10), de acordo com o agente utilizado: Grupo I: OxaGel; Grupo II: agente experimental DD-1: Grupo III: agente experimental DD-2: Grupo IV: gel placebo; e Grupo V: água deionizada. Os agentes foram aplicados por 3 min e em seguida mediu-se a condutibilidade hidráulica da dentina nos tempos imediato, 5, 15, 30 min e após a aplicação de ácido. Os dados foram submetidos a análise estatística pelos testes de ANOVA a dois critérios e teste de Duncan com nível de significância de 5 por cento. Os Grupos I, II e III não diferiram significantemente uns dos outros em nenhum dos intervalos (p>0,05). Do mesmo modo, os Grupos IV e V foram similares estatisticamente (p>0,05). Os agentes ativos reduziram significantemente a permeabilidade dentinária em comparação aos controles (p<0,05). A redução dos valores de permeabilidade em função do tempo apresentada pelo Grupo V, o qual não foi empregado agente anti-hiperestésico, faz com que a interpretação dos resultados dos demais grupos leve em consideração um arrefecimento natural da permeabilidade com o passar do tempo, proporcionado pelo dispositivo utilizado para a medição da condutibilidade hidráulica da dentina.

Bases neurofisiológicas para el manejo clínico del complejo dentinopulpar / Neurophysiological basis for the clinical management of the dentino pulpal complex

El complejo dentinopulpar cuenta con una inervación muy abundante. Por el foramen apical de cada diente humano pasan de1000 a 2000 fibras nerviosas. De ellas el 75 por ciento son amielínicas –fibras C- y el 25 por ciento mielínicas -la mayoría Aδ y pocas Aβ -. Lasramificaciones de las fibras Aδ penetran de 100 a 200 micrómetros en aproximadamente la mitad de los túbulos dentinarios,inervando la porción más interna de la dentina. Las terminaciones de las fibras nerviosas funcionan como receptores. Existiríantres grupos de receptores intradentarios: nociceptores específicos, receptores polimodales y posiblemente mecanorreceptores.Los dos primeros proveen información de alerta frente al daño tisular y su estimulación produce sensaciones dolorosas. Lasfibras Aδ intradentales median el dolor agudo intenso, pasajero, típico de la sensibilidad dentinaria. Diversos estímulos (térmicos,mecánicos, osmóticos, etc.) provocan flujo de líquido dentro de los túbulos dentinarios y es este flujo el que estimula a lasfibras nerviosas dentinopulpares. La permeabilidad de la dentina expuesta es una de las variables más importantes en la sensibilidaddentinaria. Las fibras intradentales C median el dolor sordo, difuso, mal localizado y prolongado. Hay pocas evidencias deque los estímulos mecánicos puedan causar una sensación diferente a la dolorosa cuando se aplican al complejo dentinopulpar.Existen también algunas fibras nerviosas autonómicas que tendrían función en la regulación del flujo vascular pulpar...

The dental pulp and dentin are very innervated. Between one and two thousand nerve fibers pass through the apical foramen of ahuman tooth. 75 percent of them are amielinic C-fibers and the rest are mielinic fibers, most of them from the Aδ and some from the Aβtypes. The Aδ endings penetrate 100 –200 micrometers in near half the dentin tubules, innervating the inner portion of the dentin.The endings of the nerve fibers act like receptors. There are three types of intradental receptors: specific nociceptors, polimodalreceptors and probably mechanoreceptors. The first two types provide information about threat of tissue damage and theirstimulation leads to painful sensations. Intradental Aδ fibers mediate sharp temporary pain characteristic of dentin sensibility.Many stimuli (thermal, mechanic, osmotic, etc.) produce fluid flow inside the dentinal tubules, and this flow stimulates dentinopulpalnerve fibers. The permeability of the exposed dentin is one of the main variables in dentin sensibility. Intradental C-fibers mediatedull, bad localized, diffuse pain. There is little evidence that the mechanical stimuli produce a sensation different than pain whenapplied to the dentinopulpal complex. There are some intradental autonomic fibers that may play a role in pulpal blood flowregulation...

Etiología, prevalencia y características clínicas de la sensibilidad dentinaria cervical (trad) / Etiology, prevalence and clinical features of cervical dentine sensitivity

La sensibilidad dentinaria cervical (SDC) es una respuesta dolorosa a los estímulos térmicos, físicos y químicos en la región cervical del diente. La prevalencia reportada de esta condición clínica va desde un 8 a un 35 por ciento, según la población estudiada y la metodología para evaluar la SDC. La epidemiología es posbre respecto de los posibles factores causales. Para identificar estos factores causales y poder prevenir y tratar correctamente la SDC, es esencial contar con trabajos de investigación bien realizados, en grandes poblaciones, en las que se utilice una aceptable metodología estandarizada para la evaluación por medio de un cuestionario y para el examen clínico. En este trabajo se hace una revisión de la literatura actual con respecto a la prevalencia, etiología y distribución bucal de esta dificultosa condición