Hipersensibilidade dentinária: etiologia, diagnóstico e tratamento / Dentin hypersensitivity: etiology, diagnosis and treatment

Introdução: A hipersensibilidade dentinária (HD) consiste em uma condição clínica caracterizada por dor localizada, curta e aguda, resultante de estímulos exógenos. Objetivo: Esse estudo objetivou realizar uma revisão da literatura sobre os aspectos relevantes vinculados à HD, como etiologia, diagnóstico, mecanismos biológicos, medidas preventivas e terapêuticas. Metodologia: Foi realizada a busca eletrônica de publicações nas bases de dados Scielo, PubMed, Periódicos Capes, Lilacs e Medline, utilizando os seguintes descritores: "dentin", "dentin sensitivy", "treatment". Os estudos foram publicados no período de 2010 a 2020. Resultados: Observou-se que a HD acomete cerca de 9-55% da população, principalmente indivíduos entre a terceira e quarta décadas de vida, apresentando maior prevalência no sexo feminino, afetando especialmente as regiões vestibulares dos caninos, pré-molares superiores e sequencialmente os incisivos e molares inferiores. O diagnóstico é determinado a partir de testes de sensibilidade, como o mecânico ou a desidratação. O tratamento dispõe de inúmeras propostas baseadas na obliteração dos túbulos dentinários como forma de impossibilitar a movimentação líquida intratubular ou restrição neural dos mecanorreceptores pulpares. Conclusão: Embora os aspectos clínicos sejam bem estabelecidos na literatura, a importância de um correto diagnóstico é essencial para um plano de tratamento adequado, por se tratar de uma condição de etiologia multifatorial... (AU)

Introduction: Dentin hypersensitivity (DH) consists of a clinical condition characterized by localized, hort and acute pain, resulting from exogenous stimulus. Objective: This study aimed to conduct a narrative literature review on the relevant aspects linked to DH, such as etiology, diagnosis, biological mechanisms, preventive and therapeutic approaches. Methodology: The electronic search for publications was carried out in the Scielo, PubMed, Capes, Lilacs and Medline databases, using the following descriptors: "dentin", "dentin sensitivy", "treatment". The studies were published in the period from 2010 to 2020. Results: It was observed that DH affects about 9-55% of the population, mainly belonging to the third and fourth decade of life, with higher prevalence in females, especially affecting the vestibular regions of the canines, upper premolars and sequentially the incisors and molars lower. The diagnosis is determined based on sensitivity tests, such as mechanical or dehydration. The treatment has numerous proposals based on the obliteration of the dentinal tubules as a way of preventing the intratubular liquid movement or neural restriction of the pulp mechanoreceptors. Conclusion: Although the clinical aspects are well established in the literature, the importance of a correct diagnosis is essential for an adequate treatment plan, as it is a multifactorial condition... (AU)

Clinical time and postoperative sensitivity after use of bulk-fill (syringe and capsule) vs. incremental filling composites: a randomized clinical trial

Abstract The objectives of this double-blind randomized clinical trial were to compare (a) the clinical times and (b) the occurrence and severity of postoperative sensitivity, of posterior restoration that used a universal adhesive, in a self-etch or selective enamel-etching technique, along with incremental or bulk-fill composites (presented in syringes or capsules). A total of 295 posterior restorations were placed according to the following groups: SETB - self-etch/bulk-fill in syringe; SETC - self-etch/bulk-fill in capsules; SETI - self-etch/incremental; SEEB - selective enamel-etching/bulk-fill in syringe; SEEC - selective enamel-etching/bulk-fill in capsules; and SEEI - selective enamel-etching/incremental. Clinical time was assessed by a reason (s/mm3) between the total volume of resin inserted and the total time required to perform the restorations. Postoperative sensitivity was evaluated using two scales (Numeric Rating Scale and Visual Analogue Scale). Mean clinical time results, analyzed by Wald's Chi-square, showed significant statistical differences among all groups (p<0.001), indicating that the restorative strategy affected the time required for the restoration. A generalized estimating equation model statistical analysis, performed to compare postoperative sensitivity, showed that neither the restorative technique, the adhesive strategy nor the presentation mode of the bulk-fill composite affected the overall risk of postoperative sensitivity (4.06 [2.22-6.81]). The use of bulk-fill composite, presented in capsules or syringes, is less time consuming and does not increase the risk or intensity of postoperative sensitivity relative to the traditional incremental technique.

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)

Eficacia de un dentífrico con dióxido de silicio obliterante en pacientes con hiperestesia dentinaria / Efficacy of a toothpaste containing precipitated silica particles in patients with dentin hyperesthesia

Introducción: la hiperestesia dentinaria se caracteriza por un dolor intenso y breve asociado a la exposición de estímulos térmicos, táctiles, osmóticos o químicos. De prevalencia creciente, reduce la calidad de vida del paciente. Objetivo: evaluar la eficacia, aceptabilidad y tolerancia de un dentífrico con dióxido de silicio obliterante, nitrato potásico y monofluorofosfato sódico en pacientes con hiperestesia dentinaria. Métodos: estudio observacional y longitudinal (n= 22) en el que se aplicó el dentífrico 3 veces/día durante 28 días. Se realizó una evaluación clínica, antes y después de la aplicación, a las 48 horas, a las 96 horas y los días 7, 14, 21 y 28 del estudio. Se evaluó su eficacia en términos de reducción de la hipersensibilidad dental determinada mediante técnica táctil (escala de calificación verbal) y de chorro de aire (escala de Schiff). En cada visita se valoró la tolerancia del producto. Los pacientes valoraron el grado de hipersensibilidad y su percepción del producto mediante un cuestionario de evaluación subjetiva. El estudio se realizó bajo los principios de Buena Práctica Clínica. Resultados: la hipersensibilidad dental se redujo en todos los puntos temporales del estudio y fue significativa (p< 0,05) a partir del día 5. Esta mejoría fue sostenida y aumentó a medida que avanzó el tratamiento. El día 29 la hipersensibilidad media se redujo en un 85 por ciento respecto al valor basal en todos los pacientes. El 91 por ciento de los participantes opinó que el dentífrico había cumplido sus expectativas. No se observó ninguna reacción adversa derivada del uso del producto. Conclusiones: el dentífrico, administrado 3 veces/día, consiguió una reducción de la hipersensibilidad dental, significativa a partir del día 5, que fue aumentando con el tiempo. El producto presentó muy buena aceptabilidad y tolerancia(AU)

Introduction: dentin hypersensitivity is characterized by sharp pain of short duration associated with exposure to thermal, tactile, osmotic or chemical stimuli. Dentin hypersensitivity is a disorder of growing prevalence which reduces the quality of life of patients. Objective: evaluate the efficacy, acceptability and tolerance of a toothpaste with precipitated silica, potassium nitrate and sodium monofluorophosphate in patients with dentin hypersensitivity. Methods: an observational longitudinal study was conducted (n= 22) in which the toothpaste was applied 3 times a day for 28 days. Clinical assessment was performed before and after the application, at 48 hours, at 96 hours and on days 7, 14, 21 and 28 of the study. Efficacy was evaluated in terms of dental hypersensitivity reduction as determined by tactile (Verbal Rating Scale) and air jet (Schiff scale) techniques. Tolerance to the product was assessed in every visit. Patients ranked the degree of hypersensitivity and their perception of the product by means of a subjective assessment questionnaire. The study complied with Good Clinical Practice principles. Results: areduction was observed in dental hypersensitivity at all time points throughout the study, and it was significant (p< 0,05) as of day 5. This improvement was sustained and increased as treatment progressed. On day 29 mean hypersensitivity had reduced 85 percent with respect to baseline value in all patients. 91 percent of the patients stated that the toothpaste had met their expectations. No adverse reaction attributable to the product was observed. Conclusions: applied 3 times/day, the toothpaste obtained a reduction in dental hypersensitivity, which was significant as of day 5. This improvement increased over time. The product had very good acceptability and tolerance(AU)

Hipersensibilidad dentinaria posterior al tratamiento periodontal quirúrgico / Dentine hypersensitivity after surgical periodontal treatment

El objetivo de esta investigación fue evaluar el nivel de información que poseen los odontólogos periodoncistas con respecto a la aparición de hipersensibilidad dentinaria posterior a los procedimientos quirúrgicos, identificar cuál es la cirugía que más la genera, así como los tratamientos más utilizados en el manejo de la entidad. Materiales y métodos: Se realizó un estudio de campo, de tipo descriptivo y transversal. La muestra estuvo conformada por 86 periodoncistasque corresponden al 30 por cienot de la población que integra la Sociedad Venezolana de Periodontología. La información se recolectó con un instrumento tipo encuesta. Resultados: El 89,53 por ciento manifestó que sus pacientes refieren hipersensibilidaddentinaria posterior a la realización de procedimientos quirúrgicos periodontales. La cirugía para reducción de sacos ocupó el primer lugar en generar hipersensibilidaddentinaria con un 57,14 por ciento. Un 96.10 por ciento de los especialistas entrevistados confirmó la utilización de algún tratamiento para la hipersensibilidad dentinaria. En relación a el tratamiento más utilizado, el 53,24 por ciento aplicó pastas desensibilizantes posterior a la fase periodontal quirúrgica. Conclusiones: Los resultados obtenidos en esta investigación indican que el nivel de información que poseen los profesionales de la periodontología en relación a la hipersensibilidaddentinaria posterior a la cirugía periodontal es elevado debido a la alta prevalencia de esta afección en la población tratada. El procedimiento quirúrgico más asociado a la hipersensibilidad dentinaria fue la cirugía para reducción de sacos. La aplicación de pastas desensibilizantes fue el tratamiento más utilizado paracontrolarla.

Factors associated with dentine hypersensitivity severity in Colombian dental patients / Factores asociados a la severidad de la hipersensibilidad dentinal en pacientes de odontología colombianos

Abstract: Introduction: the aim of this study was to determine the pre¬valence of dentine hypersensitivity (DH) and examine associated etiological factors related to the severity of DH in dental clinic patients treated at the School of Dentistry at Universidad Cooperativa de Colombia, Pasto, Colom¬bia. Materials and Methods: A cross-sectional study was designed in which three hundred and thirty three patients aged 15 to 44 years old were assessed for the presence and severity of DH. The dentine hypersensitivity diagnosis was based on self-reported sensitivity and a clinical examination. The ques¬tionnaire included socio-demographic information, data about oral health habits and acidic dietary intake. A descriptive analysis was performed and the association between DH severity and risk factors was determined using an ordinal logistic regression model. Results: Dentine hypersensitivity was detected in 88 out of 333 (26.4 percent) subjects (95 percent CI: 21.83-31.56). The pH of natural juices (OR=6.013; 95 percent CI: 0.995-36.319, p=0.051) and pH of alcohol beverages (OR= 7.800; 95 percent CI: 2.282-26.658, p=0.001) were signi¬ficantly associated with the severity of dentine hypersensitivity. Conclusions: The results indicated that the prevalence of dentine hypersensitivity in these patients was consistent with previous reports. Furthermore, the severity of DH was influenced by acidic diet. These results suggest that dental coun¬seling should be provided to all patients as well as to those with dentine hypersensitivity to prevent the occurrence of this oral health problem and the severity of symptoms.

Resumen: Introducción: el objetivo de este estudio fue determinar la prevalencia de hipersensibilidad dentina (HD) y examinar los factores etiológicos asociados relacionados a la severidad de la HD en pacientes de la clínica de la Facultad de Odontología de la Universidad Cooperativa de Colombia, Pasto, Colombia. Materiales y Métodos: Se diseñó un estudio transversal donde trescientos treinta y tres pacientes de edades entre 15-44 años de edad fueron evaluados para la presencia y severidad de HD. El diagnóstico de la hipersensibilidad dentinal fue basado en sensibilidad auto-reportada y un examen clínico. El cuestionario incluía información socio-demográfica, datos acerca de hábitos de salud oral e ingesta de dieta ácida. Un análisis descriptivo fue realizado y la asociación entre la severidad de la HD y los factores fue determinada usando un modelo de regresión logística ordinal. Resultados: La hipersensibilidad dentinal fue detectada en 88 de 333 (26,4 por ciento) sujetos (IC 95 por ciento: 21,83-31,56). El pH de los jugos naturales (OR=6,013; IC 95 por ciento: 0,995-36,319, p=0,051) y el pH de las bebidas alcohólicas (OR=7,800; IC 95 por ciento: 2,282- 26,658, p=0,001) fueron asociadas significativamente con la severidad de la hipersensibilidad dentinal. Conclusiones: Los resultados indican que la prevalencia de HD en estos pacientes fue concordante con previos reportes. Además, la severidad de la HD fue influenciada por la dieta acida. Estos resultados sugieren que el consejo odontológico debería ser provisto a todos los pacientes, al igual a aquellos con HD tanto para prevenir la ocurrencia de este problema de salud oral como la severidad de los síntomas.

Post-bleaching sensitivity in patients with sickle cell disease / Sensibilidade dentária pós-clareamento em pacientes com doença falciforme

Sickle cell disease (SCD) is a monogenic disease that affectsmillions of people worldwide. This study analyzed theeffectiveness of bleaching and tooth sensitivity after in-officebleaching in patients with SCD. Forty volunteers wererandomly assigned to four groups of 10 patients each (five withthe SCD and five healthy controls) and treated using in-officebleaching with 35% hydrogen peroxide and different lightactivation protocols. No statistically significant difference wasobserved with relation to presence of tooth sensitivity, with orwithout use of a source of light for peroxide activation, and allbleaching therapies were effective, regardless of the techniqueemployed and the presence/absence of sickle cell disease. Thedata showed that in-office dental bleaching is a viablealternative for improvement of oral esthetics for patients with SCD.

A doença falciforme (DF) é a doença monogênica e afetamilhões de pessoas em todo o mundo. Este estudo analisou aeficácia do clareamento e a presença de sensibilidadedentinária após clareamento dental em portadores de DF.Quarenta voluntários distribuídos aleatoriamente em quatrogrupos com diferentes fontes de luz foram submetidos à técnicade clareamento em consultório, utilizando peróxido dehidrogênio a 35%. Não foram encontradas diferenças estatisti -ca mente significativas em relação á presença de sensibilidade,com ou sem a utilização de uma fonte de luz para acelerar aativação do peróxido e todos os clareamentos foram efetivos,independentemente da técnica utilizada e da presença/ausênciade DF. Os dados mostraram que o clareamento dental em consultório, utilizando peróxido de hidrogênio a 35% é uma alternativa viável para melhoria da estética em pacientes com DF.

Hipersensibilidade dentinária cervical autorrelatada e diagnosticada: um estudo piloto / Dentin hypersensitivity self-reported and diagnosed: a pilot study

Este estudo-piloto teve como principal objetivo identificar e comparar a prevalência autorrelatada e diagnosticada de hipersensibilidade dentinária cervical (HSDC) na população da Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina/MG. Foram também verificados os fatores etiológicos associados e a distribuição dos dentes sensíveis nos arcos. Foram avaliados 54 pacientes, escolhidos aleatoriamente através de questionário, ficha clínica e exame clínico dividido em dois testes. No teste evaporativo, cada dente foi testado com o jato de ar da seringa tríplice, e o teste térmico foi realizado com spray de tetrafluoretano (Endo-Ice); em ambos os testes, adotou-se o tempo de cinco segundos para a execução dos mesmos. A dor foi avaliada por dois examinadores calibrados, através de uma escala analógica visual (EAV). Os participantes que apresentavam pelo menos um dente com escore igual ou maior do que 2,51 no teste evaporativo foram considerados como apresentando HSDC. Dos pacientes que relataram a presença de hipersensibilidade, 76,3% (n=18) tiveram confirmado o diagnóstico clínico, ao passo que, dos que disseram não apresentar HSDC, 23,7% (n=3) foram diagnosticados clinicamente com a condição. A faixa etária dos participantes variou de 18 a 45 anos. Os dentes mais acometidos foram, respectivamente, os incisivos inferiores e os superiores. Quanto aos fatores etiológicos, os de maior prevalência foram: a retração gengival e o posicionamento inadequado dos dentes. Concluiu-se que a prevalência autorrelatada é significativamente maior do que a prevalência diagnosticada clinicamente, e os fatores etiológicos mais comuns na amostra analisada foram: recessão gengival e posicionamento inadequado dos dentes.

This pilot study aimed to identify and to compare the self-reported prevalence of diagnosed and cervical dentin hypersensitivity (CDH) in the population of the Federal University of the Jequitinhonha and Mucuri (UFVJM), Diamantina. It were checked the associated etiological factors and the distribution of sensitive teeth in the arches. 54 patients randomly chosen via questionnaire, medical records and clinical examination divided into two tests were evaluated. In evaporative test; each tooth was tested with the air blast of the triple syringe; and thermal testing was done with spray tetrafluoroethane (Endo-Ice); in both tests we used a time of 5 seconds for the execution. Pain was evaluated by two calibrated examiners using a Visual Analogue Scale (VAS). Participants who had at least one tooth with a score equal to or greater than 2.51 in evaporative test were considered as presenting CDH. Of the patients who reported the presence of hypersensitivity, 76.3% (n=18) had confirmed the clinical diagnosis, while those who do not present said CDH, 23.7% (n=3) were clinically diagnosed with the condition. The age of participants ranged from 18 to 45 years. The most affected teeth were respectively the lower and upper incisors. As etiologic factors, the most prevalent were the gingival retraction and improper positioning of the teeth. It was concluded that self-reported prevalence is significantly higher than the prevalence diagnosed clinically and that gingival recession and mal apposition of teeth were the most common etiologic factors in the sample.

Dental bleaching with a 10% hydrogen peroxide product: A six-month clinical observation.

Context: The possibility of bleaching vital teeth with peroxide-based products considerably revolutionized esthetic dentistry. Aim: The aim of this clinical study was to evaluate tooth color change and dental sensitivity after exposure to preloaded film containing a 10% hydrogen peroxide whitening system (Opalescence Trθswhite Supreme). Materials and Methods: A total of 13 volunteers, aged 18 to 25 years, participated in this study. The patients used the whitening system once a day for 60 minutes during the 8-day study. For maxillary incisors and canines, the color change was visually evaluated with the Vita color scale before, immediately, and six months after the treatment. Tooth sensitivity was evaluated during the daily gel applications. All whitening applications were done in office and under the supervision of a dental professional. Statistical Analysis Used: The results were analyzed using the Friedman Test (nonparametric repeated measures ANOVA) at a level of 5%, and Dunn's Multiple Comparison Test at the level of 5%. Results: It was verified that the original mean color values observed at the baseline analysis differed significantly from those observed immediately after bleaching, as well as from those seen in the analysis at six months ( P = 0.001). There was no significant difference between the mean color values observed in the immediate time and in the analysis at six months ( P = 0.474). No tooth sensitivity was observed in any patients. Conclusion: It was concluded that the bleaching technique using the 10% hydrogen peroxide system was effective in a short period of time without tooth sensitivity during applications.

Depth of the cavity and its relationship with the post-operative sensitivity in class I posterior resin composite restorations on molars

This study was conducted to assess the post-operative sensitivity in different depths of Class I cavities in molars restored with posterior composite resin. It was an Experimental study and was conduct-ed in Fatima Jinnah Dental Hospital, Karachi from May 2010 to October 2010. One hundred and thirty one patients had Class I cavities [depth of cavities between 3-4mm] were selected after clinical and radiographic examination. After rubber dam isolation, Class 1 cavity prepared on molars teeth. Incremental technique was used to restore cavity with posterior composite resin. After finishing the filling, patient was recalled at day 7 to assess post-operative sensitivity with cold and hot stimuli. Data were collected using data collection proforma, were computerized and analyzed by using SPSS [Statistical Package of Social Sciences] version 17. One hundred thirty one patients, 61 male and 70 female formed the study group. The mean age was 29.6 [ +/- 9.004] years. The mean score of post-operative sensitivity was 1.05 for cold [ +/- 0.226] and 1.04 [ +/- 0.192] for hot. The chi-Square test revealed significant results with p- value < 0.000 for cold and < 0.009 for hot, when both stimuli were analyzed with different cavities depths. Deeper cavities in Class I composite resin restorations showed more post-restoration sensitivity as compared to cavities with lesser depth in dentine

Características bucais da perimólise e episódios recorrentes de vômitos: relato de caso / Features Oral of Perimolysis Recurrent Vomiting: Case Report

O presente trabalho teve o propósito de abordar, por meio de relato de caso clínico, aspectos relevantes sobre o diagnóstico, tratamento e acompanhamento de uma criança de 10 anos de idade portadora de perimólise. Ao exame clínico, a paciente apresentou IHO-S igual a 0,16 e ISG de 26,0%. Foram verificadas alterações do esmalte em vários elementos dentários (superfície palatina dos dentes anteriores superiores). O tratamento consistiu de 08 aplicações em intervalos semanais de verniz fluoretado a 5% NaF. Orientações de higiene e dieta também foram condutas adotadas. Após a realização das intervenções, foi constatada a redução da sensibilidade dentária.

This paper aims to address, through clinical case, the relevant aspects on the diagnosis, treatment and monitoring of a 10 year old carrier perimolysis. On clinical examination, the patient had OHI-S equal to 0.16 and 26.0% of ISG. Enamel alterations were noted in several dental elements (palatal surface of maxillary anterior teeth). Treatment consisted of 08 weekly applications at intervals of 5% NaF fluoride varnish. Guidelines hygiene and diet behaviors were also adopted. After completion of the interventions, was found to reduce tooth sensitivity.

Oral piercing and its complications in two Serbian youths a case report and review of the literature / El piercing oral y sus complicaciones en dos jóvenes de Serbia reporte de caso y revisión de la literatura

OBJECTIVE: Historically, wearing adornments on pierced body parts has been associated with many cultures as manifestations of religious or cultural identities. Currently, its use has a broad acceptance among young people. In the oral cavity, the most common sites for piercings are the tongue and lower lip. RESULTS: Pain, swelling and infection are the most serious consequences associated with this procedure. Several complications may be associated with this practice with the most frequently observed being halitosis, periodontitis, tooth fracture, glossitis, and the formation of abscesses. Other adverse outcomes include mucosal or gingival trauma, increased salivary flow, and interference with speech, mastication and swallowing. CONCLUSION: This article presents case reports on lip and tongue piercings and literature review highlights of this procedure. Special attention is given to complications and dental implications associated with such a practice.

OBJETIVO: Históricamente, el llevar adornos en partes del cuerpo perforadas ha sido asociado en muchas culturas como manifestaciones de identidades religiosas o culturales. Actualmente, su uso tiene amplia aceptación entre los jóvenes. En la cavidad oral, los sitios más comunes para el piercing son la lengua y el labio inferior. RESULTADOS: Dolor, inflamación e infección son las consecuencias más serias asociadas con este procedimiento. Varias complicaciones pueden asociarse con esta práctica, siendo la halitosis, la periodontitis, la fractura de dientes, la glositis, y la formación de abscesos, las más frecuentemente observadas. Otros resultados adversos incluyen traumas de la mucosa y la encía, aumento del flujo salival, e interferencia con la articulación del habla, la masticación, y la deglución. CONCLUSIÓN: Este artículo presenta reportes de caso de piercing del labio y la lengua, y resalta aspectos de este procedimiento como parte de una revisión de la literatura. Se presta especial atención a las complicaciones y las implicaciones dentales asociadas con tal práctica.

Root Dentine Sensitivity.

Background: Dentine hypersensitivity is one of the most painful, ubiquitous and least satisfactorily treated of all the chronic oral problems involving the teeth. Active Periodontal treatment appears to be one of the significant causes of hypersensitivity. Also, the role of plaque control in treatment of hypersensitivity is controversial. Thus the present study is aimed to study the degree to which a sample of patient developed Root Dentine Sensitivity (RDS) following nonsurgical periodontal treatment. Material & Methods: A total of 60 dental patients were evaluated for plaque scores and pain scoring using Scratch test and Air blast test. Visual Analogue Scale (VAS) was used for pain scoring. Oral hygiene instructions were given and non- surgical periodontal treatment was done quadrant wise over a period of 4 weeks. Results: The intensity of RDS given by VAS score and the percentage of teeth sensitive to both the test increased after scaling and root planing but gradually decreased when meticulous plaque control was maintained. Conclusion: Non- surgical periodontal treatment i.e. SRP and Oral hygiene maintenance may temporarily increase RDS, which reduces subsequently over a period of time with meticulous plaque control.

Selamento imediato da dentina na otimização de coroas de cerâmicas puras / Immediate dentin sealing in pure ceramic crowns optimization

Na técnica convencional de cimentação em prótese fixa, o adesivo é aplicado e/ou fotopolimerizado somente na fase de cimentação da peça. Caso a dentina seja contaminada anteriormente, esta adesão é prejudicada. A dentina recém-preparada é considerada o substrato ideal para a adesão, pois não há risco de contaminação. Com base nessa ideia, tem sido sugerido que logo após o preparo e antes da moldagem, o mesmo seja selado com um adesivo dentinário. Esta técnica é denominada Selamento Imediato da Dentina (SID) e possui várias vantagens em relação à técnica convencional de cimentação. O objetivo deste trabalho é descrever e discutir esta técnica de aplicação clínica que contribui para o aumento da resistência e ajuda a evitar a sensibilidade dentária

In indirect restorations conventional luting, the adhesive is applied and/or light cured during the luting procedure, after provisional phase. If dentin is infected previously, this adhesion is impaired. The freshly cut dentin is considered the ideal substrate for dentin bonding, because there is no risk of contamination. Based on this idea, it has been suggested that after exposing dentin, it must be sealed with a dentin adhesive. This technique is called Immediate Dentin Sealing (IDS) and has several advantages over the conventional luting. The aim of this study is describe and discuss this clinical technique that contributes to increase dentin bond strength and prevents tooth sensitivity

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.

Efecto de la arginina 8 por ciento-carbonato de calcio y del fluoruro de sodio al 5 por ciento en la reducción de la hipersensibilidad dentinaria post terapia periodontal: ensayo clínico / Effect of 8 percent arginine, calcium carbonate and 5 percent sodium fluoride on the reduction of the dentine hipersensitivity post periodontal therapy: clinical trial

Objetivo: El objetivo de este estudio clínico fue evaluar y comparar la eficacia en la reducción de la hipersensibilidad dentinaria de la arginina al 8 por ciento-carbonato de calcio, monofluorfosfato (1.450 ppm) en comparación con un grupo control tratado en base a un barniz de flúor (22.600 ppm) y un dentífrico fluorado (1.450 ppm), 3 veces al día durante un minuto, en pacientes con hipersensibilidad radicular en forma inmediata a la terapia periodontal mecánica (medición basal) y a las 4 semanas respectivamente. Materiales y Método: Estudio clínico aleatorizado de grupos paralelos, con 4 semanas de seguimiento, en el cual se reclutaron 20 pacientes con diagnóstico de periodontitis crónica leve a moderada, en tratamiento periodontal mecánico con presencia de recesiones gingivales a nivel de incisivos, caninos o premolares. A todos ellos, previa firma de consentimiento informado y en forma inmediata a los pulidos radiculares, se les aplicó el test térmico de chorro de aire con la jeringa de aire de la unidad dental a nivel de las recesiones gingivales con hipersensibilidad. La molestia o dolor fue determinado mediante la utilización de una escala visual análoga, realizada en forma inmediata a los pulidos radiculares (medición basal). Los pacientes fueron aleatoriamente asignados a uno de los siguientes grupos: grupo control, se les aplicó barniz de flúor (22.600 ppm) en todas las recesiones gingivales y se les indicó un dentífrico fluorado (1.450 ppm); grupo experimental, a quienes se les aplicó pasta tópica de arginina y carbonato de calcio (8 por ciento) a nivel de las recesiones gingivales, complementado con el uso de un dentífrico cuyo componente activo es la arginina al 8 por ciento-carbonato de calcio. Todos los pacientes fueron evaluados 4 semanas posterior a la aplicación y utilización domestica de los agentes des-sensibilizantes por un único examinador. Resultados: Ambos grupos experimentaron una disminución en la sensibilidad dentinaria, sin...

Aim: The aim of this clinical study was to evaluate and to compare the efficacy in reducing the dentine hypersensitivity of an 8 percent arginine, calcium carbonate, 1.450 ppm sodium monofluorophosphate dentifrice with topical application and twice-daily brushing, with a negative control toothpaste containing calcium carbonate and 1.450 ppm fluoride as MFP, after periodontal treatment (baseline) and four weeks respectively. Methods: A four-week clinical study with 20 subjects with diagnosis of slight to moderate chronic periodontitis under mechanical periodontal treatment and presence of gingival recessions in incisors, canines or premolars, stratified based on baseline tooth sensitivity. Subjects brushed with either a 1.450 ppm fluoride dentifrice or a marketed 8 percent arginine calcium carbonate dentifrice twice daily for approximately one minute. At screening, baseline and weeks four, subjects' tooth sensitivity was determined through both evaporative (Schiff and Visual Analogue Scale [VAS]). The same examiner throughout the study performed subject assessments using each stimulus. Results: Both subject groups exhibited significant reductions from baseline to four weeks in dentine hypersensitivity. However, patients who received 8 percent arginine calcium carbonate therapy, exhibited a greater reduction, with a 60 percent of individuals lacking of pain and with a final median of 0 in comparison with the 5 percent fluoride varnish and fluoride toothpaste group in which a 100 percent of subjects felt some degree of pain, presenting a final medium VAS scale of 2.

Um sintoma preocupante: a hipersensibilidade dentinária: [revisão] / A disturbing symptom: dentin hipersensitivity: [review]

O objetivo deste trabalho foi revisar a literatura com o intuito de se obter maiores informações sobre os fatores etiológicos, o correto diagnóstico e as possibilidades de tratamento da hipersensibilidade dentinária cervical. Pôde-se concluir que a perda de esmalte coronário ou exposição radicular por perda de estrutura periodontal é a sua principal causa, sendo a escovação incorreta, a dieta rica em ácidos, as forças oclusais excessivas, os hábitos parafuncionais, a abrasão, a erosão e a recessão gengival os fatores etiológicos mais encontrados. A presença de sinais clínicos característicos como a recessão gengival, abfração e exposição radicular facilitam o correto diagnóstico. As possibilidades de tratamento incluem o uso do nitrato de potássio, compostos fluoretados, dentifrícios essensibilizantes e até laser de baixa potência.

The objective of this paper was to review the literature in order to obtain more information about the etiological factors, the correct diagnosis and possible treatment of cervical dentin hypersensitivity. It can be concluded that the loss of enamel or crown root exposure for loss of periodontal structures is the main cause of dentin hypersensitivity, and improper brushing, diet rich in acids, excessive occlusal forces, deleterious habits, abrasion, erosion and gingival recession are the most frequent etiologic factors. The presence of characteristic clinical signs such as gum recession, root exposure and abfraction facilitate the correct diagnosis. Treatment options include the use of potassium nitrate, fluoride compounds, desensitizing toothpaste,and even low power laser.

Clinical evaluation of postoperative sensitivity using self-etching adhesives containing glutaraldehyde

The present clinical study aimed to assess the postoperative sensitivity (POS) after 48 hours and seven days in occlusal restorations bonded with three different adhesive systems, two of them containing glutaraldehyde. The restorative procedures were performed using the three-step etch-and-rinse Adper SBMP-Plus adhesive (SBMP), the two-step etch-and-rinse Gluma Comfort One Bond + Desensitizer adhesive (GC+D) and the all-in-one self-etching/priming I Bond (IB) adhesive, which also has glutaraldehyde in its formula. All cavities were restored with Filtek Supreme nanoparticle composite resin. After 48 hours and seven days the patients were recalled and the postoperative sensitivity evaluated. The data analyzed by non-parametric Friedman test showed no significant differences in POS among the three tested groups after 48 hours and seven days.

Dental manifestations in bariatric patients: review of literature

The rate of bariatric surgery has significantly risen in the past decade as an increasing prevalence of extreme obesity can be observed. Although bariatric surgery is an effective therapeutic modality for extreme obesity, it is associated with risk factors affecting also oral health. Based on an overview of the current literature, this paper presents a summary of dental manifestations in bariatric patients. Bariatric surgeries are associated with an increased risk for gastro-esophageal reflux which in turn might account for the higher amount of carious and erosive lesions observed in bariatric patients. As a result, also dentin hypersensitivity might be observed more frequently. The current data indicate that recommended postsurgical meal patterns and gastric reflux might increase the risk for dental lesions, particularly in the presence of other risk factors, such as consumption of sweet-tasting foods and acidic beverages. Further research is needed to evaluate the correlation of bariatric surgery and the development of dental diseases.