Clinical efficacy of desensitizing mouthwashes for the control of dentin hypersensitivity and root sensitivity: a systematic review and meta-analysis.

OBJECTIVE: This systematic review aimed to evaluate the scientific evidence on the efficacy of desensitizing mouthwashes for the treatment of dentin hypersensitivity (DH) and root sensitivity (RS). MATERIAL AND METHODS: A thorough search in MEDLINE, PubMed and Cochrane Plus Library was conducted up to February 2015. Randomized clinical trials, parallel, double-blinded and placebo-controlled, with a follow-up of at least 6 weeks, reporting changes on response to tactile stimuli, thermal/evaporative stimuli or patients' subjective assessment of the pain experienced during their daily life after the home use of desensitizing mouthwashes were considered for inclusion. RESULTS: The screening of titles and abstracts resulted in seven publications meeting the eligibility criteria. The desensitizing agents evaluated were potassium nitrate (n = 5), aluminium lactate (n = 1) and sodium fluoride (n = 1). A meta-analysis for each of the hypersensitivity stimuli was performed. Results demonstrated statistically significant reduction in sensitivity scores favouring test group when DH was assessed by means of patients' self-reported pain experience (SMD at 8 weeks = 0.77; 95% CI [0.23; 1.31]; P = 0.005). No significant effects were detected in response to tactile or thermal/evaporative stimuli. Meta-regression analysis demonstrated a tendency towards an increased effect favouring test group for the patients' subjective perception, whereas tactile and thermal/evaporative stimuli showed a slight tendency towards a reduction in the efficacy of the test mouthwash. CONCLUSIONS: There exists a tendency towards a decrease in DH or RS scores with time in both treatment groups, with significant differences in favour of test group when sensitivity is evaluated in terms of patients' self-reported sensitivity symptoms.

Evaluation of new chlorhexidine- and cetylpyridinium chloride-based mouthrinse formulations adjunctive to scaling and root planing: pilot study.

OBJECTIVE: To compare the effect of two newly formulated chlorhexidine (CHX) and cetylpyridinium chloride (CPC) mouthrinses after scaling and root planing (SRP) in terms of clinical, microbiological, patient-based variables and adverse events, with a positive control with the same active components, already marketed and tested. METHODS: A pilot, randomized clinical trial, double-blind, parallel design with 1-month follow-up was conducted. Chronic periodontitis patients requiring non-surgical periodontal therapy were enrolled and randomly assigned to: (i) SRP and test-1 (new reformulation: 0.12% CHX and 0.05% CPC); (ii) SRP and test-2 (new formulation: 0.03% CHX and 0.05% CPC); or (iii) SRP and positive control (commercial product: 0.12% CHX and 0.05% CPC). All variables were evaluated at baseline and 1 month after SRP. Quantitative variables were compared by means of anova or Kruskal-Wallis test and qualitative variables by chi-square or McNemar tests. RESULTS: Thirty patients (10 per group) were included. After 1 month, there were significant differences among groups in plaque levels (P = 0.016) as test-1 showed less sites with plaque than test-2 (31.15% [standard error-SE 2.21%] versus 49.39% [SE 4.60%), respectively). No significant differences were found for global patient perception of the product or in adverse effects. Test groups showed better results in levels and proportions (P = 0.022) of Capnocytophaga spp. CONCLUSIONS: Within the limitations of this pilot study, it can be concluded that the newly formulated 0.12% CHX and 0.05% CPC mouthrinse showed larger plaque level reductions, without showing more adverse effects, when compared to the other two mouthrinses, after SRP.

Técnicas de preservación de alveolo y de aumento del reborde alveolar: Revisión de la literatura / Ridge preservation and ridge augmentation procedures: A literatura review

La pérdida dentaria produce una serie de cambios dimensionales que afectan tanto a los tejidos duros como a los tejidos blandos ocasionando frecuentemente defectos en el reborde alveolar. La prevención y el tratamiento de dichos defectos, tiene como objetivo la preservación o el aumento de los tejidos duros y/o blandos para mejorar las condiciones del reborde para una futura restauración protésica. Existen diversas técnicas quirúrgicas encaminadas a prevenir o minimizar los cambios dimensionales en alveolos postextracción (técnicas de preservación de alveolo) y otras destinadas a la reconstrucción de dichas alteraciones anatómicas. En general, en defectos pequeños o moderados una técnica de aumento de tejidos blandos puede ser suficiente. Sin embargo, en defectos más severos o en aquellas localizaciones en las que se planifique la posterior colocación de implantes, un enfoque combinado (aumento de tejido duros y blandos) y/o en distintas fases puede ser necesario. En este artículo se revisan los cambios dimensionales tras la extracción o pérdida dental, los tipos de la deformidad del reborde así como las diferentes técnicas de preservación de alveolo y de aumento de la cresta alveolar

The extraction of single as well as multiple teeth induces a series of adaptative changes in the soft and hard tissues that results in an overall regress of the edentulous site(s). The prevention and treatment of alveolar ridge deformities aims preserving and reconstructing soft and hard tissues of the edentulous ridge in order to render better conditions at the site for the future prosthesis installation. Different surgical techniques have been proposed to prevent ridge collapse after tooth extraction or to reconstruct the lost anatomy prior to prosthesis installation. In general terms, in mild defects, soft tissue augmentation may be sufficient to repair the deformity. However, in more severe deformities a combined or staged approach may be more appropriate. This article reviews the dimensional changes after tooth extraction, types alveolar ridge deformities and various techniques for the prevention and treatment of alveolar ridge defects