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Prevalence and distribution of cervical dentine hypersensitivity in a population in Rio de Janeiro, Brazil.

The prevalence, distribution and possible causal factors of cervical dentine hypersensitivity were studied in a population from a Marine Dental Clinic in the city of Rio de Janeiro, Brazil. A total of 635 patients were examined for the presence of cervical dentine hypersensitivity by means of a questionnaire and intraoral tests (air and probe stimuli). There were 157 patients (25%) reporting to have hypersensitive teeth, but only 108 patients (17%) were diagnosed as having cervical dentine hypersensitivity. The prevalence of hypersensitivity was higher among females than males, but this difference was not statistically significant. Most females with hypersensitivity were aged 20-49 and most males were aged 40-59. Incisors and premolars had the highest prevalence of dentine hypersensitivity to air and probe stimuli, while molars had the lowest. The presence and history of dentine hypersensitivity were positively correlated with previous exposure to periodontal treatment. Only a few of the patients who claimed to have dentine hypersensitivity had tried treatment with desensitizing toothpastes or sought professional help.

Adolescent↗

Ten years' clinical evaluation of three luting cements.

OBJECTIVE: The aim of the present clinical longitudinal study was to observe, over 10 years, the prognosis of abutment teeth restored with fixed prostheses retained by glass ionomer luting cements and one conventional zinc phosphate cement. METHODS: Three dentists prepared 135 abutment teeth in 61 patients to retain 81 fixed prostheses. The prostheses were retained by two glass ionomer luting cements (Ketac-Cem, Fuji Ionomer), or a conventional zinc phosphate cement (De Trey Zinc Zement Improved). The patients were examined yearly for 10 years. RESULTS: Post-operative hypersensitivity occurred in five teeth restored with glass ionomer luting cement. The prevailing reason for abutment tooth failure was secondary caries (n = 21) and pulp necrosis (n = 5). Non-parametric survival estimates indicated that 80-85% of the abutment teeth remained intact after 5 years and 71-81% after 10 years. CONCLUSIONS: The 10-year results indicate that the prognosis of abutment teeth restored with fixed prostheses is good, regardless of whether a glass ionomer or a zinc phosphate luting cement is used.

Dental Abutments↗

Lasers in endodontics.

With the rapid development of laser technology, new lasers with a wide range of characteristics are now available and being used in various fields of dentistry. In the past two decades, much experience and knowledge has been gained. This article provides an overview of the current and possible future clinical applications of lasers in endodontics, including their use in alleviating dentinal hypersensitivity, modification of the dentin structure, pulp diagnosis, pulp capping and pulpotomy, cleaning and shaping of the root canal system, and endodontic surgery. Endodontic procedures for which conventional treatments cannot provide comparable results or are less effective are emphasized.

Dental Pulp Diseases↗

Effect of bleaching on restorative materials and restorations--a systematic review.

OBJECTIVE: Internal and external bleaching procedures utilizing 3-35% hydrogen peroxide solutions or hydrogen peroxide releasing agents, such as carbamide peroxide or sodium perborate, can be used for whitening of teeth. The purpose of the review article was to summarize and discuss the available information concerning the effects of peroxide releasing bleaching agents on dental restorative materials and restorations. SOURCES: Information from all original scientific full papers or reviews listed in PubMed or ISI Web of Science (search term: bleaching AND (composite OR amalgam OR glass ionomer OR compomer OR resin OR alloy) were included in the review. DATA: Existing literature reveals that bleaching therapies may have a negative effect on physical properties, marginal integrity, enamel and dentin bond strength, and color of restorative materials as investigated in numerous in vitro studies. However, there are no reports in literature indicating that bleaching may exert a negative impact on existing restorations requiring renewal of the restorations under clinical conditions. CONCLUSION: Bleaching may exert a negative influence on restorations and restorative materials. Advice is provided based on the current literature to minimize the impact of bleaching therapies on restorative materials and restorations.

Composite Resins↗

In vitro study of dentin hypersensitivity treated by Nd:YAP laser and bioglass.

OBJECTIVES: An ideal material has yet to be discovered that can completely treat dentin hypersensitivity. However, if a highly biocompatible material such as bioglass, could be melted by laser irradiation to achieve better sealing depth for dentinal tubules, it may subsequently bond to dentin structures under a physiological environment and offer a prolonged therapeutic effect. METHODS: The authors used four types of energy parameters to melt the composition-modified bioglass. These four types were 30 Hz, 330 mJ/pulse (G+ mode), 30 Hz, 160 mJ/pulse (G- mode), 10 Hz, 400 mJ/pulse (D+ mode), and 10 Hz, 200 mJ/pulse (D- mode). The temperature elevation, occlusive depth of bioglass, and phase changes in the bioglass after laser irradiation were evaluated by means of scanning electron microscope (SEM), thermometer, and X-ray diffractometer (XRD). RESULTS: The occlusive depths of 2 and 10 microm in the dentinal tubules were achieved when the bioglass underwent 30 Hz, 160 mJ/pulse (G- mode) and 30 Hz, 330 mJ/pulse (G+ mode) of laser treatments, respectively. The bioglass experienced a temperature increase of less than 600 degrees C, and no phase transformation was observed after Nd:YAP laser irradiation. SIGNIFICANCE: The melting point of a composition-modified bioglass could be reduced and its use plus Nd:YAP laser have the potential in clinical use to treat dentin hypersensitivity.

Ceramics↗

Ceramic inlays bonded with two adhesives after 4 years.

OBJECTIVE: The aim of the present study was to clinically evaluate the effect of two different adhesive/resin composite combinations for luting of IPS Empress inlays. METHODS: Ninety-four IPS Empress restorations were placed in 31 patients in a controlled prospective clinical split-mouth study. The restorations were luted with EBS Multi/Compolute (3M Espe) or with Syntac/Variolink II low (Ivoclar Vivadent) without lining. At baseline and after 0.5, 1, 2, and 4 years, the ceramic restorations were examined according to modified USPHS codes and criteria. RESULTS: Two patients including four restorations missed the 4 years recall (drop out). After 4 years of clinical service, four restorations in two patients (three luted with Compolute, one with Variolink II) had to be replaced due to hypersensitivities, 90 inlays and onlays were acceptable (failure rate 4%; Kaplan-Meier survival analysis). Between the five recalls, a statistically significant deterioration was found for the criteria marginal adaptation and inlay fracture (Friedman 2-way ANOVA; p < 0.05). Between the adhesives no statistical difference was found. At baseline, 95% of the restorations revealed luting composite overhangs. After 4 years, 55% of cases had overhangs and 38% showed marginal ditching. No differences were found for surface roughness, color matching, integrity tooth, proximal contact, hypersensitivity, and satisfaction (p > 0.05). CONCLUSION: For luting of ceramic inlays, no difference between the two luting systems was detectable. The overall failure rate after 4 years was 4%.

Adult↗

Two-year clinical evaluation of lithia-disilicate-based all-ceramic crowns and fixed partial dentures.

OBJECTIVES: The aim of this study was to evaluate the clinical performance of crowns and fixed partial dentures (FPDs) made with the Empress 2 system over a 2-year period. METHODS: Twenty anterior or posterior all-ceramic (Empress 2) crowns and 20 anterior or posterior, three-unit fixed partial dentures were fabricated for 15 patients. Evaluations of the restorations were performed at baseline and once a year during the 2-year follow-up period. U.S. Public Health Service criteria were used to examine the marginal adaptation, color match, secondary caries and visible fractures in the restorations. Survival rate of the restorations were determined using Kaplan-Meier statistical analysis. RESULTS: U.S. Public Health Service criteria showed 100% Alpha scores concerning recurrent caries for both crowns and FPDs. No crown fractures were observed during the 2-year follow-up, however, 10 (50%) catastrophic failures of FPDs occurred. Five (25%) failures occurred within the 1-year clinical period and the others (25%) within the second year. SIGNIFICANCE: Single unit Empress 2 all-ceramic crowns exhibited a satisfactory clinical performance over 2-year period. Furthermore, the high fracture rate of Empress 2 FPDs limits the usage of Empress 2 for the fabrication of all-ceramic FPD.

Adult↗

A comparison of a reformulated potassium citrate desensitising toothpaste with the original proprietary product.

OBJECTIVES: The recent tendency for toothpaste manufacturers to combine active ingredients for benefits to a number of oral problems requires that such combinations do not vitiate the action of any one agent. The aim of this study was to compare the desensitising effects of a modified formulation with the established product. MATERIALS AND METHODS: The study was a randomised, double blind, two treatment parallel design comparing an existing potassium citrate toothpaste product (Positive Control) with the same formulation to which triclosan and zinc citrate had been added (Test). A total of 56 subjects with dentine hypersensitivity (DH) completed the 8 week study period. At baseline, days 14 and 56 visual analogue scale scores were recorded by the subjects in response to air evaporative and cold water stimuli. RESULTS: Both groups showed improvements, mostly statistically significant, from baseline to day 14 and through to day 56. Most data favoured the Test paste but differences were, for the most part, not significant. CONCLUSIONS: It is concluded that the addition of known anti-plaque agents to an established potassium salt based desensitising toothpaste did not adversely affect the activity of the product in the treatment of DH.

Anti-Infective Agents, Local↗

Effect of a desensitizing agent containing glutaraldehyde and HEMA on bond strength to Er:YAG laser-irradiated dentine.

OBJECTIVES: The aim of this study was to investigate whether a desensitizing agent (GLUMA Desensitizer) containing glutaraldehyde and HEMA improved the bond strength and bonding durability of a self-etching primer adhesive to Er:YAG-irradiated dentine. METHOD: Dentine of 120 human molars was exposed by wet grinding on SiC paper for bond strength testing. Thirty specimens each were allocated to the following treatment groups: (1) control; (2) Er:YAG laser irradiation; (3) Er:YAG laser irradiation followed by application of GLUMA Desensitizer; (4) Er:YAG laser irradiation followed by application of GLUMA Desensitizer and 10s rinsing with water. Composite cylinders were bonded to the dentine surfaces with a self-etching priming adhesive system. Tensile bond strengths (TBS) of 10 specimens of each treatment group were measured after 24-h water storage, 6 months water storage and 12 months water storage, respectively, and the failure modes were analyzed. TBS data were statistically treated by two-way ANOVA and Fisher's PLSD test at a significance level of p<0.05. RESULTS: TBSs for the GLUMA-non rinse and GLUMA-rinse groups were significantly higher than for the laser group at 24 h and 12 months. Specimens from the Er:YAG-irradiated dentine group had significantly lower bond strengths than the control group at each storage time. All control specimens showed cohesive fractures in resin close to the bonding interface whereas the Er:YAG laser-irradiated groups showed both dentine cohesive, resin cohesive and dentine-resin mixed failures. CONCLUSION: Application of GLUMA Desensitizer to Er:YAG-irradiated dentine increases the bond strength and durability of the self-etching priming adhesive used.

Composite Resins↗

Complications associated with fixed partial dentures with a loose retainer.

STATEMENT OF PROBLEM: When 1 retainer of a definitive fixed partial denture (FPD) becomes loose, the clinician has the option of either sectioning and removing the FPD or attempting removal of the intact cemented retainer. Excessive force during attempted FPD removal may irreversibly damage dentition. PURPOSE: This study evaluated the type and frequency of complications that may accompany the removal of definitive cemented FPDs with a single loose retainer. MATERIAL AND METHODS: Participants included 22 patients with a definitive cemented FPD with complete cast crown coverage castings in which 1 retainer became loose and the other retainer remained cemented. Cemented FPD retainers were removed using 1 of 2 attachments supplied with a crown removal system (Dentco). The patient and FPD characteristics, type of attachment, number of attempts before removal, condition of removed FPD, and condition of the abutment teeth were recorded. Descriptive statistics were used to analyze the data. RESULTS: Clinical findings recorded prior to FPD removal showed that 41% of patients were unaware they had a loose FPD retainer and 82% reported no discomfort associated with the loose retainer. Caries were noted on 50% of the teeth with a loose retainer. Damage resulting from attempted removal of the cemented retainer included minor porcelain fracture (9%), minor core chipping (14%), minor incisal edge chipping of tooth preparations (27%), and major damage to the abutment tooth (4%). CONCLUSION: Retrieval of an intact FPD and recementation was possible 64% of the time.

Adult↗

Reduction in dentin permeability using mildly supersaturated calcium phosphate solutions.

Treatments that obturate dentin tubules have been used for reducing dentin hypersensitivity. The objective of this study was to determine the effects of multiple treatments with a mildly supersaturated calcium phosphate solution on the hydraulic conductance (Lp) of partially occluded dentin discs in vitro. The treatment solution contained 6.5 mmoll(-1) each of calcium and phosphate, 0.25 mmoll(-1) fluoride, 30 mmoll(-1) KCl, and 50 mmoll(-1) HEPES buffer (pH adjusted to 7.0). The mean baseline Lp (in microlcm(-2)min(-1) H(2)O cm(-1)) was 0.108+/-0.041 (mean +/- S.D.; n=9, microlcm(-2)min(-1) H(2)O cm(-1) = 10.20 microlcm(-2)min(-1)KPa(-1)) and after five consecutive treatments, the mean relative Lp, presented as percentage of baseline, were 71+/-11, 58+/-10, 46+/-18, 40+/-14, and 25+/-10, respectively. The Lp values of the baseline and treatment groups were significantly (P<0.05) different. Consecutive treatments appeared effective in further reducing Lp of dentin discs.

Calcium Phosphates↗

Potentiometric determination of nitrate in products used for the treatment of dentinal hypersensitivity.

In this paper, a rapid, simple and inexpensive potentiometric method for the determination of the potassium nitrate contained in different dentinal desensitizer products is described. The nitrate-selective electrode, using a tetraoctylammonium salt as sensor, was constructed without an internal filling solution. The ionic strength of the sample solutions was fixed by means of a 0.33 mol 1(-1) K2SO4 solution and direct potentiometry was used as the analytical technique of measurement. Precision and accuracy of the method developed were adequate since the mean of the relative standard deviations was 1.2% and the average percentage of spike recoveries was 100.9%. Eleven samples of toothpastes, gels and mouthwashes were analyzed by the proposed potentiometric method and the quality of the results was compared by means of linear regression analysis with those obtained by high-performance liquid chromatography (HPLC), adopted as the reference technique. Satisfactory agreement was observed.

Chromatography, High Pressure Liquid↗

Practical considerations in iontophoresis of fluoride for desensitizing dentin.

A review of the literature on treatment of dentin hypersensitivity by use of fluorides and fluoride iontophoresis was presented. It was concluded that topical applications of fluoride are modestly effective for treatment of dentin hypersensitivity, but the most rapid and effective relief follows fluoride iontophoresis. This technique has a broad application in dental practice since fluoride iontophoresis was shown to be an effective desenitizer in cavity preparation, before cementation of restorations, and in cases of occlusal wear and enamel hypoplasia. The report also presents a new and effective method for the iontophoresis of fluoride for dentin desensitization.

Dentin Sensitivity↗