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The prevalence of dentine hypersensitivity in general dental practice in the UK.

AIM: The aim of this study was to establish the prevalence of dentine hypersensitivity in a cross-sectional study of patients visiting general dental practitioners in the South West region of the UK over a period of 1 calendar month. METHOD: Twelve dental practitioners examined 3593 patients over a period of 1 calendar month and 137 patients were diagnosed as having dentine hypersensitivity, giving a prevalence figure of 3.8%. RESULTS: The commonest teeth affected were the upper premolar and molar teeth and the commonest initiating factor was cold drinks. CONCLUSIONS: The prevalence of dentine hypersensitivity in general dental practice in the UK was 3.8%.

Adolescent↗

The reproducibility of methods of assessment for cervical dentine hypersensitivity.

BACKGROUND: Many agents and toothpaste formulations have been proposed for treatment of dentine hypersensitivity. However, studies have reported equivocal or contradictory results, potentially related to a lack of clinical efficacy for agents being tested, poor study design or the use of assessment techniques which are unable to distinguish longitudinal changes in dentine hypersensitivity. AIM: To investigate the reproducibility of commonly used measurement protocols for dentine hypersensitivity on single or multiple teeth. In addition, newly-developed controlled air and cold fluid stimuli were investigated. METHODS AND MATERIALS: Standardised pain stimulation techniques were used in 2 investigations with 63 and 42 subjects, respectively. The reproducibility of perceived hypersensitivity before and following stimulation was recorded over time periods of 14 and 2 days, respectively, using visual analogue scales and threshold techniques. RESULTS: Subject demographics resembled those reported in other hypersensitivity investigations. Analysis using several measures of reproducibility indicated that subject-based reproducibility was limited, even when the stimuli were standardised. However, the data are consistent with the findings of investigations on pain assessment in other fields. CONCLUSIONS: The reproducibility of subjects in clinical trials of dentine hypersensitivity may therefore contribute to difficulties in establishing treatment efficacy of agents in clinical trials.

Adolescent↗

Chlorhexidine varnishes: a review.

BACKGROUND: Of all chemical plaque control agents, chlorhexidine digluconate has proven to be the most effective and safe. Since 1964, varnishes have been used for local delivery of fluor and are reported to be an effective and easy to use vehicle. During the past decade, varnishes for local delivery of antimicrobial agents have been developed and investigated in vitro and in vivo. AIM: In this paper, the existing literature on the use of 3 different chlorhexidine varnishes in different fields in dentistry is reviewed. METHOD: In vitro results concerning the release of the antimicrobial agents are compared for the 3 different varnish formulations. RESULTS AND CONCLUSION: Clinical reports on the efficacy of controlled-release systems in altering cariogenic and periodontopathic microflora are summarized.

Aggregatibacter actinomycetemcomitans↗

Treatment of dentin hypersensitivity by Nd:YAG laser.

BACKGROUND, AIMS: Promising results using Nd:YAG laser against dentin hypersensitivity have been reported. The aim of this double-blind, controlled, split-mouth designed clinical trial was to assess the effect of a single Nd:YAG laser application on alleviating hypersensitivity. METHODS/RESULTS: Seventeen subjects participated in the study. Each of them had two teeth treated; one with the laser activated and one with nonactivated (placebo), for 2 min The assessment of pain was performed by a VAS, after an air blast at baseline immediately after treatment, at 1 week, 4 weeks and 16 weeks. Mean values of VAS for test and control teeth were compared by paired t-test (alpha = 0.05). The results showed mean baseline VAS values of 6.59 (+/- 1.65) and 6.14(+/- 1.95) for test and control teeth, respectively. Immediately after treatment, these values decreased to 4.09(+/- 2.28) and 3.89(+/- 2.11), respectively. After 1 week, 4 weeks and 16 weeks the mean values for test and control teeth were 3.85 +/- 2.36, 4.03 +/- 1.95, 3.60 +/- 2.66, and 4.44 +/- 2.56, 3.41 +/- 2.30, 3.42 +/- 2.30, respectively. There were no statistically significant differences between test and control at any time. However, both groups improved significantly (P < 0.05) from baseline to immediately after application, and at 1 week, 4 weeks and 16 weeks, respectively. The changes that occurred between immediately after application and 1 week, 4 weeks and 16 weeks, respectively, were not statistically significant. CONCLUSION: It is concluded that the effect of treatment of hypersensitive teeth with Nd:YAG laser is not different from placebo. The observed effects seem to last for at least 16 weeks.

Adult↗

Evaluation of the efficacy of two potassium nitrate bioadhesive gels (5% and 10%) in the treatment of dentine hypersensitivity. A randomised clinical trial.

AIM: A randomised clinical trial was designed to compare the immediate efficacy (48-96 h) of two treatments with bioadhesive gels with different concentrations of potassium nitrate (NK 5% versus NK 10%) on dentine hypersensitivity (DH). We evaluated DH by means of the use of the evaporative stimulus (ES), as the main outcome, using a placebo control group as reference. PATIENTS AND METHODS: Forty-five consecutive patients who, after stimulation with a blast of air, had at least one tooth with DH > or = 2 according to the verbal ratings scale (VRS) scale were selected. They were randomly treated with a bioadhesive gel with 5% NK, 10% NK or a placebo gel without NK. The DH was evaluated at baseline, days 2, 4, 7 and 14 by an examiner blind to the procedure. The response to the ES with a blast of air, to the tactile stimulation with a probe and the subjective evaluation of the patient measured on the VRS scale were recorded. Statistical analysis was made using the Kruskal-Wallis test. RESULTS: A greater reduction of DH after ES was observed after 48 h of treatment in the NK10% group (35.8%) compared to the NK5% group and placebo group (11.8% and 13.4%, respectively). This difference increased significantly at 96 h (p=0.003). No significant differences were observed for the other variables. These preliminary results may support the usefulness of an NK 10% gel to reduce the DH after stimulation with a blast of air during the first 4 days of its appearance.

Adhesives↗

Impact of treatment provision on the epidemiological recording of root caries.

The estimation of root caries prevalence and the identification of risk factors for decay depend upon the successful identification of carious lesions in epidemiological studies. Root surface restorations can either be placed to manage decay or cervical wear/sensitivity. The handling of data for restorations during epidemiological surveys is critical to the accurate assessment of caries prevalence. The objective of this study was to determine the relative frequency of dentists' placing root surface restorations according to their reason for placement. Data for 696 restorations were recorded from 35 dentists. Forty-five % of restorations were placed because of decay compared with 55% for cervical wear/sensitivity. There were no significant differences in proportion of placement of restoration with age of the patient or between regular and irregular attenders of different ages. Using these data a correction factor was developed for inclusion in the Root Caries Index (RCI) to make allowance for the proportion of restorations placed because of wear/sensitivity. When this correction factor was introduced into an existing data-set for root caries, the RCI was reduced for all groups. This reduction was greatest in regular attenders. When these data were analysed without making allowance for treatment effects, there was a significant difference in RCI between regular and irregular attenders. When the correction factor was applied to these data, this difference was eliminated.

Adult↗

Autotransplantation of immature third molars: influence of different splinting methods and fixation periods.

Different data were published documenting the influence of fixation methods and periods on the outcome of autotransplantations of teeth. Besides studies reporting increased ankylosis and disturbances of pulpal revascularization following rigid or extended fixation, there are studies revealing no connection in this matter. The clinical and radiological results of 76 transplanted germs of third molars were to be assessed after a rigid fixation for 4 weeks or after a suture splinting for 7 days and compared with each other. The choice of fixation method depended on the initial stability of the transplant. After a mean observation period of 3.4 years (range 1.0-6.1 years), 92.9% of the teeth stabilized with a suture, but only 73.5% fixed with an acid-etch composite and wire splint could be classified as successful (P = 0.029). The significant increases in ankylosis (P = 0.036) and pulp necrosis (P = 0.041) were the factors for the less favorable results of the rigidly fixed teeth. Our data support the results of other experimental and clinical studies with regard to the negative influences of an extended and rigid fixation on the success of tooth transplantation. However, apart from a correlation with the method and period of fixation, we also suspect the influence of an incongruity between the transplant and recipient site.

Adolescent↗

Dentine hypersensitivity - an enigma? A review of terminology, mechanisms, aetiology and management.

Dentine hypersensitivity is a relatively common problem experienced in clinical dental practice. This condition may disturb the patient during eating, drinking, brushing and sometimes even breathing. Therapeutic intervention by desensitising agents may provide only partial pain relief and recurrence is common. Much remains unknown about dentine hypersensitivity, even the terminology can be questioned. Most of the literature over decades has been concerned with reporting clinical trials proving the efficacy of numerous treatments for dentine hypersensitivity. Indeed, besides haemorrhoids, there can be few other diseases or conditions known to man that can apparently be successfully treated by so many and extremely varied agents and formulations applied topically. This paper will discuss the epidemiology, mechanisms of pain production and aetiological factors for the condition in the hope of developing ideas for more realistic prevention and management strategies.

Dentin Sensitivity↗

Talon cusp: report of a case.

The methods of treatment of talon cusps are reviewed. A case is reported in which a calcium hydroxide pulpotomy was carried out on an upper central incisor with a talon cusp. This was necessary to enable (a) complete reduction of the cusp within a feasible time span, and (b) maintenance of pulpal vitality in order to allow apical development of the immature root.

Calcium Hydroxide↗