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PubMed2005

In vitro dentine permeability evaluation of HEMA-based (desensitizing) products using split-chamber model following in vivo application in the dog.

The aim of this study was to evaluate in vitro dentine permeability evaluation of 2-Hydroxyethyl methacrylate (HEMA)-based desensitizing products using split-chamber model following in vivo application in the dogs for three experimental time periods of 1 week, 1 month and 3 months. Buccal enamel of upper and lower canines of nine young dogs was removed and flat dentinal surface was obtained using a water-cooled diamond bur. The dentinal surface divided into four quarters, three experimental and a control. Health-Dent and Gluma Desensitizing agent and Single bond were applied to respective quarters of one tooth, according to manufacturers' instructions. The last quarters were left as control without any applications. For the each experimental period, 10 dentine samples from each group including control were used to measure the hydraulic conductance values. The dentine discs were placed pulp-side down in a split-chamber device in which the plastic spacers containing the rubber 0 rings have a surface area of 1 mm(2) and permeability was measured by fluid filtration. The data were expressed as hydraulic conductance (Lp). Differences in dentine permeability obtained for the desensitizing agents against the control were tested for statistical significance using Kruskal-Wallis one-way ANOVA and Bonferroni-adjusted Mann-Whitney U-tests. Differences in permeability in three time periods for each desensitizing agent were analysed using Friedman's anova and Wilcoxon signed rank tests. All desensitizing applications caused decreased Lp values compared with the control Lp value at the end of 1 week. In the 1-month samples, between the Lp values of Single bond and control, no statistical difference was found (P > 0.05). At the end of the 3-month period, the Gluma Desensitizing agent had the lowest the Lp value (P < 0.05). The result of this study is that the topical application of desensitizing agents led to decrease in dentine permeability in the dog model. The Gluma Desensitizing agent provide the more lasting tubule-occluding effect than the other material tested in this model.

Animals↗
PubMed2005

Effect of provisional restorations on the final bond strengths of porcelain laminate veneers.

The purpose of this in vitro study was to evaluate the effect of the different provisional restorations cementation techniques on the final bond strengths of porcelain laminate veneers (PLVs). Thirty-six extracted human central incisors were sectioned 2 mm below the cemento-enamel junction, and crown parts were embedded into self-cure acrylic resin. Standardized PLV preparations were carried out on labial surfaces of the teeth. Then the teeth were randomly divided into three groups of 12 each. In group 1, provisional restorations were cemented with eugenol-free cement. In group 2, prepared teeth surfaces were first coated with a desensitizing agent then provisional restorations were cemented with resin cement. In group 3, provisional restorations were not fabricated to serve as control. After specimens were stored in distilled water for 2 weeks, provisional restorations were removed and final IPS Empress 2 ceramic veneers were bonded with a dual-curing resin. Two microtensile samples from each tooth measuring 1.2 x 1.2 x 5 mm were prepared. These sections were subjected to microtensile testing and failure values were recorded. The data were analysed by one-way anova and Tukey HSD tests. The PLVs, placed on the tooth surface that had received a dentine desensitizer and provisional restorations luted with resin cement (group 2), showed the lowest bond strength in all test groups. But no statistically significant differences were found between the bond strength of PLVs in control group (no provisional restorations) and group 1 (provisional restorations cemented with eugenol-free cement before final cementations). Scanning electron microscopic (SEM) examination of this study also showed that the bonding to enamel surface was better in control group and group 1 than group 2.

Dental Bonding↗
PubMed1996

Short-term results of IPS-Empress inlays and onlays.

PURPOSE: A leucite-reinforced, glass-ceramic material was recently introduced for clinical use. In this clinical trial, IPS-Empress inlays and onlays were evaluated using the modified United States Public Health Service (USPHS) criteria. MATERIALS AND METHODS: The teeth of 36 patients were restored with 105 posterior inlays and 25 onlays, fabricated by an indirect technique. After etching the restorations with hydrofluoric acid, they were silanized and luted using composite cements. The restorations were evaluated visually, clinically with a mirror and probe, and by bitewing radiographs and clinical photographs, using modified USPHS criteria. Restorations having neither charlie nor delta criteria were defined as successful, and their survival rate was calculated according to Kaplan-Meier analysis. RESULTS: The mean observation period for the 130 restorations was 23.4 +/- 6.1 months. After 2 years, 127 restorations were successful with an estimated survival rate of 97.5%. Three restorations failed because of fractures. The esthetic results were excellent. CONCLUSIONS: The initial clinical results of this esthetic restorative material are encouraging. However, because of fatigue phenomena for all ceramic materials, a longer observation period is needed to provide a definitive prognosis of the long-term clinical behavior.

Aluminum Silicates↗
PubMed1983

Dentine hypersensitivity--a review. Clinical and in vitro evaluation of treatment agents.

A large number of compounds have been employed in the management of dentine hypersensitivity. The symptomatic nature of the condition and its variability poses many problems to any evaluation of effect. Several semi-quantitative methods of response have been used; however, at this time it is uncertain what advantages they hold over the patients' subjective assessment of improvement. A review of the clinical studies reveals that a positive result for every agent tested to date may be found. Nevertheless considerable placebo responses have been obtained and equivocal results are occasionally reported. The fluorides and metal salts, particularly of strontium, have been most studied when used either in solution or delivered in toothpaste formulations. For these compounds the literature contains considerable information concerning the reaction with dental hard tissues which can be extrapolated into hypotheses for the modes of action in relieving dentine hypersensitivity. Moreover, some in vitro studies provide useful information concerning the effects of certain compounds on dentine, and are consistent with the clinical data. Unfortunately, contradictory findings and anomalies between clinical and in vitro effects still prevent the development of a sound clinical basis for the treatment of the condition. Moreover, there is a need to recognise those factors which predispose to dentine exposure, if the prevention of the occurrence or re-occurrence of hypersensitivity is to be achieved.

Calcium Hydroxide↗
PubMed1985

A direct technique with a double lateral bridging flap for coverage of denuded root surface and gingiva extension. Clinical evaluation after 2 years.

We are introducing a new surgical technique which enables us to cover gingival recessions and extend the gingiva with a one-step procedure. This method can be described generally as a combination of a coronally repositioned flap and a modified vestibulum plastic. So far this method has been applied to 55 teeth of 19 different patients. The results have been observed for 2 years. After this time, 54.4% (30 teeth) still had complete coverage of the previously denuded root surfaces. The results show that it is possible to cover gingival recessions without increasing the zone of keratinized gingiva.

Dentin Sensitivity↗
PubMed1987

Dentine hypersensitivity. The effects in vitro of acids and dietary substances on root-planed and burred dentine.

Evidence indicates that teeth exhibiting cervical dentine hypersensitivity have open dentinal tubules at the dentine surface. The identification of factors which render dentine exposed and tubules open is important both to the prevention and management of dentine hypersensitivity. In this study, recently extracted teeth were root planed or burred to expose the root dentine. Specimens were horizontally sectioned and then using the apical portion as control, the coronal portions placed in a variety of strong and weak acids and dietary fluids. Examination under the scanning electron microscope revealed a smear layer covering completely underlying tubules on the control root planed or burred portions. Test portions exposed to strong and weak acids showed loss of the smear layer and exposure of large numbers of tubules. Formic and tannic acids produced no changes. Some dietary fluids, in particular red and white wine, citrus fruit juices, apple juice and yogurt produced similar etching effects to the acids. The low pH carbonated drink, coca-cola, and a blackcurrent cordial produced no effects. The results of this study in vitro cannot necessarily be extrapolated to the clinical situation, but suggest that certain dietary factors could play a rôle in the aetiology of dentine hypersensitivity. Dietary advice to patients may prove important in the management of this often recurrent condition.

Acids↗
PubMed1992

The effect of strontium chloride hexahydrate dentifrices on plaque accumulation and gingival inflammation.

2 strontium chloride hexahydrate-containing dentifrices (SCH), similar except for their respective abrasive systems, diatomaceous earth or silica-based, were compared for their effects on plaque accumulation and gingival inflammation as part of a 2-month randomised double-blind parallel clinical study. No attempt was made to change the patients' oral hygiene prior to participation in the study. Plaque was assessed using the Silness & Löe index and the gingival condition by the Löe & Silness index GI. There was a slight and non-significant increase in plaque accumulation at 2 weeks from baseline, but relatively negligible change thereafter, the effect being identical in both groups. Similarly, the gingival condition showed a slight index change from baseline, although it tended to be slightly higher in the diatomaceous earth group. The results do not support the conclusions of previous studies which indicated that SCH dentifrices increased plaque accumulation. Neither plaque accumulation nor gingival condition significantly changed from baseline levels during the course of the study.

Adult↗
PubMed1994

Clinical evaluation of a potassium nitrate dentifrice for the treatment of dentinal hypersensitivity.

The effectiveness of a 5% potassium nitrate dentifrice as a daily home treatment for dentinal hypersensitivity was evaluated in a double-blind study in 36 Japanese subjects who complained of cold and/or tactile hypersensitivity. The subjects were divided into 2 groups, with 18 being given a 5% potassium nitrate dentifrice (treated group) and the other 18 a vehicle paste (control group). Both groups were instructed to brush their teeth 2 x a day. The hypersensitivity levels of the affected teeth were assessed by 2 stimuli, one tactile and the other cold air, and by the perception of pain. The results of all 3 assessment methods indicated that the potassium nitrate dentifrice significantly decreased the level of hypersensitivity at weeks 4, 8, and 12. In the treated group, a rapid decrease of positive scores for both the cold air stimulus and the subjective symptoms appeared from week 2. Although a significant decrease of the assessment score was also observed in the control group, the reduction rate of the score was much greater in the treated group by all 3 assessment methods at weeks 4, 8, and 12. Complete relief of subjective symptoms throughout the 12 weeks' examination was noted in 67% of the subjects in the treated group, but in only 6% in the control group. These results suggest the usefulness of a 5% potassium nitrate dentifrice in Japanese patients with dentinal hypersensitivity.

Adult↗
PubMed1994

Control of supragingival calculus. Scaling and polishing and anticalculus toothpastes: an opinion.

The removal of supragingival calculus by scaling and polishing of the teeth is only one aspect of a dental prophylaxis. However in many countries, a large number of individuals only require and receive, at regular intervals, a supragingival scale and polish. The association of supragingival calculus to gingival and periodontal disease is unclear, however, it is logical to assume a plaque retention role. Moreover, for the individual, supragingival calculus may pose cosmetic problems. Regular calculus removal is both time consuming and exacting for dental professionals and has important financial implications to patients and/or health schemes. The benefits of regular supragingival calculus removal are not established, yet potential detrimental effects for the patient are known, and certain groups are susceptible to systemic disease consequent on scaling and polishing of the teeth. The oral hygiene habits of most individuals appear insufficient to prevent the reformation of supragingival calculus once removed and for this reason chemical inhibition is an attractive proposition. Most success to date has been with agents which inhibit crystal growth, notably pyrophosphates, and toothpaste products are available containing such agents. Clinical studies support efficacy for some products and indicate that the magnitude of calculus inhibition would reduce the need for or frequency of scaling and polishing of teeth in a proportion of individuals. Anticalculus toothpastes would appear to be proven worthy of recommendation for those individuals in whom supragingival calculus formation is a problem.

Bacteremia↗
PubMed1994

The effect of electronic dental analgesia during sonic scaling.

The aim of the present study was to investigate the effects of electronic dental analgesia (EDA) during sonic scaling. The clinical trial included 30 healthy adult subjects and was conducted as a randomised single-blind split-mouth design. The applied procedure consisted of periodontal scaling by means of a sonic scaler, while using the EDA device either in an active or placebo state. Rather similar results were obtained for the subjective pain rating in both the active and the placebo trials. When patients rated their discomfort on a scale 0-4 from no pain to very severe pain, the mean (s.d.) score for both the EDA and the placebo was 1.2 (0.6). The subjective pain estimate was positively correlated to the electrical current intensity provided. This implied that with a stronger pain experience, patients tried to administer more anaesthesia by turning the dial of the control box to an increased intensity of the electrical current. This remained insufficient to eliminate pain sensation. It was concluded that application of electronic dental anaesthesia in periodontal treatment remains questionable.

Adult↗
PubMed1998

The effects of Pain-Free Desensitizer on dentine permeability and tubule occlusion over time, in vitro.

The purpose of this in vitro study was to evaluate the efficacy of a new resin emulsion (Pain-Free Desensitizer) treatment for dentine hypersensitivity, for its ability to decrease dentine permeability. Crown segments were prepared from extracted, unerupted human 3rd molars by horizontal sectioning to remove occlusal enamel and the roots. The specimens were allocated in one of two groups: In group 1, the dentine surface was acid-etched to simulate the patent tubules of hypersensitive dentine. In group 2, the mineralized dentine surface was polished free of smear layer using a hydroxyapatite paste and ultrasonication. The hydraulic conductance of each specimen was then measured to obtain a pretreatment of control value. After a single treatment with resin desensitizer, the permeability was remeasured at 5 min, 1 day, 1 week and 1 month. Between measurements, the specimens were stored in buffer solution to simulate the solubilizing effects of saliva. Parallel specimens were followed by SEM examination. The results showed that a single treatment with resin desensitizer produced large, immediate, reductions in dentine permeability in both acid-etched and mineralized surfaces. In the acid-etched (group 1) specimens, the permeability returned to control values within 7 days, while the permeability of the group 2 specimens remained low even after 30 days of soaking. This simple treatment for occluding dentinal tubules may provide sufficient temporary reduction in dentine permeability to permit the development of natural desensitization.

Analysis of Variance↗
PubMed2005

Pain during prophylaxis treatment elicited by two power-driven instruments.

BACKGROUND: Sonic scalers have an elliptical and piezoceramic ultrasonic scalers a linear oscillation pattern. Thus, a sonic scaler "hammers" the tooth surface, irrespective of its alignment to the tooth, whereas a piezoceramic ultrasonic scaler may oscillate parallel to the tooth surface and gently remove calculus if the alignment is correct. The aim of this study was to measure pain on a visual analogue scale (VAS) during removal of supragingival calculus on mandibular incisors with a sonic or an ultrasonic scaler. MATERIAL AND METHODS: Seventy-four periodontally healthy subjects with supragingival calculus on the mandibular incisors were treated with both a sonic and a piezoceramic ultrasonic scaler in a split-mouth design. The sequence of instrument application and allocation of instruments to jaw side were randomized. Patient comfort was assessed with a VAS after treatment. RESULTS: The VAS results did not show any difference between the two instrumentation modalities. CONCLUSION: For calculus removal during prophylaxis the type of power-driven instrument does not seem to have an impact on perceived pain. This means that the oscillation pattern does not influence the pain experience.

Adult↗
PubMed2006

Periodontal healing after non-surgical therapy with a modified sonic scaler: a controlled clinical trial.

AIM: The aim of this study was to compare the clinical and microbiological healing outcomes following non-surgical periodontal therapy using a modified sonic scaler system versus scaling and root planing (S/RP) with hand instruments. MATERIAL AND METHODS: The study comprised 20 chronic periodontitis patients. Using a split-mouth design, both treatment modalities were randomly applied to one quadrant of the upper and lower jaws. Clinical and microbiological parameters were assessed at baseline, 4 weeks, and 6 months after treatment. Furthermore, post-operative hypersensitivity was investigated. The Wilcoxon signed-rank test (alpha = 0.05) was used for statistical analysis. RESULTS: With both therapy methods, periodontal conditions showed statistically significant clinical and microbiological improvements after 4 weeks and 6 months. Hypersensitive teeth were found only 4 weeks after S/RP. Besides a significantly better bleeding on probing reduction in deep S/RP sites and less time required for root instrumentation by the sonic scaler, no other clinical and microbiological parameters revealed significant differences between sites treated with the sonic scaler or S/RP. CONCLUSION: The sonic scaler system and S/RP seem to provide similarly favourable periodontal healing results, although in deep pockets S/RP appeared to achieve a better resolution of inflammation.

Adult↗
PubMed1987

Prevalence of oral and facial pain and discomfort: preliminary results of a mail survey.

A mail survey was undertaken to estimate the prevalence of oral and facial pain and discomfort in the City of Toronto. Self-complete questionnaires were sent to a random sample of 1014 persons drawn from the voter's list. Replies were received from 72% of those eligible. Overall, 53% of respondents had experienced some pain or discomfort in the 4 wk prior to the completion of the questionnaire. The most common kinds of pain and discomfort reported were pain in the teeth with hot or cold fluids (28.8%), sore and bleeding gums (26.3%) and toothache (14.1%). Pain in jaws, face and oral mucosa was reported by less than 10% of the subjects. While much of the pain experienced by the respondents was classified as mild, half (50.1%) said that it was moderately severe or severe. Only 40% of those reporting pain had sought the advice of a dentist or doctor. Sex differences in the reporting of pain were small and statistically non-significant, although age differences were marked and significant. The younger age groups were more likely to report both pain and discomfort than the older age groups. The survey has revealed a substantial amount of oral and facial pain in the community, much of which is not subject to professional attention.

Adolescent↗
PubMed1987

Treatment of dentin with stannous fluoride--SEM and electron microprobe study.

The effect of SnF2-treatment of dentin surfaces was investigated by means of scanning electron microscopy (SEM) and electron microprobe analysis. Human dentin was treated with aqueous SnF2 solutions of concentrations varying from 1 to 10%. The treatment periods lasted for 1, 5, 10, or 60 min. Both tin and fluoride were identified on the surfaces. The concentration varied depending on the extensiveness of the treatment. Immersion in 1 M KOH for 15 h removed both tin and fluoride from the surfaces. This reaction was not observed after immersion in H2O for the same time period. Examination of the SnF2-treated dentin surfaces showed a dense layer of globular particles and in addition some larger particles. The dentinal tubules were totally covered even after the treatment with the lowest concentration of SnF2. Deposition of tin- and fluoride-containing globules on dentin surfaces may be of clinical interest. This layer may have importance both for the caries resistance of dentin and for hypersensitivity reactions.

Dental Caries↗
PubMed1997

Chemical agents for the control of plaque and plaque microflora: an overview.

This presentation provides an overview of the technologies available for the chemical control of plaque. It is generally accepted that the formation of dental plaque at the interfaces of tooth/gingiva is one of the major causes of gingival inflammation and dental caries. Several therapeutic approaches have been used to control dental plaque and supragingival infections. These include fluoride preparations such as stannous fluoride, oxygenating agents, anti-attachment agents, and cationic and non-cationic antibacterial agents. Among the fluoride preparations, stable stannous fluoride pastes and gels have been shown to reduce supragingival plaque, gingivitis, hypersensitivity and caries. The effect of the oxygenating agents on the supragingival plaque has been equivocal, but recent data indicate that a stable agent which provides sustained active oxygen release is effective in controlling plaque. A polymer, PVPA, which reduced attachment of bacteria to teeth was shown to significantly reduce plaque formation in humans. A new generation of antibacterials includes non-ionics such as triclosan, which in combination with a special polymer delivery system, has been shown to reduce plaque, gingivitis, supragingival calculus and dental caries in long-term studies conducted around the world. Unlike the first generation of agents, the triclosan/copolymer/sodium fluoride system is effective in long-term clinicals and does not cause staining of teeth, increase in calculus, or disturbance in the oral microbial ecology.

Anti-Infective Agents, Local↗
PubMed2006

Spectroscopic investigation of the function of aqueous 2-hydroxyethylmethacrylate/glutaraldehyde solution as a dentin desensitizer.

Fourier-transform (FT)-Raman and -infrared (IR) spectroscopy were employed to investigate the function of the aqueous 2-hydroxyethylmethacrylate/glutaraldehyde solution (Gluma) as a desensitizer. 2-Hydroxyethylmethacrylate (HEMA), glutaraldehyde (GA), and the mixture of HEMA/GA (i.e. Gluma) were used to interact with dentin, collagen, hydroxyapatite (HAP), and bovine serum albumin (BSA) individually. All the interactions were monitored by an FT-Raman spectrometer. FT-IR spectroscopy was also used in this study. The results show that HEMA could be absorbed by dentin and collagen; GA could cross-link collagen and BSA; and when BSA was added to Gluma, polymerization of HEMA occurred. The results suggest that Gluma acts as a desensitizer whereby, first, GA reacts with part of the serum albumin in dentinal fluid, which induces a precipitation of serum albumin, then, second, a reaction of GA with serum albumin induces polymerization of HEMA. The function of Gluma as a desensitizer to block dentinal tubules occurs via these two reactions.

Absorption↗