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PubMed1997

Penetration of varnishes into demineralized root dentine in vitro.

In this paper the penetration of three different varnishes employed in caries prevention (Duraphat, Fluor Protector and Cervitec) into demineralized dentine is quantified using confocal laser scanning microscopy. The results show that the varnish penetration into lesions about 85 microns in depth if for Cervitec about 35 microns and considerably less for Duraphat and Fluor Protector. The penetration is into the dentinal tubules and is influenced by dentinal tubule direction. The drying procedure--pretreatment of the dentine--influences the penetration, though sizeably only for Cervitec applications. This paper shows that varnish penetration into the tissue and presumably 'sealing' tubules completely or partly is valuable with respect to root caries prevention and hypersensitivity.

Adolescent↗
PubMedDate not supplied

Natural desensitization of exposed tooth roots in dogs.

With scanning electron microscopy, electron microprobe elemental analysis, and an objective method for eliciting responses to electrical stimuli, exposed tooth root surfaces in dogs were found to become naturally desensitized with time, perhaps because of the formation of acquired pellicle.

Animals↗
PubMed1977

Diffusion of strontium from desensitizing agents into human dentin as determined by energy-dispersive analysis.

Strontium-containing desensitizing agents were applied to one set of tooth surfaces and were burnished onto another set of diametric surfaces. Concentration of strontium at dentin depth was determined by X-radiation dispersive analysis. Burnishing produced deeper strontium penetration. Fick's Second Law provided an estimate of relative effective time for equal strontium distributions by the two methods.

Dentin↗
PubMed1987

The neurobiology of facial and dental pain: present knowledge, future directions.

This review outlines recent research which has identified critical neural elements and mechanisms concerned with the transmission of sensory information related to oral-facial pain, and which has also revealed some of the pathways and processes by which pain transmission can be modulated. The review highlights recent advances in neurobiological research that have contributed to our understanding of pain, how acute and chronic pain conditions can develop, and how pain can be controlled therapeutically. Each section of the review also identifies gaps in knowledge that still exist as well as research approaches that might be taken to clarify even further the mechanisms underlying acute and chronic oral-facial pain. The properties of the sense organs responding to a noxious oral-facial stimulus are first considered. This section is followed by a review of the sensory pathways and mechanisms by which the sensory information is relayed in nociceptive neurones in the brainstem and then transmitted to local reflex centers and to higher brain centers involved in the various aspects of the pain experience--namely, the sensory-discriminative, affective (emotional), cognitive, and motivational dimensions of pain. Reflex and behavioral responses to noxious oral-facial stimuli are also considered. The next section provides an extensive review of how these responses and the activity of the nociceptive neurones are modulated by higher brain center influences and by stimulation of, or alterations (e.g., by trauma) to, other sensory inputs to the brain. The neurochemical processes, involved in these modulatory mechanisms are also considered, with special emphasis on the role of neuropeptides and other neurochemicals recently shown to be involved in pain transmission and its control. The final section deals with recent findings of peripheral and central neural mechanisms underlying pain from the dental pulp.

Animals↗
PubMed1990

Transmission electron microscopic characterization of hypersensitive human radicular dentin.

Transmission electron microscopy (TEM) and x-ray microanalysis (XMA) were used for the study of the ultrastructure of the lumens of dentinal tubules in superficial layers of dentin specimens obtained by use of a new biopsy technique from both hypersensitive and naturally desensitized areas of exposed root surfaces, in vivo. The TEM images showed clearly that the lumens of most of the tubules were occluded with mineral crystals in naturally desensitized areas, but such lumens were empty and surrounded with peritubular and intertubular dentin in hypersensitive areas. Moreover, electron-dense structures that lined peritubular dentin were observed in the empty lumens of dentinal tubules.

Adult↗
PubMed1994

Occlusion of dentinal tubules with calcium phosphate using acidic calcium phosphate solution followed by neutralization.

The occlusion of dentinal tubules with calcium phosphate, by a calcium phosphate precipitation method (CPP method), was investigated in vitro for evaluation of the potential value of this method for the treatment of dentin hypersensitivity. The method consists of treating the dentinal surface with a CPP solution, i.e., an acidic solution that contains both calcium and phosphate, followed by neutralization with basic post-treatment solution. The CPP solutions used in this study ([Ca] = 0.2 - 1.0 mol/L, [PO4] = 0.2 - 4.0 mol/L) were prepared by dissolving Ca(OH)2 or CaHPO4 x 2H2O in H3PO4 or HCl, and 1 mol/L NaOH solution was used for the post-treatment solution. Sections of human dentin disks treated by the CPP method were observed by scanning electron microscopy, and the precipitate in the dentinal tubules was subjected to x-ray micro-analysis. After treatment by the CPP method, dentinal tubules were occluded to a distance of approximately 15 microns from the surface, and the precipitate showed a Ca/P molar ratio of 1.03 +/- 0.01 To obtain a larger amount of precipitated mineral for further analysis, we used the same procedure with glass tubes (inside diameter, 1 mm). Powder x-ray diffraction analysis and FT-IR measurement revealed that the precipitate was dicalcium phosphate dihydrate (CaHPO4 x 2H2O). The instant precipitation of calcium phosphate mineral in the dentinal tubules demonstrated the potential value of the CPP method for the occlusion of dentinal tubules, this occlusion may be useful for the treatment of dentin hypersensitivity.

Calcium Phosphates↗
PubMed1995

Effects of potassium ions on action potential conduction in A- and C-fibers of rat spinal nerves.

Potassium ions in dentifrices for treating 'hypersensitive' dentin are believed to act directly on intradental nerves by raising extracellular potassium ion concentration ([K+]o) sufficiently to prevent action potential generation by axonal accommodation. However, the [K+]o necessary to block nerve conduction is not precisely known, nor is it certain that K+ can diffuse from a dentifrice in sufficient amounts to inactivate intradental nerves. To establish more accurately the [K+]o required to block nerve conduction under controlled conditions, we studied the effects of increased [K+]o on the sizes of compound action potentials (CAP) recorded from rat spinal nerves in vitro. [K+]o was increased by the addition of either KCl or KNO3 to Krebs' solutions applied to the central portion of the nerves. CAP attenuation increased in a dose-dependent manner as [K+]o was raised in the 8 to 64 mmol/L range, and complete block was generally produced with solutions containing at least 32 mmol/L K+. CAP attenuation was reversible, and recovery times increased with increasing [K+]o. The effects of KCl and KNO3 solutions were the same for all [K+]o tested. Half-maximal (50%) reduction in the A beta-fiber component of the CAP occurred with 17.4 mmol/L K+, and with 17.8 mmol/L and 19.3 mmol/L K+, respectively, for the A delta- and C-fiber components. Control experiments with glucose and choline chloride confirmed that the conduction block observed with increased [K+]o was not due to increased solution osmolarity or ionic strength.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1995

Effects of fluoride on the calcium phosphate precipitation method for dentinal tubule occlusion.

Use of the calcium phosphate precipitation (CPP) method makes possible the occlusion of dentinal tubules to approximately 10 to 15 microns from the dentinal surface, and thus shows good potential for the treatment of dentin hypersensitivity. The precipitate formed in the dentinal tubules by the CPP method is, however, not apatite [HAP; Ca10(PO4)6(OH)2], a component of tooth and bone, but dicalcium phosphate dihydrate (DCPD; CaHPO4.2H2O). Since fluoride enhances the conversion of DCPD to HAP, we evaluated the effects of fluoride on the texture of the precipitate formed by the CPP method and on its capacity to occlude dentinal tubules in this in vitro study. CPP solution (1.0 mol/L CaHPO4.2H2O dissolved in 2.0 mol/L H3PO4) was applied to a dentin disk and was subsequently neutralized with a post-treatment solution (1 mol/L NaOH, from 0 to 0.1 mol/L NaF). Scanning electron microscopy revealed that the precipitate occluded dentinal tubules to a depth of approximately 10 to 15 microns from the dentinal surface, regardless of the NaF concentration (from 0 to 0.1 mol/L) in the post-treatment solution. Also, dentin permeability was reduced to 15% by the CPP treatment regardless of the NaF concentration. The Ca/P molar ratio of the precipitate, measured by x-ray micro-analysis, was higher (1.25 +/- 0.04) in the presence of NaF than in its absence (1.03 +/- 0.01). For further identification of the precipitate formed in the dentinal tubules, the same procedure was used in glass tubes (diameter, 1 mm), so that a larger amount of precipitate would be obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcium Phosphates↗
PubMed1995

Duration of dentinal tubule occlusion formed by calcium phosphate precipitation method: in vitro evaluation using synthetic saliva.

The use of a calcium phosphate precipitation method occluded dentin tubules with apatitic mineral and, thus, showed good potential for the treatment of dentin hypersensitivity. The aim of this study was to elucidate the occluding behavior of the precipitate in the oral environment. Dentin disks treated by the calcium phosphate precipitation method, and disks treated with potassium oxalate, NaF, and SrCl2 solutions, were immersed in synthetic saliva, which was regularly replenished so that ionic concentration would be maintained. Treatment of dentin disks by the calcium phosphate precipitation method immediately reduced dentin permeability to 6 +/- 8%. When the disk was immersed in synthetic saliva, dentin permeability remained low, even seven days after immersion. Scanning electron microscopic observation showed no distinct boundary line between the precipitate and intertubular dentin; this indicated further mineralization on the precipitate. Potassium oxalate treatment also reduced the dentin permeability to 8 +/- 3%. However, the dentin permeability gradually but steadily increased with immersion time, reaching 39 +/- 14% at seven days. To elucidate the mechanism underlying dentin permeability changes in synthetic saliva, we immersed the precipitates, i.e., apatitic mineral and calcium oxalate, in a fixed volume of synthetic saliva. When calcium oxalate was immersed in synthetic saliva, there was a large concentration of oxalate ions, indicating dissolution of the calcium oxalate; this phenomenon was ascribed to the increase in dentin permeability. In contrast, calcium and phosphate ions decreased when apatitic powder, the precipitate formed by the calcium phosphate precipitation method, was immersed in synthetic salvia. The decrease in the calcium and phosphate ions in synthetic saliva indicated further precipitation of calcium phosphate on the apatitc precipitate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

An ultrastructural study of the relationship between sensory trigeminal nerves and odontoblasts in rat dentin/pulp as demonstrated by the anterograde transport of wheat germ agglutinin-horseradish peroxidase (WGA-HRP).

Because the ultrastructure of the trigeminal sensory nerves in dentin, especially in relation to odontoblasts, remains to be clarified, we investigated the relationship between the trigeminal sensory nerves and the odontoblast processes using the anterograde axonal transport technique by injecting wheat germ agglutinin-horseradish peroxidase (WGA-HRP) into the rat trigeminal ganglion. Light microscopically, the nerves labeled with WGA-HRP were mainly concentrated at the pulpal horn, forming a nerve plexus at the subodontoblastic region and penetrating the predentin/dentin about 50 to 70 microns. Ultrastructurally, HRP reaction products were observed intra-axonally in the myelinated (A delta) and unmyelinated (C) axons in the subodontoblastic region. Most nerves lost the Schwann sheath and were naked in the predentin/dentin. The labeled varicosities were close to the odontoblast processes in the dentinal tubules. No synaptic structures could be detected between the varicosities and the odontoblasts, but a gap about 20 nm wide was found between them. One type of varicosity was a rich mitochondria-containing varicosity, while the other was a rich vesicle-containing (large dense core vesicles and small clear vesicles) one. The reaction products were also found in the extracellular spaces surrounding the axons. Sometimes the reaction products were seen in the coated pits or the endocytotic vesicles of the odontoblast processes. The present study demonstrated that nerve endings (varicosities) derived from the trigeminal ganglion were present in the dentinal tubules, and that WGA-HRP extracellularly extruded from the sensory nerves in the odontoblastic layer or predentin/dentin. These findings thus suggest that sensory nerves may have some (e.g., trophic) effect on either odontoblasts or the environment around the sensory nerves in the dentin/pulp.

Afferent Pathways↗
PubMed1986

Controlled trial of the action of a toothpaste containing nicomethanol hydrofluoride in the treatment of dentine hypersensitivity.

A double-blind clinical trial was performed on 76 patients with dentine hypersensitivity. For four weeks the patients used either a toothpaste containing nicomethanol hydrofluoride or one containing potassium nitrate and sodium monofluorophosphate. After one, two and four weeks the pain responses of the teeth to three types of stimuli were assessed. In normal conditions of oral hygiene, the nicomethanol hydrofluoride toothpaste was found at least as effective as the potassium nitrate/sodium monofluorophosphate preparation.

Adult↗
PubMed1987

Dentin bonding agents--a perspective on research and clinical use.

The last several years have shown remarkable advances in the development of dentin bonding agents. Today, a majority of dentists routinely use dentin bonding agents in clinical practice. Yet, despite this widespread acceptance, these materials are still in their infancy and require improvements in their performance as well as an understanding of their adhesion mechanisms. Bond strengths to dentin are sufficient to prove useful but are less than needed for totally reliable results. Furthermore, problems related to polymerization shrinkage of composite restorative materials can compromise the bond to dentin resulting in decreased adhesion and marginal seal. Better materials are now being developed, but, in the meantime, limitations of the current materials should be understood and respected in clinical application.

Dental Bonding↗
PubMedDate not supplied

Bleaching discoloured teeth.

The bleaching of teeth has encountered some legislative problems over the past few years but it is now possible to use both vital and non-vital bleaching techniques in the UK. Hydrogen peroxide has a long history of use and would appear to be safe to use to change the appearance of discoloured teeth. It is conservative of tooth tissue and may delay the need for more invasive veneers and crowns. This article describes some of the methods of bleaching using hydrogen peroxide that are currently available.

Animals↗
PubMed2002

The management of gingival recession.

This, the second paper in a short series on gingival recession, discusses the various modalities of treatment for gingival recession and the indications for treatment. Special consideration is given to the surgical treatment techniques. Factors affecting the outcome of treatment and success rates of the treatment options are also discussed.

Connective Tissue↗
PubMed2002

'Do-it-yourself' dental treatment: a case report.

The use of topical desensitizing agents and the placement of superficial restorations at cervical margins are part of a conventional treatment plan for hypersensitive teeth. This case report describes a dental-phobic patient who employed a rather peculiar 'do-it-yourself' approach to alleviate the problems of hypersensitivity, by covering her teeth with a mixture of candle wax and 'household' glue.

Adhesives↗