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Ceramic veneers are extremely popular and have been used for many years. In spite of their phenomenal success, they offer numerous challenges during service. In this column, I have identified and discussed several degenerative situations commonly observed, and I have described methods of preventing or reducing the problems. When properly placed, ceramic veneers are among the most beautiful and long-lasting of all dental restorations.
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This is a preliminary study to determine a methodological sequence in vitro which may allow the reproduction of dentin for SEM analysis, after the use of different desensitizing agents. Dentin discs obtained from extracted human third molars were etched with 6% citric acid, an artificial smear layer was created and the surface dentin discs were divided into four quadrants. Quadrants 2, 3 and 4 of each disc were conditioned with 6% citric acid. The desensitizing agents (Oxa-Gel, Gluma Desensitizer and an experimental agent) were applied to quadrants 3 and 4. To evaluate the acid resistance of the treatment, quadrant 4 was etched again with 6% citric acid. An impression was then taken with Aquasil ULV. After a setting period of 6 min, each disc was removed from the impression and stored in a moist-free environment for 24 h at 37 degrees C. After that time, a low-viscosity epoxy resin (Araltec GY 1109 BR) was poured into the impression and cured for 24 h. All specimens were metal-coated for SEM analysis. Comparison of the photomicrographs of dentin discs with their respective impressions and resin replicas showed that this technique can reproduce the characteristics of the dentin surface treated with desensitizing agents.
Dentin hypersensitivity is a common painful condition observed in clinics. Dietary habits have been much associated with its development and persistence during and following periodontal treatment. The aim of this in vitro study was to evaluate the influence of vinegars on the removal of smear layer and exposure of dentinal tubules. Extracted human teeth were submitted to manual scaling with Gracey curettes in order to remove the cementum as well as to form a smear layer. Dentin samples with 3 mm(2) were obtained and distributed into six experimental groups: one control and five types of vinegars (alcohol, apple, rice, white wine and balsamic). Each group included two methods of vinegar application: topical and friction. After routine preparation for SEM analysis, photomicrographs were assessed by a calibrated and blind examiner using an appropriate index system. Kruskal-Wallis test indicated a significant influence of vinegars on smear layer removal. There was a statistically significant difference between groups treated with apple, white and rice vinegars and the control group (p < 0.05). Nevertheless, Mann-Whitney test indicated that removal of smear layer did not vary with the method of application (topical versus friction) for any of the tested substances. We can conclude that the contact of vinegar may remove smear layer and expose dentinal tubules, regardless of the type of application. However, balsamic vinegar was associated with less removal of smear layer after both methods of application.
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Explore the source record for details and available documents.
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Sixty adult patients were examined for dentin hypersensitivity prior to periodontal surgery. Stimuli used included mechanical, cold water and compressed air blasts. A subjective assessment of the degree of hypersensitivity for each stimulus was recorded. This presurgical examination revealed 249 hypersensitive areas among 60 subjects. Following surgery there was over a 100% increase in the pain (hypersensitivity) score. Desensitization with a 10% strontium chloride hexahydrate dentifrice was begun 1 week after surgical treatment. After 7 weeks of dentifrice use the pain score was reduced 75.5% in the test group. This was a reduction to a point below the preoperative level. The placebo group showed a reduction of 34.2% which was still above the preoperative level. These results agree with other clinical studies that have demonstrated a desensitizing effect of strontium chloride.
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Effectiveness of iontophoresis with and without electric current and sodium fluoride on tooth hypersensitivity was evaluated. In eleven volunteers, teeth received a 2% neutral sodium fluoride solution applied using an electrode phoresor. Test teeth received the solution with current and control teeth received the solution without current. The subjects were tested at Day 0 and 7 by means of a mechanical stimulating device and a temperature probe. The data were then analyzed using X2 analysis. Statistically, the test teeth demonstrated more improvement than the control teeth.
A double-blind investigation comparing a control dentifrice with one containing active ingredients was conducted to determine their effect on dentinal hypersensitivity in 67 human subjects. Baseline data was obtained by patient questionnaire, dental examination and by soliciting subjective responses to controlled mechanical and thermal stimuli. A calcium carbonate-based toothpaste constituted the base for both the control and active dentifrice. The active dentifrice contained 0.8% sodium monofluorophosphate and 1.3% formalin while the control lacked these ingredients. Dentifrices were supplied to patients on a random basis, and patients were instructed to brush twice each day for 28 days. Mechanical and thermal response as accomplished at baseline were obtained at 14 and 28 days after baseline on 60 subjects. A statistically significant reduction was not obtained in response to mechanical stimulus. The active dentifrice demonstrated a statistically significant reduction (P less than 0.05) to thermal stimulus at both 14 and 28 days.