Many patients have been suffering the continued hypersensitivity and pain of teeth after operative or endodontic treatment. The primary purpose of this paper is to examine the causes of the pain and the hypersensitivity of teeth, and to resolve conflicts between dentists and patients. The secondary aim of this paper is to prevent medical disputes. Evidence-based dentistry and making a good relationship with patients will reduce disputes on dental treatment.
The purpose of this study is for evaluating the effect of MS Coat desensitizing agent in clinical situation. In this study total 60 teeth of 30 patients who is feeling hypersensitivity after periodontal surgery were treated with MS Coat desensitizing agent, and 20 teeth with saline solution for placebo effects and evaluated. All teeth were cleaned with rubber cup and pumice, after then the antibacterial agent was applied for 20 seconds and simply isolated using cotton roll Desensitizing agent was applied with a specific instrument in the manufacturers package by abrading motion for 10 seconds and re-done 8 times. Tactile stimulus with sharp explorer, air stimulus with syringe of dental unit, $7^{\circ}C$ cold water stimulus using micropipette applicator was done to evaluate hypersensitivity before apply test agent, immediate after application, 1 week after, and 3 month after application. The degree of hypersensitivity was recorded using 100mm Visual Analogue Scale and compared between group and evaluation times. From this clinical study sensitivity to the stimulus was significantly induced in both groups and MS Coat made a significant reduction in VAS score than placebo group did(p<.01). The results of this study could demonstrate that MS Coat desensitizing agent can use effectively to heat dentinal hypersensitivity.
Inferior alveolar nerve (IAN) injury is usually caused by stretching or crushing of the neurovascular structures and postoperative intra-alveolar hematoma or edema after dental procedures. This results in paresthesia in the ipsilateral chin, lip (vermilion border, skin, and mucosa), and labial or buccal alveolar mucosa of the mandibular anterior teeth. However, there are no reports of sensory alterations in the teeth, especially tooth hypersensitivity, after IAN injury. I report a case in which paresthesia of the lower lip and hypersensitivity of the lower anterior teeth occurred simultaneously after the removal of the third molar that was located close to the IAN. In addition, I discuss the reasons for the different sensory changes between the tooth and chin (skin) after nerve injury from a neurophysiological point of view. Since the dental pulp and periodontal apparatus are highly innervated by the inferior alveolar sensory neurons, it seems necessary to pay attention to the changes in tooth sensitivity if IAN injury occurs during dental procedures.
Root surface exposure due to gingival recession after periodontal surgery, dentin exposure after root planing elicit pain response when exposed to mechanical, heat, chemical or osmotic stimulation. Especially, patients treated with periodontal surgery, show high frequency and there have been reports showing the 1 out of 7 patients have dentin hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentin hypersensitivity. but, none could provide absolute clinical efficacy. In this study, 45 teeth from 30 patients, who had had periodontal surgery and showed dentin hypersensitivity after surgery were chosen for the experimental group and they were illuminated with laser, 15teeth were chosen for the control group and they were not exposed to laser. After this dentin hypersensitivity was elicited by tactile, compressed air, cold water and then, the degree was evaluated using NRS(Numerical Rating Scale). And during LLLT(Low Level Laser Therapy) semiconductor laser using Gallium - Arsenide as a diode was illuminated for 180 seconds at a frequency of 7(500Hz). This therapy was done 10 times, and each time the changes in dentin hypersensitivity was evaluated using NRS. The results were as follows : 1. After treat with LLLT on dentin hypersensitivity due to periodontal surgery, 22.2% showed total loss of dentin hypersensitivity, 60.0% showed loss of tactile dentin hypersensitivity, 48.8% showed loss of compressed air dentin hypersensitivity, 22.2% showed loss of cold water dentin hypersensitivity. 2. As a result of clinical evaluation of dentin hypersensitivity using NRS, there was significant increase in improvement of dentin hypersensitivity in the experimental group compare to the control group(P<0.05). And there was almost no natural loss of dentin hypersensitivity in the control group. 3. In comparison of the stages of evaluation, there was significant difference in between experimental and control group. after the second visit(P<0.05), and the difference increased with each visit.
Exposure of the root surface due to gingival recession after periodontal surgery, elicit pain response when exposed to mechanical, heat, chemical or osmotic irritation. Especially patients treated with periodontal surgery, show high frequency. There have been reports that the 1 out of 7 patients complains of dentinal hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentinal hypersensitivity. The purposes of this study were to evaluate the effect of sodium chloride and potassium oxalate and to observe the relationship between the dentinal hypersensitivity and surface characteristics such as dentinal tubule size and number. This study included 20 teeth which were scheduled for extraction and had no pulpal disease. These teeth were divided into Root planing group, EDTA group, NaCl group and Oxalate group. Dentinal hypersensitivity is measured by tactile, pressured air and cold water using NRS (Numerical Rating Scales). Teeth were extracted under local anesthesia and each specimen was sectioned to a size about 3 X 5 mm and was examined under the scanning electron microscope (X2,000) The results were as follows, 1. The EDTA group exhibited significantly increased dentinal hypersensitivity comparing with the other groups. 2. The NaCl and Oxalate groups showed significantly reduced dentinal hypersensitivity comparing with the EDTA group. 3. As a method for dentinal hypersensitivity measurement, it was presumed thet tactile sensitivity test was not sensitive method but air blast test and cold water test were adequate method. 4. In a SEM study, the root planing group exhibited amorphous smear layer and showed no dentinal tubule orifice, but the EDTA group showed the large number of dentinal tubules. On the other hand, the NaCl and Oxalate groups did not show exposed dentinal tubules. The NaCl group showed more rough root surface than the EDTA group, and the Oxalate group showed many participates to be presumed as calcium oxalate particle. As the results from this study, root planing couldn't expose the dentinal tubule and NaCl and potassium oxalate occluded exposed dentinal tubule effectively. Dentinal hypersensitivity has close relationship with the exposure of dentinal tubules, especially with it's size and number.
A non-carious cervical lesion(NCCL) is the loss of tooth structure at the cementoenamel junction level that is unrelated to dental caries. This study was to evaluate the occlusal and periodontal status of teeth with non-carious cervical lesions. We evaluated 105 teeth with non-carious cervical lesions in 35 subjects aged 38-75 years and characterized them based on the shape and dimension, plaque retention, bleeding on probing(BOP), probing pocket depth(PPD), occlusal status, brushing type, hypersensitivity and wear facet. The results of this study were as follows 1. No significant association was observed between cervical lesions and occlusal contact in lateral excursions. 2. No significant difference occurred in plaque retention, PPD, BOP between teeth with and without cervical lesions. 3. Test teeth had a significantly higher percentage of hypersensitivity and occlusal wear facet than teeth without cervical lesions. 4. Wedge shaped lesions had a significantly higher percentage of plaque than saucer shaped lesions. 5. Teeth with plaque were found to have significantly deeper PPD than teeth without plaque retention in cervical regions. 6. Teeth with occlusal contacts were found to have significantly deeper PPD than teeth without occlusal contacts. 7. No significant association was observed between cervical lesions and PPD independent of plaque retention and occlusal contacts Although more knowledge is necessary, our results suggest that occlusal contact and bacterial plaque may influence on periodontal tissue, but NCCL is not directly associated with periodontal health
In this study, 40 hypersensitive teeth of 19 patients were investigated. The procedures performed were as follows: Before desensitization, EPT at occlusal third of buccal surface was done for the evaluation of pulp vitality and the EPT value was recorded for the reference value. And mechanical and thermal test was executed for the test of hypersensitivity. If the tooth responded to the above tests, we did EPT at the exposed surface, using toothpaste as a electrolite medium and recorded the EPT value at patient's response. After the tests had been done, desensitization procedures with Gluma(R) Desensitizer were performed according to the manufacturer's instructions. After desensitization, the same tests except EPT at occlusal third were repeated. All the 40 teeth responded positive before desensitization and negative after desensitization procedures. The EPT value at occlusal third ranged from 31 to 65 (48.9${\pm}$7.2). Before desensitization 34 teeth responded at EPT value of 2 and the remaining 6 teeth was in the range of 17 to 25. After desensitization all 40 teeth responded from 12 to 27 (19.6${\pm}$3.5). The 6 teeth responded at greater number than 2 before desensitization was in the range of 18 to 23. Within the limitations of this study we can conclude that: When a tooth with dentinal hypersensitivity responds to mechanical and thermal stimulation, the tooth shows very low resistance to electricity at the exposed surface while when a tooth is desensitized and doesn't show respond to mechanical and thermal stimuli, the tooth shows increased level of resistance to electric stimulation at the exposed surface. EPT can be used for the diagnosis of dentinal hypersensitivity. Furthermore EPT will be useful to evaluate the outcome of desensitization procedures. However, EPT is not a valid tool for measuring dentinal hypersensitivity.
Purpose: Dentin hypersensitivity is a potential threat to oral health. Laser irradiation may provide reliable and reproducible treatment but remains controversial. The present study aimed to evaluate the effects of $CO_2$ or erbium-doped yttrium aluminium garnet (Er:YAG) laser therapy, and to assess mineral content. Methods: Eighteen human single-rooted teeth affected with advanced periodontitis were obtained. Buccal and lingual surfaces were planed to form 36 specimens. Ethylenediaminetetraacetic acid gel (24%) was applied to remove the smear layer and simulate hypersensitive teeth. The experimental groups were: group 1, control (no irradiation); group 2, $CO_2$ laser (repetitive pulsed mode, 2 W, $2.7J/cm^2$); and group 3, Er:YAG laser (slight contact mode, 40 mJ/pulse and 10 Hz). To evaluate dentinal tubule occlusion, six specimens per group (2-mm thickness) were prepared and observed using scanning electron microscopy (SEM) for calculation of the occlusion percentage. To evaluate the mineral content, six specimens per group (0.6-mm thickness) were used, and then the levels of Ca, K, Mg, Na, and P were measured by inductively coupled plasma-atomic emission spectrometry. In addition, the surface temperature of the specimens during laser irradiation was analyzed by a thermograph. Results: The SEM photomicrographs indicated melted areas around exposed dentinal tubules and a significantly greater percentage of tubular occlusion in the $CO_2$ and Er:YAG laser groups than the control, and in the Er:YAG group than the $CO_2$ laser group. In addition, no significant differences were noted among the experimental groups for the mineral elements analyzed. The $CO_2$ laser group showed an evident thermal effect compared to the Er:YAG group. Conclusions: $CO_2$ and Er:YAG laser are effective in treating dentin hypersensitivity and reducing its symptoms. However, the Er:YAG laser has a more significant effect; thus, it may constitute a useful conditioning item. Furthermore, neither $CO_2$ nor Er:YAG lasers affected the compositional structure of the mineral content.
Kim, Min-Soo;Chae, Gyung-Joon;Choi, Seong-Ho;Chai, Jung-Kiu;Kim, Chong-Kwan;Cho, Kyoo-Sung
Journal of Periodontal and Implant Science
/
v.38
no.1
/
pp.1-6
/
2008
Purpose: The purpose of this study was to evaluate the effects of hydroxyapatite containing toothpaste for patients who received periodontal therapy and felt hypersensiptivity. Material and Methods: After application of toothpaste, patients were evaluated for VAS(Visual Analog scale) scores to a cold stimulate on baseline, 1 week, and 4 weeks. VAS scores were analyzed by statistical methods. Results: The results of this study were as follows. 1. VAS scores in control group on baseline, 1 week, 4 weeks were $5.39{\pm}2.05$, $4.75{\pm}2.00$, $4.21{\pm}1.75$. 2. VAS scores in experimental group on baseline, 1 week, 4 weeks were $5.61{\pm}2.37$, $4.81{\pm}2.46$, $4.08{\pm}2.54$. 3. Decrease of VAS scores on hypersensitivity after 1week was $0.64{\pm}0.49$(p<.0001) in control group, $0.80{\pm}1.65$ (p<.0001) in experimental group. 4. Decrease of VAS scores on hypersensitivity after 4weeks was $1.18{\pm}1.60$(p<.0001) in control group, $1.53{\pm}1.88$ (p<.0001) in experimental group. 5. When compared, decrease of VAS scores after 1 week between 2 groups were not statistically different(p=0.2622). 6. When compared, decrease of VAS scores after 4 weeks between 2 groups were not statistically different(p=0.1219). Conclusion: It was confirmed that hydroxyapatite containing toothpaste have the similar effect with pre-existing proven dentifrice for relieving teeth hypersensitivity.
The purpose of this study was to evaluate the effect of diode laser & desensitizing agents to overcome hypersensitizing root surfaces problem after periodontal treatment. 20 patients(60 teeth) presented were volunteered in this study. Diode laser & MS coat was respectively applied on hypersensitizing root surfaces after periodontal treatments. Following application they were evaluated immediately. The results were as follows: 1. The frequency and degree of root surface hypersensitivity levels were measured by the sequence of tactile and air stream. 2. Reduction of root surfaces hypersensitivity by tactile were for Diode laser and Ms coat application respectively $3.0294{\pm}2.0224$ and $3.2692{\pm}1.6139$. 3. Reduction of root surfaces hypersensitivity by air stream were for Diode laser and Ms coat apapplication respectively $3.0294{\pm}2.0224$ and $2.2692{\pm}1.6139$. 4, It could be said that Diode Laser and Ms coat application were significantly effective in reducing dentin hypersensitivity as far as concerned effect, Ms coat applicatio showed more effective than Diode laser. In conclusion, both methods were significantly effective in reducing dentinal hypersensitivity. Therefore, it was recommended that Diode laser and desensitizing agents could be used routinely for patients dentinal hypersensitivity following periodontal treatment.
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