scholarly journals Multi-factoriality of dentine hypersensitivity

2008 ◽  
Vol 61 (7-8) ◽  
pp. 359-363 ◽  
Author(s):  
Ivana Stojsin ◽  
Ljubomir Petrovic ◽  
Igor Stojanac ◽  
Milan Drobac
Keyword(s):  
Differential Diagnosis ◽  
Average Diameter ◽  
Gingival Recession ◽  
Dentin Hypersensitivity ◽  
Dentine Hypersensitivity ◽  
Enamel Defect ◽  
Indexing Method ◽  
Suitable Treatment ◽  
Sensitive Teeth ◽  
Enamel Erosion

Introduction. Dentine hypersensitivity has been defined as a sharp, short pain arising from exposed dentin in response to stimuli typically thermal, evaporative tactile, osmoticor, chemical and which cannot be ascribed to any other form of dental defect or pathology. Prevalence. The most affected patients range in age from 20 to 40. The following teeth tend to be most sensitive: cuspids, premolars and incisors, location-concentrated on the facial surface. Morphological bases of dentine hypersensitivity Sensitive teeth have much greater numbers of open tubules per unit area and the average diameter of tubules is almost 2 times greater than tubules in nonsensitive teeth. Mechanisms of dentine hypersensitivity. The most widely accepted theory of how the pain occurs is Brannstroms theory. Etiology Dentine hypersensitivity represents a condition of presumable multifactorial pathology. Two processes are essential for its development: (1) dentin must be exposed through either genetic disturbance, enamel defect (lamellae, tufts and spindles), loss of enamel (erosion, abrasion, attrition, abfraction), gingival recession with rapid loss of cementum and (2) the dentin tubules must be open to both the oral cavity and the pulp. Diagnosis. Diagnostic protocol for this condition consisted of Medical, Dental Dietary, Oral Hygiene History and Intra-oral examinations with air indexing method. Differential Diagnosis: We must take into consideration a number of variables such as: dental caries, cracked tooth, restorative sensitivity, medication sensitivity, bleaching sensitivity and abscessed or non-vital tooth. Conclusion. Dentin hypersensitivity is a problem that bothes many patients. Many conditions share the symptoms of tooth sensitivity so differential diagnosis is essential for suitable treatment or preventive measures.

scholarly journals Prevalence of dentin hypersensitivity in Bihar and Jharkhand- A multicentric study

2021 ◽  
Vol 6 (3) ◽  
pp. 68-73
Author(s):  
Sumit Mohan ◽  
Jyoti Thakur ◽  
Santosh Kumar Verma ◽  
Rima Jaiswal ◽  
Abhishek Verma ◽  
...  
Keyword(s):  
Health Workers ◽  
Age Groups ◽  
Gingival Recession ◽  
Dentin Hypersensitivity ◽  
Multicentric Study ◽  
Female Ratio ◽  
Dentine Hypersensitivity ◽  
Multi Stage ◽  
Study Population ◽  
Sensitive Teeth

Aim: Dentine hypersensitivity is a common oral problem. This pilot study investigated the prevalence of dentine hypersensitivity in the diverse population across four centres of Bihar and Jharkhand.   Materials and Methods: A multi-stage, random sampling method was used to investigate the study population. A total of 5622 subjects were examined at four centres in Bihar and Jharkhand. Subjects were divided into 8 age groups. Participants completed a dentine hypersensitivity questionnaire and underwent clinical examination. The diagnosis of dentine hypersensitivity was confirmed. Gingival recession of sensitive teeth was measured by a Williams periodontal probe.   Results: Among 5622 subjects, 1253 were found to be suffering from dentin hypersensitivity indicating a prevalence of 22.28%. Females were more prone to dentin hypersensitivity with male to female ratio of 1:1.31. While subjects in age group of 50-59 were predominantly affected, the molars and premolars were commonly affected with dentin hypersensitivity.   Conclusion: The prevalence of dentine hypersensitivity in East India was 22.28%, indicating that it is a common condition. For its effective management, public education about the condition and effective treatment of dentine hypersensitivity are required.   Clinical Significance: Assessment of prevalence of hypersensitivity in this demographical location would enable the dental care health workers to devise strategies to educate masses about the prevention and management of this disease  

scholarly journals Clinical Dentin Hypersensitivity: Understanding the Causes and Prescribing a Treatment

2001 ◽  
Vol 2 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Peter L. Jacobsen ◽  
Gretchen Bruce
Keyword(s):  
Treatment Strategies ◽  
Gingival Recession ◽  
Potassium Nitrate ◽  
Nerve Tissue ◽  
Tooth Bleaching ◽  
Hydrodynamic Theory ◽  
Dentin Hypersensitivity ◽  
Dentinal Tubules ◽  
Dental Restorations ◽  
Sensitive Teeth

Abstract Dentin hypersensitivity is a common condition of transient tooth pain associated with a variety of exogenous stimuli. There is substantial variation in the response to such stimuli from one person to another. Except for sensitivity associated with tooth bleaching or other tooth pathology, the clinical cause of dentin hypersensitivity is exposed dentinal tubules as a result of gingival recession and subsequent loss of cementum on root surfaces. The most widely accepted theory of how the pain occurs is Brännström's hydrodynamic theory of dentin hypersensitivity. Dentinal hypersensitivity must be differentiated from other conditions that may cause sensitive teeth prior to treatment. Three principal treatment strategies are used. Dentinal tubules can be covered by gingival grafts or dental restorations. The tubules can be plugged using compounds that can precipitate together into a large enough mass to occlude the tubules. The third strategy is to desensitize the nerve tissue within the tubules using potassium nitrate. Several over-the-counter products are available to patients to treat this condition.

scholarly journals The control of pain due to dentin hypersensitivity in individuals with molar–incisor hypomineralisation: a protocol for a randomised controlled clinical trial

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044653
Author(s):  
Ana Paula Taboada Sobral ◽  
Elaine Marcilio Santos ◽  
Ana Cecilia Aranha ◽  
Paulo Vinícius Soares ◽  
Caroline Moraes Moriyama ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Tooth Enamel ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Dentin Hypersensitivity ◽  
Molar Incisor Hypomineralisation ◽  
Randomised Controlled Clinical Trial ◽  
Sensitive Teeth ◽  
Randomised Controlled ◽  
Incisor Hypomineralisation

IntroductionDentin hypersensitivity (DH) is defined as high sensitivity of the vital dentin when exposed to thermal, chemical or tactile stimuli. Two mechanisms are required for the occurrence of DH: (1) the dentin must be exposed and (2) the dentinal tubules must be open and connected to the pulp. Molar–incisor hypomineralisation (MIH) is a qualitative abnormality of a genetic origin that affects tooth enamel and, in most cases, is accompanied by DH. The control of tooth sensitivity is fundamental to the successful treatment of MIH. The aim of the proposed randomised, controlled, clinical trial is to evaluate the effectiveness of different protocols for the control of DH in patients with teeth affected by MIH.Methods and analysisOne hundred and forty patients who meet the inclusion criteria will be allocated to four groups. Group 1 will be the control group (placebo). In Group 2, sensitive teeth will be sealed with PermaSeal (Ultradent). In Group 3, sensitive teeth will receive low-level laser (LLL, AsGaAl) at a wavelength of 780 nm (Laser XT Therapy, DMC, São Carlos, Brazil). In Group 4, sensitive teeth will be treated with both LLL and PermaSeal (Ultradent). DH will be evaluated 15 min after the application of the treatments and the patients will be reevaluated 1 week, 1 month, 3 months and 6 months after the treatments. The primary outcome of this study is change in pain/sensitivity, when evaluated through a Visual Analogue Scale, to determine the effectiveness of the proposed treatments, as well as differences among the evaluation times for each proposed treatment.Ethics and disseminationThis protocol has been ethically approved by the local medical ethical committee (protocol number: 4.020.261). Results will be submitted to international peer-reviewed journals and presented at international conferences.Trial registration numberNCT04407702.

Detecting and Quantifying Cervical Dentin Hypersensitivity Using Air Indexing Combined with the T-Scan System

2015 ◽  
pp. 429-466 ◽  
Author(s):  
Thomas A. Coleman, DDS
Keyword(s):  
Retrospective Study ◽  
Contact Force ◽  
Clinical Signs ◽  
Applied Force ◽  
Dentin Hypersensitivity ◽  
Occlusal Force ◽  
Occlusal Contact ◽  
Occlusal Adjustment ◽  
Indexing Method ◽  
Analysis System

This chapter introduces the Air Indexing method for detecting and quantifying cervical dentin hypersensitivity as a companion to the T-Scan Occlusal Analysis System, which evaluates occlusal force and timing values of contacting teeth. The chapter discusses detection, diagnosis, and treatment of clinical signs and/or symptoms of Cervical Dentin Hypersensitivity (CDH). A 17-year-long retrospective study conducted between 1979 and 1996 is presented that illustrates the correlation between Cervical Dentin Hypersensitivity and its resolution following occlusal adjustment. Resulting stress from occlusal contact force is etiologic for non-carious cervical lesion formation and root degradation. This chapter details how biocorrosion and lost protective glycoproteins hasten the effects of applied force, creating CDH symptoms and cervical abfractions. Lastly, the Air Indexing method of CDH diagnosis is melded with T-Scan occlusal analysis to diagnose and treat CDH symptoms. Together, these two methods yield more CDH/occlusal insight than either method can alone.

Combining the Air Indexing Method With the T-Scan System to Detect and Quantify Cervical Dentin Hypersensitivity

2020 ◽  
pp. 829-878
Author(s):  
Thomas A. Coleman. DDS
Keyword(s):  
Contact Force ◽  
Case Reports ◽  
Dentin Hypersensitivity ◽  
Cervical Lesions ◽  
Occlusal Contact ◽  
Indexing Method ◽  
Timing Data ◽  
Clinical Benefits ◽  
Analysis System ◽  
Common Clinical Finding

This chapter introduces the air indexing method for detecting and quantifying cervical dentin hypersensitivity (CDH) as a companion to the T-Scan Occlusal Analysis System which evaluates force and timing values for occlusal contacts of teeth. This chapter will also highlight an evidence-based retrospective investigation undertaken between 1979 and 1996 that evaluated associations and/or correlations between diagnosed CDH and its resolution following occlusal adjustment. This retrospective's method described the detection, diagnosis, and treatment of the signs and/or symptoms of the common clinical finding amongst patients with CDH. Stress physics will illustrate how small occlusal contacts magnify the impact that applied occlusal contact force has on the cervical regions of teeth. This resultant cervical stress is etiologic for how non-carious cervical lesions (NCCLs) form and degrade tooth roots. This chapter also explains how biocorrosion from endogenous and exogenous sources produces loss of dentin's protective proteins, glycoproteins, and cementum, which add to the effects of applied occlusal force, thereby creating CDH symptoms and NCCLs. CDH appears resultant from the co-factors of occlusal forces that produce cervical stress, along with biocorrosion, that are both modified by occlusal surface friction. The air indexing method of CDH diagnosis is an objective diagnostic means to detect and quantify CDH symptoms during the formation of cervical lesions. This chapter presents the clinical benefits of melding the T-Scan Occlusal Analysis System with the Air Indexing Method when clinically assessing and treating cervical hard tissue pathologies. The clinician gains significantly more occlusal insight as opposed to using either methodology alone, when air indexing is combined with T-Scan's occlusal contact force and timing data. Lastly, this chapter introduces two case reports of how T-Scan guided occlusal adjustments can be effective at reducing CDH and prohibiting the progression of gingival recession.

Treatment options for deciduous molar hypomineralization: a report of three cases

Dental Update ◽  
2019 ◽  
Vol 46 (6) ◽  
pp. 546-553
Author(s):  
Yasmy Quintero ◽  
Manuel Restrepo ◽  
Jenny Angélica Saldarriaga ◽  
Alexandra Saldarriaga ◽  
Lourdes Santos-Pinto
Keyword(s):  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Treatment Options ◽  
Clinical Implications ◽  
Therapeutic Approaches ◽  
Enamel Defect ◽  
Delayed Treatment ◽  
Molar Incisor Hypomineralization ◽  
Permanent Molars ◽  
Deciduous Molar

Deciduous molar hypomineralization (DMH) is an enamel defect of systemic and multifactorial origin that affects the second deciduous molar. Currently, its treatment is based on guidelines for Molar Incisor Hypomineralization (MIH), a disturbance that affects permanent molars and may or may not be associated with permanent incisors. To date, there are no guidelines for DMH. Therefore, three different therapeutic approaches are presented to treat DMH, emphasizing the relevance of early diagnosis, differential diagnosis and treatment options, and tailored to take into account each patient's and parents' specific needs, as well as the involved tooth, severity of DMH, patients' symptoms and behaviour. CPD/Clinical Relevance: To understand the clinical implications of DMH since the diagnosis and delayed treatment of this enamel alteration could have important complications in both the primary and permanent dentition.

Orthodontic Treatment and Isolated Gingival Recession: A Review

1994 ◽  
Vol 21 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Joyce Lilias McComb
Keyword(s):  
Orthodontic Treatment ◽  
Adult Life ◽  
Gingival Recession ◽  
Root Caries ◽  
Gingival Inflammation ◽  
Dentine Hypersensitivity

Isolated gingival recession may occur in as many as 30 per cent of adolescents, and lead to problems of dentine hypersensitivity, root caries, and gingival inflammation in adult life. This review discusses the prevalence and aetiology of isolated recession, with particular reference to the implications for orthodontic treatment. Consideration is also given to the differing philosophies for management

scholarly journals Di-Calcium Phosphate and Phytosphingosine as an Innovative Acid-Resistant Treatment to Occlude Dentine Tubules

2016 ◽  
Vol 50 (3) ◽  
pp. 303-309 ◽  
Author(s):  
Salvatore Sauro ◽  
Ching-Yang Lin ◽  
Floris J. Bikker ◽  
Giuseppe Cama ◽  
Peter Dubruel ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Calcium Phosphate ◽  
Artificial Saliva ◽  
Permeability Reduction ◽  
Spectroscopy Analysis ◽  
Dentine Hypersensitivity ◽  
Multiple Comparison Test ◽  
Suitable Treatment ◽  
Human Dentine ◽  
Scanning Electron

The present investigation evaluated the ability of an experimental di-calcium phosphate (DCP) desensitising agent used alone or combined with phytosphingosine (PHS) to occlude dentine tubules and resist a citric acid (CA) or artificial saliva (AS) challenge. Three groups of human dentine specimens (DS) were treated with the following: (1) PHS alone, (2) DCP or (3) a combination of PHS and DCP. Dentine hydraulic conductance of DS was evaluated using a digital flow sensor at 6.9 kPa. The average fluid volume for each of the treated DS was used to calculate the total dentine permeability reduction (%P) prior to and following CA immersion for 1 min or AS immersion for 4 weeks. The treated DS were subjected to both scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy analysis. Statistically significant differences (%P) were identified between the groups by ANOVA and Fisher's multiple comparison test (p < 0.05), respectively. Interestingly, both PHS and DCP appeared to work synergistically. DS treated with DCP or PHS/DCP demonstrated a significant reduction (%P) prior to and following CA or AS challenge (p < 0.05). Both the SEM and FTIR analyses showed consistent brushite crystals occluding the dentine tubules. Conversely, the application of PHS alone failed to demonstrate any significant reduction of dentine permeability (p > 0.05) or show any evidence of occlusion of the dentine tubules. DCP can be used alone or combined with PHS to decrease the dentine permeability as well as to resist a CA and AS challenge. These results would, therefore, suggest that DCP may be a suitable treatment option for dentine hypersensitivity.

scholarly journals Features of electric and viscoelastic parameters of erythrocytes in patients with inflammatory intestinal diseases

2021 ◽  
Vol 1 (5) ◽  
pp. 19-30
Author(s):  
M. V. Kruchinina ◽  
I. O. Svetlova ◽  
A. V. Azgaldyan ◽  
M. F. Osipenko ◽  
E. Yu. Valuiskikh ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Differential Diagnosis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Average Diameter ◽  
Acute Stage ◽  
Viscoelastic Parameters ◽  
Surface Character

The aim of this work is to study the features of the electrical and viscoelastic parameters of erythrocytes in patients with inflammatory bowel diseases (ulcerative colitis, Crohn’s disease, unclassified colitis), taking into account the stage of the disease for possible use in differential diagnosis.The electrical and viscoelastic parameters of erythrocytes were studied using dielectrophoresis in 109 patients with IBD, mean age 37,7 + 11,7 years (50 patients with ulcerative colitis (UC), 41 with Crohn’s disease (CD), 18 with unclassified colitis (UCC) and 53 conditionally healthy, comparable in age and sex with the main groups.Red blood cells of individuals with IBD differed from those in the comparison group by a smaller average diameter, an increased proportion of deformed, spherocytic cells with a changed surface character with a reduced ability to deform, a lower level of surface charge of cells, an altered membrane structure with an increased ability to conduct electric current, prone to destruction and the formation of aggregates (p <0,0001–0,05).Analysis in individual groups with IBD in the acute stage, taking into account the therapy, revealed significant differences between the forms of IBD: in patients with Crohn’s disease, in contrast to patients with UC, red blood cells had lower values of the amplitude of deformation, capacity, dipole moment, and velocity of movement of cells towards electrodes, the proportion of discocytes, polarizability at most of the frequencies of the electric field (p <0,00001–0,05). On the contrary, the summarized indicators of rigidity, viscosity, electrical conductivity, aggregation and destruction indices were higher in CD than in UC (p <0,0001–0,05). CD patients had a greater number of deformed cells with altered surface character (p <0,00001).The features of the electrical and viscoelastic parameters of erythrocytes in patients with differentnosological forms of IBD can be used for the differential diagnosis of ulcerative colitis and Crohn’s disease in case of colon lesions, in the long term — for verification of the diagnosis in unclassified colitis.

A User-oriented Approach to Decision Making in Differential Diagnosis and Therapeutic Advice

1986 ◽  
Vol 25 (04) ◽  
pp. 199-206 ◽  
Author(s):  
N.G. Rao ◽  
B.E. Prasad ◽  
S.K. Guha ◽  
P.G. Reddy
Keyword(s):  
Differential Diagnosis ◽  
Expert System ◽  
Computer Assisted ◽  
Medical Expert ◽  
Simple Method ◽  
Natural Behaviour ◽  
Suitable Treatment ◽  
Methods Of Treatment ◽  
And Training ◽  
Selection Of

SummaryA search for a user-oriented, computer-assisted expert system resulted in a simple method of simulation of a human consultant’s thinking and action. Making a quick decision in differential diagnosis and selection of the proper line of treatment when faced with a problematic patient has always been a challenging task for clinicians, especially those working in emergency wards, intensive care wards and acute wards. Consulting a vast memory of a number of past cases of a similar nature is near to the natural behaviour of a medical expert and well acceptable to most of the users and patients alike. In this method, the case details of an undiagnosed fresh patient are compared with the details of similar cases diagnosed and treated earlier by experienced consultants and stored in the computer memory. These old cases with confirmed final diagnoses, proven methods of treatment and correctly recorded outcomes enable the system to arrive at the most likely diagnosis, the next likely diagnosis and the most suitable treatment for the new case.A check facility to ensure the accuracy of the decisions made by MEMCONSULT through comparison with a textbook description and any particular old case in the memory has been added in view of the education and training of newcomers in the field of medicine. A self revising capability depending on the changed clinical condition of the patient is also implemented to suit the basic requirements of an ideal expert system in medicine.

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