“COMPARATIVE EVALUATION OF EFFECT ON DENTINAL TUBULE OCCLUSION BY THREE DIFFERENT DESENSITIZING DENTIFICES: A SEM STUDY”

Introduction: Dentine hypersensitivity (DH) occurs on exposed dentine and is dependent on the patency of dentinal tubules. This study compared the effectiveness of toothpaste containing Strontium Chloride, Novamine, Pro-Arginine in occluding dentine tubules along with comparision of those. Materials and Method: 45 freshly extracted teeth were randomly divided (15 each) into 3 groups: Group 1 15 Teeth treated with toothpaste containing Strontium Chloride. Group 2 15 Teeth treated with toothpaste containing Novamine Group 3 15 Teeth treated with toothpaste containing Pro-Arginine. Each specimen was brushed with the dentifrice slurries and examined under SCM. Result: The mean of occluded dentinal tubules on the dentin surface after brushing with three dentifrices were significant among them Pro-arginine group showed maximum occlusion. Conclusion: The present in vitro SEM study results revealed that: All the experimental agents– Strontium chloride, novamin, Pro- Argenine were effective in occluding dentinal tubules & the percentage (%) of occluded tubules was found to be highest for Pro- Argenine as compared to the other groups. Keywords: SCM, DH

Knowledge of Brazilian dentists and students in treating dentine hypersensitivity

Objective: To evaluate knowledge of undergraduates and qualified dentists from a Brazilian Dental School in treating Dentine Hypersensitivity (DH). Methodology: Data obtained from a 22-item questionnaire were analysed and arranged in distribution figures. Results: Of 100 respondents, 66.3% indicated that up to 25% of their patients had DH; 41.7%, that the duration of discomfort was up to eight weeks; 78.4%, that they examined a patient with DH within the last two-four weeks; and 70.4%, that this was done after the patient initiated the conversation on DH. Most of participants responded DH affects patients’ quality of life, and its aetiology was attrition, exposed dentine, occlusal interference, gingival recession or abrasion. The most common ways to diagnose DH were sensitivity history analysis, clinical examination, clinical testing and probing; and conflicting conditions were fractured restoration, bleaching sensitivity, marginal leakage, chipped tooth and periodontal disease. Furthermore, 82.5% and 78.7% of respondents indicated they were confident in diagnosing DH and providing advice to patients, but only 38.8% identified hydrodynamic theory as its underlying mechanism. To evaluate pain from DH they considered self-assessment, dental examination, dietary analysis and thermal assessment; and as recommendations, the use of desensitizing dentifrices, education on toothbrushing, in-office application of desensitizing products, and restorations. Conclusion: There is still confusion concerning the aetiology, the diagnosis and the subsequent management of DH, and both students and qualified dentists need better education.

A Potassium Based Fluorine Containing Bioactive Glass for Use as a Desensitizing Toothpaste

Potassium releasing bioactive glasses (BAGs) may offer improved relief for dentine hypersensitivity compared to conventional sodium containing BAGs by releasing K+ ions for nerve desensitization and occluding dentinal tubules to prevent fluid flow within dentinal tubules. Potassium oxide was substituted for sodium oxide on a molar basis in a fluoride containing BAG used in toothpastes for treating dentine hypersensitivity. The BAG powders were then immersed in an artificial saliva at pH 7 and tris buffer and the pH rise and ion release behavior were characterized by ICP-OES and ISE. The potassium and sodium containing BAGs were characterized by XRD, DSC, FTIR and NMR. Both BAGs presented amorphous diffraction patterns and the glass transition temperature of the potassium glass was higher than that of the sodium glass. The 31P MAS-NMR spectra indicated a peak at 2.7 ppm corresponding to apatite and a small peak at −103 ppm indicated crystallization to fluorapatite. Both BAGs dissolved and formed apatite at similar rates, although the dissolution of the potassium glass was slightly slower and it released less fluoride as a result of partial nanocrystallization to fluorapatite upon quenching. The potassium release from the potassium ions could potentially result in nerve deactivation when used in toothpastes.

Comparison between effectiveness of dentine desensitizer and one bottle self-etch adhesive on dentine hypersensitivity

BACKGROUND: Dentine hypersensitivity is one of the most common chief complaints of patients observed by dentists in their practice. However, there is lack of universal consensus over the selection of reliable treatment modality. OBJECTIVES: To compare the effectiveness between dentine desensitizer and self-etch adhesive in patients complaining of moderate to severe dentine hypersensitivity pain. METHODS: A total 254 patients were randomly divided into Group A (Single Bond Universal Agent) and Group B (Seal & Protect Agent) according to the treatment provided. Sensitivity was assessed by means of mechanical (probing) and evaporative (air blast) stimuli. Discomfort Internal Scale (DIS) was explained to patients. DIS scores were recorded after one minute and one month following the application of both agents. Descriptive statistics were calculated. Stratification was done to control confounder and post stratification chi-square test was also applied. RESULT: The statistically significant difference (p= 0.000) in effectiveness between the two groups was observed. The mean discomfort internal scale score at baseline, after 1 minute and after 1 month in Group A was 3.65 ± 0.60, 2.33 ± 0.64 and 0.41 ± 0.71 respectively, while in Group B, it was 3.55 ± 0.58, 2.40 ± 0.62 and 0.72 ± 0.92 respectively. Overall, 86.6% patients observed improvement in dentinal sensitivity in Group A while in Group B only 67.7% patients reported reduction in sensitivity. CONCLUSION: Self-etch adhesive significantly reduces dentin hypersensitivity, immediately after one minute of its application and is effective for a period of one month when compared to desensitizing agent.

An unusual endodontic complication following crown lengthening surgery: A Case Report.

A gummy smile is a form of excessive gingival display when smiling. The excessive gingival display due to altered eruption is likely to benefit from crown lengthening surgery in order to restore the esthetic smile. Case Report: The potential complications of the crown lengthening surgery include possible esthetic deformities, dentine hypersensitivity, transient mobility, and root resorption. The present case report reveals a rare complication happened after an esthetic crown lengthening surgery which was performed to correct the gummy smile of a 37-year-old female. The patient experienced dull throbbing pain and mild tender to percussion on tooth 11, 3 weeks after the surgery, and the symptoms did not improve after the composite restorations were placed at the cervical regions. Instead, the tooth was tender to percussion and palpation with a sign of coronal discoloration. Pulp necrosis was confirmed with the clinical tests. A cone-beam computed tomography was taken after the root canal treatment, and apical fenestration on tooth 11 was noted. Therefore, this case report shows the possible correlation between crown lengthening surgery on a tooth with apical fenestration and pulp necrosis, if the apical vasculature is severed accidentally during the procedure. Conclusion: A cone-beam computed tomography should be considered prior to the surgery and extra precaution during the surgery may reduce the risk of severing the apical vasculature if apical fenestration is evidenced.

Is there a role for casein phosphopeptide–amorphous calcium phosphate (cpp-acp) in paediatric dentistry?

In the age of minimally invasive dentistry, products with the ability to prevent and reverse common dental diseases are becoming increasingly popular. Casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) contains the compounds casein, phosphate and calcium, which all have the ability to remineralize enamel. Dental caries, visible demineralization following removal of orthodontic appliances, non-carious tooth surface loss and dentine hypersensitivity due to structural anomalies are frequently seen in children and young people. The evidence for CPP–ACP and fluoride-containing CPP–ACP is positive for managing dental caries and non-carious tooth surface loss, specifically erosion, but is less clear in the management of visible demineralization following orthodontic appliance removal and dentine hypersensitivity owing to structural anomalies. When recommending CPP–ACP-containing products, dental practitioners should be aware of medical and social contra-indications that preclude its use. CPD/Clinical Relevance: CPP–ACP may have a role in the management of common paediatric dental conditions.