Dentine hypersensitivity

Treatment of cervical dentin hypersensitivity using neodymium: Yttrium-aluminum-garnet laser. Clinical evaluation

BACKGROUND AND OBJECTIVE

The incidence of cervical dentinal hypersensitivity is related to the high number of non-carious cervical lesions. This clinical research was developed in order to evaluate the Nd:YAG laser treatment of cervical dentin hypersensitivity after attempting the removal and control of etiologic factor after two different stimuli.

STUDY DESIGN/MATERIALS AND METHODS

Twenty patients participated in this study in a total of 145 teeth, where 104 received the Nd:YAG laser treatment and 41 remained as control.

RESULTS

The results showed that there was statistically significant reduction of hypersensitivity as for the groups that received the treatment with Nd:YAG laser, as for the control teeth. However, the reduction of cervical dentinal hypersensitivity was statistically greater when there was the association of the removal of etiologic factors with the application of Nd:YAG laser.

CONCLUSIONS

We concluded that the laser irradiation was effective in the treatment of cervical dentin hypersensitivity after 6 months.

Evaluation of ferric oxalate as an agent for use during surgery to prevent post-operative root hypersensitivity

The aim of this study was to evaluate the effectiveness of a 6% ferric oxalate solution applied during periodontal surgery to prevent post-operative tooth hypersensitivity. Twenty-five adult patients with similar bilateral periodontal defects participated in this study. Data were collected at baseline (1 week prior to surgery) and 1, 2, 4, and 6 weeks following surgery. Sensitivity level was determined using the visual analog scale (VAS) with the following stimuli: 1) mechanical stimulation with a No. 23 dental explorer; 2) water at 50 degrees C; 3) ice; and 4) electric pulp tester (EPT). Teeth were randomly assigned to either test (6% ferric oxalate in 0.9% saline) or control (0.9% saline) groups. Solutions were applied to the exposed root surfaces for 1 minute during surgery. Data were analyzed by repeated measures ANOVA, paired t-test, and Pearson's correlation test. Results from this study demonstrated statistically significant reduction in the responses to thermal stimuli, especially cold, between groups treated with ferric oxalate as compared to those treated with saline. For the cold test the difference increased with time from baseline to 6 weeks. Statistically significant (P < 0.05) differences in sensitivity to heat between groups were also observed, but only at 2 and 4 weeks following surgery. There were no differences at any time period between the test and control groups when tactile or EPT techniques were used. In addition, there was no correlation between sensitivity and other clinical parameters. It was concluded from this study that 6% ferric oxalate was effective in reducing post-surgical cold sensitivity when applied during periodontal surgical procedures.

Assessment of pain in cervical dentinal sensitivity studies. A review

Traditionally cervical dentinal sensitivity (CDS) has been evaluated mainly subjectively on the basis of the individual patient's subjective response, e.g., in the form of verbal rating and visual analogue scales and questionnaires. The stimuli used for evaluating this response can be grouped into 4 main categories: mechanical, chemical, electrical and thermal. This review of the literature, however, indicates that there are problems in evaluating patient subjective response to these various test stimuli used in the assessment and treatment of CDS. Opinions also vary as to the reliability of some of these methods of assessment, although recently, efforts have been made to develop controlled reproducible stimuli more suited to the evaluation of CDS. Currently no single method of eliciting and assessing CDS may be considered ideal. Further research is required to evaluate suitable methodology for the quantification of realistic test stimuli under controlled clinical conditions, whereby the subjective response may be objectively measured by the investigator.

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.