Risk of Postoperative Sensitivity and Pulpal Complications in Respect of: Amount of Reduction, Temporization, Cement Type

Fixed partial dentures (FPDs) made of metal ceramic are a popular treatment option for missing teeth. Studies have shown that posterior abutments of FPDs had a higher pulp survival rate than anterior abutments. Postoperative sensitivity following the cementation of a fixed prosthesis is a frequent symptom, especially when the abutments include important pulp. Dentinal hypersensitivity affects between 4 and 74 percent of people. Females are found to have a somewhat greater DH incidence than males. While DH can affect individuals of any age, there have been several theories on what causes abutment sensitivity after tooth preparation and cementation. In this review we included some of it. Also, we discussed methods of management of postoperative sensitivity and Management of fractured abutment screw.

Review on Theobromine: An Alternative to Fluorides in Treating Dentinal Hypersensitivity

Theobromine is a unique constituent that can help dentistry and general health in the future. The generic name of theobroma is obtained from two Greek words i.e., Theo and Broma, which means “food of the gods". It can be found in cocoa beans and chocolates. Theodent toothpaste harness the power of cocoa. Rennou, the main component in Theodent, is a unique compound that combines theobromine, calcium, and phosphate to enhance enamel remineralization. This article is to review the effectiveness of theobromine in blocking dentinal tubules by preventing dentinal hypersensitivity, and its positive effects on general health. Various researches and valid documents were reviewed by us. Several studies have been conducted that shows theobromine is effective in blocking dentinal tubules, thus preventing dentinal hypersensitivity as well as tooth demineralization. It also has other general health benefits. Because of its potent vasodilation, diuretic and heart stimulant effect, theobromine can also be used in treating high blood pressure. It also aids in opening of airways and helps in preventing kidney stones. The use of fluoride dentifrices is debatable, as it has many detrimental effects. Also, we consider that theobromine if used as a component in dentifrices, if unintentionally swallowed, cause no catastrophic effects.

An Update on Dentinal Hypersensitivity - Aetiology to Management – A Review

BACKGROUND Dentinal hypersensitivity is a common clinical disease that occurs as a result of dentin exposure. Though the term dentin hypersensitivity and dentin sensitivity is used interchangeably, dentin hypersensitivity is an exaggerated form of dentinal sensitivity which arises due to localized pulpal inflammation, pulpal nerve sprouting, and development of inflammatory sodium channels. It is characterised by short sharp pain emerging from exposed dentinal tubules in reaction to various stimuli. Such dentin exposure could be due to either enamel loss or cemental loss. This is followed by removal of smear layer by mechanical or chemical means. At present, the hydrodynamic theory, which describes fluid movement in response to stimuli within exposed dentinal tubules, is a commonly recognized explanation for dentin hypersensitivity. It is more common in premolars and canines, and it affects the facial surfaces of the teeth towards the cervical aspect. Studies suggested microscopic changes in the structure of sensitive dentin compared with normal dentin. The diagnosis of dentinal hypersensitivity requires careful clinical examination and eliciting the response using various stimuli. Dentinal hypersensitivity is usually managed by the use of physical or chemical agents. They work either by disturbing the neural response to pain stimulus or block fluid flow by occluding the tubule. The desirable features of a desensitising agent include the ability to give instant and longlasting pain relief, being simple to use, well accepted, not harmful to the pulp. It is recommended that the desensitizing agent is used for at least two weeks. Some of the newer agents used for management includes CPP-ACP, proarginine, nanomaterials, herbal products, propolis etc. In cases where there is tooth structure loss, appropriate restorative material is used to cover the exposed dentin. Root canal therapy is considered the last resort for pain relief after all other options have failed to provide relief. The present article outlines the etiopathogenesis, risk factors, diagnosis, prevention and treatment of dentinal hypersensitivity. KEY WORDS Dentinal Hypersensitivity; Dentin Sensitivity; Desensitizing Agents; Iontophoresis

Evaluation and comparision of the clinical effectiveness of diode laser and Gluma as desensitizing agents in the treatment of dentinal hypersensitivity

Dentin hypersensitivity is one of the most common presenting symptoms in dental practice. It may range from mild discomfort to severe pain affecting the person. Laser desensitization has been introduced as a useful tool for the treatment of hypersensitivity. Gluma Dentin Bond is an adhesive system, where the primer contains 5% glutaraldehyde and 35% hydroxyethyl methacrylate. Practitioners have reported a strong desensitizing effect of the Gluma® system on dentin The aim of this study is to evaluate and compare the clinical effectiveness of Diode laser and Gluma ®desensitizing agent in the treatment of dentin hypersensitivity. 24 patients aged between 20 and 50 years was included to assess tooth sensitivity, a controlled air stimulus (evaporative stimulus) was used. Sensitivity was measured using a 10-cm Visual Aanalog Scale (VAS) score. The teeth was randomly allocated to two groups i.e., Group I or II using the lottery method. Gluma® showed a statistically significant reduction in the VAS score as compared to diode laser 1, 2- and 4-weeks follow-up period (p < 0.05). The result of the present investigation revealed that application of Gluma® resulted in better control dentin hypersensitivity as compared to diode laser.

Silver diamine fluoride - Magic alternative in caries management: A review

Silver diamine fluoride (SDF) is a clear and odorless liquid used for dentinal hypersensitivity and arresting caries unless there’s no pulpal involvement for all age groups across all countries. Discoveries let us change old paradigms with the new ones. SDF being cleared for commercial use now can help in achieving the all-time goal of caries prevention. Various studies have established that options like potassium iodide and different restorations can help mask the staining problem of SDF. This can restore form and function as well for the teeth. With the unimaginable COVID 19 situation, dentistry has realized the importance of minimally invasive interventions than ever before. SDF is a blessing in such challenging times and it may be the magical alternative to caries management in the future.

Efficacy of an occluding toothpaste on dentinal hypersensitivity over 14 days

Objectives: To evaluate a 0.454% stannous fluoride/5% sodium tripolyphosphate (STP) toothpaste’s ability to provide relief from dentinal hypersensitivity (DH) applied using ‘focused brushing.’ Materials and methods: In two randomised, examiner-blind, parallel-group studies, a SnF2/STP toothpaste was applied by brushing two selected sensitive teeth before 1 min whole-mouth brushing, compared to 1 min whole-mouth brushing only, with a negative control toothpaste. DH was assessed via evaporative (air) (Schiff scale) and tactile (Yeaple probe) stimuli after 7 and 14 d of twice-daily brushing. Results: In total, 141 (Study 1)/142 (Study 2) participants were randomised. In Study 1, the test treatment significantly reduced DH at 7/14 d versus baseline (7/14 d Schiff difference: −0.74 [−0.84,−0.65]/−1.39 [−1.54,−1.23]; tactile: 6.00 [4.88,7.13]/15.30 [13.34,17.26]); whereas the Control treatment did not (7/14 d Schiff difference −0.03 [−0.13,0.06]/−0.10 [−0.25,0.06]; tactile: 0.77 [−0.36,1.90]/0.77 [−1.20,2.74]). Differences between Test and Control were statistically significant (p < 0.0001 all cases). In Study 2, both treatments reduced DH compared to baseline by both measures, but there were no significant between-treatment differences. Toothpastes were generally well-tolerated. Discussion and conclusions: Previous studies and Study 1 support SnF2/5% STP toothpaste efficacy; Study 2 results may have been influenced by placebo/Hawthorne effects. DH study design needs to, where possible, negate such effects.