Impact of repeated preheating of bulk-fill resin composite on postoperative hypersensitivity; a randomized controlled clinical trial.

BACKGROUND: This clinical study was conducted aiming to evaluate the impact of repeated preheating of bulk-fill resin composite on postoperative hypersensitivity. METHODS: A total of 105 eligible, consenting adults were recruited. Patients had posterior teeth suffering from proximal decay with no signs of irreversible pulpitis. Patients were prepared for Class II restorations and restored with bulk-fill resin composite. Patients were randomized into three groups of 35 patients according to the number of preheating cycles for the resin composite syringe used; group I: no preheating; control group at room temperature, group II: Resin composite preheated once, and group III: Resin composite preheated ten cycles. Patients were assessed for postoperative dentin hypersensitivity using the visual analogue scale (VAS) at three-time intervals: day one, one week and by the end of one month after restorative treatment. Statistical analysis was performed; ANOVA with a single factor was used to test for significance at a p value ≤ 0.05. For nonparametric data, the Kruskal‒Wallis test was used to compare the three testing groups. Friedman's test was used to study the changes within each group. Dunn's test was used for pairwise comparisons when the Kruskal‒Wallis test or Friedman's test was significant. RESULTS: The scores of the three groups through the three time intervals were almost zero except for the first day where VAS scores were recorded with maximum score of 3 for groups I and II. Groups II and III; there was no statistically significant change in hypersensitivity scores by time with P-values 0.135 and 0.368, respectively. However, for group I there was a significant difference from VAS score recorded on first day and the two following time intervals. CONCLUSION: The repeated preheating cycles of bulk-fill resin composite prior to curing had no adverse effect on the patients regarding postoperative dentin hypersensitivity. This information could be of utmost significance, as the same resin composite syringe can undergo numerous preheating cycles clinically before it is completely consumed with the advantage of improvement on the handling properties. TRIAL REGISTRATION: The protocol of the current study was registered at www. CLINICALTRIALS: gov , with the identification number NCT05289479 on 21/03/2022. All procedures involving human participants were performed in accordance with the ethical standards of the Research Ethics Committee of the Faculty of Dentistry, Minia University, Egypt, under the approval number 73/440 on 11/09/2020.

Prevalence of dentin hypersensitivity after orthodontic treatment: A cross-sectional study.

INTRODUCTION: The prevalence of cervical dentin hypersensitivity in patients after corrective orthodontic treatment has been poorly studied, although such hypersensitivity is very common. This study aimed to assess the prevalence of dentin hypersensitivity in patients who received corrective orthodontic treatment, the impact of general oral problems on quality of life, and the impact of hypersensitivity on the quality of life of this population. METHODS: This observational, cross-sectional study evaluated 232 patients who finished orthodontic treatment between 2000 and 2020 for self-reported hypersensitivity and clinically diagnosed hypersensitivity. The following tests were used: tactile, evaporative (bellows), evaporative (triple syringe), and thermal. The patients were also evaluated regarding their quality of life using questionnaires (Oral Health Impact Profile-14 and Dentine Hypersensitivity Experience Questionnaire). We evaluated data with nonparametric statistics. RESULTS: The prevalence of hypersensitivity was higher in women and in those aged <30 years; the most affected teeth were the mandibular incisors and premolars; different diagnostic tests for hypersensitivity may indicate different prevalence values; patients with hypersensitivity had a lower quality of life in most of the domains of both of the tests that were used. CONCLUSIONS: The prevalence of hypersensitivity among patients after orthodontic treatment may be higher than in the general population. Further investigation is needed to indicate the possible factors associated with orthodontic tooth movement.

The prevalence and predictive factors of dentine hypersensitivity among adults in Turkey.

AIM: This study sought to determine the prevalence of dentine hypersensitivity (DH) among adults in Turkey. Also, to ascertain the association between DH and both etiological predictors and demographic patient characteristics. MATERIAL METHOD: Using a questionnaire and thermal and evaporative tests, 259 women and 209 men in the age range of 18 to 72 were analyzed. Individually, a clinical evaluation of DH signs was conducted. The DMFT index, gingival index, and gingival bleeding were reported for each subject. The gingival recession and tooth wear of sensitive teeth were also evaluated. Pearson Chi-square test was used to compare categorical data. Logistic Regression Analysis was used to examine the risk factors of DH. Data with dependent categorical variables were compared using the McNemar-Browker test. The significance level was p < 0.05. RESULTS: The average age of the population was 35.6 years. In the present study, a total of 12,048 teeth were analyzed. 1755 had thermal hypersensitivity (14.57%), while 470 experienced evaporative hypersensitivity (3.9%). The incisors were the teeth most impacted by DH, whereas the molars were the least affected. Exposure to cold air and sweet foods, gingival recession, and the presence of noncarious cervical lesions were all strongly linked to DH (Logistic regression analysis, p < 0.05). The cold stimulus increases sensitivity more than the evaporation stimulus. CONCLUSION: Significant risk factors for both thermal and evaporative DH include cold air, consumption of sweet food, presence of noncarious cervical lesions, and gingival recession. More epidemiological research in this area is still required to fully characterize the risk factors and implement the most effective preventive interventions.

The prevalence, clinical features, and related factors of dentin hypersensitivity in the Turkish population.

OBJECTIVES: The purpose of this study was to identify the prevalence and predisposing and etiologic factors of dentin hypersensitivity (DH), as well as the demographic characteristics of patients. MATERIALS AND METHODS: The 1210 patients were examined. The research was based on a two-step investigation: questionnaire and clinical examination. DH was evaluated by the response of the patient to tactile and air-blast stimuli. Loss of attachment and gingival recession of sensitive teeth was measured on the buccal and lingual surfaces. Also, the tooth wear of sensitive teeth was graded on the buccal and lingual surfaces. Comparisons of nonnormally distributed continuous variables were performed using the Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance (ANOVA) and Dunn's post hoc test. Comparisons of categorical variables were performed using Pearson's chi-square, Fisher's exact chi-square, Yates's chi-square, and the Monte Carlo chi-square test. RESULTS: One hundred twenty-four patients reported DH, showing a prevalence for self-reported DH of 10.2%. Eight hundred forty teeth were diagnosed as having DH, giving a clinical diagnosis rate of DH of 29.4%. Females (76.8%), the 31-40 years age group (26%), housewives (36.8%), and high school education level (38%) had the highest prevalence of DH as demographic properties. A cold stimulus was the most common stimuli trigger for hypersensitivity (97.1%). Occasional pain (55.5%) showed the highest prevalence in terms of frequency of DH. A higher rate of DH was found with the use of medium brushes (47.4%) and brushing twice per day (59.4%) for 1-2 min (56.2%) with the circular method (33.8%) as oral hygiene habits. The buccal surface of the lower right central incisors (5.7%) had the highest prevalence. The most affected teeth by DH were incisors (38.4%). The buccal surfaces (86.3%) of teeth showed a higher high prevalence of DH compared with the lingual surface (52.7%), similar to gingival recession (40.9% vs. 15.7%) and loss of attachment (68.3% vs. 42.6%). CONCLUSIONS: Clinically diagnosed DH was more common than self-reported DH. Some factors related to patients such as sex (female), the 31-40 years age group, housewives, high school students, using medium brushes, brushing twice per day, and the circular brushing method were more likely to have a risk for DH. Also, buccal surfaces of teeth, gingival recession, and loss of attachment on the buccal surface of teeth should be considered as predisposing factors for DH. CLINICAL RELEVANCE: To control and prevent DH, clinicians should consider patients' demographics, predisposing factors, and etiologic factors.

[An integrated approach to reducing hyperesthesia of teeth in patients with underlying somatic pathology]. / Kompleksnyi podkhod v reabilitatsii patsientov s giperesteziei tverdykh tkanei zubov na fone somaticheskikh zabolevanii.

THE AIM OF THE STUDY: Was to analyze the effectiveness of therapeutic and preventive measures aimed at reducing hyperesthesia of hard dental tissues in patients with background somatic diseases. MATERIALS AND METHODS: The study involved 113 patients with increased tooth sensitivity and treated in the gastroenterological and endocrinological departments of the S.M. Kirov City Clinical Hospital No.3¼ in Astrakhan in the period from 2018 to 2021 at the age of 26-43 years. The main group included 52 patients with confirmed diagnoses of gastric and duodenal ulcer, pancreatitis and type II diabetes mellitus who were treated for dental hyperesthesia with an integrated approach. The control group included 61 patients with periodontal disease without background somatic pathologies in whom hyperesthesia was treated by remineralizing therapy. The effectiveness of the treatment was determined in dynamics on the 10th and 40th days of treatment using OHI-S, PMA indices, dental hypersensitivity prevalence (DHP), dental hypersensitivity intensity (DHI), Dental Sensitivity Index (DSI), Efficacy of Dental Sensitivity Index (EDSI). In addition, the pH of saliva, the activity of lysozyme and S-IgA, and the levels of cytokines IL-1ß, IL-4, IL-6, and IL-8 were determined. RESULTS: The average value of OHI-S in the main group on the 10th day of treatment decreased from 2.25±0.12 (poor level of hygiene) to 1.47±0.09 (satisfactory level). The PMA index in the main group also tended to decrease from 32.1±1.44% (moderate degree of gingivitis) to 20.5±2.08% (mild degree) on the 10th day of treatment. The average values of DPH, DPI, EDSI and DSI in the main group had a noticeable decrease already on the 10th day from the start of treatment (from 12.3±1.66% to 2.1±1.22%; from 2.5±0.48 to 1.2±0.16; from 48.3±1.14% to 40.8±1.71%; from 42.1±2.07% to 20.8±1, 65% respectively). In the main group on the 10th and 40th day of treatment the pH values of non-stimulated and stimulated saliva stabilized (from 4.61±0.12 to 6.94±0.07 and from 5.47±0.21 to 7.42±0.24, respectively), the activity of lysozyme increased (from 45.97±1.46% to 55.19±0.96%) alongside with secretory IgA (from 0.17±0.02 to 0.33±0.21 mg/ml). Also, indicators of cytokines IL-1ß, IL-4, IL-6, IL-8 tended to improve. The analysis of the control group revealed persistent mean values that did not yield to significant changes either in the course of treatment. CONCLUSION: Thus, in patients of the main group, the results obtained indicate an improvement in the dental status and activation of cytokine regulation, providing a combination of active components of the mineral complex. In controls the method of remineralizing therapy for tooth hyperesthesia alleviated dental hypersensitivity, but without significant improvement of the laboratory results.

Effect of 940 nm laser diode irradiation prior to bonding procedure on postoperative sensitivity following class II composite restorations: a split-mouth randomized clinical trial.

The aim of this study was to evaluate the effect of 940 nm laser diode on class II composite cavities prior to bonding and restoration process on the postoperative sensitivity (POS). Thirty patients with two bilateral premolars with mesio or disto-occlusal carious lesions were evaluated. In each patient, the teeth were randomly divided into the control and laser groups. After cavity preparation and isolation and before the bonding process, the laser group was subjected to 940 nm irradiation (Epic 10, Biolase, USA) by 400 µ tip continuously at 100 mW with 398 J/cm2 energy density of tip, which was applied for 5 s at a distance of 2 mm on the axial wall of the cavity. In the control group, irradiation was performed by using the aiming beam. Access cavity was then restored with a composite resin. Cold sensitivity was measured using a cold spray application on the middle third of teeth buccal surface at baseline (before the intervention), 1, 14, and 30 days after the restoration by visual analog scale (VAS) criteria. The mean Friedman and Wilcoxon signed-rank tests were used for data analysis. It was shown that in both laser and control groups, the VAS was significantly decreased at all times compared to the baseline (p ≤ 0.05). There was no statistically significant difference between the mean VAS of two groups at baseline and first day (p ≤ 0.05), but at 14 and 30 days after the intervention, it was significantly lower in the laser group (p ≤ 0.05). The results of this study demonstrated that the cavity pretreatment with laser diode (940 nm) effectively reduces the postoperative sensitivity in class II composite restorations.

Bleaching-induced tooth sensitivity with application of a desensitizing gel before and after in-office bleaching: a triple-blind randomized clinical trial.

OBJECTIVES: This randomized triple-blind clinical trial, split-mouth design, evaluated the application effect of the desensitizing gel before and after in-office bleaching on tooth sensitivity. MATERIALS AND METHODS: In one group, the desensitizing gel was applied for 10 min before the bleaching with 35% hydrogen peroxide, and then application of placebo gel after (n = 90). In the other group, the desensitizing gel was applied before and after the bleaching procedure for 10 min (n = 90). The primary outcome was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a shade guides. RESULTS: The proportion of patients that experienced pain in the side of before application was 90% (95% CI 82 to 94.6%), while the side of before and after was 93% (95% CI 86.2 to 96.9%), without significant difference between groups (OR = 0.25; 95% CI 0.005 to 2.52; p = 0.37). Pain was correlated in both groups, for the NRS scale (p < 0.0001) and the VAS scale (p < 0.0001) in all assessment periods. Significant whitening was detected, and no significant difference of color change was observed between groups (p > 0.45). CONCLUSIONS: The application of the desensitizing agent did not influence the effectiveness of bleaching, but it was not efficient in reducing the sensitivity, when applied before the procedure, or before and after. CLINICAL RELEVANCE: The use of a desensitizing gel before or after in-office bleaching does not reduce incidence or intensity of tooth sensitivity.

Dental cavity liners for Class I and Class II resin-based composite restorations.

BACKGROUND: Resin-based composite (RBC) is currently accepted as a viable material for the restoration of caries for posterior permanent teeth requiring surgical treatment. Despite the fact that the thermal conductivity of the RBC restorative material closely approximates that of natural tooth structure, postoperative hypersensitivity is sometimes still an issue. Dental cavity liners have historically been used to protect the pulp from the toxic effects of some dental restorative materials and to prevent the pain of thermal conductivity by placing an insulating layer between restorative material and the remaining tooth structure. This is an update of the Cochrane Review first published in 2016. OBJECTIVES: The objective of this review was to assess the effects of using dental cavity liners in the placement of Class I and Class II resin-based composite posterior restorations in permanent teeth in children and adults. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 12 November 2018), the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 10) in the Cochrane Library (searched 12 November 2018), MEDLINE Ovid (1946 to 12 November 2018), Embase Ovid (1980 to 12 November 2018) and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 12 November 2018). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomized controlled trials assessing the effects of the use of liners under Class I and Class II posterior resin-based composite restorations in permanent teeth (in both adults and children). We included both parallel and split-mouth designs. DATA COLLECTION AND ANALYSIS: We utilized standard methodological procedures prescribed by Cochrane for data collection and analysis. Two review authors screened the search results and assessed the eligibility of studies for inclusion against the review inclusion criteria. We conducted risk of bias assessments and data extraction independently and in duplicate. Where information was unclear we contacted study authors for clarification. MAIN RESULTS: Eight studies, recruiting over 700 participants, compared the use of dental cavity liners to no liners for Class I and Class II resin-based composite restorations.Seven studies evaluated postoperative hypersensitivity measured by various methods. All studies were at unclear or high risk of bias. There was inconsistent evidence regarding postoperative hypersensitivity (either measured using cold response or patient-reported), with a benefit shown at some, but not all, time points (low-quality evidence).Four trials measured restoration longevity. Two of the studies were judged to be at high risk and two at unclear risk of bias. No difference in restoration failure rates were shown at 1 year follow-up, with no failures reported in either group for three of the four studies; the fourth study had a risk ratio (RR) 1.00 (95% confidence interval (CI) 0.07 to 15.00) (low-quality evidence). Three studies evaluated restoration longevity at 2 years follow-up and, again, no failures were shown in either group.No adverse events were reported in any of the included studies. AUTHORS' CONCLUSIONS: There is inconsistent, low-quality evidence regarding the difference in postoperative hypersensitivity subsequent to placing a dental cavity liner under Class I and Class II posterior resin-based composite restorations in permanent posterior teeth in adults or children 15 years or older. Furthermore, no evidence was found to demonstrate a difference in the longevity of restorations placed with or without dental cavity liners.

Effect of gel replacement during in-office dental bleaching: a case report.

In-office dental bleaching allows the dentist to have greater control of the procedure and prevents patients from ingesting chemicals. To obtain optimum results, in-office bleaching usually requires a longer period of application as well as changes of the bleaching agent applied to the tooth surfaces at each appointment. The objective of this case report was to assess, by means of a split-mouth design in a single patient, the final tooth color and tooth sensitivity resulting from 2 different bleaching protocols: 1 application of 35% hydrogen peroxide for 45 minutes and 3 applications of 35% hydrogen peroxide for 15 minutes each. Neither the patient nor 5 individuals who were blinded to the techniques noted a difference in the final esthetic results of the 2 protocols immediately after the procedure. In addition, the patient reported that no tooth sensitivity was associated with either protocol. The results of dental bleaching on both sides were maintained after 15 days. The results shown in the present case report suggest that there may be no need to renew the gel during in-office dental bleaching.

Associated factors to cervical dentin hypersensitivity in adults: a transversal study.

BACKGROUND: This cross-sectional study aimed to identify the factors associated to the cervical dentin hypersensitivity (DH) in Brazilian adult population. METHODS: Three hundred and eighty patients (67.2% women and 32.8% men) were assessed by questionnaire and thermal test with ice. Participants marked in a visual analogue scale (VAS) the intensity of pain, and a calibrated examiner (ICC 0.990) measured the scores using a caliper. Pain scores above 0.5 mm were considered sensitive teeth. The DH associated factors were investigated by clinical examination. The association between variables was assessed by Spearman correlation and the Chi-square test. Logistic regression was used to determine the variables that predict DH (p < 0.05). RESULTS: The mean age of participants was 24.08 years. In this population, 8958 teeth were evaluated, of those 3037 (33.9%) were diagnosed sensitive. The most prevalent associated factors to DH were abnormal tooth positioning (9.0%), occlusal trauma (6.5%) and gingival recession (5.6%). The erosion predicted significantly the DH on both simple (OR 7.85, p < 0.001) and multiple(OR 4.36, p < 0.001) analysis. CONCLUSION: The exposure of dentinal tubules by erosion is probably the major predictor of dentin hypersensitivity. The healthy tooth is able to protect against DH.

Clinical Evaluation of 10% Hydrogen Peroxide on Tooth Sensitivity and Effectiveness in at Home Dental Bleaching.

AIM: The purpose of this study was to evaluate the dental effect and sensitivity of at-home dental bleaching with 10% hydrogen peroxide (H2O2). MATERIALS AND METHODS: Twenty volunteers with A2 or darker central incisors were selected for this study. Was used 10% H2O2 for thirty minutes twice a day, for two weeks. Shade evaluation was assessed visually by the value-oriented shade guide Vita Classical shade guide, Vita Bleachedguide 3D-MASTER and by the Easyshade spectrophotometer at baseline, during bleaching (first and second weeks), and post-bleaching (one month). The perceptions of sensitivity were recorded by the patients through the numerical rating scale (0 to 4) and 0 to 10 visual analog scales daily. Data from the shade guide units was subjected to a one way repeated measures (RM) analysis of variance (ANOVA) test (a = 5%). The overall AE, absolute risk and intensity of tooth sensitivity were calculated as well as the 95% confidence interval. RESULTS: The absolute risk of tooth sensitivity was 65% and the intensity was mild. Data from ASGU and AE after 1 month of bleaching for H2O2 10% showed significant whitening, 4 units for Vita Classical, 5 units for Vita Bleachedguide and 9.7 units for spectrophotometer. CONCLUSION: At-home bleaching using 10% hydrogen peroxide is effective in 14 days of bleaching. The most common adverse events were mild tooth sensitivity, and no subjects discontinued use early because of a treatment-related adverse event. CLINICAL SIGNIFICANCE: At-home dental bleaching with 10% hydrogen peroxide gel reduces the time of use of the tray, maintaining the effectiveness with low intensity of dental sensitivity. Brazilian clinical trials registry (REBEC) RBR-45xmzj.

Efficacy of desensitizing products containing 8% arginine and calcium carbonate for hypersensitivity relief in MIH-affected molars: an 8-week clinical study.

OBJECTIVES: The objective of this study was to compare the efficacy in reducing hypersensitivity in molar incisor hypomineralization (MIH)-affected molars immediately and over 8 weeks combining a single in-office application and a homed-based program with desensitizing products containing 8% arginine and calcium carbonate. MATERIALS AND METHODS: Nineteen children with at least one MIH-affected molar with hypersensitivity were included. Hypersensitivity was assessed with an evaporative (air) stimulus and a tactile stimulus. Each child received a single in-office treatment with a desensitizing paste containing 8% arginine and calcium carbonate (elmex Sensitive Professional desensitizing paste), followed by 8 weeks of brushing twice daily with a desensitizing toothpaste containing 8% arginine, calcium carbonate with 1450 ppm fluoride (elmex Sensitive Professional toothpaste), using the elmex Sensitive Professional toothbrush. Additionally, the corresponding mouthwash (elmex Sensitive Professional mouthwash) was used. Clinical assessments were made at baseline, immediately after the in-office treatment and after 1, 2, 4 and 8 weeks of brushing twice daily. RESULTS: Fifty-six molars with an air blast hypersensitivity score of 2 or 3 (Schiff Cold Air Sensitivity Scale) were included. Application of the desensitizing paste decreased hypersensitivity significantly immediately and throughout the 8 weeks recalls (p < 0.001). CONCLUSIONS: In conclusion, 8% arginine and calcium carbonate were able to reduce hypersensitivity successfully during this 8-week trial. CLINICAL RELEVANCE: Hypersensitivity is a major complaint in patients with MIH. This is the first study evaluating the desensitizing effect of a desensitizing paste containing 8% arginine and calcium carbonate in patients with MIH.

Does orthodontic debonding lead to tooth sensitivity? Comparison of teeth with and without visible enamel microcracks.

INTRODUCTION: Our aim was to assess the possible changes in sensitivity of teeth with and without visible enamel microcracks (EMCs) up to 1 week after the removal of metal brackets. METHODS: After debonding, 15 patients possessing teeth with visible EMCs and 15 subjects whose teeth were free of EMCs were enrolled in the study. For each experimental group, a control group was formed. The assessments of tooth sensitivity elicited by compressed air and cold testing were performed 5 times: just before debonding, immediately after debonding, and at 1, 3, and 7 days after debonding. Tooth sensitivity was recorded on a 100-mm visual analog scale. RESULTS: For the patients without visible EMCs, discomfort peaked immediately after debonding and started to decrease on day 1; at 1 week after debonding, the visual analog scale scores were lower than just before debonding and immediately after debonding. For the subjects possessing teeth with visible EMCs, the pattern of sensitivity dynamic was inherently the same. However, the patients with visible EMCs showed higher visual analog scale values at each time interval. CONCLUSIONS: Debonding leads to a short-term increase in tooth sensitivity. EMCs, a form of enamel damage, do not predispose to greater sensitivity perception in relation to bracket removal.

The potential of low-power laser for reducing dental sensitivity after in-office bleaching: a case report.

Postoperative sensitivity is one of the most common side effects of in-office bleaching with hydrogen peroxide. Laser phototherapy (LPT) has been suggested as an adjunctive treatment to prevent or minimize tooth sensitivity. This case report aimed to verify the efficacy of LPT in the reduction of sensitivity after in-office bleaching. Tooth bleaching was performed with 35% hydrogen peroxide activated with a hybrid LED-laser device. Immediately after the bleaching treatment, the patient reported dental sensitivity, as measured with a visual analog scale (VAS). To reduce sensitivity, LPT was applied with a 780-nm laser using the following parameters: 70 mW, exposure time of 10 seconds per point of irradiation (middle region of the buccal surfaces of each compromised tooth) in contact mode, energy of 1 J per point. Immediately after LPT, the patient reported a substantially lower level of pain on the VAS. Twenty-four hours after bleaching, the score on the VAS indicated that sensitivity levels had rebounded, and the patient received additional LPT. After 48 hours, the patient reported no dental sensitivity. The results in this patient indicated that irradiation with an infrared low-power laser substantially reduced dental pain generated by bleaching, suggesting that LPT should be considered as an auxiliary method to reduce postbleaching tooth sensitivity.

A New Perspective on Dentine Hypersensitivity ­ Guidelines for General Dental Practice.

The aim of this review is to update dental professionals on the issues and challenges associated with the clinical management of dentine hypersensitivity (DH) and to provide simple guidelines based on presenting clinical features that may help them successfully manage the condition in their day-to-day clinical practice. Details on the management of DH have been previously published in Dental Update which indicated that there was a need for such guidelines. The authors of these guidelines also suggested that, despite the various published clinical studies, there does not currently appear to be one ideal desensitizing agent that can be recommended for treating DH. A joint working relationship between the dental professional and the patient in changing the patient's behaviour is therefore essential if the condition is to be successfully treated. Clinical relevance: Dentine hypersensitivity is a persistent and a troublesome clinical condition which at times is under diagnosed by dental professionals who may struggle to resolve the problem to their patients' satisfaction successfully. The recent UK Forum guidelines on the management of DH, based on the presenting features of the condition, provide practical recommendations, helping dental professionals to manage this persistent problem correctly.

[Preventive dentistry 3. Prevalence, aetiology and diagnosis of dentine (hyper)sensitivity]. / Preventieve tandheelkunde 3. Prevalentie, etiologie en diagnostiek van dentine-over­gevoelig­heid.

Many people sometimes experience pain when they inhale breath across the cingula, or sensitivity and/or pain when they eat ice cream, for example. In some cases, however, this can become seriously unpleasant. In those cases, one can speak of dentine hypersensitivity. In Europe, an average of 27% of the population suffers from this. Dentine hypersensitivity is characterised by a short, sharp pain reaction after a warm or cold sensation. The external sensation causes an accelerated or converse flow of fluid in the dentinal tubules that excites the extremities of the nerve cells, which results in the sensation pain. For the external sensation, it is necessary that the cingula are exposed and the dentinal tubules are open. Dentine hypersensitivity is diagnosed after other possibilities have been eliminated.

Dental cavity liners for Class I and Class II resin-based composite restorations.

BACKGROUND: Resin-based composite (RBC) is currently accepted as a viable material for the restoration of caries for posterior permanent teeth requiring surgical treatment. Despite the fact that the thermal conductivity of the RBC restorative material closely approximates that of natural tooth structure, postoperative hypersensitivity is sometimes still an issue. Dental cavity liners have historically been used to protect the pulp from the toxic effects of some dental restorative materials and to prevent the pain of thermal conductivity by placing an insulating layer between restorative material and the remaining tooth structure. OBJECTIVES: The objective of this review was to assess the effects of using dental cavity liners in the placement of Class I and Class II resin-based composite posterior restorations in permanent teeth in children and adults. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 25 May 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 4) in the Cochrane Library (searched 25 May 2016), MEDLINE Ovid (1946 to 25 May 2016), Embase Ovid (1980 to 25 May 2016) and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 25 May 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomized controlled trials assessing the effects of the use of liners under Class I and Class II posterior resin-based composite restorations in permanent teeth (in both adults and children). We included both parallel and split-mouth designs. DATA COLLECTION AND ANALYSIS: We utilized standard methodological procedures prescribed by Cochrane for data collection and analysis. Two review authors screened the search results and assessed the eligibility of studies for inclusion against the review inclusion criteria. We conducted risk of bias assessments and data extraction independently and in duplicate. Where information was unclear we contacted study authors for clarification. MAIN RESULTS: Eight studies, recruiting over 700 participants, compared the use of dental cavity liners to no liners for Class I and Class II resin-based composite restorations.Seven studies evaluated postoperative hypersensitivity measured by various methods. All studies were at unclear or high risk of bias. There was inconsistent evidence regarding postoperative hypersensitivity (either measured using cold response or patient-reported), with a benefit shown at some, but not all, time points (low-quality evidence).Four trials measured restoration longevity. Two of the studies were judged to be at high risk and two at unclear risk of bias. No difference in restoration failure rates were shown at one year follow-up, with no failures reported in either group for three of the four studies; the fourth study had a risk ratio (RR) 1.00 (95% confidence interval (CI) 0.07 to 15.00) (low-quality evidence). Three studies evaluated restoration longevity at two years follow-up and, again, no failures were shown in either group.No adverse events were reported in any of the included studies. AUTHORS' CONCLUSIONS: There is inconsistent, low-quality evidence regarding the difference in postoperative hypersensitivity subsequent to placing a dental cavity liner under Class I and Class II posterior resin-based composite restorations in permanent posterior teeth in adults or children 15 years or older. Furthermore, no evidence was found to demonstrate a difference in the longevity of restorations placed with or without dental cavity liners.

A novel approach for in-office tooth bleaching with 6% H2O2/TiO_N and LED/laser system-a controlled, triple-blinded, randomized clinical trial.

UNLABELLED: The purpose of this randomized, parallel, triple-blinded clinical trial was to compare efficacy and tooth sensitivity (TS) after use of an in-office bleaching agent of 6% hydrogen peroxide containing nanoparticles of nitrogen-doped titanium oxide (HP6) vs. 35% hydrogen peroxide (HP35). Forty-eight volunteers were randomly divided either a HP6 or HP35. Two clinical sessions were performed with an interval of 7 days between them for each group. In each session, two consecutive applications of each bleaching agent were performed and activated by a hybrid LED/laser light. Efficacy was determined by color alteration (ΔE), recorded with reflectance spectroscopy. It was assessed at baseline and after the first and second bleaching session. TS was characterized according to occurrence, intensity, duration, and type. Efficacy was analyzed by repeated measures analysis of variance (ANOVA) and post hoc Bonferroni test, and TS was analyzed by means of chi(2) test (α = 0.05). For HP35, highest and significant values of ΔE were found after bleaching when compared to HP6 (p = 0.002). However, HP35 showed a significantly higher occurrence of TS than HP6 (p = 0.008). Also, intensity and duration were higher in HP35. The majority of volunteers classified the type experienced in their sensitivity in the form of a "shock." The use of HP6 despite reducing efficacy when compared to an in-office bleaching in higher concentration (35%) produced less tooth sensitivity. CLINICAL RELEVANCE: In terms of tooth sensitivity, the use of lower concentrations of in-office bleaching should be the first choice, suggesting greater biocompatibility and safety compared to a conventional HP35.

Effect of low-level laser therapy on tooth sensitivity induced by in-office bleaching.

This study aimed to investigate the effect of low-level laser therapy (LLLT) on tooth sensitivity induced by in-office bleaching. Sixty-six patients enrolled in this randomized clinical trial. Following the in-office procedure with 40% hydrogen peroxide, the participants were randomly divided into three groups. The patients in group 1 received irradiation from a low-level red laser (LLRL; 660 nm, 200 mW, 15 s, 12 J/cm(2)), whereas participants in group 2 were subjected to a low-level infrared laser (LLIL; 810 nm) under similar conditions as in group 1. In group 3 (placebo), the laser treatment was the same as that in groups 1 and 2, but without energy output. The degree of tooth sensitivity was recorded at 1, 24, and 48 h after bleaching using a visual analog scale (VAS). The change in tooth shade was measured 30 days after tooth whitening. The intensity of tooth sensitivity was not significantly different between groups at 1 h after bleaching (p > 0.05). At 24 h after therapy, pain level was significantly lower in the LLIL group compared to the LLRL and placebo groups (p < 0.05). At 48 h after bleaching, VAS scores in the LLIL and LLRL groups were comparable to each other (p > 0.05) and both were significantly lower than that of the placebo group (p < 0.05). There was no significant difference in the efficacy of tooth whitening among groups (p > 0.05). LLLT with an infrared diode laser could be recommended as a suitable strategy to reduce the intensity of tooth sensitivity after in-office bleaching.

Self-adhesive Luting of Partial Ceramic Crowns: Selective Enamel Etching Leads to Higher Survival after 6.5 Years In Vivo.

PURPOSE: To investigate the influence of selective enamel etching on long-term clinical performance of partial ceramic crowns (PCCs) luted with a self-adhesive luting material (RXU: RelyX Unicem). MATERIALS AND METHODS: At baseline, 34 patients received the intended treatment: two PCCs (Vita Mark II; Cerec 3D) for the restoration of extended lesions with multiple-cusp coverage were placed in a split-mouth design with a self-adhesive luting material, one without (RXU) and one with selective enamel etching (RXU+E). Patients were evaluated clinically (modified USPHS criteria) at baseline and up to 6.5 years (70 to 88 months). The chi-square test was used for statistical analyses (α=0.05). Clinical survival of all restorations (n=68) after 6.5 years was evaluated by Kaplan-Meier analysis. RESULTS: After 6.5 years, 18 patients (9 male, 9 female; median age 41, range 25 to 59 years) with 36 RXU and RXU+E restorations were available for clinical assessment (patient recall rate: 53%), with 13 RXU and 14 RXU+E PCCs placed in molars and 5 RXU and 4 RXU+E PCCs in premolars. Clinically, no statistically significant differences between the luting procedures were detected. Both RXU and RXU+E revealed significant changes over time with respect to marginal adaptation (significant deterioration) and marginal discoloration (significant increase). RXU revealed no cases of postoperative hypersensitivity and RXU+E only did so at baseline (n=5). Kaplan-Meier analysis showed a cumulative survival for RXU of 60% and for RXU+E of 82%, indicating a significantly higher survival rate for RXU+E. CONCLUSION: Clinically, RXU and RXU+E perform similarly. In PCC restorations with multiple-cusp coverage, lack of retention due to adhesive preparation, and little dentin available for adhesion caused by extensive core buildups or cavity linings, selective enamel etching is recommended.