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1.
Swiss Dent J ; 130(6): 493-501, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32512985

RESUMO

This study aimed to evaluate the efficacy and complications of several bleaching methods in patients with discolored teeth after orthodontic treatment. This randomized clinical trial involved 60 volunteers (31 women, 29 men) aged 14 to 30 years, who finished fixed orthodontic therapy at least three months before the study commencement and complained of discoloration on upper front teeth. The subjects were divided into four groups by treatment. The patients in group 1 received home bleaching, whereas those in groups 2 to 4 underwent in-office bleaching using a diode laser, a plasma arc and no light source, respectively. Tooth color was measured at baseline, one hour after the end of the bleaching procedure, and one week later, and the color alteration between different stages was compared among the groups. The severity of tooth sensitivity and the occurrence of other post-treatment complications were recorded. The color change between baseline and one week after treatment was greatest in the home-bleaching and the laser-assisted bleaching groups, and lowest in the plasma-arc bleaching group, although the difference between the groups was not significant (p > 0.05). Tooth sensitivity over 24 hours after bleaching was lowest in subjects who had undergone laser-assisted bleaching and highest in those who had received in-office bleaching without light (p < 0.05). All methods were effective in managing tooth discoloration after orthodontic treatment. Home bleaching produced favorable color alteration. Amongst the in-office approaches, laser-assisted bleaching should be considered as the best option, as it produced effective results with lowest tooth sensitivity and over a shorter period of time.


Assuntos
Sensibilidade da Dentina , Clareamento Dental , Descoloração de Dente , Dente , Adolescente , Adulto , Feminino , Humanos , Peróxido de Hidrogênio , Masculino , Adulto Jovem
2.
Braz Oral Res ; 34: e043, 2020 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-32401933

RESUMO

The aim of the present study was to compare the sensitivity and specificity of pain scales used to assess dentin hypersensitivity (DH). The preferred scale, and toothbrushing habits of participants were also investigated. This cross-sectional study was conducted with students and employees of a Brazilian Federal University who presented DH. The participants answered a questionnaire about their toothbrushing and drinking habits. Hypersensitive and non-sensitive teeth were submitted to tactile and ice stick stimuli. Then, the subjects marked their pain level in the visual analogue (VAS), numeric scale (NS), faces pain scale (FPS) and verbal evaluation scale (VES). DH was also assessed by Schiff scale (SS). The data were analyzed by Wilcoxon and Chi-Square tests, as well as by ROC curve. The mean age of the sample (56 women, 16 men) was 27.8 years. The most prevalent acidic beverage was coffee (36.0%) and the most preferred scale was the NS (47.2%). The pain level was statistically higher in teeth with DH compared to teeth without DH (p < 0.05). The accuracy ranged from 0.729 (SS) to 0.750 (NS). The highest sensitivity value was 81.9% for NS. The SS presented the highest specificity (91%). The visual analog, numerical, verbal evaluation, faces pain, and Schiff scales were accurate for DH diagnosis. The Schiff scale was the preferred scale for DH assessment.


Assuntos
Sensibilidade da Dentina/diagnóstico , Medição da Dor/métodos , Adolescente , Adulto , Bebidas/efeitos adversos , Estudos Transversais , Expressão Facial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Inquéritos e Questionários , Escovação Dentária/efeitos adversos , Adulto Jovem
3.
Stomatologiia (Mosk) ; 99(2): 91-96, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32441082

RESUMO

AIM: To design an algorithm of decreasing dentin hypersensitivity in children after professional oral hygiene. METHODS AND MATERIALS: Intact teeth extracted for orthodontic reasons in children and adults were involved in the pilot study. The enamel surface was cleaned by manual instruments and then polished with polishing pastes containing sodium bicarbonate, fluoride, calcium and phosphates. The results were studied with the help of a scanning electronic microscope. 60 14-15 years schoolchildren, the residents of Krasnogorsk, a town in the Moscow region, took part in the study. All of them were diagnosed dental plaque (K03.6) and underwent professional oral hygiene by manual instruments. Then the teeth were polished with polishing toothpastes. To reduce dentin hypersensitivity after these procedures the SENSODYNE Rapid Relief toothpaste was applied. RESULTS: The pilot study showed a destructive effect of a manual instrument on the tooth enamel especially in children. The data of the scanning electronic microscope demonstrated that the manual method with the use of polishing pastes containing sodium bicarbonate, fluoride, calcium and phosphates led to a significantly lower negative effect of this manual method on the tooth enamel both in children and adults. The application of SENSODYNE Rapid Relief by children at home after professional oral hygiene led to a decrease of dentin hypersensitivity by 65, 37%. CONCLUSION: The designed algorithm of the children's follow-up procedures after professional oral hygiene includes the application of polishing pastes containing sodium bicarbonate, fluoride, calcium, phosphates and the Sensodyne Rapid Relief toothpaste at home. This helps to minimize negative consequences of manual tooth plaque removal in case of professional oral hygiene.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Adulto , Arginina , Carbonato de Cálcio , Criança , Método Duplo-Cego , Fluoretos , Humanos , Moscou , Higiene Bucal , Fosfatos , Projetos Piloto , Fluoreto de Sódio , Escovação Dentária , Cremes Dentais , Resultado do Tratamento
4.
Am J Dent ; 33(3): 138-144, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32470239

RESUMO

PURPOSE: To evaluate the effect of nanohydroxyapatite ( nHAP) associated with photobiomodulation (PBM) in the control of dentin hypersensitivity (DH). (C-Shape It). METHODS: 32 subjects with 83 hypersensitive teeth were randomized into four groups (N =8) : GPlacebo - simulated PBM (without light emission) followed by the application of nHAP-free toothpaste; GLaser - PBM followed by the application of nHAP-free toothpaste; GnHAP - simulated PBM followed by the application of nHAP; GLasernHAP - PBM followed by the application of nHAP. A visual analogue scale (VAS) was used to measure DH after a tactile and evaporative stimulus. DH evaluations were performed at four times: baseline, 1st, and 2nd treatment sessions, and 1 month. A questionnaire was used to evaluate the risk factors associated with DH intensity. Mixed-design ANOVA followed by Tukey test and logistic regression were used. RESULTS: The mechanical stimulus showed a significant reduction in DH in all experimental groups (P< 0.05) at the 2nd treatment session. For the evaporative stimulus, the GLasernHAP group presented a significant reduction in DH at the 1st treatment session (P< 0.05). Intragroup analysis showed that only the GnHAP group showed regression of DH at 1 month for the two applied stimuli. The variables of parafunctional habits, diets rich in acidic drinks and anxiety had significant relationships with the intensity of DH (P< 0.05). CLINICAL SIGNIFICANCE: The use of nHAP and application of PBM to laser are effective in the control of dentin hypersensitivity. However, their association did not enhance the desensitizing effect.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Método Duplo-Cego , Humanos , Cremes Dentais , Resultado do Tratamento
5.
J Appl Oral Sci ; 28: e20190720, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32428059

RESUMO

Objective This study evaluated the clinical effect of violet LED light on in-office bleaching used alone or combined with 37% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). Methodology A total of 100 patients were divided into five groups (n=20): LED, LED/CP, CP, LED/HP and HP. Colorimetric evaluation was performed using a spectrophotometer (ΔE, ΔL, Δa, Δb) and a visual shade guide (ΔSGU). Calcium (Ca)/phosphorous (P) ratio was quantified in the enamel microbiopsies. Measurements were performed at baseline (T 0 ), after bleaching (T B ) and in the 14-day follow-up (T 14 ). At each bleaching session, a visual scale determined the absolute risk (AR) and intensity of tooth sensitivity (TS). Data were evaluated by one-way (ΔE, Δa, ΔL, Δb), two-way repeated measures ANOVA (Ca/P ratio), and Tukey post-hoc tests. ΔSGU and TS were evaluated by Kruskal-Wallis and Mann-Whitney, and AR by Chi-Squared tests (a=5%). Results LED produced the lowest ΔE (p<0.05), but LED/HP promoted greater ΔE, ΔSGU and Δb (T 14 ) than HP (p<0.05). No differences were observed in ΔE and ΔSGU for LED/CP and HP groups (p>0.05). ΔL and Δa were not influenced by LED activation. After bleaching, LED/CP exhibited greater Δb than CP (p>0.05), but no differences were found between these groups at T 14 (p>0.05). LED treatment promoted the lowest risk of TS (16%), while HP promoted the highest (94.4%) (p<0.05). No statistical differences of risk of TS were found for CP (44%), LED/CP (61%) and LED/HP (88%) groups (p>0.05). No differences were found in enamel Ca/P ratio among treatments, regardless of evaluation times. Conclusions Violet LED alone produced the lowest bleaching effect, but enhanced HP bleaching results. Patients treated with LED/CP reached the same efficacy of HP, with reduced risk and intensity of tooth sensitivity and none of the bleaching protocols adversely affected enamel mineral content.


Assuntos
Peróxido de Carbamida/administração & dosagem , Peróxido de Hidrogênio/administração & dosagem , Luz , Fototerapia/métodos , Clareadores Dentários/administração & dosagem , Clareamento Dental/métodos , Adolescente , Adulto , Análise de Variância , Colorimetria , Terapia Combinada , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/efeitos da radiação , Sensibilidade da Dentina/induzido quimicamente , Feminino , Humanos , Masculino , Valores de Referência , Fatores de Risco , Espectrofotometria , Estatísticas não Paramétricas , Propriedades de Superfície/efeitos dos fármacos , Propriedades de Superfície/efeitos da radiação , Resultado do Tratamento , Adulto Jovem
6.
Oper Dent ; 45(3): 265-275, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32396502

RESUMO

OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate a high concentration of hydrogen peroxide (35%) regarding tooth sensitivity and color change in tooth bleaching in comparison to low concentrations (6% to 20%). METHODS AND MATERIALS: This review was conducted using the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and is registered on the Prospective Register of Systematic Reviews (CRD42017064493). The PICO question was "Does a concentration of hydrogen peroxide ≥35% using in-office bleaching procedure contribute to greater tooth sensitivity?" A search was made in PubMed/MEDLINE, Scopus, and the Cochrane Library. RESULTS: Fourteen studies were selected for the qualitative analysis and seven for quantitative analysis. A total of 649 patients were evaluated (mean age: 36.32 years; range: 13.9 to 31 years), and the follow-up period ranged from one week to 12 months. The meta-analysis demonstrated that tooth sensitivity was higher in the patients submitted to treatment involving a high concentration of hydrogen peroxide (0.67; 95% confidence interval [CI]: 0.44 to 1.03; p=0.04; I 2 : 56%), and a significant difference was found regarding objective color ΔE (1.53; 95% CI: 2.99 to 0.08; p<0.0001; I 2 : 82%) but no significant difference was found regarding subjective color ΔSGU (0.24; CI: 0.75 to 1.23; p<0.00001; I 2 : 89%). CONCLUSIONS: This study indicated that a lower concentration of hydrogen peroxide causes less tooth sensitivity and better effectiveness in objective color change (ΔE); however, there is no difference between them related to subjective color (ΔSGU).


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Pré-Escolar , Cor , Humanos , Peróxido de Hidrogênio , Lactente , Resultado do Tratamento
7.
Am J Dent ; 33(2): 79-82, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32259412

RESUMO

PURPOSE: To evaluate the bleaching efficacy of laser application with chemical treatment compared to chemical treatment alone. METHODS: This was a randomized controlled trial (RCT), single blind (evaluator), in 24 patients randomized into two groups: Laser and chemical intervention (12) or chemical intervention alone without laser (12). The commercial products used were Whiteness HP 35% hydrogen peroxide gel and the Whitening Laser II of DCM equipment. The color was measured with a spectrophotometer before, immediately and 3 days after the bleaching procedure. The trial outcome measures were obtained using the Vita EasyShade spectrophotometer and the International CIELCh system. To establish differences before vs. after treatments and between groups, the T test and chi² tests were applied. The data was statistically analyzed with Student's T-test (P ≤ 0.05). RESULTS: After applying the delta formula to measure the change in color, both groups gave clinically significant results before vs. after bleaching procedures ( P ≤ 0.05). The deltas for luminosity, chroma, and hue all showed significant improvements for baseline to 15 minutes post treatment (P ≤ 0.05), baseline to 3 days post treatment (P ≤ 0.05), but not for 15 minutes to 3 days post treatment (P ≥ 0.05). When comparing between groups applying T-test, no statistically significant differences were found (P ≥ 0.05) for all three deltas. When comparing sensitivity after bleaching, no differences were found between groups (P ≥ 0.05). CLINICAL SIGNIFICANCE: The use of laser during bleaching treatment did not improve the results compared to not using laser.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Cor , Humanos , Peróxido de Hidrogênio , Resultado do Tratamento
8.
Am J Dent ; 33(2): 95-105, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32259415

RESUMO

PURPOSE: To review the scientific evidence for the efficacy of stabilized stannous fluoride (SnF2) dentifrice in relation to dental caries, dental erosion and dentin hypersensitivity. METHODS: Medline OVID, Embase.com, and the Cochrane Library were searched until January 2018. Two researchers independently selected studies according to inclusion and exclusion criteria, data were extracted, the risk of bias in eligible studies was assessed and a meta-analysis was performed wherever feasible. RESULTS: Three studies on dental caries, eight studies on dental erosion and 11 on dentin hypersensitivity were included. Risk of bias was judged as high for most of the caries and erosion studies and low or medium for the hypersensitivity studies. A similar or slightly higher anti-caries activity compared with non-stannous fluoride dentifrices was observed. Stannous fluoride showed a greater anti-erosive potential in seven of the eight studies. A mean difference score in favor of stannous fluoride dentifrices compared with controls was found in a meta-analysis including six 8-week hypersensitivity studies. CLINICAL SIGNIFICANCE: The use of stabilized stannous fluoride dentifrices to relieve dentin hypersensitivity and to prevent the initiation of dental erosion speaks in favor of this treatment strategy.


Assuntos
Cárie Dentária , Dentifrícios , Sensibilidade da Dentina , Cariostáticos , Método Duplo-Cego , Humanos , Fosfatos , Fluoreto de Sódio , Fluoretos de Estanho
9.
Am J Dent ; 33(1): 17-24, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32056410

RESUMO

PURPOSE: To review and assess the literature on in vitro studies evaluating tooth bleaching efficacy considering the use of a negative control, type of tooth substrate, storage medium, color evaluation methods, and evaluation time points. METHODS: The following databases were searched: PubMed (MEDLINE), Web of Science. Search used Medical Subject Headings (MeSH) in PubMed in addition to free text. The following limits were applied: English, articles published between January 1989 and October 2017. Additional free text key terms included: in vitro, tooth bleaching, placebo, negative control, overall CIELAB color change (ΔE*ab), change in shade guide units (ΔSGU), tooth color stabilization, evaluation time points, bovine teeth, and staining. Search was repeated in Web of Science but no additional articles were identified. A total of 11 studies were included for qualitative and quantitative analysis. RESULTS: The meta-analysis of nine included studies that reported ΔE*ab values, revealed that the NC statistically exceeded the perceptibility threshold (PT) of 1.2 (P< 0.05). The estimate was 2.872 with lower and upper bounds of 1.955 and 3.790, respectively. CLINICAL SIGNIFICANCE: Randomized controlled trials are gold standards to evaluate bleaching efficacy of different materials. However, in vitro studies offer a way to screen for potential bleaching efficacy. It is vital to determine an appropriate cut-off value for determining bleaching efficacy in vitro and further apply for clinical relevance.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Dente , Animais , Bovinos , Cor , Peróxido de Hidrogênio
10.
Niger J Clin Pract ; 23(2): 165-171, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32031090

RESUMO

Aims: The aim of this study is to evaluate the effect of the diode laser used for dentin sensitivity on the clinical success of non-carious cervical lesion (NCCL) restorations restored with different adhesive systems. Methods: 20 NCCLs were restorated with Universal Single Bond (Self Etch) (3M, USA) and Grandio (Voco, Germany), 20 NCCLs were restorated with Universal Single Bond (Total Etch) and Grandio. After diode laser application, 20 NCCLs were restorated with Universal Single Bond and Grandio, 20 NCCLs were restorated with Universal Single Bond (Total Etch) and Grandio. The restorations were clinical evaluated by two examiners at baseline, for 6 and 18 months using modified United States Public Health Service (USPHS) Criteria. Chi-square test was used for statistical analyse. Results: The lowest rates of retention was found in the Group 1. There was no statistically significant difference among the groups in marginal discoloration, marginal integrity, sensitivity (P > 0.05). Conclusion: Diode laser application prior to the restoration of teeth with NCCL don't reduce the retention rate of restorations, may reduce hypersensitivity and may affect the success of restoration. However, further laboratory and clinical studies are required.


Assuntos
Adesivos/farmacologia , Resinas Compostas , Corrosão Dentária , Restauração Dentária Permanente/métodos , Lasers Semicondutores/uso terapêutico , Colo do Dente , Adulto , Bis-Fenol A-Glicidil Metacrilato , Adaptação Marginal Dentária , Sensibilidade da Dentina , Adesivos Dentinários , Feminino , Seguimentos , Humanos , Lasers Semicondutores/efeitos adversos , Masculino , Pessoa de Meia-Idade
11.
Int J Esthet Dent ; 15(1): 16-42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994534

RESUMO

Noncarious cervical lesions (NCCLs) involve the loss of hard tissue from the cervical areas of teeth through processes unrelated to caries. NCCLs are nowadays a common pathology caused by changes in lifestyle and diet. The prevalence and severity of cervical wear increase with age. It is generally accepted that the lesions are not generated by a single factor but result from a combination of factors. Among the factors proposed to be related to the formation and progression of NCCLs are biocorrosion (erosion), friction (abrasion), and possibly occlusal stress (abfraction). The clinical appearance of NCCLs can vary depending on the type and severity of the etiologic factors involved. Practitioners should follow a checklist to achieve an accurate diagnosis of the etiology of multifactorial NCCLs. The successful prevention and management of NCCLs require an understanding of the etiology and risk factors, including how these change over time in individual patients. The decision to monitor NCCLs rather than intervene should be based on the progression of the lesions and how they compromise tooth vitality, function, and esthetics. Treatment options include techniques to alleviate dentin hypersensitivity and the placement of an adhesive restoration, eventually in combination with a root coverage surgical procedure. An adhesive restoration is considered the last treatment option for NCCLs. Based on their excellent esthetic properties and good clinical performance, there is a general indication to place composite restorations for NCCLs. The clinical performance of these restorations is highly product-dependent, particularly regarding the adhesive system used. The type of composite material seems to have no significant influence on the clinical performance of NCCL restorations in clinical trials. It is much more important that the operator carries out the clinical procedure correctly. Marginal degradation is frequently seen during aging. Yearly maintenance with the eventual repolishing of the restoration margins will lengthen the lifespan of the restorations.


Assuntos
Cárie Dentária , Sensibilidade da Dentina , Cimentos Dentários , Restauração Dentária Permanente , Estética Dentária , Humanos , Colo do Dente
12.
Oper Dent ; 45(1): E1-E10, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31891544

RESUMO

OBJECTIVES: This study aimed to evaluate the desensitizing effect of a prefilled disposable tray containing potassium nitrate and fluoride on the self-reported tooth sensitivity (TS) and the bleaching efficacy of 40% hydrogen peroxide bleaching agent used for in-office bleaching in comparison with potassium nitrate and fluoride gel applied in a conventional-delivered tray system in an equivalence clinical trial. METHODS AND MATERIALS: Seventy-eight patients, with a right maxillary canine darker than A3, were selected for this single-blind (evaluators), randomized clinical trial. Teeth were bleached in two sessions with a one-week interval in between. Before in-office bleaching, the prefilled disposable tray or conventional tray containing potassium nitrate and fluoride was used for 15 minutes. Subsequently, the bleaching agent was applied in two 20-minute applications (per the manufacturer's directions) in each session. The color change was evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (Easyshade Advance Spectrophotometer) methods at baseline and 30 days after the first bleaching session. TS was recorded for up to 48 hours using a 0-10 visual analog scale. The absolute risk was evaluated by chi-square test, while the intensity of TS was evaluated by McNemar test (α=0.05). Color change in shade guide units and ΔE was analyzed by Student t-test for independent samples (α=0.05). RESULTS: Significant whitening was observed in both groups after 30 days of clinical evaluation. The use of different methods of desensitizer in a tray did not influence the absolute risk and intensity of TS (p>0.05), although a tendency of lower risk of TS with the prefilled disposable tray containing potassium nitrate and fluoride was observed. CONCLUSION: The use of a prefilled disposable tray containing potassium nitrate and fluoride before the application of the in-office bleaching product did not affect the whitening degree and decreased self-reported TS when compared with a conventional-delivered tray system.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Humanos , Peróxido de Hidrogênio , Método Simples-Cego , Resultado do Tratamento
13.
Braz Oral Res ; 33: e123, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994596

RESUMO

The objective of this study was to determine whether collagen matrix (CM) is an alternative to connective tissue graft technique (CTG) in the treatment of multiple gingival recessions (GR). The indication of CM for the treatment of multiple GR is not yet clear. More studies are needed to better understand this treatment modality, as an alternative to CTG. In this single-blind, split-mouth randomized clinical trial, fifteen patients with multiple Miller class I upper GR were selected and randomly assigned to control group (CTG) or test group (CM). Root coverage (RC) and patient-centered outcomes were evaluated at baseline and after 3, 6, and 12 months. A total of 82 GRs were treated. There was no significant difference regarding GR depth (GRD, primary outcome) between CTG (0.5 ± 0.9 mm) and CM groups (0.6 ± 1.0 mm) (p = 0.225). Percentage of RC was 82.14% in CTG and 77.7% in CM. Both groups demonstrated a gain in keratinized tissue width at 12 months (p < 0.05). Dentine hypersensitivity was effectively reduced in both groups. Postoperative pain was significantly higher in the CTG (p = 0.001). Esthetic satisfaction was high for both groups, with no significant difference (p > 0.05) between groups. After 12 months, both surgical treatments were able to promote RC, and GRD was similar in both CTG and CM groups.


Assuntos
Colágeno/uso terapêutico , Tecido Conjuntivo/transplante , Retração Gengival/cirurgia , Adolescente , Adulto , Sensibilidade da Dentina/prevenção & controle , Feminino , Seguimentos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Reprodutibilidade dos Testes , Método Simples-Cego , Estatísticas não Paramétricas , Retalhos Cirúrgicos , Fatores de Tempo , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
14.
Braz Oral Res ; 33: e115, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939497

RESUMO

The aim of this study was to investigate how Brazilian dentists perceive and manage dentin hypersensitivity (DH) in their clinical routine. A 13-item questionnaire-based survey was developed and sent electronically to a convenience sample of dentists. The questionnaire assessed the personal and dental practice characteristics of the sample, the occurrence of DH in their daily clinical practice, and management strategies. The data were analyzed descriptively and together with the chi-square test (a = 0.05). A total of 353 responses were obtained from September 2017 to March 2018. Of all the respondents, 62% were females, 49.9% reported fewer than five years of dental practice, and 70.5% were self-identified as private practitioners. Most of the dentists reported an estimated frequency (30-60%) of patients with DH in their practice. The most frequently cited (91.79%) trigger of DH was air blast and/or scratching with a probe. The first-choice strategy to manage DH was a dentin desensitizer (48.16%). The number of years in clinical practice did not influence DH relapse frequency (p = 0.76) significantly, or consider DH treatment as a problem (p = 0.22). The present findings indicate that, regardless of clinical experience, dentists in Brazil still consider DH management a challenge in their daily dental practice. In addition, the results suggest that guidelines should be developed to disseminate the available knowledge regarding this condition in ways that may influence decision-making processes among practitioners.


Assuntos
Sensibilidade da Dentina/terapia , Gerenciamento Clínico , Padrões de Prática Odontológica/estatística & dados numéricos , Brasil , Tomada de Decisão Clínica , Dessensibilizantes Dentinários/uso terapêutico , Odontólogos/estatística & dados numéricos , Feminino , Humanos , Masculino , Inquéritos e Questionários
15.
Clin Oral Investig ; 24(1): 385-394, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31104111

RESUMO

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.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Descoloração de Dente , Sensibilidade da Dentina/etiologia , Sensibilidade da Dentina/prevenção & controle , Feminino , Humanos , Peróxido de Hidrogênio , Clareamento Dental/efeitos adversos , Resultado do Tratamento
16.
Oper Dent ; 45(2): E66-E76, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31750804

RESUMO

OBJECTIVE: This systematic review evaluates the effect of preemptive analgesia on tooth sensitivity induced by in-office tooth bleaching. METHODS: The review was structured based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The methods were recorded at PROSPERO (CRD42018095440). Randomized clinical trials, studies published in English, and studies in which the efficacy of preemptive analgesia with analgesic and anti-inflammatory medications prior to in-office tooth bleaching was compared with that of placebo were included. PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library were used for searching. The electronic search provided 373 articles, and seven of them were selected based on the inclusion criteria. RESULTS: Immediately after time point, a significant reduction of dental sensitivity was observed in the drug group compared to the control group (p=0.02; mean difference [MD]: -0.90; confidence interval [CI]: -1.63 to -0.16), while there was no significant difference at up to one-hour (p=0.22; MD: -0.42; CI: -1.09 to -0.25), at 1-24-hour (p=0.88; MD: -0.05; CI: -0.61 to 0.72), or 24-48-hour (p=0.69; MD: 0.05; CI: -0.21 to 0.32) time points. The incidence of sensitivity during the procedure was not statistically different between the groups (p=0.64; MD: 0.91; CI: 0.92 to 1.15). The nonsteroidal anti-inflammatory drug group showed a statistically significant reduction (p=0.04; MD: -0.69; CI: -1.36 to -0.03) in tooth sensitivity compared with the other groups. CONCLUSIONS: This systematic review and meta-analysis demonstrated that the medications analyzed did not interfere with the incidence of sensitivity symptoms. Regarding the intensity, no difference was observed between the drug and placebo groups at the up to one-hour, 1-24-hour, or 24-48-hour time points, and there was a statistically significant difference at the zero-hour time point in favor of the drug group. However, based on the variables that influenced this result, it should be considered with prudence because a small difference was observed.


Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Dente , Analgésicos , Humanos
17.
J Oral Rehabil ; 47(4): 473-479, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31860124

RESUMO

BACKGROUND: Dentine hypersensitivity is a frequent oral complaint that is usually associated with several factors including diet and oral hygiene practices. OBJECTIVE: The aim of this study was to assess the prevalence, severity and correlates of dentine hypersensitivity and dentine exposure-related risk indicators in a sample from six Arab countries. METHODS: A multinational cross-sectional study was conducted on a sample of 2924 participants, attending dental practices, aged 18-35 years from six Arab countries. Trained examiners assessed dentine hypersensitivity using the Schiff scale and scored the tooth with the highest value in each sextant. Participants were asked to complete a questionnaire that assessed the frequency of drinking and eating acidic foods and their oral health habits. RESULTS: Overall, the Schiff score 1 was found in 938 (32.6%), score 2 in 613 (21%) and score 3 in 274 (9%) of the participants. There was variation between countries with Saudi Arabia (13.9%) and Oman (15%) having the highest prevalence of hypersensitivity and Kuwait (2.2) and Jordan the lowest (4.8%). Participants who experienced toothache and difficulty eating once a day were significantly more likely to have Schiff score 2 or 3 (OR: 2.51, 95% CI: 1.54-2.87; OR: 1.34, 95% CI: 1.04-1.73, respectively). Furthermore, drinking soft drinks once a day was also significantly associated with dentine exposure (OR: 1.4, 95% CI: 1.19, 1.65). CONCLUSION: In this cross-sectional study, dentine sensitivity and exposure were common in Arab patient populations.


Assuntos
Sensibilidade da Dentina , Adolescente , Adulto , Árabes , Estudos Transversais , Dentina , Humanos , Prevalência , Arábia Saudita , Adulto Jovem
18.
J Photochem Photobiol B ; 203: 111740, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31887638

RESUMO

PURPOSE: The aims of this ex vivo study were to evaluate the effectiveness of the Nd:YAP laser in the treatment of dentin hypersensitivity, to compare the temperature rise during laser irradiation at three different dentine thicknesses, and to analyse the composition of the dentine-lased surface. METHODS: A total of 33 teeth were used in this study. For scanning electron microscopy (SEM) observation, 24 teeth were transversely sectioned and divided into 4 groups: group A was irrigated with EDTA; group B was irradiated by Nd:YAP laser with 180 mJ energy/per pulse, 0.9 W average power, and 5 Hz frequency (power density [PD] = 229 W/cm2); group C was irradiated by Nd:YAP laser with 280 mJ energy/pulse, 1.4 W average power, and 5 Hz frequency (PD = 356 W/cm2); and group D was irradiated by Nd:YAP with 360 mJ energy/pulse, 1.8 W average power, and 5 Hz frequency (PD = 458 W/cm2). Energy-dispersive spectroscopy (EDS) analysis was performed on the same teeth evaluated for SEM observations. For temperature increase evaluation performed with thermocouples, 9 teeth were transversely sectioned at 3 different thicknesses (3 for each group) of 1, 2, and 3 mm. RESULTS: Statistical analysis showed significant changes in the diameter of the dentinal tubule orifices among all groups; EDS did not show modification of the Ca/P ratio. Temperature increase under irradiation exceeded 5.5 °C only in the group D samples. CONCLUSIONS: This ex vivo study, based on temperature recording, SEM observation, and EDS analysis, demonstrated that Nd:YAP laser at a PD of 356 W/cm2, corresponding to an average power of 1.4 W, defines the best treatment for dentine hypersensitivity in terms of compromise between efficacy of the treatment and safety of the pulp.


Assuntos
Sensibilidade da Dentina/radioterapia , Lasers de Estado Sólido/uso terapêutico , Dentina/fisiologia , Dentina/efeitos da radiação , Humanos , Microscopia Eletrônica de Varredura , Espectrometria por Raios X , Temperatura
19.
PLoS One ; 14(12): e0225501, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31790452

RESUMO

OBJECTIVE: This randomized controlled clinical trial aimed to evaluate the effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH), and the impact of this on the health-related quality of life (HRQL). METHODS: Eighty teeth with DH were randomized into four groups and received three treatment sessions: PLACEBO = placebo + LASER application mimicking; CPP-ACPF = CPP-ACPF + LASER application mimicking; PBM = placebo + LASER active application; CPP-ACPF+PBM = CPP-ACPF + LASER active application. Tactile (exploratory probe) and evaporative (triple syringe) stimuli were used to measure DH and were recorded with the aid of a visual analogue scale (VAS) after the 1st, 2nd and 3rd treatment sessions and one-month follow-up. The HRQL was recorded in the DH experience questionnaire (DHEQ). RESULTS: The intragroup comparison showed a significant reduction in DH (p < 0.05) with both stimuli after one-month follow-up. The intergroup comparison with the evaporative stimulus showed that CPP-ACPF+PBM significantly reduced DH when compared to the rest of treatments, after one-month follow-up. CPP-ACPF+PBM group statistically differed from the other treatment groups in the DHEQ evaluation after one-month follow-up. CONCLUSION: After one-month follow-up, the association of CPP-ACPF with PBM was effective in the reduction of DH and promoted a positive impact on the HRQL of the participants of this study.


Assuntos
Cariostáticos/administração & dosagem , Caseínas/administração & dosagem , Sensibilidade da Dentina/terapia , Fluoretos Tópicos/administração & dosagem , Terapia com Luz de Baixa Intensidade/métodos , Adolescente , Adulto , Terapia Combinada/métodos , Sensibilidade da Dentina/complicações , Sensibilidade da Dentina/diagnóstico , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Placebos/administração & dosagem , Qualidade de Vida , Resultado do Tratamento , Adulto Jovem
20.
Oral Health Prev Dent ; 17(6): 547-556, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31825027

RESUMO

PURPOSE: Dentin hypersensitivity (DH) is a prevalent painful condition of the teeth, the management of which lies in the obliteration of patent dentinal tubules. The purpose of this study was to compare the efficacy of 5% potassium nitrate (PN), low-level laser therapy (LLLT), and combination of low-level laser therapy and 5% potassium nitrate (LLLT+PN) in patients with fluorotic and non-fluorotic hypersensitive teeth. MATERIALS AND METHODS: Ninety self reporting patients with DH completed the randomised, double-blind study. Patients were equally divided into fluorosis group (FG), with moderate to moderately severe fluorosis and the non-fluorosis group (NFG) and subdivided into 3 groups to receive PN, LLLT (810 nm, 1 W) alone and LLLT+PN. Each participant had at least one tooth eliciting a response of ≥ 3 on a visual analog scale (VAS) to evaporative, thermal and electric tactile stimulus (digital scratch-o-meter). The teeth were evaluated at baseline, 30 min post treatment, 1 week, 4 weeks and 12 weeks. The magnitude of pressure applied by the scratch-o-meter was also assessed for all three interventions. RESULTS: Statistically, LLLT+PN was more effective in alleviating DH at all time intervals compared to baseline. However, statistically significant results (p ˂ 0.05) were seen with LLLT+PN at 12 weeks in FG. Magnitude of pressure applied showed statistically significant differences with LLLT+PN at 30 min post treatment. CONCLUSION: LLLT+PN alleviated DH at all time intervals, with a greater effect in the fluorotic group. However, LLLT+PN was more efficacious in reducing DH at 12 weeks post treatment in the fluorotic group.


Assuntos
Dessensibilizantes Dentinários , Sensibilidade da Dentina , Fluorose Dentária , Terapia com Luz de Baixa Intensidade , Método Duplo-Cego , Humanos , Resultado do Tratamento
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