The accuracy of identifying the greater palatine neurovascular bundle: a cadaver study.

BACKGROUND: The palate is a common site for harvesting subepithelial connective tissue grafts (SCTG). The size of SCTG that can be harvested is dictated by the position of the greater palatine neurovascular bundle (GPB). The aims of this cadaver study are to assess the accuracy of predicting the location of the GPB on study models and to evaluate anatomic factors that might influence the predictability. METHODS: Eleven fully dentate or partially edentulous maxillary cadavers were used. Study models were fabricated after the greater palatine foramen was identified. The GPB was recognized after dissection, from which the distance to the cemento-enamel junction of the first molar and premolar was measured. Eight periodontists and twelve periodontal residents were asked to estimate the location of the GPB on the study models and the same measurements were taken. Comparisons of the estimated and true GPB position were performed. The correlation between the palatal vault height and the variability of detecting the GPB was investigated. RESULTS: The most frequent greater palatine foramen location was between the second and third molars (66.6%). For most cases, there was an underestimation of the location of the GPB up to 4 mm. The interexaminer variability was positively correlated with the vault height. CONCLUSIONS: The estimated location of the GPB was commonly closer to the cemento-enamel junction of posterior teeth. Agreement on the location of the GPB was lowered with the presence of high palatal vaults. The results of this study could assist clinicians in planning the location for harvesting SCTG on the hard palate.

An investigation of potential desensitizing agents in the dentine disc model: a scanning electron microscopy study.

Cervical dentine sensitivity (CDS) may be defined as pain arising from exposed dentine. The prefix cervical indicates the location of the sensitivity and/or its subsequent treatment. Currently the most accepted mechanism of intradental nerve activation associated with dentine sensitivity appears to be hydrodynamic in nature. The concept of tubule occlusion as a method of dentine desensitization is a logical conclusion of the hydrodynamic theory. The authors employed the dentine disc model, qualitative scanning electron microscopy (SEM) and X-ray microanalysis to investigate whether selected desensitizing agents occlude dentinal tubule orifices. Strict control procedures have been used together with various methods of application to apply these agents to human dentine discs. SEM was used to examine the degree of deposit left by the various agents on disc surfaces and X-ray microanalysis was employed to characterize the elemental composition of the deposit. Analysis of selected agents, both prior to and after application on dentine discs was performed for comparative purposes. The degree of retention of the surface deposit upon rotation with saliva supernatant for 6 h was also studied. The results of this study indicated that ferric oxalate, the active ingredient of Sensodyne Sealant, which produced initial crystal-like structures, occluding almost all the tubule orifices was superior to potassium oxalate (Butler Protect). Of the over-the-counter (OTC) desensitizing products tested, both silica- and calcium-based abrasive components were observed both on the surface and within the tubules, indicating a certain degree of therapeutic potential for these two components. These findings suggest that certain desensitizing agents have tubule occluding properties as observed in this in vitro system which, in turn, may indicate a therapeutic potential in vivo.

The effectiveness of desensitizing agents for the treatment of cervical dentine sensitivity (CDS)--a review.

The treatment of dentine sensitivity or cervical dentine sensitivity (CDS) has been in the form of dentifrices, mouth rinses, sealants, and other therapeutic techniques. Claims of efficacy of the "so-called" active ingredients of these desensitizing agents have been made on the basis of the proposed mode of action generally extrapolated from in vitro or animal studies. Evidence from published, well-controlled clinical studies, however, generally has failed to substantiate such claims, although there has been a reported significant reduction in discomfort by subjects participating in these studies. Currently, the most accepted mechanism of intradental nerve activity associated with dentine sensitivity appears to be hydrodynamic in nature, although other mechanisms cannot be eliminated. The concept of tubule occlusion as a method of dentine desensitization is a logical conclusion from the hydrodynamic hypothesis. This paper reviews the present position with regard to the treatment of dentine sensitivity by various desensitizing agents and evaluates their claims of efficacy in the context of available scientific evidence.