MicroRNAs in Gingival Crevicular Fluid: An Observational Case-Control Study of Differential Expression in Periodontitis.

OBJECTIVES: microRNAs (miRNAs) present in the gingival crevicular fluid (GCF) of patients with chronic periodontitis may serve as biomarkers of periodontal disease. The aim of this study was to perform a miRNA-sequencing study of all miRNAs present in GCF, comparing miRNA expression level profiles between advanced chronic periodontitis (CP) patients and healthy subjects (HS). MATERIALS AND METHODS: GCF samples were collected from the single-rooted teeth of patients with severe CP (n = 11) and of HS (n = 12). miRNAs were isolated from GCF using an miRNeasy Serum/Plasma kit(Qiagen GmbH, Hilden, Germany). Reverse transcription polymerase chain reaction (qRT-PCR) was used to determine the expression levels of miRNA candidates involved in periodontal pathogenesis. RESULTS: Of all the sequenced miRNAs, miR-199, miR-146a, miR-30a, and miR-338 were identified as best representing the CP patient samples. The validation study identified miR-199 as the most powerful biomarker used to define periodontitis. CONCLUSIONS: Upon sequencing all known miRNAs in GCF for the first time, we uncovered several potential biomarkers to define periodontitis. Identifying miRNAS in the GCF using high-throughput approaches will clarify the role of these molecules in periodontitis and provide biomarkers with potential applications.

MicroRNAs and periodontal disease: a qualitative systematic review of human studies.

PURPOSE: MicroRNAs (miRNAs) are epigenetic post-transcriptional regulators that modulate gene expression and have been identified as biomarkers for several diseases, including cancer. This study aimed to systematically review the relationship between miRNAs and periodontal disease in humans, and to evaluate the potential of miRNAs as diagnostic and prognostic biomarkers of disease. METHODS: The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (reference number CRD42020180683). The MEDLINE, Scopus, Cochrane Library, Embase, Web of Science, and SciELO databases were searched for clinical studies conducted in humans investigating periodontal diseases and miRNAs. Expression levels of miRNAs across the different groups were analysed using the collected data. RESULTS: A total of 1,299 references were identified in the initial literature search, and 23 articles were finally included in the review. The study designs were heterogeneous, which prevented a meta-analysis of the data. Most of the studies compared miRNA expression levels between patients with periodontitis and healthy controls. The most widely researched miRNA in periodontal diseases was miR-146a. Most studies reported higher expression levels of miR-146a in patients with periodontitis than in healthy controls. In addition, many studies also focused on identifying target genes of the differentially expressed miRNAs that were significantly related to periodontal inflammation. CONCLUSIONS: The results of the studies that we analysed are promising, but diagnostic tests are needed to confirm the use of miRNAs as biomarkers to monitor and aid in the early diagnosis of periodontitis in clinical practice.

Performance of the dentogingival junction with mta and biodentine on the treatment of invasive cervical resorptions. A literature review and case report.

Invasive cervical resorption (ICR) is an uncommon phenomenon (0.1%), however, it represents a challenge to the structural and functional integrity of the dentogingival junction, as well as a risk for the survival of the affected tooth. They are characterized by their location and invasive character, being able to appear in any tooth of the permanent dentition. It shows up after the damage to the cervical insertion apparatus, leaving the pulp without participation in the origin of the lesion. They may appear just below the junctional epithelium or at a more apical level. The MTA® (Dentsply, Tulsa dental, Tulsa OK) and the Biodentine® (Septodent, Saint Maur of Fossés, France) are two biomaterials that have demonstrated the ability to promote the neoformation of cement so they are considered an alternative in the treatment of the ICR. This article presents an ICR clinical cases treated with these biomaterials, in which favorable post-operative healing is observed. Key words:MTA, Biodentine, biomaterials, root resorption, invasive cervical resorption.

Impact of periodontal treatment on the RANKL/OPG ratio in crevicular fluid.

AIM: Alveolar resorption is one of the most important events in periodontitis. Osteoclast activity is regulated by the ratio between receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG). The aim of this study was to evaluate changes in the RANKL/OPG ratio in crevicular fluid after periodontal treatment. MATERIAL AND METHODS: A total of 15 patients with periodontitis were included in the study group. Samples were collected from an area with active periodontitis and a healthy area. The RANKL and OPG levels were measured before and after periodontal scaling and root planing (SRP) treatment. The study group was compared to the control group, which included 10 patients without periodontitis. ID Clinicaltrial.gov: NCT03787875. RESULTS: A decrease in the RANKL level was found in areas with active periodontitis after periodontal treatment, but no change in the OPG level was observed. Therefore, the treatment induced a decrease in the RANKL/OPG ratio in sites with destructive periodontal activity. CONCLUSIONS: Periodontal treatment acts on the RANKL/OPG ratio by decreasing osteoclastogenesis. These results encourage the use of these molecules for periodontal diagnosis, monitoring and treatment. ID CLINICALTRIAL.GOV: NCT03787875.

Assessment of the capacity of a pyrophosphate-based mouth rinse to inhibit the formation of supragingival dental calculus. A randomized double-blind placebo-controlled clinical trial

Background: This study aimed to analyze the efficacy of an anti-calculus mouth rinse and its possible adverse effects on the mucosa and teeth. Material and Methods: This randomized double-blind placebo-controlled clinical trial included 40 patients with treated and managed periodontal disease, all with a history of rapid calculus formation. Patients used a pyrophos-phate-based test mouth rinse (B) or a placebo (A). A range of parameters were measured for: saliva (saliva flow, pH and chemical composition); calculus (Volpe-Manhold [V-M] index, weight, and volume); adverse effects on mucosa and teeth; and the patients’ subjective perceptive of mouth rinse efficacy. Results: the test mouth rinse B produced reductions in urea, uric acid, and phosphorous, calcium, saliva flow, and increases in pH. V-M index and calculus weight decreased after using the test mouth rinse. Calculus volume decreased with both mouth rinses. No changes to the mucosa or teeth were observed. Patients perceived that the test mouth rinse was more effective

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Epigenetics and periodontics: A systematic review

Background: Despite decades of research, our knowledge of several important aspects of periodontal pathogenesis remains incomplete. Epigenetics allows to perform dynamic analysis of different variations in gene expression, providing this great advantage to the static measurement provided by genetic markers. The aim of this systematic review is to analyze the possible relationships between different epigenetic mechanisms and periodontal diseases, and to assess their potential use as biomarkers of periodontitis. Material and Methods: A systematic search was conducted in six databases using MeSH and non-MeSH terms. The review fulfilled PRISMA criteria (Preferred Reporting Items for Systematic reviews and Meta-analysis). Results: 36 studies met the inclusion criteria. Due to the heterogeneity of the articles, it was not possible to conduct quantitative analysis. Regarding qualitative synthesis, however, it was found that epigenetic mechanisms may be used as biological markers of periodontal disease, as their dynamism and molecular stability makes them a valu-able diagnostic tool. Conclusions: Epigenetic markers alter gene expression, producing either silencing or over-expression of molecular transcription that respond to the demands of the cellular surroundings. Gingival crevicular fluid collection is a non-invasive and simple procedure, which makes it an ideal diagnostic medium for detection of both oral and systemic issues. Although further research is needed, this seems to be a promising field of research in the years to come

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miR-1226 detection in GCF as potential biomarker of chronic periodontitis: A pilot study

BACKGROUND: The study and identification of new biomarkers for periodontal disease, such as microRNAs (miR-NAs), may give us more information about the location and severity of the disease and will serve as a basis for treatment planning and disease-monitoring. miRNAs are a group of small RNAs which are involved in gene regulation by binding to their messenger RNA target (mRNA). In this pilot study, the procedure for purifying miRNAs from gingival crevicular fluid (GCF) was, for the first time, described. In addition, the concentration of miRNAs in GCF was analyzed and compared between patients with moderate or severe chronic periodontitis (CP) and healthy controls. MATERIAL AND METHODS: GCF samples were collected from single-rooted teeth of patients with moderate or severe CP (n=9) and of healthy individuals (n=9). miRNAs were isolated from GCF using miRNeasy Serum/Plasma kit (Qiagen, CA. USA). Reverse transcription polymerase chain reaction (qRT-PCR) was used to determine the expression of a series of miRNAs candidates that are related to bone metabolism. The significance of differences in miRNA levels between both groups was determined using Mann-Whitney U test. RESULTS: The results from this pilot study indicate that miRNAs can be isolated from GCF. Six different miRNAs were analyzed (miR-671, miR-122, miR-1306, miR-27a, miR-223, miR-1226), but only miR-1226 showed statically significant differences between the CP group and healthy controls (p < 0.05). This miRNA was downregulated in patients with CP. CONCLUSIONS: Within the limitations of the present study, it may be concluded that miR-1226 can be a promising biomarker for periodontal disease, adding relevant information to common clinical parameters used for diagnosis and prognosis of periodontitis

Palatal fenestration after orthodontic treatment. Intermodal approach and evolution. A case report.

A 15-year-old patient is referred to the Department of Periodontics of the University of Valencia. The patient reported dissatisfaction with the position of upper right canine after orthodontic treatment. Previously, in a private center, surgical approaches were performed for the traction of the canine included. On clinical examination at first appointment, generalized plaque-induced gingivitis was observed, with palatal fenestration of the root of upper right lateral incisor of approximately 75% of the total surface, with suppuration and very little gingiva inserted at the cervical level, which presents a buccal torque of the crown. Radiologically, a mild rhizolysis and bone loss adjacent to upper right lateral incisor was observed. An interdisciplinary treatment is decided between the departments of Orthodontics, Endodontics and Periodontics: - Canal treatment of upper right lateral incisor, performing a retrograde filling of the cavity with Biodentine ® (Septodent, Saint Maur de Fossés, France). - Orthodontic treatment, modifying the torque and improving the stability. - Periodontal treatment, performing a connective tissue graft by Langer technique adapted to the case. After the conclusion of the orthodontic treatment, an improvement in the situation is observed. The graft was performed, presenting at 3 months a line of fenestration in the mucosa. At 4 years, the patient is asymptomatic, without suppuration, with a total closure of the fenestration. Key words:Recession, orthodontics, connective tissue graft.

Effects of photodynamic therapy in periodontal treatment: A randomized, controlled clinical trial.

AIM: To evaluate the effects of photodynamic therapy (PDT) in the nonsurgical treatment of chronic periodontitis. MATERIALS AND METHODS: A randomized, single-blind, controlled, parallel-group clinical trial was performed. Sixty patients were enrolled: 20 healthy controls and 40 patients with periodontitis. The 40 patients were randomized for scaling and root planing (SRP) or SRP + PDT. Periodontal (plaque index, probing depth, clinical recession, clinical attachment level, bleeding on probing and gingival crevicular fluid volume, corresponding to 381 versus 428 critical sites), microbiological (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia and Campylobacter rectus presence, 18 versus 19 samples) and biochemical (interleukin (IL)-1ß, IL-6 and tumour necrosis factor (TNF)-α, receptor activator of nuclear factor-kappaB ligand (RANK-L) and osteoprotegerin (OPG) levels, 18 versus 19 samples) parameters were recorded. RESULTS: Within each group, significant improvements were found for clinical parameters, though without significant differences between groups. RANK-L was significantly decreased at week 13 in the SRP + PDT group compared with the SRP group. SRP + PDT, but not SRP alone, significantly reduced the abundance of A. actinomycetemcomitans. CONCLUSIONS: Except for a significant decrease in the pathogenic burden of A. actinomycetemcomitans, coadjuvant PDT resulted in no additional improvement compared with SRP alone in patients diagnosed with moderate-to-advanced chronic periodontitis.

Hereditary gingival fibromatosis: Characteristics and treatment approach.

Hereditary gingival fibromatosis (HGF) is a rare disorder characterized by a benign, non-hemorrhagic, fibrous gingival overgrowth that can appear in isolation or as part of a syndrome. Clinically, a pink gingiva with marked stippling can be seen to cover almost all the tooth, in many cases preventing eruption. HGF usually begins during the transition from primary to permanent teeth, giving rise to a condition that can have negative psychological effects at that age. As it does not resolve spontaneously, the treatment of choice is gingivectomy, which can be performed with an internal or external bevel incision, depending on each case and bearing in mind the changes that will take place at the dentogingival junction (DGJ). This paper describes clinical aspects and treatment in two eight-year-old boys with HGF, considering different facets of the surgical approach with conscious sedation in young children. Key words:Hereditary gingival fibromatosis, gingivectomy, internal bevel incision, external bevel incision, gingival overgrowth.

A controlled clinical study of periodontal health in anticoagulated patients: Assessment of bleeding on probing.

BACKGROUND: According to the Spanish Society of Cardiology, 700,000 patients receive oral anticoagulants, and in these cases bleeding on probing (BOP) could be altered. However, no studies have analyzed the periodontal status of these patients and the effects anticoagulants may have upon BOP. A study was made of the possible relationship between plaque index, probing depth, INR (International Normalized Ratio) and acenocoumarol dose versus the clinical signs of BOP in a sample of anticoagulated patients. Likewise, an analysis was made of oral hygiene habits and attitude towards bleeding in these patients. MATERIAL AND METHODS: A controlled observational clinical study was made in La Ribera Hospital (Valencia, Spain) involving 44 anticoagulated patients treated with Sintrom® (acenocoumarol) and a homogeneous control group of 44 non-anticoagulated patients. A survey on oral hygiene habits and attitude towards bleeding was carried out, and the main periodontal parameters were recorded. RESULTS: Probing depth was the parameter with the strongest correlation to BOP (p<0.001), followed by the plaque index (p<0.002). In contrast, no relationship was observed between acenocoumarol dose or INR and BOP. Mean BOP was greater in the control group than in the anticoagulated group (p<0.001). Oral hygiene habits and attitude towards bleeding differed significantly between groups. CONCLUSIONS: We have found no explanation why BOP was greater in the control group. What seems clear is that in the presence of the same plaque index and probing depth, anticoagulated patients did not bleed more than non-anticoagulated patients. A lack of knowledge of health and oral hygiene habits was observed in these subjects. Key words:Anticoagulant therapy, bleeding on probing, periodontal health.

Comparison of the clinical effects of white brand toothbrushes versus Vitis Suave®.

BACKGROUND: There has been an increase in the use of white label manual toothbrushes and a greater increase in inquiries for discomfort of the gingiva and mucosa. MATERIAL AND METHODS: A randomized, double-blind, cross-over clinical trial was made of four white brand toothbrushes versus a control brush (Vitis Suave®), with the recording of plaque index, bleeding upon probing, and gingival abrasions following utilization of the different brushes. RESULTS: All the brushes except Deliplus® were equally effective in terms of plaque removal (p<0.05). Vitis Suave® and Veckia® were the brushes associated to the greatest increase in minor abrasions (p<0.01), while Veckia®, Carrefour® and Deluxe® significantly increased the number of medium intensity abrasions (p<0.05). These brushes also increased the number of large abrasions, though statistical significance was not reached in this case. CONCLUSIONS: The white brand brushes proved effective in controlling bacterial plaque, but were associated to more intense soft tissue abrasion. KEY WORDS: Gingival abrasions, manual tooth brushing, white brand, clinical effects.

Morphology and dimensions of the dentogingival unitin the altered passive eruption

Objetives: This study define altered passive eruption (APE) and evaluate the morphology of the dentogingival unit.Material and Methods: 123 individuals subjected to clinical examination and parallel profile radiography of the upper central incisor. An evaluation was made of the correlation between the clinical diagnosis of APE and the degree of gingival overlap; by using a 19% overlap to define APE (Kappa concordance index = 0.7). The MannWhitney / Wilcoxon test was used to identify the variables influencing APE.Results: Statistically significant differences were observed between the teeth with and without APE: gingival width (p = 0.0073), clinical crown length (p = 0.0000), smiling exposed gums (p = 0.0000), bone crest thickness (p = 0.0030), connective tissue attachment thickness (p = 0.0003) and biological width (p = 0.0015). Conclusions: The APE is characterized by: a gingival overlapping of over 19% of the length of the anatomical crown, increased gingival width and gingival smile; furthermore is associated to a thick bone crest and connective tissue attachment. Statistical analysis confirms two morphological patterns of APE (AU)

Morphology and dimensions of the dentogingival unit in the altered passive eruption.

OBJECTIVES: This study define altered passive eruption (APE) and evaluate the morphology of the dentogingival unit. MATERIAL AND METHODS: 123 individuals subjected to clinical examination and parallel profile radiography of the upper central incisor. An evaluation was made of the correlation between the clinical diagnosis of APE and the degree of gingival overlap; by using a 19% overlap to define APE (Kappa concordance index=0.7). The Mann-Whitney / Wilcoxon test was used to identify the variables influencing APE. RESULTS: Statistically significant differences were observed between the teeth with and without APE: gingival width (p=0.0073), clinical crown length (p=0.0000), smiling exposed gums (p=0.0000), bone crest thickness (p=0.0030), connective tissue attachment thickness (p=0.0003) and biological width (p=0.0015). CONCLUSIONS: The APE is characterized by: a gingival overlapping of over 19% of the length of the anatomical crown, increased gingival width and gingival smile; furthermore is associated to a thick bone crest and connective tissue attachment. Statistical analysis confirms two morphological patterns of APE.

Altered passive eruption (APE): A little -known clinical situation

Gummy smile constitutes a relatively frequent aesthetic alteration characterized by excessive exhibition of thegums during smiling movements of the upper lip. It is the result of an inadequate relation between the lower edgeof the upper lip, the positioning of the anterosuperior teeth, the location of the upper jaw, and the gingival marginposition with respect to the dental crown.Altered Passive Eruption (APE) is a clinical situation produced by excessive gum overlapping over the enamellimits, resulting in a short clinical crown appearance, that gives the sensation of hidden teeth. The term itselfsuggests the causal mechanism, i.e., failure in the passive phase of dental eruption, though there is no scientificevidence to support this. While there are some authors who consider APE to be a risk situation for periodontalhealth, its clearest clinical implication refers to oral esthetics.APE is a factor that frequently contributes to the presence of a gummy or gingival smile, and it can easily be correctedby periodontal surgery. Nevertheless, it is essential to establish a correct differential diagnosis and goodtreatment plan. A literature review is presented of the dental eruption process, etiological hypotheses of APE, itsmorphologic classification, and its clinical relevance (AU)

Altered passive eruption (APE): a little-known clinical situation.

Gummy smile constitutes a relatively frequent aesthetic alteration characterized by excessive exhibition of the gums during smiling movements of the upper lip. It is the result of an inadequate relation between the lower edge of the upper lip, the positioning of the anterosuperior teeth, the location of the upper jaw, and the gingival margin position with respect to the dental crown. Altered Passive Eruption (APE) is a clinical situation produced by excessive gum overlapping over the enamel limits, resulting in a short clinical crown appearance, that gives the sensation of hidden teeth. The term itself suggests the causal mechanism, i.e., failure in the passive phase of dental eruption, though there is no scientific evidence to support this. While there are some authors who consider APE to be a risk situation for periodontal health, its clearest clinical implication refers to oral esthetics. APE is a factor that frequently contributes to the presence of a gummy or gingival smile, and it can easily be corrected by periodontal surgery. Nevertheless, it is essential to establish a correct differential diagnosis and good treatment plan. A literature review is presented of the dental eruption process, etiological hypotheses of APE, its morphologic classification, and its clinical relevance.

Periodontal regeneration in clinical practice.

The regeneration or restitution of lost supporting tissue has always been considered the ideal objective of periodontal therapy. However, attempts to convert this intention into solid clinical practice can become tremendously complex, the results of which are very different from the original intention. The aim of this article is to offer an up-to-date, general perspective on periodontal regeneration, orienting the clinician within the global strategy for oral treatment. To this end, we revise the healing process of periodontal injury, the different therapeutic approaches, the interpretation of the results, and finally, limiting factors in periodontal regeneration.

Regeneración periodontal en la practica clínica / Periodontal regeneration in clinical practice

Siempre se ha considerado que el objetivo ideal de la terapia periodontal es la regeneración o restitución de los tejidos de soporte perdidos. Sin embargo, el intentar traducir este objetivo, en actuaciones clínicas concretas puede convertirse en una tarea tremendamente compleja y cuyos resultados disten mucho del objetivo inicial.La intención de este artículo es ofrecer una perspectiva general y actualizada de la regeneración periodontal que permitaal clínico situarla dentro de la estrategia de tratamiento oral global. Para ello se revisa: el proceso de curación de la herida periodontal, los diferentes enfoques terapéuticos, la interpretación de los resultados, y por último, los factores que limitan las indicaciones de las técnicas de regeneración periodontal

The regeneration or restitution of lost supporting tissue has always been considered the ideal objective of periodontal therapy. However, attempts to convert this intention into solid clinical practice can become tremendously complex, the results of which are very different from the original intention.The aim of this article is to offer an up-to-date, general perspective on periodontal regeneration, orienting the clinician within the global strategy for oral treatment. To this end, we revise the healing process of periodontal injury, the different therapeutic approaches, the interpretation of the results, and finally, limiting factors in periodontal regeneration

¿Son los adhesivos dentinarios una opción válida para el tratamiento de la sensibilidad cervical dentinaria? / Are dentin bonding systems a valid option for the treatment of Cervical Dentin Sensitivity (C. D. S.)?

El objetivo de este trabajo es evaluar la capacidad in vitro de sellar túbulos dentinarios y reducir la permeabilidad dentinaria que tienen catorce productos propuestos para el tratamiento de la sensibilidad cervical dentinaria (SCD) y evaluar el efecto que la humedad y el cepillado tienen sobre ellos. Material y método: 140 discos de dentina (obtenidos de 3º molares humanos recién extraídos) se dividen en catorce grupos de 10 discos que se montan en un sistema de perfusión basado en la máquina de Pashley que mantiene una presión positiva sobre las discos. Cada disco se graba con ácido ortofosfórico al 35% y su permeabilidad se mide en una hora, este valor se considera el de referencia (100%). Un disco queda como control y se aplica tratamiento a los otros 9, midiéndose su permeabilidad en una hora. Después se deja un disco como control, a los 8 restantes se les realiza un lavado y cepillado, viéndose su permeabilidad en una hora. Resultados: Todos los productos afectaron a la perfusión dentinaria en mayor o menor grado. El cepillado de las muestras con el producto aplicado afectó a la permeabilidad, que en todas las preparaciones aumentó en mayor o menor grado. El mejor producto fue el Seal & Protect, seguido del Amm-i-dent + Xeno III, el Clearfil SE Bond y el Amm-i-dent + Scotchbond1. Conclusiones: Todos los productos presentan mala resistencia al lavado y cepillado, lo que justifica el limitado éxito clínico de los agentes desensibilizantes. El que los cuatro mejores productos o combinaciones en cuanto a reducción de permeabilidad pertenezcan al grupo de los adhesivos dentinarios indica que estos pueden ser una alternativa válida para ser investigada y perfeccionada como tratamiento de la SCD

The aim of this study is to evaluate the “in vitro” capability of fourteen agents proposed for the treatment of cervical dentin sensibility (CDS) to seal dentine tubules, to reduce dentine permeability and to resist the effect of wetness and tooth brushing. Materials and Methods: 140 dentin discs were obtained from freshly extracted human third molars. Samples were divided into fourteen groups of 10 each and were mounted in a perfusion device based on the Pashley ´s system. Each disc was etched with 35% phosphoric acid. Permeability was measured after 1 hour, this value was considered the reference value (100%). One disc was used as a control and nine were treated with a bonding system. Permeability was measured again after 1 hour. One disc was used as a control and 8 were washed with water and subjected to simulated tooth brushing equivalent to three weeks of normal brushing. Subsequebtly, permeability was measured again. Results: All systems reduced dentinal perfusion when applied. Brushing of products produced an increase of permeability. The best results were obtained with Seal & Protect, follwed by Amm-i-dent + Xeno III, Clearfil SE Bond and Amm-i-dent+Scotchbond 1. Conclusions: All products have shown low resistance to washing and brushing. This can justify unsatisfactory clinical results in reducing dentinal sensibility. The best four products were all adhesives or a combination of these, it seems to indicate that adhesives are a good choice to be investigated and improved for the treatment of CDS

¿Son los adhesivos dentinarios una opción válida para el tratamiento de la sensibilidad cervical dentinaria? / Are dentin bonding systems a valid option for the treatment of Cervical Dentin Sensitivity (C. D. S.) ?

El objetivo de este trabajo es evaluar la capacidad in vitro de sellar túbulos dentinarios y reducir la permeabilidad dentinaria que tienen catorce productos propuestos para el tratamiento de la sensibilidad cervical dentinaria (SCD) y evaluar el efecto que la humedad y el cepillado tienen sobre ellos. Material y método: 140 discos de dentina (obtenidos de 3º molares humanos recién extraídos) se dividen en catorce grupos de 10 discos que se montan en un sistema de perfusión basado en la máquina de Pashley que mantiene una presión positiva sobre las discos. Cada disco se graba con ácido ortofosfórico al 35% y su permeabilidad se mide en una hora, este valor se considera el de referencia (100%). Un disco queda como control y se aplica tratamiento a los otros 9, midiéndose su permeabilidad en una hora. Después se deja un disco como control, a los 8 restantes se les realiza un lavado y cepillado, viéndose su permeabilidad en una hora. Resultados: Todos los productos afectaron a la perfusión dentinaria en mayor o menor grado. El cepillado de las muestras con el producto aplicado afectó a la permeabilidad, que en todas las preparaciones aumentó en mayor o menor grado. El mejor producto fue el Seal & Protect, seguido del Amm-i-dent + Xeno III, el Clearfil SE Bond y el Amm-i-dent + Scotchbond1. Conclusiones: Todos los productos presentan mala resistencia al lavado y cepillado, lo que justifica el limitado éxito clínico de los agentes desensibilizantes. El que los cuatro mejores productos o combinaciones en cuanto a reducción de permeabilidad pertenezcan al grupo de los adhesivos dentinarios indica que estos pueden ser una alternativa válida para ser investigada y perfeccionada como tratamiento de la SCD (AU)

The aim of this study is to evaluate the “in vitro” capability of fourteen agents proposed for the treatment of cervical dentin sensibility (CDS) to seal dentine tubules, to reduce dentine permeability and to resist the effect of wetness and tooth brushing. Materials and Methods: 140 dentin discs were obtained from freshly extracted human third molars. Samples were divided into fourteen groups of 10 each and were mounted in a perfusion device based on the Pashley ´s system. Each disc was etched with 35% phosphoric acid. Permeability was measured after 1 hour, this value was considered the reference value (100%). One disc was used as a control and nine were treated with a bonding system. Permeability was measured again after 1 hour. One disc was used as a control and 8 were washed with water and subjected to simulated tooth brushing equivalent to three weeks of normal brushing. Subsequebtly, permeability was measured again. Results: All systems reduced dentinal perfusion when applied. Brushing of products produced an increase of permeability. The best results were obtained with Seal & Protect, follwed by Amm-i-dent + Xeno III, Clearfil SE Bond and Amm-i-dent+Scotchbond 1. Conclusions: All products have shown low resistance to washing and brushing. This can justify unsatisfactory clinical results in reducing dentinal sensibility. The best four products were all adhesives or a combination of these, it seems to indicate that adhesives are a good choice to be investigated and improved for the treatment of CDS (AU)