Using Laser-Doppler Flowmetry to Evaluate the Therapeutic Response in Dentin Hypersensitivity.

Dentin hypersensitivity (DH) is a common medical condition with underreported prevalence and it is difficult to quantify. This study aimed to investigate whether assessing dental pulp vascular micro-dynamics by laser-Doppler flowmetry (LDF) would be functional for therapeutic evaluation, in contrast to a verbal rating scale (VRS). A split-mouth single-blind randomized study was conducted on seven patients and a total of 36 teeth. Two DH therapeutic methods were employed: (i) fluoride gel; (ii) Nd:YAG radiation combined with fluoride gel. For each tooth, five consecutive LDF determinations of pulp blood flow were made (before and immediately after desensitizing treatment, then after 24 h, 7 days, and 1 month), and the VRS was applied each time. Spearman's correlation was applied for concurrent validation. Two-way (treatment and patient) repeated measures ANOVA full factorial was applied, followed by Tukey's post-hoc comparisons and Pillai's trace multivariate statistic. While VRS scores had moderate reliability, LDF could objectively estimate treatment effects. Based on partial eta-squared values, treatment and patient characteristics were estimated to explain about 84% and 50% of the variability, respectively. In conclusion, LDF is an objective technique that can quantitatively assess DH evolution, and it is effective in reliably monitoring oral health therapeutic interventions.

Diagnostic accuracy of a charge-coupled device and a photostimulable phosphor plate in detection of non-cavitated proximal caries

Objective: the aim of this study was to compare the diagnostic accuracy of two direct digital radiography systems: the charge-coupled device (CCD) XIOS XG Sirona and the photostimulable storage phosphor (PSP) VistaScan DürrDental, in the detection of non-cavitated proximal caries lesions. materials and methods: in this experimental and cross-sectional study 112 proximal surfaces from 27 molars and 31 premolars with or without proximal caries lesions were evaluated and randomly allocated in a study unit. bitewing radiographs were acquired with a CCD XIOS XG and with the PSP VistaScan. a single x-ray unit was used for both systems. radiographic images were assessed independently by two calibrated radiologists. histological evaluation on a stereomicroscope was used as gold standard. results: sensitivity values were found to be 0.35 for CCD and 0.31 for PSP. specificity values were found to be similar for both systems (0.867). az values showed a low diagnostic accuracy for both sensors: 0.61 for CCD and 0.59 for PSP, no statistical difference was found between these two values (p=0.78). conclusion: both digital radiology systems have a high diagnostic accuracy to detect sound surfaces but low diagnostic accuracy to detect proximal carious lesions.

Comparative Evaluation of Fluoridated Mouthwash and Sodium Bicarbonate in Management of Dentin Hypersensitivity: An In Vitro SEM Study.

Sodium bicarbonate (ie, baking soda) can be used as an adjunct to surgical periodontal therapy to reduce dentin hypersensitivity (DH). Sodium bicarbonate mouthwash has numerous appealing attributes, including high availability, low cost, low abrasivity, water solubility, buffering capability, and, in high concentrations, antimicrobial properties. It is also safe to use. The primary underlying cause of DH is open dentinal tubules from loss of either cementum or enamel. The aim of this in vitro study was to evaluate, through scanning electron microscopic examination, the effect of sodium bicarbonate on dentinal tubule occlusion and compare it with that of fluoridated mouthwash.

The Assessment and Management of External Cervical Resorption with Periapical Radiographs and Cone-beam Computed Tomography: A Clinical Study.

INTRODUCTION: This in vivo study assessed whether there was a difference between periapical radiographs (PRs) and cone-beam computed tomographic (CBCT) imaging in the detection, assessment, and management of external cervical resorption (ECR). The secondary aim was to determine if parallax radiographs were of any further benefit compared with a single PR. METHODS: PR and CBCT data were gathered for 115 teeth (98 patients) consecutively diagnosed with ECR. The diagnosis and treatment plan of each tooth were determined with PRs and CBCT imaging. Sensitivity, specificity, positive predictive values, negative predictive values, and receiver operator characteristic values were determined. RESULTS: The overall sensitivity (0.86) and specificity (0.89) of PRs was significantly lower than CBCT imaging (P < .001). PRs had a limited ability to accurately detect the size (0.75), circumferential spread (0.60), and location of ECR compared with CBCT imaging (P < .001). PRs also underestimated the size of the ECR lesion. Significant differences (P < .001) were apparent in the treatment plans formed when PRs were assessed versus CBCT imaging. Parallax radiographs were shown to be of no additional benefit compared with a single radiograph. CONCLUSIONS: PRs have significant limitations in the detection, assessment, and treatment planning of ECR when compared with CBCT imaging. A CBCT scan should be considered before the management of a potentially restorable ECR lesion.

Dentin hypersensitivity: differential diagnosis, tests, and etiology.

Dentin hypersensitivity (DHS) is a painful condition that affects up to 57 percent of the adult population. It occurs as a result of exposure of dentin to the oral environment. Ensuring the correct diagnosis of this condition is based on history and examination. An oral screening for DHS should encompass such elements as patient history, clinical examination that includes radiographs, a variety of tests, identification of risk factors, and a differential diagnosis. An understanding of dentinal fluid and odontoblasts is also beneficial for diagnosis.

Evaluation of a calcium phosphate desensitizer using an ultrasonic device.

This study evaluated the effect of a calcium phosphate desensitizer on the demineralization of bovine dentin by measuring changes in transmitted ultrasonic velocity. Bovine dentin specimens with and without application of desensitizer were immersed in 0.1 M lactic-acid buffer solution (pH 4.75) 10 min twice daily throughout the test period, and stored in artificial saliva solution (pH 7.0) between treatments. The propagation time of longitudinal ultrasonic waves was measured by a pulser-receiver. Data were evaluated using one-way ANOVA followed by Tukey HSD test (α=0.05). The ultrasonic velocity decreased over time in specimens stored in demineralizing solution (3,785-3,462 m/s); however, desensitizer-applied specimens had a significantly higher sonic velocity (3,945-3,990 m/s) than those without application. The calcium phosphate desensitizer appeared to reduce the demineralization of dentin and occluded dentinal tubules.

Clinical evaluation of postoperative sensitivity in composite resin restorations using various liners.

Light-cured resin composites are a viable option for restoring Class I and Class II cavities; however, several researchers have reported postoperative sensitivity in such restorations. In this in vivo study, 80 teeth with Class I and Class II cavities were selected. They were divided into four groups of 20 teeth each, to be restored with composite resin using different treatment protocols. Postoperative sensitivity to cold water at various temperatures was assessed for up to three months. The data was interpreted using Chi Square Test for homogeneity among the groups, and Z values of significance for pair-wise evaluation were determined. It was found that use of self-etching primers as bonding agents underneath the composite resin restorations were associated with significantly decreased incidence of postoperative sensitivity to cold stimuli.

Reasons for taking radiographs in general dental practice in Dar-es-Salaam, Tanzania.

This study investigated the reasons why dental practitioners at the Muhimbili Dental OPD clinic in Dar-es-Salaam take radiographs. Information was obtained from medical records at the Department of Dental Radiology for an eighteen month period, during which 28,171 patients were seen at the hospital, and of which 2,672 (9.48 per cent) were radiographed. The main reasons for taking radiographs (percentages) was to detect fractures (17.2), tumours (14.1), caries (12.5), impacted teeth (12.2), periodontal disease (11.3), and non-specific dental pain (10.4). Radiographs were also taken for orthodontic (7.0 per cent) and endodontic (6.8 per cent) reasons. Some of the reasons for taking radiographs such as hypersensitive teeth, apicectomy, neuralgia and xerostomia were previously unheard of, indicating an increasing diversity of dental services. In conclusion, there is a need to increase the utilisation of dental radiographs from the present modest level in order to meet the growing need of the increasingly informed dental population in Dar-es-Salaam.