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Dalmolin AC, Silva KR, Dechandt ICJ, Ribeiro KC, Gallo LS, Pochapski MT, Serbena FC, Dos Santos FA. Efficiency of cavitary varnishes containing experimental bioglass particles in the occlusion of dentinal tubules. Odontology 2024:10.1007/s10266-024-00952-y. [PMID: 38769194 DOI: 10.1007/s10266-024-00952-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
This research aims to evaluate the efficiency of cavitary varnishes containing experimental bioglasses in the occlusion of dentinal tubules. One hundred and sixty-eight cervical buccal dentin samples were obtained from bovine teeth. Samples were randomized into the following groups: I. Distilled Water (DW); II. Cavity Varnish (CV); III. Colgate® Sensitive Pro-Relief™ (CS); IV. 45S5 Bioglass (45S5); V. KSr Bioglass strontium potassium (KSr); VI. P Bioglass phosphorus (P); and VII. PSi Bioglass phosphorus silica (PSi). The treatments were applied to the surfaces of the samples, which were then subjected to simulated brushing. The samples were analyzed for a) characterization of bioactive glasses; b) surface roughness; c) descriptive analysis of the dentin surface; d) total versus occluded number of dentinal tubules; e) diameter of the dentinal tubules; f) chemical composition of the dentin surfaces, and g) dentin permeability. All groups treated with biomaterials without the brushing challenge showed an increase in roughness and (total or partial) occlusion of the dentinal tubules. The PSi group had the best values for occlusion, while the KSr group had the highest calcium and phosphorus concentrations. After the brushing challenge the roughness was controlled by the presence of biomaterials; 45S5, KSr, and PSi showed occlusion of the dentin tubules. All bioactive glasses showed reduced tooth permeability compared to distilled water. The PSi group had the smallest tubule diameter and highest phosphorus concentration. KSr and PSi bioglasses are promising materials for dentin occlusion and remineralization and are promising new biomaterials for the treatment of dentin hypersensitivity.
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Affiliation(s)
- Ana Cláudia Dalmolin
- Dentistry Department, State University of Ponta Grossa - UEPG, Ave. Carlos Cavalcanti, N. 4748.. Uvaranas, Ponta Grossa, PR, Zip Code: 84030-900, Brazil
| | - Kellen Rutes Silva
- Dentistry Department, State University of Ponta Grossa - UEPG, Ave. Carlos Cavalcanti, N. 4748.. Uvaranas, Ponta Grossa, PR, Zip Code: 84030-900, Brazil
| | - Iolanda Cristina Justus Dechandt
- Physics Department, State University of Ponta Grossa - UEPG, Ave. Carlos Cavalcanti, N. 4748. Uvaranas, Ponta Grossa, PR, . Zip Code: 84030-900, Brazil
| | - Karen Cristiane Ribeiro
- Physics Department, State University of Ponta Grossa - UEPG, Ave. Carlos Cavalcanti, N. 4748. Uvaranas, Ponta Grossa, PR, . Zip Code: 84030-900, Brazil
| | - Leonardo Sant'Ana Gallo
- Department of Chemical Engineering and Materials, Federal University of Lavras - UFLA, ABI Building, 33 Bureau. , Post Office Box: 3037, Ignácio Valentin. Lavras, MG, Zip Code: 37200-900. , Brazil
| | - Márcia Thaís Pochapski
- Dentistry Department, State University of Ponta Grossa - UEPG, Ave. Carlos Cavalcanti, N. 4748.. Uvaranas, Ponta Grossa, PR, Zip Code: 84030-900, Brazil
| | - Francisco Carlos Serbena
- Physics Department, State University of Ponta Grossa - UEPG, Ave. Carlos Cavalcanti, N. 4748. Uvaranas, Ponta Grossa, PR, . Zip Code: 84030-900, Brazil
| | - Fábio André Dos Santos
- Dentistry Department, State University of Ponta Grossa - UEPG, Ave. Carlos Cavalcanti, N. 4748.. Uvaranas, Ponta Grossa, PR, Zip Code: 84030-900, Brazil.
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Ronan EA, Nagel M, Emrick JJ. The anatomy, neurophysiology, and cellular mechanisms of intradental sensation. FRONTIERS IN PAIN RESEARCH 2024; 5:1376564. [PMID: 38590718 PMCID: PMC11000636 DOI: 10.3389/fpain.2024.1376564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/11/2024] [Indexed: 04/10/2024] Open
Abstract
Somatosensory innervation of the oral cavity enables the detection of a range of environmental stimuli including minute and noxious mechanical forces. The trigeminal sensory neurons underlie sensation originating from the tooth. Prior work has provided important physiological and molecular characterization of dental pulp sensory innervation. Clinical dental experiences have informed our conception of the consequence of activating these neurons. However, the biological role of sensory innervation within the tooth is yet to be defined. Recent transcriptomic data, combined with mouse genetic tools, have the capacity to provide important cell-type resolution for the physiological and behavioral function of pulp-innervating sensory neurons. Importantly, these tools can be applied to determine the neuronal origin of acute dental pain that coincides with tooth damage as well as pain stemming from tissue inflammation (i.e., pulpitis) toward developing treatment strategies aimed at relieving these distinct forms of pain.
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Affiliation(s)
- Elizabeth A. Ronan
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Maximilian Nagel
- Sensory Cells and Circuits Section, National Center for Complementary and Integrative Health, Bethesda, MD, United States
| | - Joshua J. Emrick
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
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Klima M, Auwärter V, Altenburger MJ, Neukamm MA. In vitro studies on the dependence of drug deposition in dentin on drug concentration, contact time, and the physicochemical properties of the drugs. Arch Toxicol 2023; 97:2675-2685. [PMID: 37587384 PMCID: PMC10474980 DOI: 10.1007/s00204-023-03573-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023]
Abstract
The chemical analysis of dental hard tissues can provide information on previous drug use due to the deposition of drugs into this tissue. For the interpretation of analytical results in, e.g., postmortem toxicology or regarding archeological samples, the influence of drug dosing, consumption frequency, duration of intake and type of drug on analyte concentrations in teeth has to be characterized. To approximate these correlations, in vitro models were applied to investigate the time dependency of drug deposition via and against pulp pressure (perfusion studies) and the concentration dependency of drug deposition via oral cavity (incubation study) as well as the influence of de- and remineralization (pH cycling) on the incorporation of drugs in bovine dentin pellets. Some of the drugs of abuse most relevant in forensic case work (amphetamines, opiates, cocaine and benzoylecgonine) were applied. Concentrations in dentin samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) after pulverization and extraction via ultrasonication with methanol. The studies showed that drug deposition in dentin likely depends on the physicochemical properties of the drug molecules as well as on the duration of contact with drugs via the blood stream and on drug concentrations present in the oral cavity. Higher drug concentrations in teeth can result from a more frequent or longer drug use. In addition, intake of higher doses or oral/inhalative consumption can also be expected to lead to higher drug concentrations. These findings can be helpful for the interpretation of postmortem cases.
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Affiliation(s)
- Miriam Klima
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Laboratory Medicine and Toxicology, Labor Berlin-Charité Vivantes GmbH, Berlin, Germany
| | - Volker Auwärter
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Markus J Altenburger
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Merja A Neukamm
- Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Freiburg, Germany.
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Dalmolin AC, Finkler BC, Almeida CV, Bechtold LB, Silva KR, Centenaro GG, Coelho U, Pochapski MT, Dos Santos FA. Prevalence of dentin hypersensitivity after orthodontic treatment: A cross-sectional study. Am J Orthod Dentofacial Orthop 2023; 164:431-440. [PMID: 37086249 DOI: 10.1016/j.ajodo.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 04/23/2023]
Abstract
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.
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Affiliation(s)
- Ana Cláudia Dalmolin
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Bruna Caroline Finkler
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Camila Vieira Almeida
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Laura Borato Bechtold
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Kellen Rutes Silva
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Gabrielle Gomes Centenaro
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Ulisses Coelho
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Márcia Thaís Pochapski
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Fábio André Dos Santos
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil.
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Dias S, Casqueiro L, Pereira R, Silveira J, Mata A, Marques D. Hydrogen Peroxide Diffusion through Dental Tissues-In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5552. [PMID: 37629843 PMCID: PMC10456627 DOI: 10.3390/ma16165552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023]
Abstract
Whitening products commonly utilize hydrogen peroxide (HP) as an active principle, which can penetrate dental tissues with potential side effects due to its low molecular weight. This study aimed to evaluate the HP diffusion of two in-office whitening products, namely 6% VivaStyle Paint On Plus (VS) and Opalescence Boost 40% (OP), in different tooth types. Additionally, the influence of the area of exposure, dental tissue thickness and pulp chamber volume was assessed. Each group consisted of eighteen intact anterior (A), premolar (PM) and molar (M) human teeth, and a positive pulpal pressure model was employed. The samples were analyzed using spectrophotometry, and results were expressed as the mean and 95% confidence interval. Statistical tests and linear regression models were appropriately applied at α = 5%. The total HP (µg) retrieved was as follows: VS-A, 1.333 [1.214, 1.452]; OP-A, 1.538 [1.457, 1.620]; VS-PM, 1.208 [1.123, 1.291]; OP-PM, 3.628 [3.401, 3.855]; VS-M, 2.560 [2.297, 2.823]; and OP-M, 4.197 [3.997, 4.396], with statistically significant differences in diffusion kinetics between whitening products for PM and M. Several HP concentrations attained a minimum cytotoxicity value of 2.22 µg/mL. The regression model shows that OP exposed the pulp chamber to 1.421 µg of HP more than that of VS. Different whitening products can cause cytotoxic HP concentrations in the pulp chamber, with a higher risk observed in molars.
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Affiliation(s)
- Susana Dias
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal; (S.D.); (L.C.); (R.P.); (J.S.); (A.M.)
| | - Leonor Casqueiro
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal; (S.D.); (L.C.); (R.P.); (J.S.); (A.M.)
| | - Ruben Pereira
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal; (S.D.); (L.C.); (R.P.); (J.S.); (A.M.)
| | - João Silveira
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal; (S.D.); (L.C.); (R.P.); (J.S.); (A.M.)
- LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal
| | - António Mata
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal; (S.D.); (L.C.); (R.P.); (J.S.); (A.M.)
- LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal
| | - Duarte Marques
- Oral Biology and Biochemistry Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal; (S.D.); (L.C.); (R.P.); (J.S.); (A.M.)
- LIBPhys-FCT UID/FIS/04559/2013, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal
- Postgraduate Programme in Prosthodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, 1950-044 Lisboa, Portugal
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Samir PV, Mahapatra N, Dutta B, Bagchi A, Dhull KS, Verma RK. A Correlation between Clinical Classification of Dental Pulp and Periapical Diseases with its Patho Physiology and Pain Pathway. Int J Clin Pediatr Dent 2023; 16:639-644. [PMID: 37731799 PMCID: PMC10507313 DOI: 10.5005/jp-journals-10005-2636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Background Dental pain due to pulpal involvement is difficult to diagnose due to the apparent inaccessibility of pulp to the clinical tests, indistinct symptoms, and referred toothache originating from the periodontal tissues. Though we have various clinical classification systems to categorize pulpal diseases, we are yet biased about the exact pathophysiology and pain pathway associated with it. Dental pulp has a complex physiology, and so is its pathophysiology. Aims & objectives To concisely reviews the basic understanding of the pathophysiology of pulp, pain pathway, and its correlation with the classification of various clinical conditions of pulpal inflammation and periapical diseases. Methodology Literature search on pulpal diseases and pathophysiology from the sources: MEDLINE, PubMed, Web of Science and Cochrane Databases dated from 1965 till December 2020 was carried on to collect 163 articles. Results Filtered search on the pathophysiology of pulp, pain pathway, and classification of various clinical conditions of pulpal inflammation resulted us to precise 36 articles required for our understanding and demystifying the correlation. Conclusion The emphasis should be laid on understanding the minute changes occurring inside the pulp in due course of inflammation to aid its diagnosis and a treatment plan accordingly. How to cite this article Samir PV, Mahapatra N, Dutta B, et al. A Correlation between Clinical Classification of Dental Pulp and Periapical Diseases with its Patho Physiology and Pain Pathway. Int J Clin Pediatr Dent 2023;16(4):639-644.
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Affiliation(s)
- PV Samir
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Niva Mahapatra
- Department of Oral and Maxillofacial Pathology, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Brahmananda Dutta
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Anandamoy Bagchi
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Kanika S Dhull
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Rajnish K Verma
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
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The effect of iontophoresis delivery of fluoride in stannous fluoride desensitizing toothpaste on dentin permeability in human extracted teeth. Sci Rep 2022; 12:13615. [PMID: 35948761 PMCID: PMC9365827 DOI: 10.1038/s41598-022-18043-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 08/04/2022] [Indexed: 11/20/2022] Open
Abstract
This study aimed to determine the effect of iontophoresis delivery of fluoride in stannous fluoride (SnF2) toothpaste on dentin permeability in human extracted third molars. For dentin permeability test, 26 dentin specimens were randomly divided into 4 groups; SnF2 without-iontophoresis (n = 10), SnF2 with-iontophoresis (n = 10), no SnF2 without-iontophoresis (n = 3), and no SnF2 with-iontophoresis (n = 3). The hydraulic conductance of dentin (HD) was measured after smear layer removal, immediate treatment, 7 days, and acid challenge. The other 26 specimens were also prepared under these different conditions to assess degree of dentinal tubule occlusions using scanning electron microscopy (SEM). Percentage decrease of HD in SnF2 without-iontophoresis after immediate treatment, 7 days and acid challenge were 38.38 ± 13.61, 56.92 ± 17.22 and 33.07 ± 23.57%. The corresponding values in SnF2 with-iontophoresis were 42.16 ± 14.49, 62.35 ± 15.67 and 50.01 ± 12.60%, respectively. There was a significant difference between without- and with-iontophoresis groups after acid challenge (p < 0.05). For SEM, after 7 days, SnF2 with-iontophoresis showed deeper dentinal tubule occlusion (p < 0.05) and more resistance to acid challenge than SnF2 without-iontophoresis. No significant change was observed in groups of no SnF2 treatment. Cathode iontophoresis could enhance the effect of SnF2 toothpaste in decreasing dentin permeability and increasing resistance to acid challenge.
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Cho YS, Han HM, Jeong SY, Kim TH, Choi SY, Kim YS, Bae YC. Expression of Piezo1 in the Trigeminal Neurons and in the Axons That Innervate the Dental Pulp. Front Cell Neurosci 2022; 16:945948. [PMID: 35846568 PMCID: PMC9276962 DOI: 10.3389/fncel.2022.945948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/03/2022] [Indexed: 12/02/2022] Open
Abstract
Information on the neurons and axons that express the mechanosensitive channel Piezo1 and its expression in axons innervating the dental pulp may help understand the nature of the Piezo1-mediated mechanosensation and the underlying mechanism of dentin sensitivity elicited by mechanical stimuli. For this, we here investigated the neurochemical properties of the neurons in the rat trigeminal ganglion (TG) and their axons in its sensory root that express Piezo1 and the expression of Piezo1 in the rat and human dental pulp by light and electron microscopic immunohistochemistry and quantitative analysis. Piezo1 was expressed mainly in medium-sized and large TG neurons. Piezo1-immunopositive (+) neurons frequently coexpressed the marker for neurons with myelinated axons, NF200, but rarely the markers for neurons with unmyelinated axons, CGRP or IB4. In the sensory root of TG, Piezo1 was expressed primarily in small myelinated axons (Aδ, 60.2%) but also in large myelinated (Aβ, 24.3%) and unmyelinated (C, 15.5%) axons. In the human dental pulp, Piezo1 was expressed in numerous NF200+ axons, which formed a network in the peripheral pulp and often “ascended” toward the dentin. Most Piezo1+ myelinated axons in the radicular pulp became unmyelinated in the peripheral pulp, where Piezo1 immunoreaction product was associated with the axonal plasma membrane, suggesting a functional role of Piezo1 in the peripheral pulp. These findings suggest that Piezo1 is involved primarily in mediating the acute pain elicited by high-threshold mechanical stimuli, and that the Piezo1-mediated dental mechanotransduction occurs primarily in the axons in the peripheral pulp.
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Affiliation(s)
- Yi Sul Cho
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Hye Min Han
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Soon Youn Jeong
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Tae Heon Kim
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - So Young Choi
- Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Yun Sook Kim
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Yong Chul Bae
- Department of Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, South Korea
- *Correspondence: Yong Chul Bae
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Current Concepts of Dentinal Hypersensitivity. J Endod 2021; 47:1696-1702. [PMID: 34302871 DOI: 10.1016/j.joen.2021.07.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Although many clinical studies have reported on the prevalence of dental pain, far fewer studies have focused on the mechanisms of dental pain. This is an important gap because increased understanding of dental pain mechanisms may lead to improved diagnostic tests or therapeutic interventions. The aim of this study was to comprehensively review the literature on the mechanisms of dentinal sensitivity. METHODS PubMed and Ovid were searched for articles that addressed dentinal pain and or pulpal sensitivity. Because of the breadth of research ranging from cellular/molecular studies to clinical trials, a narrative review on the mechanisms of dentinal sensitivity was constructed based on the literature. RESULTS Five various mechanisms for dentinal sensitivity have been proposed: (1) the classic hydrodynamic theory, (2) direct innervation of dentinal tubules, (3) neuroplasticity and sensitization of nociceptors, (4) odontoblasts serving as sensory receptors, and (5) algoneurons. CONCLUSIONS These theories are not mutually exclusive, and it is possible that several of them contribute to dentinal sensitivity. Moreover, pulpal responses to tissue injury may alter the relative contribution of these mechanisms. For example, pulpal inflammation may lead to neuronal sprouting and peripheral sensitization. Knowledge of these mechanisms may prompt the development of therapeutic drugs that aim to disrupt these mechanisms, leading to more effective treatments for pulpal pain.
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Mazur M, Jedliński M, Ndokaj A, Ardan R, Janiszewska-Olszowska J, Nardi GM, Ottolenghi L, Guerra F. Long-Term Effectiveness of Treating Dentin Hypersensitivity with Bifluorid 10 and Futurabond U: A Split-Mouth Randomized Double-Blind Clinical Trial. J Clin Med 2021; 10:jcm10102085. [PMID: 34066300 PMCID: PMC8152040 DOI: 10.3390/jcm10102085] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The definition of dental hypersensitivity is “pain derived from exposed dentin in response to chemical, thermal tactile or osmotic stimuli which cannot be explained as arising from any other dental defect or disease”. One of the treatments proposed is tubular occlusion. The aim of this in vivo split-mouth randomized clinical trial was to evaluate the clinical efficacy of a in-office application of a fluoride varnish (Bifluorid 10) and a bonding resin (Futurabond U) in adults with dentin hypersensitivity. Material and methods: A total of 180 teeth were treated with Bifluorid 10 and 160 with Futurabond U. Outcome measurements were taken one or two weeks before treatment, at baseline at the application days, at 1 week and at 1–6 months after first treatment. Results: Both treatments reduced pain intensity. Bifluorid 10 and Futurabond U have similar efficacy in reducing SCHIFF-measured pain reduction, while Bifluorid 10 is significantly more efficient for VAS-measured pain reduction, mainly due to long-term pain reduction. Patient age has a significant negative influence on pain reduction, while the influence of patient gender and BEWE of the tooth is insignificant. Conclusions: Bifluorid 10 and Futurabond U are effective in the treatment of dental hypersensitivity. The RCT was registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT04813848.
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Affiliation(s)
- Marta Mazur
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
- Correspondence:
| | - Maciej Jedliński
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Artnora Ndokaj
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
| | - Roman Ardan
- Chair of Econometrics, Department of Economic Sciences, Koszalin University of Technology, 75-343 Koszalin, Poland;
| | | | - Gianna Maria Nardi
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
| | - Livia Ottolenghi
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
| | - Fabrizio Guerra
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (M.J.); (A.N.); (G.M.N.); (L.O.); (F.G.)
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McMillan H, Lundy FT, Dunne OM, Al-Natour B, Jeanneau C, About I, Curtis TM, El Karim I. Endogenous Mas-related G-protein-coupled receptor X1 activates and sensitizes TRPA1 in a human model of peripheral nerves. FASEB J 2021; 35:e21492. [PMID: 33788969 DOI: 10.1096/fj.202001667rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 12/21/2022]
Abstract
Mas-related G-protein-coupled receptor X1 (MrgprX1) is a human-specific Mrgpr and its expression is restricted to primary sensory neurons. However, its role in nociception and pain signaling pathways is largely unknown. This study aims to investigate a role for MrgprX1 in nociception via interaction with the pain receptor, Transient Receptor Potential Ankyrin 1 (TRPA1), using in-vitro and in-vivo human neuronal models. MrgprX1 protein expression in human trigeminal nociceptors was investigated by the immunolabeling of the dental pulp and cultured peripheral neuronal equivalent (PNE) cells. MrgprX1 receptor signaling was monitored by Fura-2-based Ca2+ imaging using PNEs and membrane potential responses were measured using FluoVoltTM . Immunofluorescent staining revealed MrgprX1 expression in-vivo in dental afferents, which was more intense in inflamed compared to healthy dental pulps. Endogenous MrgprX1 protein expression was confirmed in the in-vitro human PNE model. MrgprX1 receptor signaling and the mechanisms through which it couples to TRPA1 were studied by Ca2+ imaging. Results showed that MrgprX1 activates TRPA1 and induces membrane depolarization in a TRPA1 dependent manner. In addition, MrgprX1 sensitizes TRPA1 to agonist stimulation via Protein Kinase C (PKC). The activation and sensitization of TRPA1 by MrgprX1 in a model of human nerves suggests an important role for this receptor in the modulation of nociception.
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Affiliation(s)
- Hayley McMillan
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, UK
| | - Fionnuala T Lundy
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, UK
| | - Orla M Dunne
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, UK
| | - Banan Al-Natour
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, UK
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Imad About
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Tim M Curtis
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, UK
| | - Ikhlas El Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, UK
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12
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Galler KM, Weber M, Korkmaz Y, Widbiller M, Feuerer M. Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues. Int J Mol Sci 2021; 22:ijms22031480. [PMID: 33540711 PMCID: PMC7867227 DOI: 10.3390/ijms22031480] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 02/08/2023] Open
Abstract
The macroscopic and microscopic anatomy of the oral cavity is complex and unique in the human body. Soft-tissue structures are in close interaction with mineralized bone, but also dentine, cementum and enamel of our teeth. These are exposed to intense mechanical and chemical stress as well as to dense microbiologic colonization. Teeth are susceptible to damage, most commonly to caries, where microorganisms from the oral cavity degrade the mineralized tissues of enamel and dentine and invade the soft connective tissue at the core, the dental pulp. However, the pulp is well-equipped to sense and fend off bacteria and their products and mounts various and intricate defense mechanisms. The front rank is formed by a layer of odontoblasts, which line the pulp chamber towards the dentine. These highly specialized cells not only form mineralized tissue but exert important functions as barrier cells. They recognize pathogens early in the process, secrete antibacterial compounds and neutralize bacterial toxins, initiate the immune response and alert other key players of the host defense. As bacteria get closer to the pulp, additional cell types of the pulp, including fibroblasts, stem and immune cells, but also vascular and neuronal networks, contribute with a variety of distinct defense mechanisms, and inflammatory response mechanisms are critical for tissue homeostasis. Still, without therapeutic intervention, a deep carious lesion may lead to tissue necrosis, which allows bacteria to populate the root canal system and invade the periradicular bone via the apical foramen at the root tip. The periodontal tissues and alveolar bone react to the insult with an inflammatory response, most commonly by the formation of an apical granuloma. Healing can occur after pathogen removal, which is achieved by disinfection and obturation of the pulp space by root canal treatment. This review highlights the various mechanisms of pathogen recognition and defense of dental pulp cells and periradicular tissues, explains the different cell types involved in the immune response and discusses the mechanisms of healing and repair, pointing out the close links between inflammation and regeneration as well as between inflammation and potential malignant transformation.
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Affiliation(s)
- Kerstin M. Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93093 Regensburg, Germany;
- Correspondence:
| | - Manuel Weber
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Yüksel Korkmaz
- Department of Periodontology and Operative Dentistry, University of Mainz, 55131 Mainz, Germany;
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93093 Regensburg, Germany;
| | - Markus Feuerer
- Department for Immunology, University Hospital Regensburg, 93053 Regensburg, Germany;
- Regensburg Center for Interventional Immunology (RCI), University Hospital Regensburg, 93053 Regensburg, Germany
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13
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Pei F, Liu J, Zhang L, Pan X, Huang W, Cen X, Huang S, Jin Y, Zhao Z. The functions of mechanosensitive ion channels in tooth and bone tissues. Cell Signal 2020; 78:109877. [PMID: 33296740 DOI: 10.1016/j.cellsig.2020.109877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 02/08/2023]
Abstract
Tooth and bone are independent tissues with a close relationship. Both are composed of a highly calcified outer structure and soft inner tissue, and both are constantly under mechanical stress. In particular, the alveolar bone and tooth constitute an occlusion system and suffer from masticatory and occlusal force. Thus, mechanotransduction is a key process in many developmental, physiological and pathological processes in tooth and bone. Mechanosensitive ion channels such as Piezo1 and Piezo2 are important participants in mechanotransduction, but their functions in tooth and bone are poorly understood. This review summarizes our current understanding of mechanosensitive ion channels and their roles in tooth and bone tissues. Research in these areas may shed new light on the regulation of tooth and bone tissues and potential treatments for diseases affecting these tissues.
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Affiliation(s)
- Fang Pei
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, PR China
| | - Jialing Liu
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, PR China
| | - Lan Zhang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, PR China
| | - Xuefeng Pan
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, PR China
| | - Wei Huang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, PR China
| | - Xiao Cen
- Department of the Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Shishu Huang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, PR China.
| | - Ying Jin
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, PR China.
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, PR China.
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14
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Krunic J, Mladenovic I, Radovic I, Stojanovic N. Changes in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders. J Oral Rehabil 2020; 48:124-131. [PMID: 33064877 DOI: 10.1111/joor.13116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/25/2020] [Accepted: 10/06/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Menstrual cycle may contribute to experimental pain measures in healthy women and women with chronic pain. OBJECTIVES The present study aimed to investigate variation in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders (TMD) and to explore the effect of TMD pain and psychosocial variables on the pulp response. METHODS This longitudinal study involved 47 regularly menstruating women aged 20-45, 24 healthy and 23 with diagnosed painful TMD. The electric and cold stimuli were performed by electric pulp tester and refrigerant spray, respectively, on mandibular lateral incisors, in five menstrual phases (menstrual, follicular, periovulatory, luteal and premenstrual). Research Diagnostic Criteria for TMD were used to assess TMD, chronic pain, depression and somatisation. Regression analysis was performed to investigate the effect of the predictor variables on the pulp sensitivity. RESULTS Significant phase-related differences were observed for pain intensity to cold stimuli. Higher pain sensitivity was reported in menstrual in comparison with luteal phase (P = .019) among healthy women, and in menstrual in comparison with follicular (P = .033), periovulatory (P = .003) and luteal (P = .007) phases in TMD women. No significant differences were recorded for electric stimuli. Regression analysis identified depression as the determinant of cold and electric response in menstrual phase, regardless of age and presence of TMD. CONCLUSION Menstrual phase in healthy and TMD women with regular menstrual cycle is characterised with higher pulp sensitivity to cold stimuli. Depressive symptoms independently influence pulp response in this phase.
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Affiliation(s)
- Jelena Krunic
- Department of Dental Pathology, Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | - Irena Mladenovic
- Department of Prosthodontics, Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
| | - Ivana Radovic
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Nikola Stojanovic
- Department of Dental Pathology, Faculty of Medicine, University of East Sarajevo, Foca, Bosnia and Herzegovina
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15
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Abstract
The pulp-dentin complex is innervated by a high density of trigeminal neurons free nerve endings. These neuronal fibers are highly specialized to sense noxious stimuli such as thermal, mechanical, chemical, and biological cues. This robust alert system provides immediate feedback of potential or actual injury triggering reflex responses that protect the teeth from further injury. In the case of patients, pain is the most important experience that leads them to seek oral health care. The adequate removal of the etiology, such as caries, provides ample opportunity for the robust reparative and regenerative potential of the pulp-dentin complex to restore homeostasis. In addition to this elaborated surveillance system, evidence has accumulated that sensory neuronal fibers can potentially modulate various steps of the reparative and regenerative process through cellular communication processes. These include modulation of immunologic, angiogenic, and mineralization responses. Despite these orchestrated cellular events, the defense of the pulp-dentin complex may be overwhelmed, resulting in pulp necrosis and apical periodontitis. Regenerative endodontic procedures have evolved to restore the once lost function of the pulp-dentin complex. After these procedures, a large subset of successful cases demonstrates a positive response to sensitivity testing, suggesting reinnervation of the canal space. This process is likely mediated through cellular and noncellular release of neurotrophic factors such as brain-derived nerve growth factor. In addition, these newly recruited nerve fibers appear equipped to sense thermal stimuli through nonhydrodynamic mechanisms. Collectively, the significance of innervation in the normal physiology of the pulp-dentin complex and its role in regeneration need to be better appreciated to promote further research in this area that could potentially bring new therapeutic opportunities.
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Affiliation(s)
- Anibal Diogenes
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
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16
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Tanapitchpong R, Chunhacheevachaloke E, Ajcharanukul O. In vivo and in vitro study of enamel fluid flow in human premolars. Arch Oral Biol 2020; 117:104795. [DOI: 10.1016/j.archoralbio.2020.104795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
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17
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Liu XX, Tenenbaum HC, Wilder RS, Quock R, Hewlett ER, Ren YF. Pathogenesis, diagnosis and management of dentin hypersensitivity: an evidence-based overview for dental practitioners. BMC Oral Health 2020; 20:220. [PMID: 32762733 PMCID: PMC7409672 DOI: 10.1186/s12903-020-01199-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 07/20/2020] [Indexed: 01/01/2023] Open
Abstract
Though dentin hypersensitivity (DHS) is one of the most common complaints from patients in dental clinics, there are no universally accepted guidelines for differential diagnosis as well as selection of reliable treatment modalities for this condition. The neurosensory mechanisms underlying DHS remain unclear, but fluid movements within exposed dentinal tubules, i.e., the hydrodynamic theory, has been a widely accepted explanation for DHS pain. As several dental conditions have symptoms that mimic DHS at different stages of their progression, diagnosis and treatment of DHS are often confusing, especially for inexperienced dental practitioners. In this paper we provide an up-to-date review on risk factors that play a role in the development and chronicity of DHS and summarize the current principles and strategies for differential diagnosis and management of DHS in dental practices. We will outline the etiology, predisposing factors and the underlying putative mechanisms of DHS, and provide principles and indications for its diagnosis and management. Though desensitization remains to be the first choice for DHS for many dental practitioners and most of desensitizing agents reduce the symptoms of DHS by occluding patent dentinal tubules, the long-term outcome of such treatment is uncertain. With improved understanding of the underlying nociceptive mechanisms of DHS, it is expected that promising novel therapies will emerge and provide more effective relief for patients with DHS.
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Affiliation(s)
- Xiu-Xin Liu
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA.,Department of Dentistry, Atlanta VA Medical Center, Atlanta, GA, USA
| | - Howard C Tenenbaum
- Department of Periodontology, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca S Wilder
- Office for Professional Development and Faculty Affairs, Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ryan Quock
- Department of Restorative Dentistry & Prosthodontics, University of Texas School of Dentistry at Houston, Houston, TX, USA
| | - Edmond R Hewlett
- Section of Restorative Dentistry, UCLA School of Dentistry, Los Angeles, California, USA
| | - Yan-Fang Ren
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA. .,Outreach and Diversity, UCLA School of Dentistry, Los Angeles, California, USA.
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18
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Li H, Liu W, Zhou HJ, Sun Y, Zhang M, Wang J, Limer A, Owens G, Joiner A. In vitro dentine tubule occlusion by a novel toothpaste containing calcium silicate and sodium phosphate. J Dent 2020; 103S:100024. [DOI: 10.1016/j.jjodo.2020.100024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/25/2022] Open
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19
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Savage KO, Oderinu OH, Oginni AO, Uti OG, Adegbulugbe IC, Dosumu OO. Dentine hypersensitivity and associated factors: a Nigerian cross-sectional study. Pan Afr Med J 2019; 33:272. [PMID: 31692856 PMCID: PMC6814907 DOI: 10.11604/pamj.2019.33.272.18056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 07/19/2019] [Indexed: 12/04/2022] Open
Abstract
Introduction Prevalence of dentine hypersensitivity (DH) may be on the increase as a result of changing lifestyles. This study aimed to assess the prevalence of DH and relative importance of associated factors in 18-35 year old Nigerians and compare to findings from a similar European study. Methods Following ethical approval, 1349 subjects from the six geopolitical zones in Nigeria participated in this cross sectional study. DH was clinically evaluated by cold air tooth stimulation, patient pain rating (yes/no) and investigator rated pain using the Schiff ordinal scale (0-3). Erosive tooth wear using the BEWE index was assessed. A questionnaire regarding the nature of the DH, erosive dietary intakes, tooth brushing habits and other factors was completed by patients. Bivariate analysis was conducted. Results 32.8% of patients reported pain on tooth stimulation and 32.9% scored ≥1 on Schiff scale for at least one tooth. Questionnaire reported sensitivity was 41.2%. There were statistically significant associations between Schiff score and clinically elicited DH (p < 0.001); and BEWE erosive tooth wear score and clinically elicited DH (p < 0.001). There were significant associations between DH and some oral hygiene practices such as brushing frequency, brush movement and brushing after breakfast. Fresh fruit and fruit/vegetable juice intake also showed significant association. Conclusion The most important risk factors of DH for this population in Nigeria appear to be the frequency and characteristics of tooth brushing. This should be considered in its prevention and management.
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Affiliation(s)
- Kofoworola Olaide Savage
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olabisi Hajarat Oderinu
- Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Adeleke Oke Oginni
- Department of Restorative Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Ife-ife, Nigeria
| | - Omolara Gbonjugbola Uti
- Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ilemobade Cyril Adegbulugbe
- Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Oluwole Oyekunle Dosumu
- Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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20
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Zheng J, Wu Z, Niu K, Xie Y, Hu X, Fu J, Tian D, Fu K, Zhao B, Kong W, Sun C, Wu L. Microbiome of Deep Dentinal Caries from Reversible Pulpitis to Irreversible Pulpitis. J Endod 2019; 45:302-309.e1. [DOI: 10.1016/j.joen.2018.11.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 11/25/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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21
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Racich MJ. Occlusion, temporomandibular disorders, and orofacial pain: An evidence-based overview and update with recommendations. J Prosthet Dent 2018; 120:678-685. [DOI: 10.1016/j.prosdent.2018.01.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/25/2018] [Accepted: 01/25/2018] [Indexed: 12/13/2022]
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22
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Yu CY, Abbott PV. Pulp microenvironment and mechanisms of pain arising from the dental pulp: From an endodontic perspective. AUST ENDOD J 2018. [DOI: 10.1111/aej.12257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Christine Y. Yu
- Discipline of Endodontics; UWA Dental School; Oral Health Centre of Western Australia; The University of Western Australia (M512); Crawley Western Australia Australia
| | - Paul V. Abbott
- Discipline of Endodontics; UWA Dental School; Oral Health Centre of Western Australia; The University of Western Australia (M512); Crawley Western Australia Australia
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23
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Rangcharoen M, Sirimaharaj V, Wanachantararak S, Vongsavan N, Matthews B. Observations on fluid flow from exposed dentine in primary teeth: An in vitro study. Arch Oral Biol 2017; 83:312-316. [DOI: 10.1016/j.archoralbio.2017.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 08/17/2017] [Accepted: 08/21/2017] [Indexed: 10/19/2022]
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24
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Eskander MA, Takimoto K, Diogenes A. Evaluation of mesenchymal stem cell modulation of trigeminal neuronal responses to cold. Neuroscience 2017; 360:61-67. [PMID: 28757246 DOI: 10.1016/j.neuroscience.2017.07.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 01/09/2023]
Abstract
Tissue engineering protocols, such as regenerative endodontic procedures (REPs), comprise biologically based procedures designed to restore normal physiologic function. For REPs, the goal is reconstitution of the pulp-dentin complex by delivering mesenchymal stem cells (MSCs), including the stem cells of the apical papilla (SCAP) into a root canal system. Many patients regain cold sensitivity after REPs, but the mechanism is not understood. We hypothesized that SCAP modulate nociceptive function through a paracrine mechanism that activates cold-sensitive ion channels in neurons. We established a co-culture system with human SCAP and rat trigeminal (TG) sensory neurons in order to determine the effect of SCAP co-culture on neuronal responses using whole-cell patch-clamp electrophysiology. TG neurons co-cultured with SCAP demonstrated increased TRPA1-mediated (p<0.01) and TRPM8-mediated inward current densities (p<0.01) at 24h in co-culture. Cold stimulation to SCAP significantly increased ATP release (p<0.01), and supernatant collected after cold stimulation to SCAP was able to activate cultured TG neurons. Co-culture with SCAP significantly increased sustained ATP-evoked inward current density (p<0.05). These data suggest that SCAP release trophic factors that act on afferent neurons to enhance cold-sensitive ion channel activity.
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Affiliation(s)
- Michael A Eskander
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Koyo Takimoto
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Anibal Diogenes
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
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25
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Kim D, Park SH. Effects of age, sex, and blood pressure on the blood flow velocity in dental pulp measured by Doppler ultrasound technique. Microcirculation 2016; 23:523-529. [DOI: 10.1111/micc.12302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/10/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Dohyun Kim
- Department of Conservative Dentistry and Oral Science Research Center; Yonsei University College of Dentistry; Seoul Korea
| | - Sung-Ho Park
- Department of Conservative Dentistry and Oral Science Research Center; Yonsei University College of Dentistry; Seoul Korea
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26
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Sukapattee M, Wanachantararak S, Sirimaharaj V, Vongsavan N, Matthews B. Effect of full crown preparation on pulpal blood flow in man. Arch Oral Biol 2016; 70:111-116. [PMID: 27343693 DOI: 10.1016/j.archoralbio.2016.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/19/2016] [Accepted: 06/06/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine if full crown preparation causes an increase in pulpal blood flow (PBF), indicating inflammation, in human subjects. DESIGN The experiments were carried out on 35 intact, mandibular posterior teeth in 13 subjects: 32 were abutments for 16 fixed bridges that replaced first molars; the other 3 were first premolars adjacent to abutment teeth that served as un-operated controls. Crown preparations were made using an air-rotor with water-spray under regional block anaesthesia (4% articaine with epinephrine 1:100,000). PBF was recorded with a laser Doppler flow meter (LDF) before and after administering the anaesthetic, with the LDF probe on the buccal enamel. PBF was then recorded from the abutment teeth with the probe on buccal dentine after preparing the buccal surfaces of both teeth, after completing the crown preparations, and after 1 and 7days. PBF was also recorded from the buccal enamel of the control teeth on each occasion. RESULTS The mean±S.D. PBF values before and after anaesthesia were 2.63±2.13 and 2.42±2.38P.U. respectively, which were not significantly different (Paired t-test). The mean values for the abutment teeth after buccal preparation, after complete crown preparation, and after 1 and 7days were 5.20±2.49, 4.53±2.52, 4.92±2.98 and 5.48±2.65P.U. respectively. The 4 values for each tooth were not significantly different (two-way RM ANOVA). In the control group, the values under all six conditions were not significantly different. CONCLUSIONS Regional block anaesthesia produced no change in PBF, nor did full-crown preparation, neither immediately after the procedure nor 1 and 7days later.
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Affiliation(s)
- Marisa Sukapattee
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50202, Thailand
| | - Sitthichai Wanachantararak
- Department of Oral Biology and Oral Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50202, Thailand.
| | - Varisara Sirimaharaj
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50202, Thailand
| | - Noppakun Vongsavan
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Bruce Matthews
- Department of Physiology and Pharmacology, School of Medical Sciences, University of Bristol, University Walk, Bristol BS8 1TD, UK
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27
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Zhou W, Niu LN, Huang L, Fang M, Chang G, Shen LJ, Tay FR, Chen JH. Improved secondary caries resistance via augmented pressure displacement of antibacterial adhesive. Sci Rep 2016; 6:22269. [PMID: 26928742 PMCID: PMC4772086 DOI: 10.1038/srep22269] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/05/2016] [Indexed: 11/09/2022] Open
Abstract
The present in vitro study evaluated the secondary caries resistance potential of acid-etched human coronal dentin bonded using augmented pressure adhesive displacement in conjunction with an experimental antibacterial adhesive. One hundred and twenty class I cavities were restored with a commercial non-antibacterial etch-and-rinse adhesive (N) or an experimental antibacterial adhesive (A) which was displaced by gentle air-blow (G) or augmented pressure air-blow (H). After bonding and restoration with resin composite, the resulted 4 groups (N-G, N-H, A-G and A-H) were exposed to Streptococcus mutans biofilm for 4, 8, 15, 20 or 25 days. The development of secondary caries in the bonding interface was then examined by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Data acquired from 15, 20 and 25 days of artificial caries induction were analyzed with three-way ANOVA at α = 0.05. The depth of the artificial carious lesions was significantly affected by “adhesive type” (Single Bond 2 vs experimental antibacterial adhesive p = 0.003), “intensity of adhesive displacement” (gentle vs augmented-pressure adhesive displacement; p < 0.001), as well as “artificial caries induction time” (p < 0.001). The combined use of augmented pressure adhesive displacement and experimental antibacterial adhesive reduces the progression of secondary caries.
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Affiliation(s)
- Wei Zhou
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Li-na Niu
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Li Huang
- State Key Laboratory of Military Stomatology, Department of General Dentistry and Emergency, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Ming Fang
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Gang Chang
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Li-juan Shen
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Franklin R Tay
- Department of Endodontics, College of Dental Medicine, Augusta University, Augusta, Georgia, USA
| | - Ji-hua Chen
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
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Wang K, He T, Luo YI, Bentsen B, Arendt-Nielsen L. Quantitative sensory testing of dentinal sensitivity in healthy humans. Acta Odontol Scand 2015; 74:259-64. [PMID: 26542888 DOI: 10.3109/00016357.2015.1110248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The study was to provide information on quantitative sensory testing (QST) of normal teeth to establish a sensory profile and investigate the possible gender and regional differences. MATERIALS AND METHODS A modified QST protocol was applied on both left and right upper-jaw incisors and pre-molar sof 14 healthy men and 14 age-matched healthy women (18-25 years). Mechanical stimulus sensitivity (MSS), cold detection threshold (CDT), cold pain threshold (CPT), warm detection threshold (WDT), heat pain threshold (HPT), electrical detection threshold (EDT) and electrical pain threshold (EPT) were determined from the four teeth (labial side of incisor and buccal side of the first premolar). The QST parameters were analysed by ANOVA. RESULTS The applied mechanical or thermal stimuli did not evoke any pain sensation. A normal tooth did not seem to be able to distinguish between the warm or cold stimuli applied. No significant differences were found between genders (p > 0.099) or teeth (p > 0.053) regarding mechanical and thermal stimuli. The EDT and EPT were significantly higher in the pre-molar compared with incisor (p < 0.002) without gender differences (p > 0.573). CONCLUSION The established methods and results provided important information on diagnosis and treatment evaluation of dentinal hypersensitivity.
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Affiliation(s)
- Kelun Wang
- a Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine , Aalborg University , Aalborg , Denmark
| | - Tao He
- b The Procter & Gamble Company , Global Oral Care Clinical , Mason , Ohio USA
| | - Y I Luo
- a Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine , Aalborg University , Aalborg , Denmark
| | - Bo Bentsen
- a Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine , Aalborg University , Aalborg , Denmark
| | - Lars Arendt-Nielsen
- a Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine , Aalborg University , Aalborg , Denmark
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Is Pulp Inflammation a Prerequisite for Pulp Healing and Regeneration? Mediators Inflamm 2015; 2015:347649. [PMID: 26538825 PMCID: PMC4619968 DOI: 10.1155/2015/347649] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/05/2015] [Accepted: 07/14/2015] [Indexed: 12/16/2022] Open
Abstract
The importance of inflammation has been underestimated in pulpal healing, and in the past, it has been considered only as an undesirable effect. Associated with moderate inflammation, necrosis includes pyroptosis, apoptosis, and nemosis. There are now evidences that inflammation is a prerequisite for pulp healing, with series of events ahead of regeneration. Immunocompetent cells are recruited in the apical part. They slide along the root and migrate toward the crown. Due to the high alkalinity of the capping agent, pulp cells display mild inflammation, proliferate, and increase in number and size and initiate mineralization. Pulp fibroblasts become odontoblast-like cells producing type I collagen, alkaline phosphatase, and SPARC/osteonectin. Molecules of the SIBLING family, matrix metalloproteinases, and vascular and nerve mediators are also implicated in the formation of a reparative dentinal bridge, osteo/orthodentin closing the pulp exposure. Beneath a calciotraumatic line, a thin layer identified as reactionary dentin underlines the periphery of the pulp chamber. Inflammatory and/or noninflammatory processes contribute to produce a reparative dentinal bridge closing the pulp exposure, with minute canaliculi and large tunnel defects. Depending on the form and severity of the inflammatory and noninflammatory processes, and according to the capping agent, pulp reactions are induced specifically.
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Thongkukiatkun W, Vongsavan K, Kraivaphan P, Rirattanapong P, Vongsavan N, Matthews B. Effects of the iontophoresis of lignocaine with epinephrine into exposed dentine on the sensitivity of the dentine in man. Arch Oral Biol 2015; 60:1098-103. [DOI: 10.1016/j.archoralbio.2015.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 04/04/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
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A novel potassium oxalate-containing tooth-desensitising mouthrinse: a comparative in vitro study. J Dent 2015; 41 Suppl 4:S18-27. [PMID: 23929641 DOI: 10.1016/s0300-5712(13)70003-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the efficacy of a new potassium oxalate (KO)-containing mouthrinse [Listerine® Advanced Defence Sensitive (LADS)] in reducing dentine permeability and occluding open dentinal tubules versus other desensitising products. METHODS The permeability of acid-etched dentine disks was measured by hydraulic conductance; dentine surfaces were examined by scanning electron microscopy and energy-dispersive X-ray spectroscopy. The KO concentration was optimised for tubule occlusion by screening formulations containing 0.0-2.0% KO (n=5 disks per concentration). The optimal formulation was compared with five commercial products with non-oxalate occlusion technologies. After establishing the baseline permeability of acid-etched dentine disks, disks (n=6 per product) were randomly treated with the desensitising products (12 treatments, each 60 s, alternated with distilled-water rinses) and permeability was measured at intervals. Occluded disks were acid challenged. All experiments were conducted at room temperature. An unpooled, two-tailed t test was performed to assess between-treatment differences in relative residual permeability. RESULTS The optimal concentration of KO in LADS was 1.4%, which provided ≈ 100% reduction in dentine permeability after nine treatments. Only LADS reduced permeability to zero and was significantly more effective in reducing dentine permeability than the other products (p ≤ 0.033 vs all other test products). All products partially occluded dentine. The occlusion associated with LADS was substantially more stable in resisting acid challenge versus Colgate® Sensitive Pro-Relief mouthrinse (p=0.054) and significantly more stable versus all other test products (p ≤ 0.045), as determined by dentine permeability. CONCLUSION LADS was significantly more effective in occluding open dentinal tubules versus other desensitising products. CLINICAL SIGNIFICANCE LADS provides fast, complete and stable intratubular occlusion of patent dentinal tubules.
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Abstract
OBJECTIVE This review defines dentine sensitivity (DS), its prevalence, its aetiology, the mechanism(s) responsible for DS, its diagnosis and its treatment. The review then examines the modes of action of various treatments for DS including potassium salts, strontium salts, bioglasses, arginine/calcium carbonate and professional treatments such as adhesives and oxalates. The methods used to evaluate the various treatment modalities are discussed, including laboratory studies and randomised controlled clinical trials. DATA SOURCES AND STUDY SELECTION A literature search was conducted using PubMed, Ovid Medline and Cochrane reviews for information on DS and its treatments, as well as laboratory and clinical studies used to evaluate the efficacy of various DS treatments. With regard to efficacy of treatments for DS only reports of clinical studies that were randomised, controlled and blinded were reviewed. The authors offer new insights into the shortcomings of the recent systematic review of the use of oxalates for DS. CONCLUSION The authors introduce the concept of a novel desensitising mouthrinse containing 1.4% potassium oxalate: Listerine® Advanced Defence Sensitive mouthrinse. Readers of this supplement issue of the Journal of Dentistry are invited to review the significance of managing the clinical problem of DS. They are also invited to assess data from laboratory and randomised controlled clinical studies in order to understand the advantages offered by regular use of 1.4% potassium oxalate-containing mouthrinse, Listerine Advanced Defence Sensitive, in particular its resistance to daily erosive and/or abrasive challenges.
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Affiliation(s)
- Maria Mantzourani
- Oral Care Scientific and Professional Affairs, Johnson & Johnson Consumer Services EAME Ltd, Foundation Park, Maidenhead, UK
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Effectiveness of various toothpastes on dentine tubule occlusion. J Dent 2015; 43:440-9. [DOI: 10.1016/j.jdent.2015.01.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/29/2015] [Accepted: 01/31/2015] [Indexed: 11/20/2022] Open
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Oskui IZ, Ashtiani MN, Hashemi A, Jafarzadeh H. Effect of thermal stresses on the mechanism of tooth pain. J Endod 2014; 40:1835-9. [PMID: 25172227 DOI: 10.1016/j.joen.2014.06.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/20/2014] [Accepted: 06/20/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Daily hot and cold thermal loadings on teeth may result in structural deformation, mechanical stress, and pain signaling. The aim of this study was to compare the adverse effects of hot and cold beverages on an intact tooth and, then, to provide physical evidence to support the hydrodynamic theory of tooth pain sensation mechanism. METHODS Three-dimensional finite element analysis was performed on a premolar model subjected to hot and cold thermal loadings. Elapsed times for heat diffusion and stress detection at the pulp-dentin junction were calculated as measures of the pain sensation. RESULTS Extreme tensile stress within the enamel resulted in damage in cold loadings. Also, extreme values of stress at the pulpal wall occurred 21.6 seconds earlier than extreme temperatures in hot and cold loadings. CONCLUSIONS The intact tooth was remarkably vulnerable to cold loading. Earlier changes in mechanical stress rather than temperature at the pulp-dentin junction indicate that the dental pain caused by hot or cold beverages may be based on the hydrodynamic theory.
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Affiliation(s)
- Iman Z Oskui
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran
| | - Mohammed N Ashtiani
- Faculty of Biomedical Engineering, Hamedan University of Technology, Hamedan
| | - Ata Hashemi
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran.
| | - Hamid Jafarzadeh
- Dental Research Center, Department of Endodontics, Faculty of Dentistry Mashhad University of Medical Sciences, Mashhad, Iran
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Borges AB, Batista GR, Arantes PT, Wiegand A, Attin T, Torres CRG. Influence of Simulated Pulpal Pressure on Efficacy of Bleaching Gels. J Contemp Dent Pract 2014; 15:407-12. [PMID: 25576104 DOI: 10.5005/jp-journals-10024-1553] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Aim
The aim of this study was to investigate the influence of simulated pulpal pressure on efficacy of bleaching gels.
Materials and methods
Cylindrical enamel-dentin specimens from bovine teeth (3 mm diameter, enamel and dentin layer each 1 mm thick) were divided into 4 groups, according to the bleaching treatment: negative control (non-bleached), bleached with 10% carbamide peroxide (CP), bleached with 7.5% hydrogen peroxide (HP) and bleached with 35% hydrogen peroxide. Ten percent CP gel was applied for 8 h/day and 7.5% HP for 1 h/day, during 14 days. For 35% HP treatment, two sessions of 45 minutes each were employed. In intermediate periods specimens were stored in artificial saliva. Experimental groups (n = 19) were subdivided according to the simulation of pulpal pressure (25 mm Hg) during bleaching treatment. Initial color measurement and after bleaching treatment were assessed by spectrophotometry, using CIE L*a*b* system. The data were statistically analyzed by ANOVA and Dunnett's posthoc tests (p < 0.05).
Results
There was significant difference of ∆E for all experimental groups compared to negative control group, according to Dunnett's test (p < 0.0001). There were no significant difference for total color variation (∆E) among experimental groups (p > 0.05).
Conclusion
It was concluded that all bleaching gels showed bleaching efficacy compared to non-bleached group and that the simulated pulpal pressure did not influence the bleaching outcomes of the tested gels.
Clinical significance
Although numerous in vitro studies investigating the efficacy of bleaching agents have been performed, they do not properly simulate the pulpal pressure. In order to make these studies closer to clinical conditions, it is important to reproduce these conditions in laboratory, so the results can be more reliable. This in vitro study was performed under simulated pulpal pressure, aiming to investigate its influence on dental bleaching outcomes.
How to cite this article
Borges AB, Batista GR, Arantes PT, Wiegand A, Attin T, Torres CRG. Influence of Simulated Pulpal Pressure on Efficacy of Bleaching Gels. J Contemp Dent Pract 2014;15(4):407-412.
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Affiliation(s)
- Alessandra Bühler Borges
- Assistant Professor, Department of Restorative Dentistry, School of Dentistry UNESP, São Jose dos Campus, São Paulo, Brazil, e-mail:
| | - Graziela Ribeiro Batista
- PhD Student, Department of Restorative Dentistry, School of Dentistry UNESP, São Jose dos Campus, São Paulo, Brazil
| | - Paula Tamião Arantes
- MSc Student, Department of Restorative Dentistry, School of Dentistry UNESP, São Jose dos Campus, São Paulo, Brazil
| | - Annette Wiegand
- Head, Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen, Göttingen, Germany
| | - Thomas Attin
- Chairman, Department of Preventive Dentistry, Periodontology and Cariology, University of Zürich, Plattenstrasse, Zürich Switzerland
| | - Carlos Rocha Gomes Torres
- Associate Professor, Department of Restorative Dentistry, School of Dentistry UNESP, São Jose dos Campus, São Paulo, Brazil
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Jain N, Gupta A, N M. An insight into neurophysiology of pulpal pain: facts and hypotheses. Korean J Pain 2013; 26:347-55. [PMID: 24156000 PMCID: PMC3800706 DOI: 10.3344/kjp.2013.26.4.347] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 09/03/2013] [Indexed: 11/30/2022] Open
Abstract
Pain and pain control are important to the dental profession because the general perception of the public is that dental treatment and pain go hand in hand. Successful dental treatment requires that the source of pain be detected. If the origin of pain is not found, inappropriate dental care and, ultimately, extraction may result. Pain experienced before, during, or after endodontic therapy is a serious concern to both patients and endodontists, and the variability of discomfort presents a challenge in terms of diagnostic methods, endodontic therapy, and endodontic knowledge. This review will help clinicians understand the basic neurophysiology of pulpal pain and other painful conditions of the dental pulp that are not well understood.
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Affiliation(s)
- Niharika Jain
- Department of Conservative Dentistry & Endodontics, Hitkarni Dental College & Hospital, Jabalpur, India
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Rirattanapong P, Vongsavan K, Kraivaphan P, Vongsavan N, Matthews B. Effect of the topical application of 50% lignocaine hydrochloride on the sensitivity of dentine in man. Arch Oral Biol 2013; 58:1549-55. [DOI: 10.1016/j.archoralbio.2013.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 05/20/2013] [Accepted: 06/05/2013] [Indexed: 11/30/2022]
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Influence of concentration and activation on hydrogen peroxide diffusion through dental tissues in vitro. ScientificWorldJournal 2013; 2013:193241. [PMID: 24163616 PMCID: PMC3791642 DOI: 10.1155/2013/193241] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 08/18/2013] [Indexed: 11/17/2022] Open
Abstract
This study evaluated the effect of physical and chemical activation on the diffusion time of different concentrations of hydrogen peroxide (HP) bleaching agents through enamel and dentin. One hundred and twenty bovine cylindrical specimens were divided into six groups (n = 20): 20% HP; 20% HP with light activation; 20% HP with manganese gluconate; 35% HP; 35% HP with light activation; and 35% HP with manganese gluconate. The specimens were fixed over transparent epoxy wells with internal cavities to simulate a pulpal chamber. This chamber was filled with an enzymatic reagent to simulate pulpal fluid. The bleaching gels were applied on enamel surface and the image of the pulpal fluid was captured by a video camera to monitor the time of peroxide penetration in each specimen. ANOVA analysis showed that concentration and type of activation of bleaching gel significantly influenced the diffusion time of HP (P < 0.05). 35% HP showed the lowest diffusion times compared to the groups with 20% HP gel. The light activation of HP decreased significantly the diffusion time compared to chemical activation. The highest diffusion time was obtained with 20% HP chemically activated. The diffusion time of HP was dependent on activation and concentration of HP. The higher concentration of HP diffused through dental tissues more quickly.
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Gibson M, Sharif MO, Smith A, Saini P, Brunton PA. A practice-based randomised controlled trial of the efficacy of three interventions to reduce dentinal hypersensitivity. J Dent 2013; 41:668-74. [PMID: 23791771 DOI: 10.1016/j.jdent.2013.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 06/03/2013] [Accepted: 06/05/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the efficacy of three different interventions (non-desensitising toothpaste, desensitising toothpaste and professionally applied dentine bonding agent) in reducing dentinal hypersensitivity over a 2-week, 3-month and 6-month-period in a dental practice setting. METHODS This was a randomised controlled, single-blind; parallel-group trial conducted in general dental practice by a single general dental practitioner. Seventy-five subjects were randomly allocated to three groups; non-desensitising toothpaste (NDT), desensitising toothpaste (DT) and professionally applied desensitising agent (DA). Dentinal hypersensitivity was measured using a Visual Analogue Scale (VAS) to record the response from a standardised short blast of air from a triple syringe. Dentinal hypersensitivity was recorded at baseline, two weeks, three months and six months for all groups. RESULTS Dentinal hypersensitivity reduced significantly (p<0.0001) in both groups DT and DA, in addition the reduction in sensitivity was sustained and continued to improve over a 6-month-period. The greatest reduction in dentinal hypersensitivity was recorded in group DA. CONCLUSIONS The results from this study suggest that application of dentine bonding agents, to teeth diagnosed with dentine hypersensitivity provides the greatest improvement in dentine hypersensitivity at 2 weeks and 6 months. This reduction in dentine hypersensitivity is greater than that achieved by the desensitising toothpaste tested and a non-desensitising toothpaste.
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Affiliation(s)
- M Gibson
- Poulton Dental Practice, Poulton Road, Wallasey, Wirral CH44 9DQ, United Kingdom
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40
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Investigation of the prevalence, clinical features, and risk factors of dentin hypersensitivity in a selected Brazilian population. Clin Oral Investig 2013; 18:651-7. [DOI: 10.1007/s00784-013-1008-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 05/24/2013] [Indexed: 10/26/2022]
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Bharti R, Wadhwani K. Spectrophotometric evaluation of peroxide penetration into the pulp chamber from whitening strips and gel: An in vitro study. J Conserv Dent 2013; 16:131-4. [PMID: 23716964 PMCID: PMC3659857 DOI: 10.4103/0972-0707.108192] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/10/2012] [Accepted: 11/19/2012] [Indexed: 11/13/2022] Open
Abstract
Aim: To investigate pulp chamber penetration of different concentration of hydrogen peroxide. Materials and Methods: Fifty extracted human maxillary central incisor teeth were taken and grouped into five (n = 10). All teeth were cut approximately 3 mm apical to the cemento-enamel junction. Pulp was removed and the pulp chamber filled with acetate buffer. Buccal crown surfaces of teeth in the experimental groups were subjected to whitening strip and paint on whitener gel. Control group teeth were exposed to distilled water. The acetate buffer solution in each tooth was then transferred to a glass test tube after 30 min. Leuco-crystal violet dye and enzyme horse radish peroxidase were added. The optical density of resultant blue color in the tubes was measured by UV-visible spectrophotometer. The values were converted into microgram equivalents of hydrogen peroxide. Results: The results were evaluated statistically using nonparametric Mann–Whitney U test. Whitening strip showed the lowest pulpal peroxide penetration whereas paint on whitener gel showed highest pulpal peroxide penetration. Conclusion: This study demonstrate that peroxide is readily penetrate into the pulp chamber of teeth.
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Affiliation(s)
- Ramesh Bharti
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
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Su KC, Chuang SF, Ng EYK, Chang CH. Evaluation of dentinal fluid flow behaviours: a fluid-structure interaction simulation. Comput Methods Biomech Biomed Engin 2013; 17:1716-26. [PMID: 23477663 DOI: 10.1080/10255842.2013.765410] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study uses the fluid-structure interaction (FSI) method to investigate the fluid flow in dental pulp. First, the FSI method is used for the biomechanical simulation of dental intrapulpal responses during force loading (50, 100 and 150 N) on a tooth. The results are validated by comparison with experimental outcomes. Second, the FSI method is used to investigate an intact tooth subjected to a mechanical stimulus during loading at various loading rates. Force loading (0-100 N) is applied gradually to an intact tooth surface with loading rates of 125, 62.5, 25 and 12.5 N/s, respectively, and the fluid flow changes in the pulp are evaluated. FSI analysis is found to be suitable for examining intrapulpal biomechanics. An external force applied to a tooth with a low loading rate leads to a low fluid flow velocity in the pulp chamber, thus avoiding tooth pain.
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Affiliation(s)
- Kuo-Chih Su
- a Department of Biomedical Engineering , College of Engineering, National Cheng Kung University , Tainan , Taiwan
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West NX, Lussi A, Seong J, Hellwig E. Scaffold-free microtissues: differences from monolayer cultures and their potential in bone tissue engineering. Clin Oral Investig 2013; 17:9-17. [PMID: 22695872 PMCID: PMC3585766 DOI: 10.1007/s00784-012-0763-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Accepted: 05/23/2012] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Cell-based therapies for bone augmentation after tooth loss and for the treatment of periodontal defects improve healing defects. Usually, osteogenic cells or stem cells are cultivated in 2D primary cultures, before they are combined with scaffold materials, even though this means a loss of the endogenous 3D microenvironment for the cells. Moreover, the use of single-cell suspensions for the inoculation of scaffolds or for the direct application into an area of interest has the disadvantages of low initial cell numbers and susceptibility to unwanted cellular distribution, respectively. MATERIALS AND METHODS We addressed the question whether an alternative to monolayer cultures, namely 3D microtissues, has the potential to improve osteogenic tissue engineering and its clinical outcome. RESULTS By contrast, to monolayer cultures, osteogenic differentiation of 3D microtissues is enhanced by mimicking in vivo conditions. It seems that the osteogenic differentiation in microtissues is enhanced by strong integrin-extracellular matrix interaction and by stronger autocrine BMP2 signaling. Moreover, microtissues are less prone to wash out by body fluids and allow the precise administration of large cell numbers. CONCLUSION Microtissue cultures have closer characteristics with cells in vivo and their enhanced osteogenic differentiation makes scaffold-free microtissues a promising concept in osteogenic tissue engineering. CLINICAL RELEVANCE Microtissues are particularly suitable for tissue engineering because they improve seeding efficiency of biomaterials by increasing the cell load of a scaffold. This results in accelerated osteogenic tissue formation and could contribute to earlier implant stability in mandibular bone augmentation.
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Affiliation(s)
- N. X. West
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - A. Lussi
- />Department of Operative Dentistry, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - J. Seong
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - E. Hellwig
- />Department of Operative Dentistry and Periodontology, Dental School and Hospital Dentistry, University Medical Center Freiburg, Freiburg im Breisgau, Germany
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Ajcharanukul O, Chunhacheevachaloke E, Vorachart P, Chidchuangchai W. The Postural Autonomic Regulation of Pulpal Blood Flow. J Dent Res 2012; 92:156-60. [PMID: 23166042 DOI: 10.1177/0022034512469025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Evidence suggests that postural changes in systemic blood pressure may significantly affect blood flow in the dental pulp. This in vivo study examined the responses of pulpal perfusion, systemic blood pressure, and heart rate to postural changes in humans. The experiments were done on 21 premolars in 16 participants aged 20-31 yrs. Pulpal blood flow recordings were measured by means of a laser Doppler Flowmeter. A blood pressure monitor was used to record blood pressure and heart rate. All measurements were simultaneously recorded for 1 min, 5 min after participants made postural changes. Changing from supine to standing caused a significant reduction in pulpal perfusion, while heart rate and diastolic blood pressure increased significantly. A significant non-linear relationship was found between percentage changes in pulpal perfusion and heart rate resulting from standing up. We speculate that when patients arise from the supine position, the shift in venous blood to the legs transiently (2-10 sec) lowers venous return and cardiac output, causing less inhibition of the vasomotor center, which, in turn, results in increased heart rate and blood pressure, but a decrease in pulpal blood flow. These results suggest that pulpal blood flow is affected by postural change, presumably via the autonomic nervous system.
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Affiliation(s)
- O. Ajcharanukul
- Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, 114 Sukhumvit 23, Bangkok 10110, Thailand
| | - E. Chunhacheevachaloke
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok 10110, Thailand
| | - P. Vorachart
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok 10110, Thailand
| | - W. Chidchuangchai
- Department of Oral Medicine, Faculty of Dentistry, Mahidol University, Yothi Street, Rajthavee, Bangkok 10400, Thailand
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Tjäderhane L, Haapasalo M. The dentin-pulp border: a dynamic interface between hard and soft tissues. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1601-1546.2012.00266.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Treatment of dentine hypersensitivity by diode laser: a clinical study. Int J Dent 2012; 2012:858950. [PMID: 22792109 PMCID: PMC3389731 DOI: 10.1155/2012/858950] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 05/05/2012] [Accepted: 05/06/2012] [Indexed: 11/18/2022] Open
Abstract
Introduction. Dentine hypersensitivity (DH) is characterized by pain after stimuli that usually provoke no symptoms. This study compared the effectiveness of GaAlAs diode laser alone and with topical sodium fluoride gel (NaF). Materials and Methods. The study was conducted on 10 patients (8 F/2 M, age 25-60) and 115 teeth with DH assessed by air and tactile stimuli measured by Numeric Rating Scale (NRS). Teeth were randomly divided into G1 (34 teeth) treated by 1.25% NaF; G2 (33 teeth) lased at 0.5 W PW (T on 100 m and T off 100 ms), fluence 62.2 J/cm(2) in defocused mode with a 320 μ fiber. Each tooth received three 1' applications; G3 (48 teeth) received NaF gel plus laser at same G2 parameters. NRS was checked at each control. Results. Significant pain reduction was showed. The NRS reduction percentages were calculated, and there was a concrete decrease of DH above all in G3 than G2 and G1. Conclusion. Diode laser is a useful device for DH treatment if used alone and mainly if used with NaF gel.
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West NX, Lussi A, Seong J, Hellwig E. Scaffold-free microtissues: differences from monolayer cultures and their potential in bone tissue engineering. Clin Oral Investig 2012; 17 Suppl 1:S9-19. [PMID: 22695872 PMCID: PMC3585766 DOI: 10.1007/s00784-012-0887-x] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 11/21/2012] [Indexed: 12/13/2022]
Abstract
Objectives The paper’s aim is to review dentin hypersensitivity (DHS), discussing pain mechanisms and aetiology. Materials and methods Literature was reviewed using search engines with MESH terms, DH pain mechanisms and aetiology (including abrasion, erosion and periodontal disease). Results The many hypotheses proposed for DHS attest to our lack of knowledge in understanding neurophysiologic mechanisms, the most widely accepted being the hydrodynamic theory. Dentin tubules must be patent from the oral environment to the pulp. Dentin exposure, usually at the cervical margin, is due to a variety of processes involving gingival recession or loss of enamel, predisposing factors being periodontal disease and treatment, limited alveolar bone, thin biotype, erosion and abrasion. Conclusions The current pain mechanism of DHS is thought to be the hydrodynamic theory. The initiation and progression of DHS are influenced by characteristics of the teeth and periodontium as well as the oral environment and external influences. Risk factors are numerous often acting synergistically and always influenced by individual susceptibility. Clinical relevance Whilst the pain mechanism of DHS is not well understood, clinicians need to be mindful of the aetiology and risk factors in order to manage patients’ pain and expectations and prevent further dentin exposure with subsequent sensitivity.
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Affiliation(s)
- N. X. West
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - A. Lussi
- />Department of Operative Dentistry, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - J. Seong
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - E. Hellwig
- />Department of Operative Dentistry and Periodontology, Dental School and Hospital Dentistry, University Medical Center Freiburg, Freiburg im Breisgau, Germany
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LIN M, LUO ZY, BAI BF, XU F, LU TJ. FLUID DYNAMICS ANALYSIS OF SHEAR STRESS ON NERVE ENDINGS IN DENTINAL MICROTUBULE: A QUANTITATIVE INTERPRETATION OF HYDRODYNAMIC THEORY FOR DENTAL PAIN. J MECH MED BIOL 2011. [DOI: 10.1142/s0219519411003983] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Noxious thermal and/or mechanical stimuli applied to dentine can cause fluid flow in dentinal microtubules (DMTs). The fluid flow induces shear stress (SS) on intradental nerve endings and may excite pulpal mechanoreceptors to generate dental pain sensation. There exist numerous studies on dental thermal pain, but few are mathematical. For this, we developed a computational fluid dynamics (CFD) model of dentinal fluid flow (DFF) in innervated DMTs. Based on this model, we systematically investigated the effects of various parameters (e.g., biological structure, DFF velocity, and fluid properties) on the SS experienced by intradental nerve endings and thus provide a quantitative interpretation to the hydrodynamic theory. The dimensions of biological structures, odontoblastic process (OP) movement, dentinal fluid velocity, and viscosity were found to have significant influences on the SS while dentinal fluid density showed negligible influence under conditions studied. The results indicate that: (i) dental pain study of animal models may not be directly applied to human being and the results may even vary from one person to another and (ii) OP movement caused by DFF changes the dimension of the space for the fluid flow, affecting thus the SS on nerve endings. The present work enables better understanding of the mechanisms underlying dental pain sensation and quantification of dental pain intensity resulted from clinical procedures such as dentine sensitivity testing and dental restorative processes.
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Affiliation(s)
- M. LIN
- Biomedical Engineering and Biomechanics Center, School of Aerospace, Xi'an Jiaotong University, Xi'an 710049, P. R. China
| | - Z. Y. LUO
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University Xi'an 710049, P. R. China
| | - B. F. BAI
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University Xi'an 710049, P. R. China
| | - F. XU
- Biomedical Engineering and Biomechanics Center, School of Aerospace, Xi'an Jiaotong University, Xi'an 710049, P. R. China
- HST-Center for Biomedical Engineering, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - T. J. LU
- Biomedical Engineering and Biomechanics Center, School of Aerospace, Xi'an Jiaotong University, Xi'an 710049, P. R. China
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Effects of dentin tubule occlusion by dentifrice containing a PVM/MA bioadhesive copolymer in a silica base. J Dent 2011; 39:293-301. [DOI: 10.1016/j.jdent.2010.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Revised: 10/26/2010] [Accepted: 10/26/2010] [Indexed: 11/19/2022] Open
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Fluid mechanics in dentinal microtubules provides mechanistic insights into the difference between hot and cold dental pain. PLoS One 2011; 6:e18068. [PMID: 21448459 PMCID: PMC3063177 DOI: 10.1371/journal.pone.0018068] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 02/19/2011] [Indexed: 11/19/2022] Open
Abstract
Dental thermal pain is a significant health problem in daily life and dentistry. There is a long-standing question regarding the phenomenon that cold stimulation evokes sharper and more shooting pain sensations than hot stimulation. This phenomenon, however, outlives the well-known hydrodynamic theory used to explain dental thermal pain mechanism. Here, we present a mathematical model based on the hypothesis that hot or cold stimulation-induced different directions of dentinal fluid flow and the corresponding odontoblast movements in dentinal microtubules contribute to different dental pain responses. We coupled a computational fluid dynamics model, describing the fluid mechanics in dentinal microtubules, with a modified Hodgkin-Huxley model, describing the discharge behavior of intradental neuron. The simulated results agreed well with existing experimental measurements. We thence demonstrated theoretically that intradental mechano-sensitive nociceptors are not “equally sensitive” to inward (into the pulp) and outward (away from the pulp) fluid flows, providing mechanistic insights into the difference between hot and cold dental pain. The model developed here could enable better diagnosis in endodontics which requires an understanding of pulpal histology, neurology and physiology, as well as their dynamic response to the thermal stimulation used in dental practices.
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