dentine hypersensitivity
DESCRIPTION
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Dentine hypersensitivity: New perspectives on an old problem
General causes of disease:caries/non-caries: attrition, abrasion, corrosion, abfraction
bulimia/gastroesophageal reflux disease
Non-caries lesion may cause: enamel erosion, dentin hypersensitivity, pulpitis
(1450 ppm NaF or 5% KNO3降低 sensitivity)
DD:crack tooth syndrome
leakage of restoration
fractural restoration
pulpal response to caries and restoration
traumatic occlusion
chipped teeth
vital bleaching
palatal-gingival groove and enamel invagination
Tx:Patient education: erosive drinks, brush teeth one hour after soft drinks
Home-use: tooth paste,鉀塩,strontium chloride,草酸鈣In-office: occluding the dentinal tubules, reducing intradental nerve excitablity
Support: potassium,stannous fluoride, calcium,sodium phosphate silicate, arginine containing desensitizing
搭配漱口水可增強效果laser treatment: sealing or occluding dentinal tubules, melting recrystalization, evaporate dentinal fluid
Er-YAG,Er-CrYSGG
Novamin: calcium,sodium phosphate silicate
和唾液起反應提高 pH值, 產生磷酸鈣沉澱, 於牙齒表面形成類氫氧磷灰石層
CLASSIFICATION OF DESENSITIZING AGENTS1. Mode of administration
At home desensitizing agents
In-office treatment
2. On the basis of mechanism of actionNerve desensitization
o Potassium nitrate
Protein precipitation
o Gluteraldehyde
o Silver nitrate
o Zinc chloride
o Strontium chloride hexahydrate
Plugging dentinal tubules
o Sodium fluoride
o Stannous fluoride
o Strontium chloride
o Potassium oxalate
o Calcium phosphate
o Calcium carbonate
o Bio active glasses (SiO2–P2O5–CaO–Na2O)
Dentine adhesive sealers
o Fluoride varnishes
o Oxalic acid and resin
o Glass ionomer cements
o Composites
o Dentin bonding agents
Lasers
o Neodymium:yttrium aluminum garnet (Nd-YAG) laser
o GaAlAs (galium-aluminium-arsenide laser)
o Erbium-YAG laser
Homeopathic medication
o Propolis