牙本质过敏症课件.ppt

Dentin Hypersensitivity Introduction Definition: Characteristic Stimuli Etiology Two phases of development of dentin hypersensitity Mechanism Treatment Treatment Strategies Treatment Steps * Zhang Qi Wuhan University School of Stomatology Dentin hypersensitivity is a common condition of transient tooth pain caused by a variety of exogenous stimuli. Short , sharp pain. Most in cervical, then occlusal The exogenous stimuli include: Thermal (cold) Tactile (touch) Osmotic changes (sweets, drying the surface) The primary clinical cause is exposed dentinal tubules. First, dentin has to be exposed. —lesion localization The dentinal tubules must be opened —lesion initiation The most common clinical cause for exposed dentinal tubules is gingival recession. Common Reasons for Gingival Recession Inadequate attached gingiva Prominent roots Tooth brush abrasion Pocket reduction periodontal surgery Oral habits resulting in gingival laceration Excessive tooth cleaning Excessive flossing others Reasons for Continued Dentinal Tubular Exposure Poor plaque control, acidic bacterial byproducts Excess oral acids, sodas, fruit juice Cervical decay Toothbrush abrasion Tartar control toothpaste Hydrodynamic theory —M.Br?nnstr?m in 1967 The fluids within the tubule are disturbed either by temperature changes or physical osmotic changes. These fluid changes stimulate a baroreceptor which leads to neural discharge (depolarization). Baroreceptor: a never receptor sensitive to pressure A challenge for both the patients and dentists. It’s difficult measuring/comparing different patient’s pain. It’s difficult for patients to change the habits. Plug the dentinal tubules preventing fluid flow. Desensitize the nerve making it less responsive to stimulation. Nerve Desensitization Potassium Nitrate the only one approved by FDA and ADA KNO3 penetrates through the dentinal tubules