牙颈部牙本质敏感不同评估方法相关性研究

目的研究三种牙颈部牙本质敏感评估方法之间的相关性。方法本研究采用Yeaple电子压力敏感探针评估牙颈部牙本质对接触刺激的敏感程度,采用Schiff冷空气敏感指数和视觉模拟评分法(Visual Analogue Scale,VAS)评估冷空气刺激后的敏感程度。在0周、4周及8周进行检测,对所得数据进行分析。结果 Schiff冷空气敏感指数和视觉模拟评分法始终保持良好的相关性并具有统计学意义(R=0.26,P=0.003、R=0.49,P=4.18×10-9及R=0.57,P=5.32×10-12),Schiff冷空气敏感指数和Yeaple探针在8周时相关性良好(r=-0.41,P=2.01×10-6),Yeaple探针与视觉模拟评分法相关性较差。结论在评估牙颈部牙本质敏感的临床试验中,Schiff冷空气敏感指数和视觉模拟评分法可以二者选一,联合使用敏感压力探针法。     

上海市区成人牙本质敏感流行病学调查

目的:了解上海市区成人牙本质敏感的现状,为牙本质敏感的诊断、预防以及治疗提供依据.方法:采用多阶段分层等容量随机抽样调查,对上海市区1320名成年人进行牙本质敏感的现场检查,使用SPSS12.0软件包对数据进行分析.结果:上海市区成人牙本质敏感的检出率为32.58%,其中男173例,女257例,男女比例为1:1.49.牙本质敏感最好发于前磨牙,其次为第一磨牙,敏感好发牙面部位以牙颈部为主.95.58%的敏感人群伴牙龈退缩,其中92.75%敏感部位在牙颈部者出现牙龈退缩.结论:上海市区成人牙本质敏感检出率与其他国家相比处于中等水平.牙龈退缩是引起牙本质敏感的主要原因.     

压力敏感探针测定牙齿敏感症的临床评价

为评价脱敏剂的临床疗效，以提供一种客观定量的检测牙齿敏感症的方法，作者用自行研制的压力敏感探针和冷空气刺激方法，对７１例２１２颗牙齿敏感症患牙进行了检查比较，结果表明：（１）９４．８％的患牙对探诊敏感，其平均敏感阈值为２２．７９ｇ；８９．６％的患牙对冷空气刺激敏感，探诊和冷空气检测具有高度的相关性（Ｐ＜０．００１）。（２）探诊和冷空气检测均表明，Ｈｅ面的敏感度低于颊面，差异有显著性（Ｐ＜０．０５）     

脉冲Nd：YAG激光治疗牙齿敏感症的临床疗效观察

本文应用压力敏感探针和冷空气刺激两种方法，研究脉冲Ｎｄ：ＹＡＧ激光治疗牙齿敏感症的临床疗效，结果表明：在一定的参数条件下（０．７５Ｗ／１５ＰＰＳ２．０ｍｉｎ），脉冲Ｎｄ：ＹＡＧ激光能有效地治疗牙齿敏感症，用探诊检测，即刻治愈率为１００％，三个月后为８５．４％；对冷空气刺激，即刻治愈率为７３．０％，三个月后为６９．７％。激光治疗后，患牙的压力敏感阈值明显高于治疗前，冷空气刺激敏感度明显低于治疗前（Ｐ     

漂白剂对牙颈部硬组织影响的扫描电镜研究

目的：观察漂白剂直接作用于牙颈部后牙的结构变化。方法：选用几种不同的漂白剂，直接作用于牙颈部，应用扫描电镜观察漂白剂引起的牙本质、釉质、牙骨质的结构变化。结果：牙颈部的牙骨质、牙本质均有结构上改变，釉质变化不明显。结论：提出预防牙颈部外吸收的措施，使临床上能安全、有效地应用漂白技术     

自酸蚀粘接剂治疗牙颈部牙本质敏感症的临床研究

目的通过VAS（visual analogue scale）表评价两步法自酸蚀粘接荆Contax治疗牙颈部牙本质敏感症的有效性。方法从临床就诊病人中选择20例确诊为牙颈部牙本质敏感症的患者，用Contax进行脱敏治疗，在应用前后及应用之后的第2周，第4周，第8周和第12周相继进行敏感性测定并以VAS值记录临床测定结果，进行Friedman统计分析。结果统计结果显示，使用Contax前后及应用之后测得的vas值呈逐渐下降趋势，其差异有高度统计学意义（P〈0．01）。结论Contax可以作为一种牙本质脱敏荆有效地降低牙颈部牙本质敏感症状。     

精氨酸脱敏牙膏治疗牙本质敏感的Meta分析

目的：采用Meta分析方法进行系统评价并比较精氨酸脱敏牙膏与常用脱敏牙膏治疗牙本质敏感的疗效。方法计算机检索万方、PubMed、Web of Science和Cochrane图书馆等数据库,并辅以手工检索,搜集精氨酸脱敏牙膏治疗牙本质敏感的随机对照试验（randomized controlled trial ,RCT）,数据的提取和质量评价由两个评价者独立完成。采用RevMan 5.3软件进行Meta分析。结果共纳入7项RCT,所有的结果通过触压敏感测试及冷空气喷吹检测评估,使用随机效应模型分析各治疗组的均数和标准差。Meta分析结果显示,精氨酸脱敏牙膏与含钾脱敏牙膏的疗效差异有统计学意义（触压评估：SMD=1.83,95％CI[1.07,2.58],P<0.05;冷空气评估：SMD=?1.19,95％CI[?1.69,?0.69],P<0.05）;精氨酸脱敏牙膏与含锶脱敏牙膏的疗效差异无统计学意义（触压评估：SMD=0.68,95％CI[?1.59,2.96],P>0.05;冷空气评估：SMD=?0.94,95％CI[?2.28,0.40],P>0.05）。结论精氨酸脱敏牙膏治疗牙本质敏感的效果优于含钾脱敏牙膏,但与含锶脱敏牙膏无明显差异。     

TRPAl在大鼠牙本质敏感牙髓组织中的表达研究

目的:研究机械刺激诱导大鼠牙本质敏感牙齿牙髓组织TRPAl的表达变化。方法:大鼠下切牙牙体预备后,每天用探针机械刺激暴露的牙本质,观察大鼠牙本质敏感行为学变化。7 d后,用SEM观察对牙本质表面形态;用RT-PCR 和Western Blot检测大鼠牙髓组织TRPAl的表达变化。结果:牙体预备后,大部分牙本质小管暴露开放,且无穿髓处;刺激组大鼠均出现了牙本质敏感反应行为学异常,其反应评分均显著高于对照组(P＜0.01),且强度增加,行为学反应更为剧烈。刺激组大鼠牙髓组织TRPA1 mRNA和蛋白的表达水平均显著升高,且随刺激强度增加,表达上调更为显著。结论:TRPA1可能是参与机械刺激相关性牙本质敏感发病的重要因子。     

8％精氨酸牙膏降低牙本质敏感的临床试验

目的 评价含8％精氨酸的抗敏牙膏控制牙本质敏感的效果.方法 采用随机、对照、双盲的研究方法,牙本质敏感的评价采用冷空气喷吹法,在常温下距离牙面1 cm处用气枪吹压缩空气,由受试者确认是否敏感,采用数字化疼痛评判法(visual analogue scale,VAS)记录受试者的敏感程度.按照纳入和排除标准纳入受试者,基线时共纳入受试者88人,按照性别和年龄将受试者分层随机分为试验组和对照组,每组44人.试验组使用含8％精氨酸的抗敏牙膏,对照组使用含5.53％柠檬酸钾的抗敏感牙膏.基线调查后,用棉签将1 cm长的牙膏涂抹于敏感牙表面并按摩1 min,进行敏感检测.受试者使用分派的牙膏和牙刷每天刷牙2次,每次至少1 min,分别在第3天和1周时接受回访.结果 所有受试者均完成了1周的临床试验研究.试验组和对照组受试者基线时的冷空气喷吹敏感VAS值(分别为55.51 ±8.48、56.67±10.22)和自我评价敏感VAS值(分别为43.75±6.65、41.98±8.53)差异均无统计学意义(P＞0.05).局部涂抹牙膏并按摩1 min,刷牙3d和1周后试验组冷空气喷吹敏感VAS值和自我评价敏感VAS值均较基线时显著下降(P＜0.01),对照组虽有下降但差异均无统计学意义(P＞0.05).与基线相比,试验组冷空气喷吹敏感VAS值和自我评价敏感VAS值的减少程度在3个时间点均显著高于对照组(P＜0.05).结论 含8％精氨酸的抗敏牙膏在单次局部涂抹后能即刻缓解牙本质敏感,刷牙1周后可有效缓解牙本质敏感.     

氯化锶脱敏牙膏治疗牙本质过敏症的疗效观察

目的　观察氯化锶脱敏牙膏对 3种病损引起的牙本质过敏症的治疗效果。方法　采用双盲法将 112例牙本质过敏症的患者随机用Ⅰ号和Ⅱ号牙膏 ,其中有 1种含有 10 %氟化锶的牙膏。记录使用牙膏前 ,使用牙膏后1、2、4周的牙齿敏感指数和VAS值 ,观察 2种牙膏对牙体组织过度磨损、楔状缺损、牙龈退缩致牙根暴露引起的牙本质过敏症的疗效。结果　氯化锶脱敏牙膏对牙体组织过度磨损所致的牙本质过敏症的疗效不明显 (P >0 .0 5 ) ,但楔状缺损、牙龈退缩致牙根暴露而引起的牙本质过敏症有明显的治疗效果 (P <0 .0 5 ) ,且在使用 2周时已经有明显的疗效 (P <0 .0 5 )。结论　氯化锶脱敏牙膏对楔状缺损、牙龈退缩致牙根暴露而引起的牙本质过敏症有明显的治疗效果。     

A cross‐sectional study: non‐carious cervical lesions,cervical dentine hypersensitivity and related risk factors

The present survey aims to study the prevalence and clinical characteristics of non‐carious cervical lesions (NCCLs) and cervical dentine hypersensitivity (CDH), as well as their possible risk factors in a general population in China. A total of 1023 subjects were included in the present study. Each subject completed a structured interview, and all teeth of each subject were examined by a practitioner to determine NCCLs and CDH. Teeth with NCCLs and CDH were diagnosed according to the tooth wear index and by a blast of air from a triple syringe, respectively. Binary logistic regression was completed by analysing the association of risk factors with the occurrence of NCCLs and CDH. Loss of attachment (LOA) and gingival recession (GR) of teeth with NCCLs and/or CDH were measured using Williams periodontal probe. The diagnoses of NCCLs and CDH established following a clinical assessment yielded an overall prevalence of 61·7% and 27·1%, respectively. The 60–69 age group had the greatest proportion of subjects with NCCLs or CDH. The pre‐molars were the most commonly affected teeth type with NCCLs or CDH. The proportion of teeth with CDH associated with NCCLs increased significantly with age, but the proportion of teeth with CDH only associated with LOA or GR decreased slowly with age. The single variables and interactive effects of variables associated with the occurrence of NCCLs include the following: age group, occupation type, method of toothbrushing, frequency and method of toothbrushing, and method of toothbrushing and duration of a toothbrush used. Gender, age group, occupation type and frequency of toothbrushing were associated with the occurrence of CDH. The current study presented higher prevalence of NCCLs and CDH in a general Chinese population. Both diseases were closely associated with age and periodontal status. The portion of the population with NCCLs or CDH had different risk factors.     

Efficacy of a potassium nitrate mouthwash in alleviating cervical dentine sensitivity (CDS)

Abstract Potassium nitrate (KNO₃) has been used previously in a dentifrice or gel to alleviate cervical dentine sensitivity (CDS). The aim of this study was lo compare a 3% KNO₃ Silica/NaF mouthwash with a NaF/silica mouthwash in a 6-week multi-centre double-blind study. 47 subjects (12M; 35F. mean age 36.2 ISD 11.46) years) participated in the study. Subjects were evaluated for tactile (Yeaple probe) and air sensitivity (dental air syringe) together with subjective perception of pain (0–10 scale) at 0. 2 and 6 weeks. Results for Yeaple probe (gm wt) (Wilcoxon paired rank test) between 6 weeks and baseline, were highly significant for both groups. Differences between groups at 6 weeks were statistically significant. Subjective Yeaple probe scores (paired t-tests) between 6 weeks and baseline were significant for both groups. There were no significant differences (unpaired t-tests) between groups over 6 weeks for subjective Yeaple probe scores. Subjective air scores (paired t-tests) between 6 weeks and baseline were significant for both groups. There were significant differences (unpaired t-tests) between groups in favour of the 3% KNO₃./Silica/NaF group at 6 weeks. The 2 weeks and baseline results for both groups were the same as reported for 6 weeks and baseline. The results demonstrated that a 3% KNO₃/Silica/NaF mouthwash compared to a Silica/NaF control significantly reduced CDS when evaluated by tactile and thermal stimuli. A 3% KNO₃/silica/NaF mouthwash would, therefore appear to have therapeutic potential to alleviate CDS.     

Thresholds of hypersensitive teeth to 2 forms of control led stimulation

2 new methods are described for measuring the sensitivity of dentine to mechanical (probe) and cold-air stimulation. The methods are suitable for clinical use and could be used in the evaluation of desensitising treatments. In addition to qualitative differences in the pattern of sensitivity of teeth to these stimuli, considerable variation was observed in the distribution of pain thresholds to probe and air stimulation. Thresholds were not significantly affected by the age or sex of the subjects, but mean thresholds of teeth sensitive to only one stimulus were significantly greater than thresholds of teeth sensitive to both stimuli; these differences were most marked in female subjects. Factors such as the qualitative differences in sensitivity to various stimuli and quantitative differences in the degree of sensitivity to the stimuli require to be considered in clinical evaluation of desensitizing treatments.     

Cervitec治疗老年人因牙齿磨损致牙本质过敏症的疗效观察

目的：评价cervitec治疗老年人因牙齿磨损引发的牙本质敏感症的临床疗效。方法：对老年人敏感牙齿分别用cervitec（实验组66颗）和75％氟化钠甘油糊剂（对照组62颗）进行脱敏,4次为一个疗程,观察其即刻、1个月、3个月的疗效。结果：实验组与对照组在即刻疗效上的差异无统计学意义,在1个月、3个月的疗效,两者间差异具有统计学意义。结论：cervitec在治疗老年人因牙齿磨损引发的牙本质过敏症中短期疗效显著。     

3�ַ���ȥȣ�����������۲�ɨ��羵�۲�

目的应用扫描电镜观察传统高速牙钻法、空气喷砂法、CarisolvTM化学机械法去龋后牙本质表面玷污层,肉眼观察窝洞洞底表面。方法将2006年3月至2006年6月南昌大学附属口腔医院收集的新近拔除伴中度龋坏的15颗患牙,依据去龋方法的不同分为3组:传统高速牙钻组、空气喷砂组和CarisolvTM化学机械组。去龋后肉眼观察窝洞洞底表面,并用扫描电镜对牙本质表面玷污层进行观察。结果3种方法均可有效去龋。传统高速牙钻组去龋后窝洞洞底牙本质表面平整、光亮而且透明;空气喷砂组牙本质表面粗糙、凹凸不平;CarisolvTM化学机械组牙本质表面光泽较暗。扫描电镜下观察,CarisolvTM化学机械组去龋后牙本质小管附近玷污层少,牙本质小管栓塞率仅为4.4%,明显低于其他2组(P均<0.05);空气喷砂组牙本质小管清晰可见,周围玷污层仅有少量分布;传统高速牙钻组牙本质小管清晰度较差,周围玷污层大量分布,牙本质小管栓塞率明显高于其他2组(P均<0.05)。结论CarisolvTM化学机械法能有效去龋,清除牙本质玷污层。     

Comparison of two desensitizing agents for the treatment of cervical dentine sensitivity

Abstract Numerous desensitizing agents have been utilized in an effort to alleviate the discomfort associated with cervical dentine sensitivity (CDS). Recently several new tubule-occluding and sealant systems have been marketed for treatment. The aim of this study was to compare two desensitizing agents (ALL-BOND 2 and Butler Protect) in a 3-month clinical study. Ten subjects (6F; 4M mean age 45.1 years (SD 8.81) who had provided voluntary written informed consent participated in a single-blind 3-month clinical study. Subjects were evaluated for tactile (Yeaple probe) and air sensitivity (dental air syringe) together with subjective perception of pain (VAS scores) at 0.5 min, 1, 2 and 3 months. There was an overall trend in reduction of CDS over the study period in all groups with no significant differences detected between groups. The results suggested that while subjects reported overall reductions in sensitivity levels, this may not necessarily be substantiated when assessed objectively. Furthermore, there appeared to be a strong placebo effect in this study.     

Er：YAG激光对根面牙本质与玻璃离子间抗剪切强度的影响

目的：研究铒：钇铝石榴石（Er：YAG）激光照射对老年人根面牙本质与玻璃离子水门汀间的抗剪切强度的影响。方法：收集20颗老年人（≥60岁）和20颗年轻人（≤20岁）完整离体恒牙,用金刚砂车针磨除近中釉牙骨质界部位的牙釉质及牙骨质,暴露根方牙本质。老年人牙齿随机分为 G 1组和 G2组,年轻人牙齿随机分为 M1组和 M2组,每组10颗。采用不同的方式处理根面牙本质：G1组和 M1组用 Er：YAG激光照射,G2组和 M2组仅用金刚砂车针制备。将牙齿包埋于自凝塑料,制备根面使用 GC Fuji Ⅸ GP CAPSULE 玻璃离子充填。样本冷热循环后,置于万能材料试验机测定其抗剪切强度,并行统计学分析。结果：抗剪切强度比较显示：G1组＞G2组,M1组＞M2组,G1组＞M1组,G2组＞M2组（P＜0．05）。结论：Er：YAG激光照射可以提高牙本质与玻璃离子间抗剪切强度;老年人牙齿可以获得比年轻人更高的抗剪切强度。     

The cervical wedge-shaped lesion in teeth: a light and electron microscopic study

Background:  The cervical non-carious wedged-shaped lesion is controversial in that its aetiology may involve attrition, erosion, abrasion and stress-corrosion (abfraction). This study examined the histopathology of anterior teeth with cervical wedge-shaped lesions by light and electron microscopy to elucidate their pathogenesis.
Methods:  Ten undecalcified human teeth with cervical lesions were available for investigation. Patency of the dentine tubules was tested using red dye penetration from the pulp chamber. The morphology of normal and sclerotic dentine adjacent to the cervical wedge-shaped lesions was investigated by scanning electron microscopy. The numbers and diameters of dentinal tubules were measured at different levels beneath the surfaces of the lesions.
Results:  The gross and microscopic features of the worn teeth were described. Red dye penetration tests showed white tracts of sclerotic tubules contrasted with red tracts of patent tubules. Numbers of tubules per square area and diameters of patent and sclerotic tubules varied at different levels within the dentine due to deposits of intratubular dentine.
Conclusions:  The cervical wedge is shaped by interactions between acid wear, abrasion and dentinal sclerosis. No histopathological evidence of abfraction was found. Clinical diagnosis, conservation and restoration of non-carious cervical lesions need to take into account the extent of sclerotic dentine beneath wedge-shaped lesions.     

Prevalence and distribution of cervical dentine hypersensitivity in a population in Rio de Janeiro, Brazil.

The prevalence, distribution and possible causal factors of cervical dentine hypersensitivity were studied in a population from a Marine Dental Clinic in the city of Rio de Janeiro, Brazil. A total of 635 patients were examined for the presence of cervical dentine hypersensitivity by means of a questionnaire and intraoral tests (air and probe stimuli). There were 157 patients (25%) reporting to have hypersensitive teeth, but only 108 patients (17%) were diagnosed as having cervical dentine hypersensitivity. The prevalence of hypersensitivity was higher among females than males, but this difference was not statistically significant. Most females with hypersensitivity were aged 20-49 and most males were aged 40-59. Incisors and premolars had the highest prevalence of dentine hypersensitivity to air and probe stimuli, while molars had the lowest. The presence and history of dentine hypersensitivity were positively correlated with previous exposure to periodontal treatment. Only a few of the patients who claimed to have dentine hypersensitivity had tried treatment with desensitizing toothpastes or sought professional help.