即刻牙本质封闭对预备后牙本质敏感程度的影响

目的评价牙本质即刻封闭技术对牙体预备后活髓基牙牙本质敏感程度的影响。方法30例患者行后牙三单位固定义齿修复,每例口内有2颗活髓后牙参与实验,基牙随机分为实验组和对照组。实验组在基牙预备后行即刻牙本质封闭,随后取模。对照组在基牙预备后常规取模,不进行即刻牙本质封闭。1周后行最终修复,全冠粘接后1周、1个月、6个月、12个月和18个月时检查记录患者的牙本质敏感程度,并进行统计学分析。结果固定义齿粘接后1周及1个月,实验组出现敏感基牙数少于对照组（1周：Z=-1.88,P=0.03;1个月：Z=-2.15,P=0.02）。粘接后6、12及18个月两组敏感发生率间差异无统计学意义（6个月：Z=-0.69,P=0.30;12个月：Z=-0.41, P=0.69;18个月：Z=-0.42,P=0.52）。比较两组敏感程度结果显示,实验组敏感的基牙,敏感程度主要为1度;对照组主要为1度及2度。1周及1个月观察点两组疼痛程度差异有统计学意义（1周：P＜0.05,1个月P=0.027）。结论活髓基牙牙体预备后行即刻牙本质封闭,可有效降低术后短期内牙本质过敏的发生率,减小患者的术后不适感。     

牙本质敏感的概述

牙本质敏感是口腔临床上常见的疾病之一,在成年人中普遍存在,患病率为29.7%。目前最为广泛接受的发病机制是流体动力学说。牙本质敏感的治疗是封闭或部分封闭牙本质小管来减少牙本质小管内的液体流动和阻断牙本质小管内神经传导。临床上常见的脱敏方法为药剂、激光、材料充填及冠修复等多种方法。     

630名四川农村成人牙本质敏感流行病学调查分析

目的 了解四川省农村成人牙本质敏感的患病状况,并探讨可能的危险因素.方法 采用多阶段、分层、等容量、随机抽样的方法,对四川省农村630名成人进行牙本质敏感问卷调查和口腔临床检查,使用SPSS 18.0软件对调查数据进行统计分析.结果 四川省农村成人牙本质敏感的患病率为27.9%,酸刺激是最常见的敏感诱发因素.第一前磨牙...     

激光治疗牙本质敏感的研究进展

牙本质敏感是口腔常见疾病,严重影响患者的口腔健康和生活质量。激光作为一种常用的治疗措施,单独使用或与其他药剂的联合应用均获得了良好的疗效,受到口腔医学界的广泛关注。本文就目前激光治疗牙本质敏感的研究进展进行综述。     

我国激光治疗牙本质敏感疗效的循证医学分析

目的:评价我国激光治疗牙本质敏感的疗效.方法:采用Cochrane 系统评价的方法,计算机和手工方法检索1989～2009 年国内有关激光治疗牙本质敏感的随机对照临床研究.在严格筛选资料和质量评价的基础上,采用RevMan 5.0.1软件对纳入的研究进行Meta分析.结果:共检索到114 篇相关文献,最终有9 篇文献符合纳入标准.分析结果显示:除了激光治疗牙本质敏感的即刻疗效的数据可以合并外,各研究间其他时期的疗效均存在统计学异质性,数据无法合并,只能采用描述性分析.激光治疗牙本质敏感的即刻疗效优于对照组,差异有统计学意义[OR=3.83,95%CI(2.86,5.12)],其他时期疗效均有优于对照组的趋势.结论:激光治疗牙本质敏感疗效较好.但由于本研究中部分文献的质量不高,上述结论还需开展更多大样本的、设计严谨的随机对照研究来验证.     

牙周非手术治疗对牙髓和根面牙本质敏感的影响

目的：研究由牙周非手术治疗引起的牙髓和根面牙本质敏感(RDS)的改变。方法：20例患者共306个患中到重度牙周炎的牙齿，接受口腔卫生宣教(0H)2周以及浩刮治和根面平整(S／RP)1、2、4和8周后，用电活力测试仪测定牙髓的敏感性，用探诊和吹气两种方法，并用VAS量表评估根面敏感性。结果：在整个实验期内，牙髓活力无显著性改变(P＞0.05)。在2周的观察期内，经良好的菌斑控制后，RDS由4.18降至2.45(P＜0.01)，但经S／RP后，根面敏感显著增加，治疗后1周，根面敏感最为严重，达6.68(p＜0.01)，在随后3次的复诊中，根面敏感度逐渐下降，至8周时，与治疗前已无显著性差异(P＞0.05)。结论：良好的菌斑控制会减少RDS的发生；牙周非手术治疗对牙髓的敏感性无影响，但至少会引起RDS的短暂发生。     

牙本质敏感症的体外研究方法

临床上治疗牙本质敏感症的方法有很多,对其作用机制及疗效的体外研究方法包括牙本质表面观察、牙本质表层和深层的矿物质检测及牙本质通透性研究等.本文对这些研究方法作一综述.     

四川省中小城市牙本质敏感流行病学调查研究

目的：通过横断面研究了解四川省中小城市成年人群牙本质敏感的流行状况及相关危险因素。方法：2009年11～12月采用多阶段分层随机抽样的方法,对四川省中小城市的533名20～69岁年龄段人群进行牙本质敏感状况问卷调查和口腔检查,同时对牙本质敏感相关危险因素进行分析。结果：四川省中小城市成年人牙本质敏感的患病率为27.76%,冷刺激是牙本质敏感症的最常见诱发因素（78.5%）。30～39岁人群的个人平均牙敏感数最高（2.79）。右上颌第一前磨牙是最常见的敏感牙位。性别和存在胃返酸症状可能为牙本质敏感的危险因素。结论：四川省中小城市牙本质敏感患病率27.76%,牙本质敏感广泛存在,应加强口腔宣教并采取预防措施。     

光固化粘结剂治疗牙本质敏感症的初探

采用单盲自身配对对照法，用光固化粘结剂和局部涂布氟化钠治疗牙颈部敏感症，平均疗效分别是７８．５％，６４．６％，经统计学处理ｐ＜０．０１，有高度显著性差别。故认为用光固化粘结剂治疗牙颈部牙本质敏感症优于氟化钠甘油糊剂脱敏法。实验组３月、６月、９月疗效分别为７４．２％、６１．３％、５８．７％，经统计学处理ｐ＞０．０５，表明其远期疗效较佳。     

激光治疗牙本质敏感症的研究进展

牙本质敏感症作为一种口腔临床的常见病,其发病机制尚未完全清楚,目前较公认的是流体动力学说。脱敏治疗方法以封闭牙本质小管和降低牙髓神经敏感性为主,现阶段临床上仍无十分理想的脱敏手段。研究表明,激光治疗能弥补传统方法的不足,提高脱敏效果,特别是激光联合药物脱敏已成为近年牙本质敏感症治疗研究的焦点。文章对近年来国内外各种激光治疗牙本质敏感症的研究进展做一概述。     

A cross-sectional study of dentine hypersensitivity

AIM: The aim of this study was to establish the prevalence of dentine hypersensitivity in a cross-sectional study of patients visiting general dental practitioners in the United Kingdom over a period of one calendar month. METHODS: Nineteen dental practioners examined 4841 patients over a period of one calendar month and patients that had dentine hypersensitivity diagnosed were questioned further about their occupation and smoking habits. The amount of buccal gingival recession associated with the sensitive teeth was also recorded using a study form. RESULTS: 201 patients were diagnosed as having dentine hypersensitivity, giving a prevalence figure of 4.1%. The commonest teeth affected were the upper premolar teeth and the commonest initiating factor was cold drinks. A tendency for a greater number of sensitive teeth was also found for patients with periodontal disease who also smoked. There was also a tendency for the patients with sensitive teeth to come from higher social groups.     

Dentists' perceptions of dentine hypersensitivity and knowledge of its treatment

The aim of the present investigation was to determine by questionnaire, UK dentists' perception of Dentine Hypersensitivity (DH) and knowledge of its treatment. A total of 403 questionnaires were sent to a selected group of UK dentists who had either inquired about further postgraduate education or had attended a course at the Eastman Dental Institute/Hospital. A total of 181 of 403 dentists (44.9%) (118M; 36F, 17 no response, mean age 38.2 years [s.d. 8.97]) returned the questionnaire. About 92.8% (n=168) of responding dentists claimed to see patients with DH in their practice. According to the dentists' replies at least one of four of their patients suffered from the complaint. About 71.8% (n=130) of dentists reported that DH was a severe problem in at least 10% of their patients and that pain from DH lasted no more than 4 weeks. Most of responding dentists claimed to be asked about DH by their patients and stated that they offered advice or treatment to their patients. Nearly 87.3% (n=158) of responding dentists provided a wide range of treatment options/advice which included both in-office and over-the-counter (OTC) products. Popular responses included desensitizing pastes/gels, Topical F(-) varnishes and toothpastes/rinses/gels, advice on atraumatic tooth brushing, dentine bonding agents (DBA), glass-ionomer cements (GIC) and other unspecified restorations. Of the various in-office treatments Duraphat was the most cited choice of varnish/primer options. Sensodyne toothpaste was the most popular of the specified OTC products. Most dentists appeared to understand the aetiological features associated with DH and provided a wide range of factors including the effects of incorrect tooth brushing, dietary acids as well as the possible influence on non-dental topics such as stress. Most responding dentists believed that their advice on DH was generally effective although they did highlight that certain aspects on the condition were lacking such as appropriate scientific information including the prevention of DH and its treatment. The results from the present study highlight several discrepancies in the perception and knowledge of the treatment of DH between dentists and their patients. The results from this study are, however, reasonably consistent with those previously reported by Dutch investigators. The results from this study also highlighted a need for guidelines on the aetiology, prevention and treatment of DH for both dentists and their patients. The reported average frequency and duration of discomfort from DH by the responding dentists appeared to be consistent with the available literature.     

The prevalence of dentine hypersensitivity in general dental practice in the UK

AIM: The aim of this study was to establish the prevalence of dentine hypersensitivity in a cross-sectional study of patients visiting general dental practitioners in the South West region of the UK over a period of 1 calendar month. METHOD: Twelve dental practitioners examined 3593 patients over a period of 1 calendar month and 137 patients were diagnosed as having dentine hypersensitivity, giving a prevalence figure of 3.8%. RESULTS: The commonest teeth affected were the upper premolar and molar teeth and the commonest initiating factor was cold drinks. CONCLUSIONS: The prevalence of dentine hypersensitivity in general dental practice in the UK was 3.8%.     

The prevalence of dentine hypersensitivity in Chinese adults

Dentine hypersensitivity is a common oral problem. This study investigated the prevalence of dentine hypersensitivity in the adult population of Shanghai, China. A multi-stage, stratified, random sampling method was used to investigate the study population. A total of 2120 subjects were examined at 10 investigation points in Shanghai City. Subjects were divided into age groups (10 years per age group) and included the same number of male and female subjects in each group. Participants completed a dentine hypersensitivity questionnaire and underwent clinical examination. The diagnosis of dentine hypersensitivity was confirmed clinically as a sharp well-localised pain in response to administration of a blast of cold air from a triple syringe. Gingival recession of sensitive teeth was measured by a Williams periodontal probe. Among 2120 participants, 723 were diagnosed as having dentine hypersensitivity, indicating a prevalence of 34·1%. The male to female ratio of dentine hypersensitivity was 1:1·5. The prevalence of dentine hypersensitivity was highest in the 40- to 49-year age group at 43·9%. The number of teeth with dentine hypersensitivity was 3·2 per patient. Dentine hypersensitivity occurred predominantly in the premolars (49·6%), followed by the anterior teeth (30·5%). A total of 84·3% of dentine hypersensitive patients had gingival recession. The prevalence of dentine hypersensitivity in Shanghai adults was 34·1%, indicating that it is a common condition. Therefore, public education about the condition and effective treatment of dentine hypersensitivity are required.     

成都市青年人群牙本质过敏症流行病学调查研究

目的了解成都市青年人群牙本质过敏症的流行状况及危险因素。方法2008年6-7月采用多阶段、等容量、随机性抽样方法,对成都市741名18～35岁年龄段常住人口的牙本质过敏情况进行问卷调查和临床检查,并对牙本质过敏症的相关危险因素进行分析。结果成都市青年人群牙本质过敏症的患病率为17.27%,女性牙本质过敏症的患病率高于男性（P＜0.01）。冷刺激是牙本质过敏症的最常见诱发因素（62.80%）,右上颌第一前磨牙是牙本质过敏症的最常见敏感牙位（15.51%）。存在胃肠道返酸症状、饮用碳酸饮料较多、使用牙刷较硬、刷牙力量较大是牙本质过敏症的相关危险因素。结论成都市青年人群中牙本质过敏症广泛存在,酸蚀和刷牙不当会造成牙本质过敏症的发生,口腔医生应加大对牙本质过敏症预防措施的宣传。     

氟离子导入治疗牙本质敏感症的临床研究

目的探讨氟离子导入法治疗牙本质敏感症的临床疗效。方法51例牙本质敏感症患者共61对磨牙,将每对磨牙随机分为实验组和对照组。分别采用氟离子导入法和Gluma涂擦法脱敏。记录治疗前后即刻、1周和1个月时的数字化疼痛评判法(visual analogue scale,VAS)的差值,计算两种方法的有效率并进行统计学分析。结果氟离子导入法术后即刻、1周和1个月时有效率分别为86.89%、81.97%、80.33%;Gluma涂擦法分别为90.16%、78.69%、78.69%。两组在即刻、1周和1个月时的有效率呈下降趋势,但术后同一时间两组间有效率无显著差异。结论氟离子导入法治疗牙齿敏感症与Gluma涂擦法在疗效上无显著差异,可用于临床的脱敏治疗。     

Guidelines for the design and conduct of clinical trials on dentine hypersensitivity*

Abstract Clinical trials on dentine hypersensitivity have been numerous and protocols varied. To date there is little consensus as to the conduct of studies on this poorly-understood yet common and painful dental condition. A committee of interested persons from academia and industry was convened to discuss the subject of clinical trials on dentine hypersensitivity and a consensus report is presented. A double-blind randomized parallel groups design is recommended, although cross-over designs may be used for the preliminary screening of agents. Subjects may have multiple sites scored. Sample size will be determined by estimating the variability in the study population, the effect to be detected and the power of the statistical test to be used. Subject selection is based on a clinical diagnosis of dentine hypersensitivity, excluding those with conflicting characteristics such as currently-active medical or dental therapy. The vestibular surfaces of incisors, cuspids and bicuspids are preferred as sites to be tested. A range of sensitivity levels should be included. Tactile, cold and evaporative air stimuli should be applied. Negative and benchmark controls should be incorporated. Most trials should last 8 weeks. Sensitivity may be assessed either in terms of the stimulus intensity required to evoke pain or the subjective evaluation of pain produced by a stimulus using a visual analog or other appropriate scale. The subject's overall assessment may be determined by questionnaire. Outcomes should be expressed in terms of clinically significant changes in symptoms. Follow-up evaluation is required to determine the persistence of changes. At least 2 independent trials should be conducted before a product receives approval.     

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。     

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目的比较3种粘接剂治疗牙本质过敏症的临床疗效。方法选择2010年5月至2011年9月到首都医科大学附属北京口腔医院口腔内科就诊的牙根颈部暴露和后牙矜面磨耗致牙本质过敏症患者80例,共256颗患牙,分别使用G-BOND（GC组,85颗）、AdpeV？SingleBond2（3M组,85颗）、iBONDSelfEtch（iBOND组,86颗）粘接剂进行脱敏治疗,对比观察3组的临床脱敏效果。结果脱敏治疗后即刻有效率：GC组为27．1％,3M组为63．5％,iBOND组为93．0％;iBOND组即刻有效率明显高于GC组和3M组,差异有统计学意义（P〈0．05）。脱敏治疗后3、6个月,GC组有效率为14．1％和12．9％,3M组为58．8％和56．5％,iBOND组为70．9％和61．6％。3组在治疗后3、6个月的有效率均低于其即刻有效率,差异有统计学意义（P〈0．05）。iBOND组和3M组在治疗后6个月的有效率差异无统计学意义（P〉0．05）。结论iBONDSelfEtch自酸蚀光固化粘接剂治疗牙本质过敏症操作简便,近期效果满意,远期效果有待观察。