치주수술 후 상아질 지각과민증에 대한 저수준 레이저 처치의 임상적 효과

김남윤,임성빈,정진형,Kim, Nam-Yun,Lim, Sung-Bin,Chung, Chin-Hyung 대한치주과학회 1996 Journal of Periodontal & Implant Science Vol.26 No.1

Root surface exposure due to gingival recession after periodontal surgery, dentin exposure after root planing elicit pain response when exposed to mechanical, heat, chemical or osmotic stimulation. Especially, patients treated with periodontal surgery, show high frequency and there have been reports showing the 1 out of 7 patients have dentin hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentin hypersensitivity. but, none could provide absolute clinical efficacy. In this study, 45 teeth from 30 patients, who had had periodontal surgery and showed dentin hypersensitivity after surgery were chosen for the experimental group and they were illuminated with laser, 15teeth were chosen for the control group and they were not exposed to laser. After this dentin hypersensitivity was elicited by tactile, compressed air, cold water and then, the degree was evaluated using NRS(Numerical Rating Scale). And during LLLT(Low Level Laser Therapy) semiconductor laser using Gallium - Arsenide as a diode was illuminated for 180 seconds at a frequency of 7(500Hz). This therapy was done 10 times, and each time the changes in dentin hypersensitivity was evaluated using NRS. The results were as follows : 1. After treat with LLLT on dentin hypersensitivity due to periodontal surgery, 22.2% showed total loss of dentin hypersensitivity, 60.0% showed loss of tactile dentin hypersensitivity, 48.8% showed loss of compressed air dentin hypersensitivity, 22.2% showed loss of cold water dentin hypersensitivity. 2. As a result of clinical evaluation of dentin hypersensitivity using NRS, there was significant increase in improvement of dentin hypersensitivity in the experimental group compare to the control group(P<0.05). And there was almost no natural loss of dentin hypersensitivity in the control group. 3. In comparison of the stages of evaluation, there was significant difference in between experimental and control group. after the second visit(P<0.05), and the difference increased with each visit.

수종의 치근면 처치 방법에 따른 상아질 지각 과민 변화 및 표면 특성에 관한 연구

권순영,임성빈,정진형,Kwon, Soon-Young,Lim, Sung-Bin,Chung, Chin-Hyung 대한치주과학회 1999 Journal of Periodontal & Implant Science Vol.29 No.1

Exposure of the root surface due to gingival recession after periodontal surgery, elicit pain response when exposed to mechanical, heat, chemical or osmotic irritation. Especially patients treated with periodontal surgery, show high frequency. There have been reports that the 1 out of 7 patients complains of dentinal hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentinal hypersensitivity. The purposes of this study were to evaluate the effect of sodium chloride and potassium oxalate and to observe the relationship between the dentinal hypersensitivity and surface characteristics such as dentinal tubule size and number. This study included 20 teeth which were scheduled for extraction and had no pulpal disease. These teeth were divided into Root planing group, EDTA group, NaCl group and Oxalate group. Dentinal hypersensitivity is measured by tactile, pressured air and cold water using NRS (Numerical Rating Scales). Teeth were extracted under local anesthesia and each specimen was sectioned to a size about 3 X 5 mm and was examined under the scanning electron microscope (X2,000) The results were as follows, 1. The EDTA group exhibited significantly increased dentinal hypersensitivity comparing with the other groups. 2. The NaCl and Oxalate groups showed significantly reduced dentinal hypersensitivity comparing with the EDTA group. 3. As a method for dentinal hypersensitivity measurement, it was presumed thet tactile sensitivity test was not sensitive method but air blast test and cold water test were adequate method. 4. In a SEM study, the root planing group exhibited amorphous smear layer and showed no dentinal tubule orifice, but the EDTA group showed the large number of dentinal tubules. On the other hand, the NaCl and Oxalate groups did not show exposed dentinal tubules. The NaCl group showed more rough root surface than the EDTA group, and the Oxalate group showed many participates to be presumed as calcium oxalate particle. As the results from this study, root planing couldn't expose the dentinal tubule and NaCl and potassium oxalate occluded exposed dentinal tubule effectively. Dentinal hypersensitivity has close relationship with the exposure of dentinal tubules, especially with it's size and number.

다시 바라보는 지각과민증: 유병률, 진단과 치료, 한계와 미래

전미정,서덕규 대한치과의사협회 2022 대한치과의사협회지 Vol.60 No.4

Dentin hypersensitivity is sharp pain arising from exposed dentin in response to stimuli. Over the recent decades, the number of patients complaining of discomfort caused by dentin hypersensitivity has increased. The aim of this study was to find out the accurate diagnosis and treatment method of dentin hypersensitivity from an expert’s point of view. In a clinical situation, an accurate diagnosis must precede the treatment. For an accurate diagnosis, it is important to objectify and reproduce symptoms during clinical examination after a detailed history taking. Treatment of dentin hypersensitivity is often more important as long-term intervention than a one-time treatment. The invasive and irreversible treatment should be considered as the last resort after attempting sufficient conservative methods. Many types of desensitizers are currently on the market to relieve dentin hypersensitivity. Representative methods include nerve desensitization and occlusion of dentinal tubules to reduce movement of the dentinal fluid to relieve pain. However, existing desensitizers have various limitations, and several attempts are such as bioceramic, nanoparticle, and protein have been made to overcome the limitations. Treatment based on accurate diagnosis and correct understanding of dentin hypersensitivity can reduce the pain and increase the quality of life of many patients.

상아질 지각과민증에 관한 치과위생사의 경험, 교육요구도, 인식도

노지은 ( Ji-eun Noh ),배현숙 ( Hyun-sook Bae ) 대한예방치과·구강보건학회 2023 大韓口腔保健學會誌 Vol.47 No.2

Objectives: This study investigates dental hygienists’ experience, education, and awareness of dentin hypersensitivity. Its purpose is to provide a basis for the development of preventive procedures and educational materials for dentin hypersensitivity. Methods: After distributing the questionnaire, Oral health characteristics of dental hygienists and the general public were investigated. In addition, the experience of dentin hypersensitivity according to general characteristics and the need for education were confirmed. The collected data were analyzed by frequency analysis, descriptive statistical analysis, unpaired t-test, and one-way ANOVA. Results: There was no difference in the experience of dentin hypersensitivity according to oral health-related or general characteristics in the dental hygienist group. In terms of oral health, there was a difference in educational requirements for dentin hypersensitivity for ‘family support for oral health’. Conclusions: The experience of dentin hypersensitivity in this study can be used as data for the development of a Korean dentin hypersensitivity experience questionnaire. The educational requirements and perception of dentine hypersensitivity will help develop educational materials from the patient’s perspective. Moreover, they will be essential for practical education on dentine hypersensitivity in dental hygiene and educational processes.

Update on dentin hypersensitivity: with the focus on hydrodynamic theory and mechanosensitive ion channels

Jonghwa Won,Seog Bae Oh 대한구강생물학회 2019 International Journal of Oral Biology Vol.44 No.3

Dentin hypersensitivity is an abrupt intense pain caused by innocuous stimuli to exposed dentinal tubules. Mechanosensitive ion channels have been assessed in dental primary afferent neurons and odontoblasts to explain dentin hypersensitivity. Dentinal fluid dynamics evoked by various stimuli to exposed dentin cause mechanical stress to the structures underlying dentin. This review briefly discusses three hypotheses regarding dentin hypersensitivity and introduces recent findings on mechanosensitive ion channels expressed in the dental sensory system and discusses how the activation of these ion channels is involved in dentin hypersensitivity.

상아질 지각과민증에 관한 치과의사와 치과위생사의 인식 수준 측정도구에 대한 고찰

김형미,배정희,배현숙 대한구강해부학회 2021 대한구강해부학회지 Vol.42 No.1

According to the scoping review guidelines, this study discussed the measurement tools used in related studies in foreign countries to present the baseline data to investigate the knowledge of dentin hypersensitivity in Korean dentists or dental hygienists. Ten works of literature were discussed, which were conducted in foreign countries, including the Netherlands, the U.K., the U.S., and Nigeria, and nine were conducted with dentists only, and one was conducted with both dentists and dental hygienists. The items of the surveys on dentin hypersensitivity were the causes, treatment methods, prevention methods and differential diagnosis of dentin hypersensitivity. The items surveyed along with them were the general characteristics such as age, sex, educational background, work type, clinical experience, and a question to understand the dental medical status. The forms of responses included the form of judging whether the answer was correct or not to each question on a five-point Likert scale, the form of making duplicate responses to all correct answers, and the form of making single responses. It turned out that the knowledge of dentin hypersensitivity in dentists or dental hygienists was assessed with the method of understanding whether the answer was correct or not by including wrong information in the example item. In the level of Korean dentists or dental hygienists’ knowledge of the measurement tools of dentin hypersensitivity, the causative factors, symptom factors of dentin hypersensitivity, and the management method factors, including treatment and prevention methods should be included, and the form of responses that could be processed as a continuous variable is desirable, and the variables that may affect the level of knowledge should be investigated together. This study has a limitation in that it did not evaluate the quality of the literature; however, it has significance in that it integrated and investigated survey research on dentin hypersensitivity with dentists or dental hygienists and drew suggestions.

Dentin Hypersensitivity: Etiology, Symptoms, Diagnosis and Recent Trends in Management

Surbhi Agarwal 대한예방치과학회 2019 International Journal of Clinical Preventive Denti Vol.15 No.2

Dentin hypersensitivity is dental pain which is sharp in nature and persist for short duration, a comes from exposed dentin surfaces in response to stimuli, mainly thermal, tactile, osmotic, chemical or electrical. The main cause of sensitivity is receding gums with exposure of root surfaces, loss of the cementum layer and smear layer, and tooth wear. Theoretically noticed, the reported incidence is usually higher than when clinical examination is used. Overall, it is estimated to affect about 20% of the general population to some degree. The diagnosis of dentin hypersensitivity may be challenging. It is a diagnosis of exclusion, reached once all other possible explanations for the pain have been ruled out. There is no universally accepted, gold-standard treatment which reliably relieves the pain of dental hypersensitivity in the long term, and consequently many treatments have been suggested which have varying degrees of efficacy when scientifically studied. Generally, they can be divided into in-office, or treatments which can be carried out at home, available over-the-counter or by prescription. Non-invasive, simple treatments which can be carried out at home should be attempted before in-office procedures are carried out.

치과용 지혈제가 상아질 투과도에 미치는 영향

김종현,심준성,이근우,Kim, Chong-Hyun,Shim, June-Sung,Lee, Keun-Woo 대한치과보철학회 2000 대한치과보철학회지 Vol.38 No.4

Before impression making in the fixed restorations or other prosthesis, hemostatic solutions are used for hemostasis and moisture control. Hemostatic solutions effectively control bleeding but their major ingredients, acid removes smear layers which are formed in the tooth preparation, exposes the dentinal tubular orifices which are occluded by smear layers, makes dentinal tubular fluid displace more easily to the various external stimulus, and according to the hydrodynamic theory, consequently causes dentin hypersensitivity. To know the effect of hemostatic solutions on dentin permeability, coronal dentin discs, 1mm in thickness, were prepared from extracted third molars free from decay and wear, and a split chamber device was used. Hydraulic conductance values and SEMs, which were measured before and after treatment with $Astringedentr^{(R)},\;Altract^(R)\;and\;Epri-dent^{(R)}$, were compared and ana-lysed. The following conclusions were drawn: 1. Hydraulic conductance values which were measured after the treatment of hemostatic solutions were increased in all groups(p<0.05). 2. %change values of hydraulic conductance were compared but no significant difference was found among the three hemostatic solutions(p<0.05). 3. On SEM observations of all groups, after treatment smear layers were removed and dentinal tubular orifices were partially exposed. On the basis of these conclusions, the reckless use of hemostatic solutions should be restricted, and when in use, various methods should be considered to protect dentin.

치은퇴축과 상아질 지각과민증의 빈도와 분포에 대한 임상적 연구

박기영,김성조,최점일,이주연,Park, Ki-Young,Kim, Sung-Jo,Choi, Jeom-Il,Lee, Ju-Youn 대한치주과학회 2006 Journal of Periodontal & Implant Science Vol.36 No.1

Gingival recession is clinically manifested by an apical displacement of the gingival tissue and dentin hypersensitivity is often used to describe a painful condition in which exposed dentin is unduly sensitive to intraoral stimuli. The objects of this study were primarily to investigate the prevalence and distribution of gingival recession and hypersensitivity and secondarily to determine whether a relationship exists between gingival recession and hypersensitivity. The study population was 195 patients (102 males, 93 females) who were attended the department of periodontology, Pusan National University Hospital. 189 patients exhibited gingival recession at least more than 1 tooth, the prevalence was 96.9%. The maxillary and mandibular first premolar and mandibular incisors had the highest prevalence. The majority of patients (139 patients, 71.3%) were diagnosed as having dentin hypersensitivity. Dentin hypersensitivity was determined to 3 seconds application of cold air to the exposed root surface after isolating the test tooth and was commonest in maxillary and mandibular first premolars and mandibular incisors. Relationship between recession and hypersensitivity was analyzed using chi-square test (p=0.05), significant relation (p=0.000) was existed. Gingival recession was more severe, the prevalence of hypersensitivity was higher.

The Closure Effect of the Dental Tubules by Use of Dentifrice with the Desensitization Agent

김진실,임지현,박효정 대한예방치과학회 2016 International Journal of Clinical Preventive Denti Vol.12 No.3

Objective: Observation and the comparison for the closing effect on the dentinal tubules between the use of the dentifrice with the strontium chloride (SrCl2) component and potassium nitrate (KNO3), in order to find the better component for desensitization effect. Methods: Sixty specimens from 15 premolars which had been extracted for orthodontic treatment were prepared by dividing 4 groups with 4 pieces from the Buccal surface and grinded to exposure to dentin, in order to observe the dentinal tubules by use of the electric scanning microscope and for micro hardness test. SrCl2 was applied on the group 1 specimens, KNO3 was applied on the group 2 specimens, fluoride dentifrice was applied at the group 3 specimen and no treatment on the group 4 specimens. Micro-hardness test was done for all specimens and scanning electronic microscope observation for counting the closure rate of the dentinal tubule was done for 32 samples of specimens as 8 per a group for 4 groups. Results: It revealed more in micro-hardness value in experimental 1 and experimental 2 groups than in positive or negative control group. The closure rate was revealed as the highest in experimental 1 group with SrCl2 and the experimental 2 group with KNO3 next, and it was more in closure rate in 2 experimental groups than in positive control with fluoride dentifrice or no use of dentifrice group. Conclusion: SrCl2 or KNO3 contained dentifrice was considered as useful for the desensitization of the dental patient with the hypersensitive dentin. Keywords:hypersensitive dentin, desensitization, strontium chloride, potassium nitrate, micro-hardness test