DENTIN HYPERSENSITIVITY: ETIOLOGY, DIAGNOSIS AND TREATMENT

Yıl 2022, Cilt: 7 Sayı: 3, 92 - 104, 23.12.2022

Özge Uzuner Bilgiç , Sühan Gürbüz , Altan Doğan

https://doi.org/10.52881/gsbdergi.1092839

Öz

Dentin sensitivity, which affects a large part of the population, is a condition characterized by acute and sharp pain that occurs as a result of exposure of the exposed dentin surface to stimuli in the oral environment. Dentin sensitivity arises as a result of dentin being exposed to the oral environment under the impact of various etiological and predisposing factors and environmental stimuli stimulating the pulp nerves. Many clinical conditions such as the stages of deep dentin caries before reaching the pulp, cracked teeth, damaged or broken restorations, pulpal hyperemia after tooth extraction, the presence of dental plaque and gingivitis, periodontal tissue loss or after treatments, and teeth whitening may exhibit symptoms similar to dentin sensitivity. In order to create a treatment plan for dentin sensitivity, it is crucial to understand the mechanism and etiology that causes this condition, to perform the clinical examination correctly, and to know the differential diagnosis. In the treatment phase; any methods can be used, such as toothpastes and mouthwashes, occlusion of dentinal tubules with bonding agents, iontophoresis - laser applications, glass ionomer cement, composite resin etc. restorations, mucogingival operations to cover the root surfaces, and endodontic treatment in cases where treatment is not successful. This review was created in order to be a source of information about the mechanisms, etiology, differential diagnosis and treatment planning of dentin sensitivity in line with the current literature.

Anahtar Kelimeler

Dentin sensitivity, etiology, prevalence, treatment planning

DENTİN HASSASİYETİ: ETİYOLOJİ, TANI VE TEDAVİ

Öz

Dentin hassasiyeti, açık dentin yüzeyinin ağız ortamındaki uyaranlara maruz kalması sonucu ortaya çıkan, akut ve keskin ağrı ile karakterize toplumda sık karşılaşılan klinik bir durumdur. Dentin hassasiyeti, çeşitli etiyolojik ve hazırlayıcı faktörlerin etkisiyle dentinin ağız ortamına açık hale gelmesi ile çevresel uyaranların pulpa sinirlerini uyarması sonucu ortaya çıkmaktadır. Derin dentin çürüklerinin pulpaya ulaşmadan önceki evreleri, çatlak dişler, hasarlı veya kırık restorasyonlar, diş kesimi sonrası gelişen pulpal hiperemi, dental plak ve gingivitis mevcudiyeti, periodontal doku kaybı veya tedavileri sonrası ve diş beyazlatma gibi birçok klinik durum dentin hassasiyetine benzer semptomlar gösterebilir. Dentin hassasiyeti tedavi planının oluşturulabilmesi için bu duruma neden olan mekanizma ve etiyolojinin anlaşılması, klinik muayenenin doğru yapılması ve ayırıcı tanının bilinmesi büyük önem taşır. Tedavi aşamasında; diş macunları ve ağız gargaralarının kullanımı, dentin tübüllerinin bonding ajan ile tıkanması, iyontoforez – lazer uygulamaları, cam iyonomer siman, kompozit rezin vb. ile restorasyonlar, kök yüzeyinin örtülmesine yönelik mukogingival operasyonlar ve tedavide başarı sağlanamadığı durumlarda ise endodontik tedavi uygulamaları gibi birçok yöntemden yararlanılabilir. Bu derleme, güncel literatür doğrultusunda dentin hassasiyeti mekanizmaları, etiyolojisi, ayırıcı tanı ve tedavi planlaması hakkında bilgi kaynağı olabilmesi açısından oluşturulmuştur.

Anahtar Kelimeler

Dentin hassasiyeti, etiyoloji, yaygınlık, tedavi planlaması

Kaynakça

• Addy M, U.E., Dentine hypersensitivity: its prevalence, aetiology and clinical management. . Dent Update, 1992 Dec. 19(10): p. 407-8,10-2.
• Erdemir U, E.Y., Dentin Hassasiyeti Tanı ve Tedavi Planlaması. EÜ Dişhek Fak Derg 2011. 32: p. 9-22.
• Favaro Z. L., S.P.V., Cunha-Cruz J., Prevalence of dentin hypersensitivity: Systematic review and meta-analysis. J Dent, 2019. 81: p. 1-6.
• R., M., The puzzle of pain. Middlesex: Penguin Books, 1973.
• Gibson, B., Boiko, O. V., Baker, S., Robinson, P. G., Barlow, A., Player, T., & Locker, D., The everyday impact of dentine sensitivity: personal and functional aspects. Social Science and Dentistry, 2010. 1(1): p. 11-20.
• Mantzourani M, S.D., Dentine sensitivity: past, present and future. J Dent., 2013. 41: p. 3–17.
• Bartold, P.M., Dentinal hypersensitivity: a review. Australian dental journal, 2006. 51(3): p. 212-218.
• West, N.X., Sanz, M., Lussi, A., Bartlett, D., Bouchard, P., & Bourgeois, D., Prevalence of dentine hypersensitivity and study of associated factors: a European population-based cross sectional study. . Journal of dentistry, 2013. 41(10): p. 841–851.
• Fischer, C., Fischer, R. G., & Wennberg, A., Prevalence and distribution of cervical dentine hypersensitivity in a population in Rio de Janeiro, Brazil. Journal of Dentistry, 1992. 20(5): p. 272-276.
• Liang, X., Wei, Z., Hu, D., & Ruan, J., Prevalence of dentin hypersensitivity among the residents of Xi’an city, China. Acta Odontologica Scandinavica, 2017. 75(6): p. 387-393.
• Gillam, D.G., Seo, H. S., Bulman, J. S., & Newman, H. N., Perceptions of dentine hypersensitivity in a general practice population. Journal of oral rehabilitation, 1999. 26(9): p. 710–714.
• Davari, A.R., Ataei, E., & Assarzadeh, H., Dentin Hypersensitivity: Etiology, Diagnosis and Treatment; A Literature Review. Journal of Dentistry, 2013. 14(3): p. 136-145.
• Addy, M., Dentine hypersensitivity: new perspectives on an old problem. . International Dental Journal, 2002. 52(S5P2): p. 367-75.
• Gillam, D.G., & Orchardson, R., Advances in the treatment of root dentine sensitivity: mechanisms and treatment principles. Endodontic Topics, 2006. 13: p. 13-33.
• dos Santos Soares, A.R., Chalub, L. L. F. H., Barbosa, R. S., de Paiva Campos, D. E., Moreira, A. N., & Ferreira, R. C., Prevalence and severity of non-carious cervical lesions and dentin hypersensitivity: association with oral health related quality of life among Brazilian adults. Heliyon, 2021. 7(3): p. e06492.
• Närhi, M.V.O., Hirvonen, T. J., & Hakumäki, M. O. K., Activation of intradental nerves in the dog to some stimuli applied to dentine. Archives of oral biology, 1982. 27(12): p. 1053-1058.
• Liu, X.X., Tenenbaum, H. C., Wilder, R. S., Quock, R., Hewlett, E. R., & Ren, Y. F., Pathogenesis, diagnosis and management of dentin hypersensitivity: an evidencebased overview for dental practitioners,. BMC Oral Health, 2020. 20(1): p. 1-10.
• Pashley, D.H., Dynamics of the pulpo-dentin complex. Critical Reviews in Oral Biology & Medicine, 1996. 7(2): p. 104-133.
• Sigal, M.J., Aubin, J. E., & Ten Cate, A. R., An immunocytochemical study of the human odontoblast process using antibodies against tubulin, actin, and vimentin. . Journal of Dental Research, 1985. 64(12): p. 1348–55.
• Chiego, D.J., The early distribution and possible role of nerves during odontogenesis. International Journal of Developmental Biology, 1995. 39(1): p. 191-194.
• M., B., Dentin sensitivity. Arsb Goteb Tandlak Sallsk, 1964.: p. 15–35.
• Matthews, B., & Vongsavan, N., Interactions between neural and hydrodynamic mechanisms in dentine and pulp. . Archives of Oral Biology, 1994. 39: p. 87–95
• Dababneh, R.H., Khouri, A. T., & Addy, M., Dentine hypersensitivity - an enigma? A review of terminology, mechanisms, aetiology and management. British dental journal, 1999. 187(11): p. 606-611.
• Liu, X., Yu, L., Wang, Q., Pelletier, J., Fausther, M., Sevigny, J., ... & Ren, Y. F., Expression of ecto-ATPase NTPDase2 in human dental pulp. Journal of Dental Research, 2012. 9(3): p. 261–267.
• Egbuniwe, O., Grover, S., Duggal, A. K., Mavroudis, A., Yazdi, M., Renton, T., ... & Grant, A. D., TRPA1 and TRPV4 activation in human odontoblasts stimulates ATP release. Journal of dental research, 2014. 93(9): p. 911–917.
• Liu, X., Wang, C., Fujita, T., Malmstrom, H. S., Nedergaard, M., Ren, Y. F., & Dirksen, R. T., External dentin stimulation induces ATP release in human teeth. Journal of dental research, 2015. 94(9): p. 1259–1266.
• Woofter, C., The prevalence and etiology of gingival recession. . In Periodontal abstracts, 1969, June. 17(2): p. 45–50.
• Lee, W.C., & Eakle, W. S., Stress-induced cervical lesions: review of advances in the past 10 years. The Journal of prosthetic dentistry, 1996. 75(5): p. 487–494.
• Carranza, F.A., Glickman’s clinical periodontology 8 th ed. Philadelphia-London: Saunders, 1979: p. 201-207.
• Von Troil, B., Needleman, I., & Sanz, M., A systematic review of the prevalence of root sensitivity following periodontal therapy. Journal of clinical periodontology, 2002. 29(3): p. 173-177.
• Gusmão, E.S., Coelho, R. S., Farias, B. C., & Cimões, R., Dentin Hypersensitivity Before and After Periodontal Treatment. Acta Stomatol Croat, 2010. 44: p. 251-261.
• Kawasaki, A., Ishikawa, K., Suge, T., Shimizu, H., Suzuki, K., Matsuo, T., & Ebisu, S., Effects of plaque control on the patency and occlusion of dentine tubules in situ. Journal of oral rehabilitation, 2001. 28: p. 439-449.
• Miglani, S., Aggarwal, V., & Ahuja, B., Dentin hypersensitivity: recent trends in management. Journal of conservative dentistry: JCD, 2010. 13(4): p. 218.
• Orchardson, R., & Gillam, D. G., Managing dentin hypersensitivity. The Journal of the American Dental Association, 2006. 137(7): p. 990-998.
• Addy, M., Dentine hypersensitivity: definition, prevalence, distribution and aetiology. Tooth wear and sensitivity,, 2000: p. 239-248.
• Rösing C. K., F.T., Liberman D. N., Cavagni J. , Dentine hypersensitivity: analysis of self-care products. Braz Oral Res, 2009. 23(1): p. 56-63.
• Prati, C., Montebugnoli, L., Suppa, P., Valdrè, G., & Mongiorgi, R., Permeability and morphology of dentin after erosion induced by acidic drinks. . Journal of periodontology, 2003. 74(4): p. 428-436.
• Rosenstiel, S.F., Gegauff, A. G., & Johnston, W. M., Randomized clinical trial of the efficacy and safety of a home bleaching procedure. Quintessence International, 1996. 27: p. 413-424.
• Götz, H., Klukowska, M. A., Duschner, H., & White, D. J., Physical, morphological, and micro-Raman chemical studies on bleaching strip effects on enamel, coronal dentin, and root dentin. The Journal of clinical dentistry, 2007. 18(4): p. 112-119.
• Trowbridge, H.O.S.D.R., A review of current approaches to in-office management of tooth hypersensitivity. Dental Clinics of North America, 1990. 34: p. 561-582.
• ATTAR, N., KORKMAZ, Y., Dentin Aşırı Hassasiyeti Derleme. Hacettepe Dişhekimliği Fakültesi Dergisi, 2006. 30: p. 83-91.
• Schmidlin, P.R., & Sahrmann, P., Current management of dentin hypersensitivity. Clin Oral Investig., 2013. 17(1): p. 55–59.
• Oncu, E., Karabekiroglu, S.,Unlu, N., Effects of different desensitizers and lasers on dentine tubules: An in-vitro analysis. Microscopy Research and Technique, 2017. 80(7): p. 737-744.
• Poulsen, S., Errboe, M., Mevil, Y. L., & Glenny, A. M., Potassium containing toothpastes for dentine hypersensitivity. Cochrane Database of Systematic Reviews. Cochrane Database Syst Rev, 2006. 3: p. Cd001476.
• Petrou, I., Heu, R., Stranick, M., Lavender, S., Zaidel, L., Cummins, D., ... & Gimzewski, J. K., A breakthrough therapy for dentin hypersensitivity: how dental products containing 8% arginine and calcium carbonate work to deliver effective relief of sensitive teeth. Journal of Clinical Dentistry, 2009. 20(1): p. 23-31.
• Civelek, A., Emre, Ö. Z. E. L., & Çıldır, Ş. K., Diş Hekimliğinde Topikal Florür Uygulamaları. Ondokuz Mayıs Üniversitesi Diş Hekimliği Fakültesi Dergisi, 2004. 5: p. 103-109.
• Bergenholtz, G., Jontell, M., Tuttle, A., & Knutsson, G., Inhibition of serum albumin flux across exposed dentin following conditioning with Gluma primer, glutaraldehyde or potassium oxalate. J Dent, 1993. 21(4): p. 220-227.
• Attar, N., Cam İyonomer Simanlar. . Dentalife, 2003. 1(6): p. 20-24.
• Zhao, X., Pan, J., Malmstrom, H. S., & Ren, Y. F., Protective effects of resin sealant and flowable composite coatings against erosive and abrasive wear of dental hard tissues. Journal of Dentistry, 2016. 49: p. 68-74.
• Machado, A.C., Viana, Í. E. L., Farias-Neto, A. M., Braga, M. M., de Paula Eduardo, C., de Freitas, P. M., & Aranha, A. C. C., Is photobiomodulation (PBM) effective for the treatment of dentin hypersensitivity? A systematic review. Lasers in medical science, 2018. 33(4): p. 745–753.