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| The management of dentin hypersensitivity (DH) often involves the use of a variety of agents, materials, and products designed for in-office treatments. Systematic reviews and meta-analyses support the efficacy of these occlusive agents, showing statistically significant results compared to placebos. |
| Chemical Occlusion of dentinal tubules |
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Fluorides |
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Oxalates |
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Glutaraldehyde-based agents |
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| Physical Occlusion of dentinal tubules |
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Resins |
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Dentin bonding agents |
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Glass ionomers |
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| Chemical Occlusion of dentinal tubules |
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| Varnishes |
| Early copal varnishes were effective but required frequent reapplication. Modern varnishes are more effective, safer, and easier to apply. Fluoride varnishes, containing 5% sodium fluoride, are common and help remineralise enamel, reduce sensitivity, and prevent cavities. After cleaning, varnish is applied, typically taking up to 5 minutes. Post-application, patients should avoid eating for 2 hours and brushing for a day. |
| Oxalates |
| Oxalates block open dentinal tubules and are effective in managing DH. They are insoluble in acids, making them ideal for oral conditions. Systems like 1.5% oxalate gel strips offer quick, lasting relief (up to a month). These strips are safe for adults but not recommended for those with allergies, renal disease, or periodontal conditions. |
| Glutaraldehyde-based Agents |
| These agents coagulate proteins, creating a barrier within the tubules to block fluid flow. They penetrate dentin deeply and are effective in reducing DH symptoms. |
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| Physical Occlusion of Dentinal Tubules |
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| Resins |
| Composite resins combine organic and inorganic materials to restore dental surfaces and occlude dentinal tubules. These materials can release fluoride, offering additional protection from acidic attacks. |
| Dentin Bonding Systems (DBS) |
| DBS utilizes both micromechanical and chemical bonding to seal dentinal tubules. Advanced bonding systems can penetrate deeply into the dentin, ensuring effective occlusion of tubules. They have evolved from multi-step techniques to single-step applications for ease of use and improved clinical success. |
| Generations of DBS: Ranging from multi-step to one-step systems, the latest adhesives are self-etching, simplifying application and reducing contamination risks. |
| Glass Ionomers: |
| Glass ionomers (GIs) effectively manage dentin hypersensitivity by sealing dentin, bonding chemically, and releasing fluoride for remineralization. They are easy to apply, moisture-tolerant, and biocompatible but may lack the aesthetics and wear resistance of composite resins. GIs are ideal for cases needing long-term fluoride exposure and where moisture control is challenging. |
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| Significance of Technique |
| For optimal effectiveness, the bonding agents must penetrate the dentinal tubules properly. Simple application may not yield desired results; adhesives should be rubbed or scrubbed to ensure they seal the tubules effectively. The use of hydrophilic components has further improved the penetration and success of bonding agents. |
| In conclusion, effective treatment of dentin hypersensitivity (DH) involves a variety of chemical and physical occlusion methods, such as fluoride varnishes, oxalate gels, glutaraldehyde agents, resins, and glass ionomers. The success of these treatments hinges on proper application techniques to ensure deep penetration and sealing of dentinal tubules. |
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| GGI-CO-A1-AQS-300032384-DVC-L24-0140 |
| Reference: |
| 1. |
Grover V, Kumar A, Jain A, et al. ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity. J Indian Soc Periodontol. 2022;26(4):307-333. doi:10.4103/jisp.jisp_233_22 |
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