Dentine Hypersensitivity and its Significance in the Dental Practice

Preosjetljivost dentina nije nova bolest. Problemima njene simptomatologije, patogenetskih mehanizama, diferencijalne dijagnostike i liječenja bavili su se Gysi još prije stotinu godina i Brannström prije 40 godina i još mnogi drugi poslije njih. Danas obnovljeno zanimanje može se pripisati nastojanjima da se poboljša zdravlje usne šupljine i očuvanju većeg broja zuba u starijoj dobi, kao i smanjenoj učestalosti pojave karijesa. Otkrivanje dentinskih površina zbog povlačenja gingive, te zbog erozije i abrazije može izazvati ozbiljne poteškoće. Ono se javlja u oko 40 % odraslih osoba, premda se samo malobrojne zbog toga obraćaju stomatologu. Stoga stomatolozi koji rade u praksi moraju biti upoznati s mogućnostima liječenja te strategijama zbrinjavanja i prevencije. Među nove aspekte ubrajaju se pravodobno pranje zuba nakon konzumiranja acidogene, erozivne hrane i pića, kao i mogućnosti neinvazivnog (desenzibilizirajuće zubne paste s kalijevim nitratom/fluoridom) i invazivnog (rekonstrukcija s ispunama i prekrivanjem otkrivenih dijelova korijena) liječenja. Preporučuje se kontinuirana skrb o osobama s preosjetljivošću dentina, kako bi se sprječile teže posljedice (nadražaj pulpe).Dentine hypersensitivity is not a new disease. More than a hundred years ago Gysi, 40 years ago Brannström and since then many others have dealt with the problems of its symptoms, pathomechanism, differential diagnosis and therapy. The revived interest today may be attributed to improving oral health and to the presence of more teeth in older age, as well as decreasing caries prevalence. The exposure of dentine surfaces due to gingival recession, erosion and abrasion may cause serious complaints. It occurs in about 40% of the adult population, although, few of them turn to the dentist. Therefore, practising dentists should be aware of the possibilities of treatment, managing strategies and prevention. New aspects include the appropriate timing of toothbrushing after the consumption of acidogenic, erosive foods and beverages, as well as non-invasive (desensitising toothpastes with potassium nitrate/fluoride) and invasive (reconstruction with fillings, coverage of the exposed roots) treatment options. Continuous care of patients with dentine hypersensitivity is advisable in order to prevent more serious consequences (irritation of the pulp)

Ugradnja Lantanida u caklinu ljudskih zuba

The incorporation of lanthanides in human dental enamel was investigated by means o f X-ray microprobe analysis. Sound human premolar teeth - after extraction-were prepared and kept for 60 days in 10% solutions of neodymium-, samariumeuropium-, ytterbium resp. lanthanum-chloride at room temperature with constant shaking. Results of the X-ray microprobe analysis revealed 100-140 m depth penetration and incorporation o f neodymium, with transformation o f the apatite phases of enamel into neodymium-hydroxil-apatite-, resp. neodymium- hidrochlor-apatite. The changes were accompanied by a decrease in the values o f calcium, magnesium and sodium. Samarium- , ytterbium-, europium and lanthanum-chloride treatments produced a phosphate-complex containing coherent layer on the enamel surface. However, no real incorporation into the apatite-lattice was observed. The incorporation o f neodymium-apatites, and the formation of cerium-apatite into the dental enamel observed in previous studies might indicate the possibility of stabilizing the apatite structure, and discovering new ways of caries prevention.U radu je istraživana ugradnja lantanida u humanu caklinu zuba s pom oću rendgenske mikroanalize.Zdravi ljudski prem olari su poslije vađenja priprem ljeni i držani kroz 60 dana u 10% otopinama neodijsamarij, iterbij i lantanij klorida na sobnoj tem peraturi uz trajno m iješanje. Rezultati rendgenske m ikroanalize objelodanili su i potvrdili prodor i ugradnju neodija, s preobrazbom apatita cakline u neodij - -hidroxil-apatit. Promjene su bile praćene smanjenjem vrijednosti kalcija, magnezija i kalija. Samarij, iterbij, europij i lantanij klorid u postupku su uzrokovali stvaranje kompleksa fosfata stvarajući čvrst sloj na caklinskoj površini. M eđutim, prava ugradnja u caklinsku strukturu nije primijećena. Inkorporacija neodij apatita i stvaranje cerij apatita, što je bilo prim ijećeno u prethodnim studijama, moglo bi ukazivati na mogućnost stabilizacija apatitne strukture i otkriće novih putova prevencije karijesa

Correlation between Adolescent’s Caries Prevalence and Caries Related Factors in Two Hungarian Cities

Svrha istraživanja bila je procijeniti učestalost karijesa u usporedbi s održavanjem higijene usne šupljine u omladine koja živi u različitim dijelovima Mađarske, kako bi se uočila moguća korelacija sa socijalno-ekonomskim čimbenicima. Učestalost karijesa i održavanje higijene usne šupljine istraženi su u 586 ispitanika u dobi od 14 do 16 godina. Bez karijesa bilo je 5,1 % ispitanika, njihova je vrijednost DMFT iznosila 6,97±4,67, a vrijednost DMFS 9,95±7,94. Indeks VPI bio je 41,6±32,7% (srednja vrijednost ± standardna devijacija, SD) i pokazao je pozitivnu korelaciju s učestalošću karijesa. Vrijednosti DMFT i DMFS, kao i VPI smanjivale su se s porastom obrazovne razine roditelja (oca). Vrijednosti DMFT, DMFS i VPI pogoršavale su se s porastom broja braće/sestara. Uočen je određeni odnos između ranije profilakse fluoridom i smanjenja vrijednosti DMF, no taj se odnos nije pokazao statistički znatnim. Ovi nalazi ukazuju na veliku potrebu poduzimanja organiziranih mjera dentalne prevencije.The aim of the study was to assess the caries prevalence and oral hygiene in groups of adolescents living in different Hungarian localities and to establish correlations with socio-economic factors. Examinations of caries and oral hygiene were performed in 586 14-16 year old children. The percentage of caries free children was 5.1%, the DMFT and DMFS values were 6.97±4.67 and 9.95±7.94 respectively. The VPI index was 41.6±32.7% (mean±S.D.), and showed positive correlation with the caries prevalence. The DMFT and DMFS values, as well as VPI decreased as the educational level of the father increased. The number of siblings had a worsening effect on DMFT, DMFS and VPI values. There was some relationship between the previous fluoride prophylaxis and decrease of DMF values, although the difference proved to be statistically non significant. These findings indicate the necessity of organized dental preventive measures

Correlation between Adolescent’s Caries Prevalence and Caries Related Factors in Two Hungarian Cities

Svrha istraživanja bila je procijeniti učestalost karijesa u usporedbi s održavanjem higijene usne šupljine u omladine koja živi u različitim dijelovima Mađarske, kako bi se uočila moguća korelacija sa socijalno-ekonomskim čimbenicima. Učestalost karijesa i održavanje higijene usne šupljine istraženi su u 586 ispitanika u dobi od 14 do 16 godina. Bez karijesa bilo je 5,1 % ispitanika, njihova je vrijednost DMFT iznosila 6,97±4,67, a vrijednost DMFS 9,95±7,94. Indeks VPI bio je 41,6±32,7% (srednja vrijednost ± standardna devijacija, SD) i pokazao je pozitivnu korelaciju s učestalošću karijesa. Vrijednosti DMFT i DMFS, kao i VPI smanjivale su se s porastom obrazovne razine roditelja (oca). Vrijednosti DMFT, DMFS i VPI pogoršavale su se s porastom broja braće/sestara. Uočen je određeni odnos između ranije profilakse fluoridom i smanjenja vrijednosti DMF, no taj se odnos nije pokazao statistički znatnim. Ovi nalazi ukazuju na veliku potrebu poduzimanja organiziranih mjera dentalne prevencije.The aim of the study was to assess the caries prevalence and oral hygiene in groups of adolescents living in different Hungarian localities and to establish correlations with socio-economic factors. Examinations of caries and oral hygiene were performed in 586 14-16 year old children. The percentage of caries free children was 5.1%, the DMFT and DMFS values were 6.97±4.67 and 9.95±7.94 respectively. The VPI index was 41.6±32.7% (mean±S.D.), and showed positive correlation with the caries prevalence. The DMFT and DMFS values, as well as VPI decreased as the educational level of the father increased. The number of siblings had a worsening effect on DMFT, DMFS and VPI values. There was some relationship between the previous fluoride prophylaxis and decrease of DMF values, although the difference proved to be statistically non significant. These findings indicate the necessity of organized dental preventive measures

Ugradnja Lantanida u caklinu ljudskih zuba

The incorporation of lanthanides in human dental enamel was investigated by means o f X-ray microprobe analysis. Sound human premolar teeth - after extraction-were prepared and kept for 60 days in 10% solutions of neodymium-, samariumeuropium-, ytterbium resp. lanthanum-chloride at room temperature with constant shaking. Results of the X-ray microprobe analysis revealed 100-140 m depth penetration and incorporation o f neodymium, with transformation o f the apatite phases of enamel into neodymium-hydroxil-apatite-, resp. neodymium- hidrochlor-apatite. The changes were accompanied by a decrease in the values o f calcium, magnesium and sodium. Samarium- , ytterbium-, europium and lanthanum-chloride treatments produced a phosphate-complex containing coherent layer on the enamel surface. However, no real incorporation into the apatite-lattice was observed. The incorporation o f neodymium-apatites, and the formation of cerium-apatite into the dental enamel observed in previous studies might indicate the possibility of stabilizing the apatite structure, and discovering new ways of caries prevention.U radu je istraživana ugradnja lantanida u humanu caklinu zuba s pom oću rendgenske mikroanalize.Zdravi ljudski prem olari su poslije vađenja priprem ljeni i držani kroz 60 dana u 10% otopinama neodijsamarij, iterbij i lantanij klorida na sobnoj tem peraturi uz trajno m iješanje. Rezultati rendgenske m ikroanalize objelodanili su i potvrdili prodor i ugradnju neodija, s preobrazbom apatita cakline u neodij - -hidroxil-apatit. Promjene su bile praćene smanjenjem vrijednosti kalcija, magnezija i kalija. Samarij, iterbij, europij i lantanij klorid u postupku su uzrokovali stvaranje kompleksa fosfata stvarajući čvrst sloj na caklinskoj površini. M eđutim, prava ugradnja u caklinsku strukturu nije primijećena. Inkorporacija neodij apatita i stvaranje cerij apatita, što je bilo prim ijećeno u prethodnim studijama, moglo bi ukazivati na mogućnost stabilizacija apatitne strukture i otkriće novih putova prevencije karijesa