CONSERVATIVE DENTISTRY....PRESENTED IN SCI-FI..BVP IMUMBAI

1. -Surabhi desai
[Fourth year]
Guided by-Dr.Ashish Jain sir.
HOD of conservative and
endodontics department
DENTINAL HYPERSENSITIVITY

2. INTRODUCTION

3. THERMAL STIMULUS
No
icecream
No tea

4. WHAT TO DO?
What is
it??????????

5. INTRODUCTION
DEFINITION
ETIOLOGY
MECHANISM
CLINICAL FEATURES
DISTRIBUTION
DIAGNOSIS
PREVENTION
TREATMENT
DIFFRENTIAL DIAGNOSIS
CONTENTS

6. Pain is short and sharp.
caused by exposed dentin.
In response of stimulus:
1.thermal
2.Tactile
3.Chemical/osmotic
4.evaporative
INTRODUCTION

7. STIMULUS
Pain
on???
??

8. “Dentin hypersensitivity is characterised
by short , sharp pain arising from exposed
dentin in response to stimuli typically
thermal, evaporative ,tactile , osmotic or
chemical and which cannot be ascribed to
any other form of dental defect or
pathology.”HOLLAND ET AL 1997
DEFINITION:

9. ETIOLOGY

10. ETIOLOGY
ENAMEL
LOSS

11. ETIOLOGY
CEMENTAL
LOSS

12. The history and nature of pain.Describe the pain.
The number and location of sensitive teeth.
The stimuli which initiate the sensitivity.
Tooth brushing method.
If he has undergone periodontal surgery.
Obtain detailed dietary history.
Probe for gastric acid reflux and vomiting.
DIAGNOSIS

13. THEORIESOF PAIN
DIRECT
INNERVATION
THEORY
ODONTOLAST
DEFORMATION
THEORY
HYDRODYNAMIC
THEORY

14. DISTRIBUTION
FEMALE CANINE
PREMOLAR
PERIODONTITIS
Affects the
buccal aspect
of cervical
area
Age group
25-50

15. AN OUNCE OF PREVENTION IS
WORTH A POUND OF CURE
How to
prevent???
????????

16. desensitization
AT HOME
IN OFFICE
by occluding the
Dentinal tubules
by blocking the pulpal
Sensory nerve
MANAGEMENT:

17. MECHANISM

18. DESENSITISATION BY OCCLUDING DENTINAL TUBULES
A)FORMATION OF SMEAR LAYER OVER EXPOSED DENTIN
B)USE OF TOPICAL AGENTS TO OCCLUDE EXPOSED
TUBULES
CALCIUM HYDROXIDE PASTE
SILVER NITRATE
FLUORIDE
VARNISHES
DENTIN ADHESIVES
PROTEIN PRECIPITATION
GLUTERALDEHYDE
STRONTIUM CHLORIDE
CLASSIFICATION

19. C)PLACEMENT OF RESTORATIONS
GLASS IONOMER CEMENTS
COMPOSITE RESINS
D)USE OF LASERS
2. DESENSITIZING BY BLOCKING PULPAL SENSORY
NERVES
A)POTASSIUM NITRATE TOOTHPASTE
OTHERS
CORTICOSTEROID
CLASSIFICATION

20. Use of topical agents to occlude the
dentinal tubules
•Calcium hydroxide- calcium hydroxide
powder can be mixed with distilled water to
form paste. This is then applied on the
exposed dentin . It increases peritubular
dentin formation.
COMMERCIALLY AVAILABLE
PRODUCT – GC TOOTH MOUSSE.

21. SILVER NITRATE
• It reduces the fluid movement by
precipitating the protein within the
dentinal tubules.
DISADVANTAGE: this agents is not popularly
used nowadays as it stains dentin and is
also damaging to the pulp and gingiva.
Strontium chloride
•It acts by penetrating the tubules
and forming strontium apatite
which occludes the exposed
dentinal tubules
•It is incorporated in desensitizing
toothpastes.

22. Fluorides:
Agents such as sodium fluoride , stannous
fluoride, or acidulated phosphate fluoride
may be used for a few minutes as mouth
rinses, toothpastes or as topical applications
over exposed dentin.
They act by forming fluorapatite within the
tubules which blocks fluid movement within
the dentin.

23. Varnishes:
•Varnishes act by forming a barrier over
the exposed dentin.
•This lowers hypersensitivity as it reduces
dentin permeability.

24. Placement of restorations:
•Whenever a considerable amount of
dentin is lost,, a glass ionomer or a
composite resin restoration may be
placed to replace the lost tooth structure
and seal the exposed dentin.

25. It reducing the excitability of the sensory nerves
in response to stimuli.
Potassium nitrate toothpastes: Potassium ions
from potassium nitrate toothpastes can easily pass
through the dentin to the pulp .Here they
depolarizes of the sensory nerve endings present
close to the odontoblasts BY ALTERING THEIR
MEMBRANE POTENTIAL thus preventing the
transmission of impulses to brain.
DESENSITIZATION BY BLOCKING PULPAL SENSORY NERVES:

26. Nd-YAG) laser
Neodymium:yttrium aluminum garnet
GaAlAs (galium-aluminium-arsenide laser)
Erbium-YAG laser
USE OF LASERS
THEY OCCLUDE THE DENTINAL TUBULES.
The CO2 laser belongs
to the group of the middle-output power lasers.
LASERS
Direct
method
Indirect
method

27. DIFFERENTIAL DIAGNOSIS

28. THANK YOU