DENTIN PERMEABILITY, DENTIN SENSITIVITY, AND TREATMENT THROUGH TUBULE OCCLUSION
DENTIN PERMEABILITY, DENTIN SENSITIVITY, AND TREATMENT THROUGH TUBULE OCCLUSION
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DOI：
10.1016/s0099-2399(86)80201-1
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发表时间：
1986-10-01
影响因子：
4.2
通讯作者：
PASHLEY, DH
中科院分区：
文献类型：
--
作者：
PASHLEY, DH
牙本质敏感性的流体动力学理论指出，小管内容物或小管流体在任何方向上的运动都会引起牙本质敏感性。该理论的一个推论是，任何可以减少牙本质液体运动或牙本质渗透性的东西都应该降低牙本质的敏感性。事实上，许多术后牙周患者在1- 2周的时间内从过敏状态自发恢复，这表明他们暴露的牙本质随着时间的推移变得更不具有渗透性。有各种各样的物理化学机制可以导致暴露牙本质的渗透性和敏感性的降低。这些包括由唾液或牙本质液体矿物形成的小管内晶体的生长，血浆蛋白吸附到牙本质小管的内表面，或在暴露的牙本质表面形成涂抹层。所有这些手术都会导致小管部分闭塞。在没有这些事件的情况下，患者可能会持续数月至数年的敏感牙本质表面，这需要治疗干预。最近，一些治疗小管闭塞的方法被开发出来，显示出作为牙本质脱敏剂的希望。这些方法包括将未填充的树脂应用于敏感区域或局部应用草酸盐。后一种方法产生草酸钙晶体，它阻塞小管，导致立即脱敏。应该进行盲临床试验来评估这些疗法的疗效。
The hydrodynamic theory of dentin sensitivity states that movement of tubule contents or tubule fluid, in either direction, causes dentin sensitivity. A corollary of that theory is that anything that can decrease dentinal fluid movement or dentin permeability should decrease dentin sensitivity. The fact that many postsurgical periodontal patients exhibit spontaneous recovery from a hypersensitive state in a 1-to 2-wk period suggests that their exposed dentin becomes less permeable with time. There are a wide variety of physicochemical mechanisms that can lead to such reductions in the permeability and sensitivity of exposed dentin. These include the growth of intratubular crystals from salivary or dentinal fluid mineral, adsorption of plasma proteins to the inner surfaces of dentinal tubules, or formation of a smear layer on the exposed dentin surface. All of these procedures result in partial tubule occlusion. In the absence of such events, patients may continue to have sensitive dentin surfaces for months to years, which require therapeutic intervention. Recently, several therapeutic approaches to tubule occlusion have been developed which show promise as dentin desensitizing agents. These include application of unfilled resins to sensitive areas or the topical application of oxalate salts. The latter method produces crystals of calcium oxalate which occlude the tubules leading to immediate desensitization.Blind clinical trials should be done to evaluate the efficacy of these therapies.