Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 1300-9044 2667-5161 Ataturk University 10.17567/ataunidfd.419061 Health Care Administration Sağlık Kurumları Yönetimi DENTİN HASSASİYETİ TANI VE TEDAVİ YÖNTEMLERİ Özyurt Esra 04 22 2018 28 2 253 262 10 03 2016 01 17 2017 Copyright © 1986, Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 1986 Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

Dentin hassasiyetidişte herhangi bir dental defekt veya patoloji ile açıklanamayan, açık dentinyüzeylerine bağlı termal, buharlaşma, dokunma, kimyasal veya ozmotik uyaranlarsonucunda başlayan, uyaran ortadan kalktığında geçen, kısa süreli ve keskinağrı olarak tanımlanmaktadır. Dentin yüzeyinin, mine veya sement gibi diş sertdokularının kaybı veya dişeti çekilmesiyle açığa çıkması dentin hassasiyeti ilesonuçlanır. Dentin hassasiyetini meydana getiren dentin tübülleri içerisindekisıvı hareketidir. Tedavisinde amaç sıvı hareketini engellemek veya pulpadakisinir iletimini bloke etmektir. Tedavi planlamasında hassasiyete sebep olanetiyolojik faktörlerin tespiti önem taşımaktadır. Bu derlemenin amacı dentin hassasiyetinintanımı, etiyolojisi, prevelansı, oluşum mekanizması, teşhis ve tedaviplanlaması hakkında bilgi vermektir.Anahtar Kelimeler: dentin hassasiyeti, etiyoloji,teşhis, hidrodinamik teoriDIAGNOSIS AND TREATMENT METHODS OF DENTINHYPERSENSITIVITYABSTRACTDentin hypersensitivityis defined as a short and sharp pain arising from exposed dentin in response tothermal, evaporation, touch, chemical or osmotic stimuli associated with opendentin surfaces, which can not be explained by any dental defect or pathologyof the tooth. For the development of dentin hypersensitivity: dentin mustbecome exposed, through either loss of enamel, cement or gingival recession. Dentinhypersensitivity is due to fluid movement in the dentin tubules. The aim oftreatment is to reduce fluid flow in the tubules and block the nerve responsein the pulp. Treatment planning should include determination of etiologicfactors. The purpose of this review is to provide information on the definition,etiology, prevalence, mechanism, diagnosis and treatment planning of the dentinhypersensitivity.Keywords: dentinehypersensitivity, aetiology, diagnosis, hydrodynamic theory

 dentin hassasiyeti etiyoloji teşhis 1. Addy M. Dentine hypersensitivity: new perspectives on an old problem. Int Dent J 2002; 52:367-75. 2. Addy M, Dowel P. Dentine hypersensitivity- a review clinical and in vitro evaluation of treatment agents. J Clin Periodontol 1983;10:351-63. 3. Pashley D. How can sensitive dentine become hypersensitive and can it be reversed?. J Dent 2013;41:49-55. 4. Porto I, Adrade A, Montes M. Diagnosis and treatment of dentinal hypersensitivity. J Oral Sci 2009;51:323-32. 5. Çelik EU, Aka B. Dentin hassasiyeti-etiyoloji. Turkiye Klinikleri J Restor Dent-Special Topics 2015;1:1-7. 6. Orchardson R, Collins W. Clinical features of hypersensitive teeth. Br Dent J 1987;11:253-6. 7. Miglani S, Aggarwal V, Ahuja B. Dentin hypersensitivity: recent trends in management. J Conserv Dent 2010;13:218-24. 8. Holland G, Narhi M, Addy M, Gangarosa L, Orchardson R. Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. J Clin Periodontol 1997;24:808-13. 9. Canadian Advisory Board on Dentin Hypersensitivity. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc. 2003;69:221-6. 10. Addy M, Hunter ML. Can tooth brushing damage your health? Effects on oral and dental tissues. Int Dent J 2003;53:177-86. 11. Dababneh R, Khouri A, Addy M. Dentine hypersensitivity: an enigma? A review of terminology, epidemiology, mechanisms, aetiology and management. Br Dent J 1999;11:606-11. 12. Que K, Guo B, Jia Z, Chen Z, Yang J, Gao P. A crosssectional study: non-carious cervical lesions, cervical dentine hypersensitivity and related risk factors. J Oral Rehabil 2013;40:24-32. 13. Davari AR, Ataei E, Assarzadeh HB. Dentin hypersensitivity: etiology, diagnosis and treatment; a literature review. J Dent, 2013;14:136-45. 14. Gilliam DG, Orchardson R. Advances in the treatment of root dentine sensitivity: mechanisms and treatment principles. Endodontic Topics 2006;13:13-33. 15. Coleman TA, Grippo JO, Kindernecht KE. Cervical dentin hypersensitivity. Part II: associations with abfractive lesions. Quintessence Int 2000;31:466-73. 16. Addy M. Dentin hypersensitivity: definition, prevalance, distrubition, and aetiology. In: Addy M, Embery G, Edgar WM, Orchardson R (eds) Tooth wear and sensitivity Clinical advances in restorative dentistry. Martin Dunitz: London 2000. p. 239-48. 17. Attar N, Korkmaz Y. Dentin aşırı hassasiyeti. Hacettepe Üniv Diş Hek Fak Derg 2006;30:83-91. 18. West NX, Lussi A, Seong J, Hellwig E. Dentin hypersensitivity: pain mechanisms and aetiology of exposed cervical dentin. Clin Oral Investig 2013;17:9-19. 19. Bartold PM. Dentinal hypersensitivity: a review. Aust Dent J 2006;51:212-8. 20. Kadiroğlu E, Dağ A. Dentin hipersensitivitesi ve lazerlerin etkisi, Cumhuriyet Dent J 2004;7:58-62. 21. Bamise C, Esan T. Mechanism and treatment approaches of dentine hypersensitivity: a literature review. Oral Health Prev Dent 2011;9:353-67. 22. Kemaloğlu H, Türkün Ş. Dentin hassasiyeti-fizyoloji. Türkiye Klinikleri J Restor Dent-Special Topics 2015;1:8-15. 23. Pashley DH. Dynamics of the pulpo-dentin complex. Crit Rev Oral Biol Med 1996;7:104-33. 24. Addy M, Pearce N. Aetiological, predisposing and environmental factors in dentine hypersensitivity. Arch Oral Biol 1994;39:33-8. 25. Brannström M. The hydrodynamic theory of dentinal pain: sensation in preperations, caries and the dentinal crack syndrome. J Endod 1986;12:453-7. 26. Matthews B, Vongsavan N. Interactions between neural and hydrodynamic mechanisms in dentine and pulp. Arch Oral Biol, 1994;39:87-95. 27. West NX. The dentine hypersensitivity patient – a total management package. Int Dent J 2007; 57:411-9. 28. Martinez-Ricarte J, Faus-Motoses V, Faus-Llacer VJ, Flichy-Fernandez AJ, Mateos-Moreno B. Dentinal sensitivity: concept and methodology for its objective evaluation. Med Oral Patol Oral Cir Bucal 2008;13:201-6. 29. Orchardson R, Gilliam D. Managing dentin hypersensitivity. J Am Dent Assoc 2006;137:990-8. 30. Hacıoğulları İ, Ulusoy N, Er F. Dentin aşırı hassasiyeti: Tanı ve tedavi yöntemleri. Atatürk Üniv. Diş Hek. Fak. Derg 2015;25:95-106. 31. Chu CH, Lo ECM. Dentin hypersensitivity: a review. Hong Kong Dent J 2010;7:15-22. 32. Markowitz K, Bilotto G, Kim S. Decreasing intradental nerve activity in the cat with potassium and divalent cations. Arch Oral Biol 1991;36:1-7. 33. West NX, Addy M, Jackson RJ, Ridge DB. Dentine hypersensitivity and the placebo response. J Clin Periodontol 1997;24:209-15. 34. Gillam DG, Bulman JS, Jackson RJ, Newman HN. Efficacy of a potassium nitrate mouthwash in alleviating cervical dentine sensitivity (CDS). J Clin Periodontol 1996;23:993-7. 35. Frechoso SC, Menendez M, Guisasola C, Arregui I, Tejerina JM, Sicilia A. Evaluation of the efficacy of two potassium nitrate bioadhesive gels (5% and 10%) in the treatment of dentine hypersensitivity: a randomised clinical trial. J Clin Periodontol 2003;30:315-20. 36. Cummins D. Dentin hypersensitivity: from diagnosis to a breakthrough therapy for everyday sensitivity relief. J Clin Dent 2009;20:1-9. 37. Cummins D. Recent advances in dentin hypersensitivity: clinically proven treatments for instant and lasting sensitivity relief. Am J Dent 2010;23:3-13. 38. Hodosh M. A superior desensitizer: potassium nitrate. J Am Dent Assoc 1974;88:831-2. 39. Dondi O, Lone A, Finger W. Clinical evaluation of the role of glutardialdehyde in a one-bottle adhesive. Am J Dent 2002;15:330. 40. Dondi O, Malferrari S. Desensitizing effects of gluma and gluma 2000 on hypersensitive dentin. Am J Dent 1993;6:283-6. 41. Ölmez A, Erdemli E. Dentin hassasiyeti ve tedavi yöntemleri. GÜ Diş Hek Fak Derg 2003;20:65-71. 42. Davies R, Scully C, Preston AJ. Dentifrices--an update. Med Oral Patol Oral Cir Bucal 2010;15:976-82. 43. Kern DA, McQuade MJ, Scheidt MJ, Hanson B, Van Dyke TE. Effectiveness of sodium fluoride on tooth hypersensitivity with and without iontophoresis. J Periodontol 1989;60:386-9. 44. Morris MF, Davis RD, Richardson BW. Clinical efficacy of two dentin desensitizing agents. Am J Dent 1999;12:72-6. 45. Leonard RH, Smith L, Garland GE, Caplan DJ. Desensitizing agent efficacy during whitening in an at-risk population. J Esthet Restor Dent 2004;16:49-55. 46. Tilliss TS, Keating JG. Understanding and managing dentin hypersensitivity. J Dent Hyg 2002;7:296-310. 47. Schiff T, He T, Sagel L, Baker R. Efficacy and safety of a novel stabilized stannous fluoride and sodium hexametaphosphate dentifrice for dentinal hypersensitivity. J Contemp Dent Pract 2006;7:1-8. 48. Blong MA, Volding B, Thrash WJ, Jones DL. Effects of a gel containing 0.4 percent stannous fluoride on dentinal hypersensitivity. Dent Hyg 1985;59:489-92. 49. Collaert B, Fischer C. Dentine hypersensitivity: a review. Endod Dent Traumatol 1991;7:145-52. 50. Pereira JC, Segala AD, Gillam DG. Effect of desensitizing agents on the hydraulic conductance of human dentin subjected to different surface pre-treatments in vitro study. Dent Mater 2005;21:129-38. 51. Pashley DH. Dentin permeability, dentin sensitivity, and treatment through tubule occlusion. J Endodod 1986;12:465-74. 52. Guo C, McMartin KE. The cytotoxicity of oxalate, metabolite of ethylene glycol, is due to calcium oxalate monohydrate formation. Toxicology 2005;208:347-55. 53. Trowbridge HO, Silver DR. A review of current approaches to in-office management of tooth hypersensitivity. Dent Clin North Am 1990;34:561-81. 54. Hu J, Zhu Q. Effect of immediate dentin sealing on preventive treatment for postcementation hypersensitivity. Int J Prosthodont 2010;23:49-52. 55. Ling TY, Gillam DG. The effectiveness of desensitizing agents for the treatment of cervical dentine sensitivity (CDS) - a review. J West Soc Periodontol Periodontal Abstr 1996;44:5-12. 56. Hench LL, Splinter RJ, Allen WC, Greenlee TK. Bonding mechanisms at interface of ceramic prosthetic materials. J Biomed Mater Res 1971;5:117-41. 57. Wilson J, Low SB. Bioactive ceramics for periodontal treatment: comparative studies in the patus monkey. J Appl Biomater 1992;3:123-9. 58. Hench LL, Paschall HA. Direct chemical bond of bioactive glass-ceramic materials to bone and muscle. J Biomed Mater Res 1973;7:24-42. 59. Forsback AP, Areva S, Salonen JI. Mineralization of dentin induced by treatment with bioactive glass S53P4 In vitro. Acta Odontol Scand 2004;62:14-20. 60. Cai F, Shen P, Morgan MV, Reynolds EC. Remineralization of enamel subsurface lesions in-situ by sugar free lozenges containing casein phosphopeptide-amorphous calcium phosphate. Aust Dent J 2003;48:240-3. 61. Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phospho peptide on enamel lesions: An In vitro comparative evaluation. J Conserv Dent 2010;13:42-6. 62. Ohta K, Kawamata H, İshizaki T, Hayman R. Occlusion of dentinal tubules by nano-hydroxyapatite. [Absract] (85th General Session & Exhibition of the IADR, March21-24, 2007) Web: http://www.apagard.com/en/web/research/pdf/Ohta2007.pdf 63. Arısu HD, Bala O, Alimzhanova G, Türköz E. Assessment of morphological changes and permeability of apical dentin surfaces induced by Nd:Yag laser irradiation through retrograde cavity surfaces. J Contemp Dent Pract 2004;5:102-13. 64. Corona SAM, Nascimento TN, Catirse ABE, Lizarelli RFZ, Dinelli W, Palma-Dibb RG. Clinical evaluation of low level laser therapy and fluoride varnish for treating cervical dentinal hypersensitivity. J Oral Rehab 2003;30:1183-9. 65. Schwarz F, Arweiler N, Georg T, Reich E. Desensitizing effects of an Er: YAG laser on hypersensitive dentine. J Clin Periodontol 2002;29:211- 5. 66. Kimura Y, Wilder-Smith P, Yonaga K, Matsumoto K. Treatment of dentine hypersensitivity by lasers: A review. J Clin Periodontol 2000;27:715-21. 67. Krauser TJ. Hypersensitive teeth. part II: treatment. J Prosthet Dent 1986;56:307-11. 68. Mosteller JH. The use of prednisolone in the elunination of postoperative thermal sensitivity. J Prosthet Dent 1962;12:1176-9. 69. Almas K, Mahmoud A, Dahlan A. A comparative study of propolis and saline application on human dentin. A SEM study. Indian J Dent Res 2001;12:21-7. 70. Mahmoud AS, Almas K, Dahlan A. The effect of propolis on dentinal hypersensitivity and level of satisfaction among patients from a university hospital Riyadh, Saudi Arabia. Indian J Dent Res 1999;10:130-7. 71. Grossman L. A systematic method for the treatment of hypersensitive dentine. J Am Dent Assoc 1935;22:592-8. 72. Parkinson CR, Jeffery P, Milleman JL, Milleman KR, Mason S. Confirmation of efficacy in providing relief from the pain of dentinhypersensitivity of an anhydrous dentifrice containing 0.454% with or without stannous fluoride in an 8-week randomized clinical trial. Am J Dent 2015;28:190-6. 73. Ayad F, Ayad N, Delgado E, Zhang YP, DeVizio W, Cummins D, Mateo LR. Comparing the efcacy in providing instant relief of dentin hypersensitivity of a new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fuoride to a benchmark desensitizing toothpaste containing 2% potassium ion and 1450 ppm fuoride, and to a control toothpaste with 1450 ppm fuoride: a three-day clinical study in Mississauga, Canada. J Clin Dent 2009;20:115-22. 74. Bal MV, Keskiner İ, Sezer U, Açıkel C, Saygun I. Comparison of low level laser and arginine-calcium carbonate alone or combination in the treatment of dentin hypersensitivity: a randomized split-mouth clinical study. Photomed Laser Surg 2015;33:200-5. 75. Suri I, Singh P, Shakir QJ, Shetty A, Ranjeet B, Roshani T. A comparative evaluation to assess the efficacy of 5% sodium fluoride varnish and diode laser and their combined application in the treatment of dentin hypersensitivity. J Indian Soc Periodontol 2016;20:307–14. 76. Antoniazzi RP, Machado ME, Grellmann AP, Santos RC, Zanatta FB. Effectiveness of a desensitizing agent for topical and home use for dentin hypersensitivity: a randomized clinical trial. Am J Dent 2014;27:251-7. 77. Pradeep AR, Sharma A. Comparison of clinical efficacy of a dentifrice containing calcium sodium phosphosilicate to a dentifrice containing potassium nitrate and to a placebo on dentinal hypersensitivity: a randomized clinical trial. J Periodontol 2010;81:1167-73. 78. Duran I, Şengün A. The long-term effectiveness of five current desensitizing products on cervical dentine sensitivity. J Oral Rehabil 2004;31:351-6. 79. Akça AE, Gökce S, Kürkçü M, Özdemir A. Clinical assessment of bond and fluoride in dentin hypersensitivity. Hacettepe Üniv Diş Hek Fak Derg 2006;30:92-100. 80. Ünlü İ, Bala, O. Dentin duyarlılığı tedavisinde değişik materyallerin etkinliğinin klinik olarak değerlendirilmesi. GÜ Diş Hek Fak Derg 2008;25:13-8. 81. Samuel SR, Khatri SG, Acharya S, Patil ST. Evaluation of instant desensitization after a single topical application over 30 days: a randomized trial. Aust Dent J 2015;60:336-42. 82. Wang L, Magalhães AC, Francisconi-Dos-Rios LF, Calabria MP, Araújo D, Buzalaf M, Lauris J, Pereira JC. Treatment of dentin hypersensitivity using nano-hydroxyapatite pastes: a randomized three-month clinical trial. Oper Dent 2016;41:93-101. 83. Toker H, Özan F, Özdemir H, Değer O. Dentin hassasiyetinin tedavisinde propolisin etkisi. GÜ Diş Hek Fak Derg 2008;25:1-6.