Tooth Preparation and Pulpal Response: Literature Review

Yıl 2013, Cilt: 23 Sayı: 2, 282 - 288, 01.02.2013

Dr. Özlem Acar Doç. Dr. Selim Erkut

Öz

Pulp tissue reaction to tooth preparation for direct or indirect restorations is one of the major concerns in fixed prosthodontics. Although the sensitivity of dentine to a variety of stimuli is difficult to correlate with morphological and functional observations, hydrodynamic theory was used to explain dental pain mechanism. External stimuli (e.g., thermal, mechanical and dental restorative processes) applied to human tooth cause either an inward (toward the pulp chamber) or outward (away from the pulp chamber) dentinal fluid flow in dentinal microtubules. A rapid shift of tubule content may activate A and C fibers. Outward dentinal fluid shift is more effective than inward movement to activate mechanoreceptors. Tooth preparations should be performed with use of short grinding intervals and cooling water temperature and special care should be concerned on bur selection because of possible thermal damage to the dental pulp.

Anahtar Kelimeler

Dentin Sensitivity, Hydrodynamic Theory, Preparation Mine için tampon vazifesi gören dentin, odontoblast hücreleri tarafından oluşturulan mezoderm kökenli bağ dokusudur. Dentin, intratübüler dentinal sıvı ve pulpal sıvı vasıtasıyla pulpa v

Diş Preparasyonu Ve Pulpal Cevap: Literatür Derlemesi

Öz

Diş kesimi sonrası pulpa dokusunda gözlenen duyarlılık sabit protetik uygulamalarda temel bir problemdir. Dentinde çeşitli uyaranlara karşı gözlenen hassasiyeti morfolojik ve fonksiyonel gözlemlerle bağdaştırmak zor olmakla birlikte dental ağrı mekanizması hidrodinamik teori ile açıklanmaktadır. Diş yüzeyine (Isı, mekanik ve restoratif işlemler) iç (pulpa odası yönünde) ya da dış (pulpa odasının ters yönünde) yönlerde uygulanan dış uyaranlar dentin tübüllerinde dentin sıvısının hareket etmesine neden olmaktadır. Tübül içeriğinin hızlı hareketi A ve C fibrillerini uyarabilmektedir. Dış yönde gözlenen direk sıvı hareketi pulpal yöndeki sıvı hareketine kıyasla pulpal mekanoreseptörlerin aktivasyonunda daha etkili olmaktadır. Pulpal dokuda olası termal hasarı önlemek amacıyla, preparasyon kısa aralıklarla ve soğutucu su ile yapılmalı, ayrıca frez seçimine gereken özen gösterilmelidir.

Anahtar Kelimeler

Dentin Duyarlılığı, Hidrodinamik Teori, Preparasyon

Kaynakça

• Shilinburg HT. Fundamentals of Fixed Prosthodontics. In: 3 ed Quintessence Publishing Co, Chicago 1997. p. 26, 119.
• Roberson TM, Heymann H0, Swift EJ. Sturdevants’s Art and Science of Operative Dentistry In: 4 ed. Mosby, St. Louis Missouri 2002. p. 22-25, 343.
• Pashley DH. Mechanistic analysis of fluid distribution across the pulpodentin complex. J Endod 1992;18:72-5.
• Lam CW, Wilson PR. Crown cementation and pulpal health. Int Endod J 1999;32:249-56.
• Brannstrom M, Astrom A. The hydrodynamics of the dentine; its possible relationship to dentinal pain. Int Dent J 1972;22:219-27.
• Charoenlarp P, Wanachantararak S, Vongsavan N, Matthews B. Pain and the rate of dentinal fluid flow produced by hydrostatic pressure stimulation of exposed dentine in man. Arch Oral Biol 2007;52:625-31.
• Brannstrom M. The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. J Endod 1986;12:453-7.
• Brannstrom M. The elicitation of pain in human dentine and pulp by chemical stimuli. Arch Oral Biol 1962; Jan-Feb :59-62.
• Brannstrom M. Dentin sensitivity. Arsb Goteb Tandlak Sallsk 1964:15-35.
• Narhi MV. The characteristics of intradental sensory units and their responses to stimulation. J Dent Res 1985;64 Spec No:564-71.
• Mengel MK, Erkki J, Klaus-D K. Pain sensation during cold stimulation of the teeth: differential reflection of Aδ and C fibre activity. Pain 1993;55:159-69.
• Ikeda H, Yamamoto H, Sunakawa M, Suda H. [Response properties of pulpal nerve fibers with different conduction velocities]. Kokubyo Gakkai Zasshi 1991;58:555-65.
• Min Lin ZYL, Bo Feng Bai, Feng Xu, Tian Jian Lu. Fluid Mechanics in Dentinal Microtubules Provides Mechanistic Insights into the Difference between Hot and Cold Dental Pain. Plos One 2011;6:18068.
• Matthews B. Vongsavan N. Interactions between neutral and hydrodynamic mechanisms in dentine and pulp. Arch Oral Biol 1994; 39 Suppl:87S-95S.
• Vongsavan N, Matthews B. The relationship between the discharge of intradental nerves and the rate of fluid flow through dentine in the cat. Arch Oral Biol 2007;52:640-7.
• Brannstrom M, Johnson G. Movements of the dentine and pulp liquids on application of thermal stimuli. An in vitro study. Acta Odontol Scand 1970;28:59-70.
• Pashley DH, Matthews WG, Zhang Y, Johnson M. Fluid shifts across human dentine in vitro in response to hydrodynamic stimuli. Arch Oral Biol 1996;41:1065-72.
• Chidchuangchai W, Vongsavan N, Matthews B. Sensory transduction mechanisms responsible for pain caused by cold stimulation of dentine in man. Arch Oral Biol 2007;52:154-60.
• Absi EG, Addy M, Adams D. Dentine hypersensitivity. A study of the patency of dentinal tubules in sensitive and non-sensitive cervical dentine. J Clin Periodontol 1987;14:280-4.
• Brannstrom M. The effect of dentin desiccation and aspirated odontoblasts on the pulp. J Prosthet Dent 1968;20:165-71.
• Brannström MA. A study on the mechanism on pain elicited from the dentin. J Dent Res 1964 JulAug;:619-25.
• Brannstrom M, Linden LA, Astrom A. The hydrodynamics of the dental tubule and of pulp fluid. A discussion of its significance in relation to dentinal sensitivity. Caries Res 1967;1:310-7.
• Berggren G, Braennstroem M. The Rate of Flow in Dentinal Tubules Due to Capillary Attraction. J Dent Res 1965; Mar- Apr:408-15.
• Camps J, Salomon JP, Meerbeek BV, Tay F, Pashley D. Dentin deformation after scratching with clinically-relevant forces. Arch Oral Biol 2003;48:527-34.
• Trowbridge HO, Franks M, Korostoff E, Emling R. Sensory response to thermal stimulation in human teeth. J Endod 1980;6:405-12.
• Linden L, Brannstrom M. Fluid movements in dentine and pulp. An in vitro study of flow produced by chemical solutions on exposed dentine. Odontol Revy 1967;18:227-36.
• Nyborg H, Brannstrom M. Pulp reaction to heat. J Prosthet Dent 1968;19(6):605-612.
• Brannstrom M, Linden LA, Johnson G. Movement of dentinal and pulpal fluid caused by clinical procedures. J Dent Res 1968;47:679-82.
• Bagis B, Atilla P, Cakar N, Hasanreisoglu U. Immunohistochemical evaluation of endothelial cell adhesion molecules in human dental pulp: effects of tooth preparation and adhesive application. Arch Oral Biol 2007;52:705-11.
• Jackson CR, Skidmore AE, Rice RT. Pulpal evaluation of teeth restored with fixed prostheses. J Prosthet Dent 1992;67:323-5.
• Langeland K, Langeland LK. Pulp Reactions to Crown Preparation, Impression, Temporary Crown Fixation, and Permanent Cementation. J Prosthet Dent 1965;15:129-43.
• Zach LGC. Thermogenesis in operative techniques; Comparison of four methods. J Prosthet Dent 1962; 12: 977-84.
• Zach LCG. Pulp response to externally applied heat. Oral Surg Oral Med Oral Pathol 1965; 19: 515Cavalcanti BN, Otani C, Rode SM. High-speed cavity preparation techniques with different water flows. J Prosthet Dent 2002;87:158-61.
• L.Schubert. Temperature measurements in teeth using the light beam galvanometer during grinding and drilling 1957:768-72.
• Lauer HC, Rothlauf W, Zwingers T. Effects of the temperature of cooling water during high-speed and ultrahigh-speed tooth preparation. J Prosthet Dent 1990:407-14.
• Stanley HR, Jr., Swerdlow H. Reaction of the human pulp to cavity preparation: results produced by eight different operative grinding technics. J Am Dent Assoc 1959;58:49-59.
• Schuhard A. Temprature response to increased rotational speeds J Prosthet Dent 1961;11:313-7.
• Schuchard A, Watkins CE. Thermal and histologic response to high-speed and ultrahigh-speed cutting in tooth structure. J Am Dent Assoc 1965;71:1451-8.
• Bouschor CF, Matthews JL. A four-year clinical study of teeth restored after preparation with an air turbine handpiece with an air coolant. J Prosthet Dent 1966;16:306-9.
• Lockard MW. A retrospective study of pulpal response in vital adult teeth prepared for complete coverage restorations at ultrahigh speed using only air coolant. J Prosthet Dent 2002;88:473-8.
• Ozturk B, Usumez A, Ozturk AN, Ozer F. In vitro assessment of temperature change in the pulp chamber during cavity preparation. J Prosthet Dent 2004;91:436-40.
• Ottl P, Lauer HC. Temperature response in the pulpal chamber during ultrahigh-speed tooth preparation with diamond burs of different grit. J Prosthet Dent 1998;80:12-9.
• Evans CD, Wilson PR. The effects of tooth preparation on pressure measured in the pulp chamber: a laboratory study. Int J Prosthodont 1999;12:439-43.
• Cox CF, White KC, Ramus DL, Farmer JB, Snuggs HM. Reparative dentin: factors affecting its deposition. Quintessence Int 1992;23:257-70.
• Bergenholtz G, Cox CF, Loesche WJ, Syed SA. Bacterial leakage around dental restorations: its effect on the dental pulp. J Oral Pathol 1982;11:439-50.
• Hu J, Zhu Q. Effect of immediate dentin sealing on preventive treatment for postcementation hypersensitivity. Int J Prosthodont 2010;23:49-52. Brannstrom M. Reducing the risk of sensitivity and pulpal complications after the placement of crowns and fixed partial dentures. Quintessence Int 1996;27:673-8.
• Özcan E, Çanakçı CF. Dentin hipersensitivitesi ve şiddetiyle ilişkili etiyolojik faktörlerin incelenmesi. Atatürk Üniv Diş Hek Fak Derg 2010;20:145-52.
• Murray PE, Lumley PJ, Franquin JC, Remusat M. Human odontoblast cell numbers after dental injury. Journal of Dentistry 2000;28:277-85.
• Murray PE, Hafez AA, Smith AJ, Cox CF. Hierarchy of pulp capping and repair activities responsible for dentin bridge formation. Am J Dent 2002;15:236
• Kodonas K, Gogos C, Tziafas D. Effect of simulated pulpal microcirculation on intrapulpal temperature changes following application of heat on tooth surfaces. Int Endod J 2009;42:247-52. Yazışma Adresi Dr. Özlem ACAR
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