象牙質知覚過敏症の病態と治療法

The prevalence of dentin hypersensitivity ranges from 4 to 74%, and approximately 20-30% adults patient have complaints such as cold, air, and tactile pain. The pathogenesis of dentin hypersensitivity and pain transmission system in teeth are still unclear. The hydrodynamic theory is widely accepted as a mechanism to explain tooth pain. Many open dentinal tubules exist at the surface of hypersensitive teeth. In contrast, most dentinal tubules are occluded with minerals in nonhypersensitive teeth. Therefore, the treatment method for dentin hypersensitivity aims to occlude open dentinal tubules and reduce fluid flow within the tubules. Several treatment methods have been developed and applied to hypersensitive teeth, such as desensitizing agents, resins, and lasers. The representative treatment method to occlude open dentinal tubules with inorganic materials is applying potassium oxalate. Unfortunately, the duration of potassium oxalate occlusion was reported to be relatively short-lived in the oral environment. Aside from inorganic materials, several organic materials (e.g. / resin) for coating the dentin surface have recently been commercialized. Resin materials can seal not only at the dentin surface but also deep in the dentinal tubules. In addition, several kinds of dental laser have recently been used for the treatment of dentin hypersensitivity. The action mechanism of lasers in dentin hypersensitivity is still not clearly understood, although some clinical studies have reported the effectiveness of laser therapy. However, no consistent treatment regimen has been established for dentin hypersensitivity; therefore, we should choose the optimum therapy after understanding the characteristics of each treatment method.