Giovanna Corrêa Denucci

Objectives: The association between tooth wear (TW) and dentin hypersensitivity (DH) is not well understood. This systematic review investigated the role of TW (and etiological factors) as an associated factor for DH. Materials and Methods: Literature search was conducted in five databases with terms related to DH and TW, until April 2025. Three pairs of independent reviewers selected clinical studies reporting on DH and TW (and related etiology) in dentate adults, and performed data extraction. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. A structured narrative synthesis was performed. Results: Twenty‐one studies were included, with DH prevalence varying from 8.6% to 84.7%. Many indices were used for TW, the most common being BEWE ( n = 8); and for DH, the most common being Schiff ( n = 7). DH prevalence was higher in patients with (mean: 42.1%) versus without (18.7%) TW. Similar trends were observed when analyzing teeth with (34.6%) versus without (12.4%) TW. DH was associated with specific acidic diets, parafunctional behaviors, and health and lifestyle factors. There was conflicting evidence associating toothbrushing frequency and technique to DH. Conclusions: This review provides evidence for a consistent association between DH and TW and some etiological factors, observed across patient‐ and tooth‐level analyses. Clinical Relevance: Patients with TW and/or etiological factors—including dietary habits, oral hygiene practices, and parafunctional behaviors—should prompt a thorough evaluation for underlying DH, and vice‐versa. Identifying and addressing these factors will help explain the occurrence of DH and guide effective prevention strategies.

Aim: This in vitro study aimed to compare the direct (visual exam) versus indirect (3D-colored digital images exam) assessments of ICDAS (dental caries), BEWE (erosive tooth wear), and TF (enamel fluorosis lesions) indices performed on the occlusal surfaces of extracted human teeth for the detection and severity differentiation of dental caries, erosive tooth wear, and enamel fluorosis lesions. Materials and methods: A total of 453 occlusal surfaces from extracted human teeth were mounted on 28 typodont models. Surfaces were examined directly (visual) and indirectly using 3D-coloured intraoral scans (TRIOS 4, 3Shape). Three indices were assessed: International Caries Detection and Assessment System (ICDAS; caries), Basic Erosive Wear Examination (BEWE; erosive tooth wear), and Thylstrup-Fejerskov (TF; fluorosis). Agreement between methods was analysed using weighted kappa statistics and percentage agreement. Results: Substantial agreement was observed between direct and indirect methods: ICDAS (κ = 0.72, 64%), BEWE (κ = 0.70, 73%), and TF (κ = 0.75, 86%). Early lesions (ICDAS 1–2, BEWE 1) were more frequently misclassified. Conclusions: 3D-coloured intraoral scanner imaging shows substantial agreement with visual examination for detecting and grading caries, erosive tooth wear, and fluorosis. Clinical significance: This study supports the use of intraoral scanners as a practical adjunct to visual examination for documentation, education, and potentially remote consultations. Further clinical validation is warranted.

Aim: This study assessed the activity of neuron/odontoblast receptors and neuropeptide release, under an animal model of dentin hypersensitivity (DH). Methods: Wistar rats were allocated in two groups (n=10): in test group DH was induced by a validated protocol in which a sports drink (pH 3.08) was ingested for 45d, while in control group, the animals ingested filtered water instead. Animals were euthanized and blood samples were collected to measure plasma corticosterone levels. Dental pulp samples (n=6) were processed for Western Blot and ELISA analysis of TRPV1 (mechano-, thermo- and chemoreceptor), P2X7 (adenosine triphosphate (ATP)-mechanosensitive receptor), TRPM8 (cold-sensitive receptor) and substance P (neurogenic peptide released by neuron activation and due to TRPV1 expression). Data were analyzed using Student’s t tests (α=0.05). Results: DH significantly increased expression of TRPV1 (p=0.002), P2X7 (p=0.007) and substance P (p<0.001) but did not significantly affect the activity of TRPM8 (p=0.079). Conclusion: Under DH condition, neurons and odontoblasts expressed TRPV1 and P2X7 receptors as well as increased substance P release, demonstrating cellular and molecular mechanisms underlying DH.

The unique screw-shape design and microstructure of implants pose a challenge for mechanical debridement in removing biofilms. Biofilms exhibit increased resistance to antimicrobials relative to single planktonic cells, emphasizing the need for effective biofilm removal during periodontal therapy for peri-implantitis treatment. To tackle this issue, our team evaluated the effectiveness of low-temperature plasma (LTP) for disinfecting titanium discs contaminated with multispecies biofilms associated with peri-implantitis, specifically focusing on biofilms matured for 14 and 21 days as well as biofilms that had formed on Straumann^Ⓡ Ti-SLA implants for 21 days. The biofilms included Actinomyces naeslundii, Porphyromonas gingivalis, Streptococcus oralis, and Veillonella dispar, which were grown in anaerobic conditions. These biofilms were subjected to LTP treatment for 1, 3, and 5 min, using distances of 3 or 10 mm from the LTP nozzle to the samples. Control groups included biofilms formed on Ti discs or implants that received no treatment, exposure to argon flow at 3 or 10 mm of distance for 1, 3, or 5 min, application for 1 min of 14 μg/mL amoxicillin, 140 μg/mL metronidazole, or a blend of both, and treatment with 0.12% chlorhexidine (CHX) for 1 min. For the implants, 21-day-old biofilms were treated with 0.12% CHX 0.12% for 1 min and LTP for 1 min at a distance of 3 mm for each quadrant. Biofilm viability was assessed through bacterial counting and confocal laser scanning microscopy. The impact of LTP was investigated on reconstituted oral epithelia (ROE) contaminated with P. gingivalis, evaluating cytotoxicity, cell viability, and histology. The results showed that a 1 min exposure to LTP at distances of 3 or 10 mm significantly lowered bacterial counts on implants and discs compared to the untreated controls (p < 0.017). LTP exposure yielded lower levels of cytotoxicity relative to the untreated contaminated control after 12 h of contamination (p = 0.038), and cell viability was not affected by LTP (p ≥ 0.05); thus, LTP-treated samples were shown to be safe for tissue applications, with low cytotoxicity and elevated cell viability post-treatment, and these results were validated by qualitative histological analysis. In conclusion, the study's results support the effectiveness of 1 min LTP exposure in successfully disinfecting mature peri-implantitis multispecies biofilms on titanium discs and implants. Moreover, it validated the safety of LTP on ROE, suggesting its potential as an adjunctive treatment for peri-implantitis.

Albumin is a salivary enzyme capable of cleaving ester linkages and catalyzing degradation of resinbased dental materials. However, the effect of concentration-dependent esterolytic action on composite resins as yet remains unexplored. Aim: The purpose of this study was to evaluate whether artificial saliva formulations with different concentrations of albumin affected the surface roughness, flexural strength and microhardness of a composite resin. Materials and Method: Specimens (25x2x2mm) of a nanofilled composite (Filtek Z350XT, 3M/ESPE) were prepared and analyzed for average surface roughness (Ra/µm). The specimens were then allocated to 6 groups (n=30), to be treated with different salivary albumin concentrations: 0, 10, 50, 100, 200, 400 µg/mL. The specimens were stored in their respective artificial saliva groups, half of them for 24 h and the remainder for 180 days (artificial saliva renewed weekly), after which they were submitted to a new Ra reading, and tested for three-point flexural strength (FS, MPa). The specimens stored for 180 days were analyzed for Knoop microhardness (KH, Kg/mm2 ). Data were submitted to two-way ANOVA (Ra and FS) and one-way ANOVA (KH). Results: Although Ra increased (p < 0.001) and FS decreased (p < 0.001) from 24 hours to 180 days of storage, the albumin concentration did not significantly affect Ra (p = 0.168), FS (p = 0.477) or KH (p = 0.378). Conclusion: The esterolytic action of albumin did not increase the artificial-saliva-induced hydrolytic degradation of the composite resin.