Fukumoto Yoshikazu, Horibe Masumi, Inagaki Yuji, Oishi Keiji, Tamaki Naofumi, Ito Hiro-O, Nagata Toshihiko
Department of Periodontology and Endodontology, Institute of Health Biosciences, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima, 770-8504, Japan.
Odontology. 2014 Jan;102(1):42-9. doi: 10.1007/s10266-012-0099-5. Epub 2013 Jan 3.
Dentin hypersensitivity (DH) may be present in association with gingival recession. The aim of this study was to determine quantitatively the association of gingival recession and other factors with the presence of DH. One hundred and four Japanese subjects with or without gingival recession were randomly selected. Intact canines and/or first premolars in both maxillary and mandibular quadrants were analyzed. Gingival recession was measured as a vertical length at the buccal site of the teeth. DH was recorded as an ordered categorical variable registering four increasing levels of pain after cold stimulation; from no discomfort to severe pain during and after stimulation (DH1, 2, 3, and 4). Association of DH with periodontal parameters and daily lifestyle was also investigated. Tooth-based analysis of 446 teeth from 104 subjects revealed that DH level was significantly higher in recessive teeth (1, 2, 3, and 4-8 mm) than in non-recessive teeth (0 mm). DH-positive rate in non-recessive teeth was only 18 % (DH1; 14 %, DH2; 3 %, and DH3; 1 %). Highest DH level was observed in teeth with severe recession (4-8 mm), showing DH0; 21 %, DH1; 33 %, DH2; 31 %, and DH3; 15 %. Recession-dependent increase in DH was observed, showing 18, 49, 52, 60, and 79 % DH-positive in teeth with 0, 1, 2, 3, and 4-8 mm recession, respectively. Plaque-free teeth showed a higher DH level than plaque-stained teeth, suggesting that good plaque control may be associated with the presence of DH. There were no significant differences in DH of teeth on the basis of smoking, probing depth, and bleeding on probing. Multiple logistic regression analysis revealed that gingival recession [odds ratio (OR) = 10.2, 95 % confidence interval (CI) = 5.5-18.9] and plaque deposition (OR = 0.3, 95 % CI = 0.2-0.5) were significant contributors to DH. Multilevel modeling analysis revealed that not only gingival recession and plaque deposition but also V-shaped cervical notch and tooth brushing frequency were associated with DH. These results demonstrate that the progression of gingival recession, plaque-free teeth, V-shaped cervical notch, and frequent brushing may be significant predictors of DH in canines and first premolars.
牙本质过敏症（DH）可能与牙龈退缩有关。本研究的目的是定量确定牙龈退缩及其他因素与DH存在之间的关联。随机选取了104名有或无牙龈退缩的日本受试者。对上颌和下颌象限中的完整犬齿和/或第一前磨牙进行分析。牙龈退缩测量为牙齿颊侧部位的垂直长度。DH记录为一个有序分类变量，记录冷刺激后疼痛程度增加的四个级别；从刺激期间和刺激后无不适到剧痛（DH1、2、3和4）。还研究了DH与牙周参数和日常生活方式的关联。对104名受试者的446颗牙齿进行基于牙齿的分析发现，退缩牙齿（1、2、3和4 - 8毫米）的DH水平显著高于非退缩牙齿（0毫米）。非退缩牙齿的DH阳性率仅为18%（DH1为14%，DH2为3%，DH3为1%）。在严重退缩（4 - 8毫米）的牙齿中观察到最高的DH水平，显示DH0为21%，DH1为33%，DH2为31%，DH3为15%。观察到DH随退缩程度增加，在退缩0、1、2、3和4 - 8毫米的牙齿中，DH阳性率分别为18%、49%、52%、60%和79%。无牙菌斑的牙齿显示出比有牙菌斑染色的牙齿更高的DH水平，这表明良好的牙菌斑控制可能与DH的存在有关。基于吸烟、探诊深度和探诊出血情况，牙齿的DH水平没有显著差异。多因素逻辑回归分析显示，牙龈退缩[比值比（OR）= 10.2，95%置信区间（CI）= 5.5 - 18.9]和牙菌斑沉积（OR = 0.3，95% CI = 0.2 - 0.5）是DH的重要影响因素。多水平模型分析显示，不仅牙龈退缩和牙菌斑沉积，而且V形颈缘缺损和刷牙频率都与DH有关。这些结果表明，牙龈退缩的进展、无牙菌斑的牙齿、V形颈缘缺损和频繁刷牙可能是犬齿和第一前磨牙DH的重要预测因素。
