Ambulatory Center for Psychiatry and Psychotherapy, Psychiatric Services of District Aargau, Aargau, Switzerland.
Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
J Oral Rehabil. 2019 Jun;46(6):549-555. doi: 10.1111/joor.12781. Epub 2019 Mar 21.
Quantification of dentin hypersensitivity (DH) is challenging and requires standardised, graded stimulation by natural-like stimuli.
The present study aimed at identifying DH subjects and longitudinally monitoring their pain thresholds by cold air quantitative sensory testing (QST).
Subject recruitment started with an online DH questionnaire. Respondents were screened by dental air stimulation. Sensitising and habituating subjects were excluded. A recently developed stimulation device was employed for cold air QST. Single tooth DH was verified by applying an equi-intense stimulus to a control tooth. Descriptive statistics were applied for subject characteristics. Mean values were calculated for the stimulation parameters temperature and air flow. Reliability of temperatures for detecting pain and for evoking moderate pain over multiple time points within a 3-week period was analysed by two-way random single- and average-measure intra-class correlation coefficients.
A total of 353 persons completed the online DH questionnaire of which 117 were screened. Forty-four passed the screening, yet 15 were excluded for various reasons. Twenty-nine subjects were monitored by QST across 3 weeks. Results revealed a high intra-individual stability of the temperature inducing moderate to strong pain intensity (MPI) (single-measure ICC of T 0.83, P < 0.001). Mean T was -13.69°C, yet it highly varied among the 29 subjects (SD ± 10.04°C).
Using a novel approach, namely dental QST based on cold air stimuli, we present evidence for temporally stable DH perceptions over a 3-week period. The method fulfils international guideline requirements and is recommendable for obtaining valid results when testing various interventions for DH management.
牙本质敏感(DH)的量化具有挑战性,需要使用类似自然的刺激进行标准化、分级刺激。
本研究旨在通过冷空气定量感觉测试(QST)识别 DH 受试者并对其疼痛阈值进行纵向监测。
研究开始于在线 DH 问卷的招募。通过牙科空气刺激对受访者进行筛选。排除敏感和习惯化的受试者。采用最近开发的刺激装置进行冷空气 QST。通过向对照牙施加等强度刺激来验证单颗牙齿的 DH。应用描述性统计方法对受试者特征进行分析。对刺激参数温度和气流的平均值进行计算。通过双向随机单测量和平均测量的组内相关系数分析,分析在 3 周内的多个时间点检测疼痛和诱发中度疼痛的温度的可靠性。
共有 353 人完成了在线 DH 问卷,其中 117 人接受了筛选。有 44 人通过了筛选,但由于各种原因有 15 人被排除在外。29 名受试者接受了 3 周的 QST 监测。结果显示,诱发中度至强烈疼痛强度的温度具有较高的个体内稳定性(单测量 ICC 为 T 0.83,P < 0.001)。平均 T 值为-13.69°C,但在 29 名受试者中差异很大(SD ± 10.04°C)。
使用一种新方法,即基于冷空气刺激的牙科 QST,我们提供了在 3 周内 DH 感知具有时间稳定性的证据。该方法符合国际指南要求,当测试各种 DH 管理干预措施的有效性时,是一种值得推荐的方法。