CE Course 9 -Figures

CE Course 9 Figures

Figure 1
Figure 1. Assessment skills include observation of nonverbal reactions such as anxiety.




Figure 2
Figure 2. Fluid in dentinal tubules transmits stimulus from enamel to nerve endings in circumpulpal dentin. Adapted with permission from The anatomic and physiologic basis for dentinal sensitivity. Compend Contin Educ Dent. 1982;(Suppl 3)S99-104.




Figure 3
Figure 3.View of open dentinal tubules as seen under a scanning electron microscope.




Figure 4
Figure 4.Dentinal tubules extend from the pulp to the enamel.




Figure 5
Figure 5.The degree of hard or soft tissue loss does not correlate with the severity of sensitivity.




Figure 6
Figure 6.Cervical areas exhibit recession and tooth loss but are not sensitive due to effects of burnishing with a toothpick. Note that use of toothpick between teeth #8 and #9 has caused loss of tooth structure at the interproximal.




Figure 7
Figure 7.Lateral occlusal forces create tensile and compressive forces at the cervical area of tooth. Magnification depicts disruption of chemical bonds between enamel rods resulting in crystals that are more susceptible to breakage and chemical dissolution.

Reprinted from J Prosthet Dent, Vol. 53, Lee WC; WS Eakle, Possible role of tensile stress in the etiology of cervical erosive lesions of teeth, 374-380, 1984, with permission from Elsevier Science.




Figure 8
Figure 8.Abfraction due to the flexure and ultimate fatigue of enamel and dentin at the cervical area. It is probable that abfraction initiated tooth structure loss was increased by toothbrush abrasion and dietary erosion factors, due to occlusal disfunction.




Figure 9
Figure 9.Flow chart to facilitate assessment and management of hypersensitivity.




Figure 10
Figure 10.Alteration of toothbrushing approach can prevent further toothbrush abrasion.




Figure 11
Figure 11.Figure 11. Burnishing with a toothpick is a simple self-care approach which can reduce hypersensitivity over time.