Sameer Puri D.D.S. We have all been there. The seemingly uneventful procedure that now turns out to be a never ending saga of sensitivity for the patient. One of the tools I have employed very successfully in the past is Gluma. A great desensitizer that helps prevent sensitivity. Many clinicians have used Gluma and Gluma like substitutes to minimize sensitivity. This becomes especially important after using a total etch technique because of the etching and rinsing of the phosphoric acid. This potential for sensitivity with the total etch technique is also one of the many reasons that self etching bonding agents and self etching resin cements such as Unicem have gained popularity. The downside with these materials is that as you start combining steps, you lose bond strength. So to maintain the highest bond strengths and the most predictable bond many clinicians still prefer the technique with the most amount of research which is the total etch technique when bonding restorations to teeth.
One of the new products that I recently tried is Telio™ CS Desensitizer from Ivoclar. Telio™ CS Desensitizer is a specially formulated glutaraldehyde-containing solution for reducing and preventing dentinal hypersensitivity. You can use it with direct and indirect restorations, both permanent and temporarily cemented restorations. Granted as CEREC users, we don't do many temporaries, but you never know when there will be an opportunity to place a provisional for whatever reason. If you have experienced sensitivity it might behoove you to try a product such as Telio™ CS Desensitizer. How it works: The two main components of the material are glutaraldehyde and polyethylene glycol dimethacrylate (PEG-DMA). These combine to seal the dentinal tubules so that the fluid in the tubules does not compress and cause pressure on the nerve endings and cause pain.
The glutaraldehyde essentially forms covalent bonds with the proteins to form plugs in the dentinal tubules. The PEG-DMA is a wetting agent that carries the glutaraldehyde down into the tubules. The Telio desensitizer is used after etching the tooth structure with phosphoric acid when using with a total etch technique. The proper sequence is to etch, rinse and apply the Telio and scrub for 10 seconds. Air dry the desensitizer and proceed with the remainder of the procedure. You can use this for cervical desensitization of teeth as well. Simply apply for 10 seconds and blow the excess off.
The Patterson item # is 715-5906. You can find ordering information here: http://www.pattersondental.com/Supplies/ProductFamilyDetails/18731
