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CHEMOTHERAPEUTIC AGENTS AND PREVENTIVE MATERIALS - Coggle Diagram
CHEMOTHERAPEUTIC AGENTS AND PREVENTIVE MATERIALS
I. Desensitizing Agents
Definition
Therapeutic materials used to reduce dentin hypersensitivity based on the hydrodynamic theory (fluid movement inside dentinal tubules stimulates pulpal nerves).
Mechanisms of Action
A. Tubule Occlusion (Physical Mechanism)
Seals dentinal tubules
Reduces dentinal fluid movement
Decreases nerve stimulation
Examples:
Fluoride → forms calcium fluoride crystals
Oxalates → form calcium oxalate precipitates
Adhesive resins → mechanically seal tubules
B. Nerve Desensitization (Neural Mechanism)
Reduces excitability of pulpal nerves
Potassium ions prevent repolarization of A-delta fibers
Clinical Applications
Cervical abrasion and erosion lesions
Gingival recession with exposed roots
After scaling and root planing
Post-bleaching sensitivity
Before cementation of indirect restorations
Under restorations
After tooth preparation
Examples
Potassium nitrate
Sodium fluoride varnish
Stannous fluoride
Ferric oxalate
Dentin bonding agents
Glass ionomer cement
CPP-ACP
II. Whitening Agents
Purpose
Remove extrinsic and intrinsic stains
Increase light reflectance
Improve esthetic appearance
Components
In-office bleaching
30–35% hydrogen peroxide
Home bleaching
10–22% carbamide peroxide
1.5–6% hydrogen peroxide
Advantages
Improved esthetics
Simple retreatment
Effective for yellow or light brown stains
Safe for gold alloys, amalgam, composites, porcelain
Limitations
Tooth hypersensitivity
Soft tissue irritation
Nausea
TMJ discomfort from trays
III. Antimicrobial Mouthwashes
Purpose
Reduce plaque accumulation
Control gingivitis
Lower oral microbial load
Manage halitosis
Adjunct to mechanical cleaning
Post-surgical infection control
Components
A. Chlorhexidine
Gold standard
Broad-spectrum
High substantivity
Side effects: staining, taste alteration, calculus formation
B. Essential Oils
Thymol
Eucalyptol
Menthol
Methyl salicylateMechanism: disrupt bacterial cell walls
C. Cetylpyridinium Chloride (CPC)
Disrupts bacterial membrane
D. Fluoride
Anti-caries
Enhances remineralization
E. Hydrogen peroxide
Reduces anaerobic bacteria
Clinical Relevance
Reduces gingival inflammation
Supports periodontal therapy
Helpful for orthodontic patients
Beneficial for patients with limited manual dexterity
IV. Pit and Fissure Sealants
Purpose
Create a physical barrier
Prevent caries in occlusal grooves
Mechanism
Acid etching (35–37% phosphoric acid)
Formation of enamel microporosities
Resin penetration
Resin tag formation for micromechanical retention
Types
By composition
Resin-based
Glass ionomer
By polymerization
Self-cured
Light-cured
V. Fluoride-Releasing Sealants
Purpose
Mechanical sealing
Fluoride delivery
Mechanism
Physical barrier formation
Slow fluoride release for remineralization
Examples
Glass ionomer
Resin-modified glass ionomer
VI. Factors Influencing Success and Longevity
Most Critical Factor: Moisture Control
Resin materials are hydrophobic
Contamination reduces adhesion
Leads to microleakage and early failure
Rubber dam isolation is preferred
Enamel Preparation
Acid etching for 15–30 seconds
Chalky white frosted appearance
Cleaning with pumice
Resin tag formation
If contamination occurs, re-etch before placement.
Follow-Up
First evaluation at 6 months
Assess retention, marginal integrity, caries, occlusion, surface wear
If partial loss: clean, re-etch, and reapply material