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Chemotherapeutic Agents and Preventive Material, Medinna Rasha -…
Chemotherapeutic Agents and Preventive Material
Chemotherapeutic Agents
What are Desensitizing Agents?
Materials used to reduce dentin hypersensitivity
Protect exposed dentinal tubules
Prevent pain from thermal, tactile, osmotic stimuli
Mechanisms of Action
A. Tubule Occlusion (Physical)
Seal dentinal tubules
Reduce dentinal fluid movement
Prevent pulpal nerve stimulation
Examples:
Fluoride varnish
Oxalates
Calcium phosphate
Dentin bonding agents
B. Regeneration of Dentin
Stimulate mineral deposition
Repair exposed dentin
Examples:
Oligopeptides
CPP–ACP
C. Nerve Desensitization (Neural)
Reduce nerve excitability
Potassium depolarizes nerve endings
Example:
Potassium nitrate
Clinical Applications
Gingival recession
After scaling & root planing
After bleaching
Cervical abrasion/erosion/attrition
Post-periodontal surgery
Whitening Agents in Cosmetic Dentistry
Purpose
Remove stains & pellicle
Improve aesthetics
Increase light reflectance
Polish tooth surface
Components
In-office:
30–35% hydrogen peroxide
Silica-based gel
May contain calcium, phosphate, fluoride
Home whitening:
10–22% carbamide peroxide
1.5–6% hydrogen peroxide
Advantages
Improved esthetics
Long-lasting (≈1 year)
Easy retreatment
Effective for yellow/light brown stains
Safe for gold, amalgam, porcelain
Limitations
Tooth hypersensitivity
Smear layer removal
Soft tissue irritation
Nausea
TMJ discomfort
Sore throat
Antimicrobial Agents in Mouthwashes
➤ Purpose
Reduce microbial load
Inhibit plaque formation
Prevent/control gingivitis
Support periodontal therapy
Reduce halitosis
Adjunct to brushing & flossing
Components
Chlorhexidine (gold standard)
Essential oils
Cetylpyridinium chloride (CPC)
Fluoride
Alcohol/non-alcohol base
Flavoring & surfactants
Clinical Relevance
Reduce plaque & gingivitis
Useful in periodontal & implant care
Pre-procedural rinse
Limitation: staining, taste alteration
Less effective in deep pockets
Short-term use recommended
Preventive Material
Pit and Fissure Sealants
Purpose
Prevent occlusal caries
Seal deep pits & fissures
Indicated for:
Newly erupted molars
High caries risk patients
Mechanism
Acid etching → microporosities
Resin flows into fissures
Polymerization → resin tags
Mechanical micromechanical retention
Types
Based on Material
Resin-based (high retention, technique sensitive)
Glass ionomer (fluoride release, moisture tolerant)
Based on Fluoride
Fluoride-releasing
Non-fluoride
Based on Filler
Unfilled (better flow)
Filled (more wear resistant)
Fluoride-Releasing Sealants
Purpose
Dual protection (seal + fluoride)
Strengthen enamel
Prevent caries progression
Ideal for high-risk patients
Mechanism
Physical barrier
Fluoride release
Remineralization (fluorapatite formation)
Inhibit demineralization
Antibacterial effect
Fluoride recharge (GI-based)
Clinical Relevance
Reduce occlusal caries in children
Long-term fluoride delivery
Cost-effective public health strategy
Requires monitoring retention
Factors Influencing Success & Longevity
Most Critical Factor
Moisture control (isolation)
Prevent salivary contamination
Ensure resin penetration
Maintain bond strength
Enamel Preparation
Clean occlusal surface
Phosphoric acid etching
Proper rinsing & drying
Chalky white enamel appearance
Strict isolation
Follow-Up
Regular recall visits
Check
Retention
Marginal integrity
Caries presence
Reapply if partially/fully lost
Part of comprehensive preventive program
Medinna Rasha - 2506557816