牙齦退縮是DS的一個重要誘發(fā)因素[15]。一般認為,SRP術(shù)后隨著牙齦腫脹的消退,牙根進一步暴露,加重了DS的癥狀。在本研究中,牙齦退縮在3 mm以內(nèi)的DS牙數(shù)占77.4%,4 mm以上僅占6.4%,其結(jié)果未能反映出牙齦退縮與DS之間的相關(guān)性。Vaitkeviciene等[16]認為,當(dāng)牙齒因長期的慢性牙周感染導(dǎo)致附著喪失和牙齦嚴重退縮時,侵入牙本質(zhì)小管內(nèi)的細菌及其分泌物會引起牙髓神經(jīng)末梢發(fā)生明顯的退行性變,牙齒的敏感程度反而可能降低。
年齡和性別也是與DS有關(guān)的生理因素。本研究發(fā)現(xiàn),40~49歲和60歲以上年齡段發(fā)生DS的比例略高于其他年齡段,DS患者中女性的比例顯著高于未發(fā)生DS的女性患者。本研究因樣本量相對較少以及患者來源等因素,因此年齡和性別指標僅從一個側(cè)面反映了牙周治療后DS的分布特征,尚需擴大樣本量以加強研究結(jié)果的說服力。
問卷調(diào)查顯示,牙周治療后DS患者對冷、酸刺激較敏感,熱、甜和刷牙等刺激則無明顯差異。Banfield等[17]發(fā)現(xiàn),橙汁能夠去除牙表面的涂層并導(dǎo)致牙本質(zhì)小管開放,酸性食物特別是碳酸飲料與DS有一定的相關(guān)性。鑒于上述原因,筆者認為SRP術(shù)后,臨床醫(yī)生應(yīng)當(dāng)建議患者適當(dāng)控制酸性食物的攝入量以減輕DS的癥狀。
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