Multivariate Analysis Of Dentin Hypersensitivity In Patients With Periodontitis After Non-surgical Treatment

Objective: There are a series of complications in periodontal non-surgical treatment,among which dentin hypersensitivity(DH)is one of the common complications of patients after the treatment,and it is also the main reason for patients to refuse periodontal treatment.Therefore,it is necessary to analyze the influencing factors of dentin sensitivity after non-surgical treatment and make timely intervention.In this study,dentin sensitivity in different periods was divided into two groups by prospective study,and Logistic regression was used to analyze the factors affecting dentin sensitivity in different periods after periodontal non-surgical treatment,and the influencing factors of DH disappearance one month later,and provide a theoretical basis for clinical work to judge the possibility of DH in different periods after non-surgical treatment.Thus targeted intervention can be carried out to reduce patients' fear,improve patients' compliance,and be beneficial to the treatment of patients.Methods:A total of 68 patients including 40 males and 28 females,with an average of(45.46±10.6)years old,were collected from periodontics department affiliated School of Stomatology of China Medical University from June 2018 to March 2019.There were 1112 teeth with Schiff score of 0 at baseline.The general conditions of patients were recorded,including age,gender,smoking history,use of desensitized toothpaste,periodontal clinical indicators,including probing depth(PD),gingival recession(GR),gingival recession max(GRmax),clinical attachment loss(CAL),sulcus bleeding index(SBI),plaque index(PLI)and dentin hypersensitivity was assessed at the first visit,PLI,GRmax,GR and clinical indicators were recorded again at one week and one month,respectively after the treatment.According to the dentin sensitivity symptom at one week and one month after the non-surgical therapy,the involved teeth were divided into the sensitive group-1W(Schiff score ?1),non-sensitive group-1W(Schiff score =0)and sensitive group-1M(Schiff score ?1),non-sensitive group-1M(Schiff score =0).Taking the individual as the unit,according to whether there are still sensitive teeth after one month,patients who had no sensitive teeth at baseline and had sensitive teeth one week after the treatment were divided into sensitive individual group and non-sensitive individual group.Saliva of 6 patients in each group was collected and then analyzed by Surface-enhanced Raman spectroscopy(SERS).SPSS 20.0 statistical software were used for statistical data analysis.The mean PD,GR,GRmax,CAL and age of two groups at baseline,one week and one month after the treatment were compared with Mann-Whitney U test.Chi-square test was used to compare the differences of gender,smoking history,tooth position,SBI,PLI of baseline,one week and one month,respectively after the non-surgical therapy and intervention.Logistic regression analysis was used to analyze the influencing factors.T-test was used to compare the spectral intensity of the characteristic peaks of sensitive individual group and non-sensitive individual group.All statistical comparisons were two-sided with a level of significance of ? = 0.05.(P<0.05).Results: 1.Univariate analysis showed that one week after the non-surgical therapy,age,gender,tooth position,smoking history,PLI,GR and GRmax at baseline,PLI,GR and GRmax of one week after the treatment and intervention were significantly different between the sensitive group-1W and the non-sensitive group-1W(P<0.05);At one month,CAL,GR,GRmax and PLI were significantly different between the sensitive group-1M and the non-sensitive group-1M(P<0.05).2.Logistic regression analysis demonstrated that the influencing factors of DH at one week following the treatment included age,tooth position,gender,intervention,GR in one week after the treatment(P<0.05).Intervention had major influence on dentin hypersensitivity one week after treatment,while the effect of age was the least.The older the age,the more gingival recession,the incisor teeth of women without intervention were prone to have dentin hypersensitivity.The influencing factors of DH at one month were gender,PLI and GRmax at one month following the non-surgical therapy(P<0.05).One month GRmax had major influence on DH at one month after the treatment,while PLI had the least influence on DH.The more gingival retraction and poor plaque control,the sensitive symptoms of women were less likely to disappear in one month after the treatment.3.One month after non-surgical treatment,there was a difference in the characteristic peak intensity of Surface-enhanced Raman spectroscopy between the sensitive individual group and the non-sensitive individual group.The concentration of glycogen,lactose,L-tyrosine,adenine,coenzyme,L-serine,adenine,phenylalanine,L-tryptophan,valine and nucleic acid in saliva of the sensitive individual group was higher than that of the non-sensitive individual group,while the concentration of phenyl and glutamate was lower than that of the non-sensitive individual group.Conclusion:Age,tooth position,sex,intervention,GR at one week after the subgingival scaling affected dentine sensitivity at one week after the non-surgical treatment.The older the age,the more gingival recession,and the incisor teeth of women without intervention were prone to have dentin hypersensitivity.Gender,one-month PLI and one-month GRmax were the influencing factors of the existence of dentin sensitivity at one month after the treatment.The more gingival recession and poor plaque control,the sensitive symptoms of women were less likely to disappear in one month after the treatment.And,the concentration of salivary biochemical components in the sensitive individual group and the non-sensitive individual group were different,among which glutamate was closely related to dentin hypersensitivity.