The aim of this systematic review was to compare the effectiveness of laser therapy with that of topical desensitising agents in treating dentine hypersensitivity. A secondary objective was to determine the safety of laser application according to the relevant studies. A systematic search was performed in the MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the National Research Register, the Cochrane Oral Health Group's Trials Register database to retrieve all articles that were about randomised controlled trials involving the application of laser desensitising procedures and topical desensitising agents in the treatment of dentine hypersensitivity. A total of eight trials that met all inclusion criteria involving 234 participants were reviewed. Based upon the 'quality' of evidence, one study was classified as A level, five as B level and two as C level. Owing to the heterogeneity of the studies, a meta-analysis was not performed. Half of the included studies compared GaALAS laser with topical desensitising agents, but the findings were conflicting. The remaining studies involved Nd:YAG laser, Er:YAG laser and CO2 laser, and all showed that the three types of lasers were superior to topical desensitising agents, but the superiority was slight. A systematic review of the literature indicates the likelihood that laser therapy has a slight clinical advantage over topical medicaments in the treatment of dentine hypersensitivity. More large sample-sized, long-term, high-quality randomised controlled clinical trials are needed before definitive conclusions were made.
"In a systematic review of the articles, published through the years 2000-2010, on the effects of laser therapy on treating DH, it has generally been claimed that laser therapy for the treatment of DH is preferred to other relevant local therapies . However, further clinical long-term studies in many different samples and better qualities need to be done to prove this claim . In addition, this type of therapy is highly acceptable to patients because its proper usage has no negative impacts. "
[Show abstract][Hide abstract] ABSTRACT: The objective of this review is to inform practitioners about dentin hypersensitivity (DH); to provide a brief overview of the diagnosis, etiology and clinical management of dentin hypersensitivity and to discuss technical approaches to relieve sensitivity. This clinical information is described in the context of the underlying biology.
The author used PUBMED to find relevant English-language literature published in the period 1999 to 2010. The author used combinations of the search terms “dentin*”, “tooth”, “teeth”, “hypersensit*”, “desensitiz*”. Abstracts and also full text articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action were used.
"To identify relevant studies, we used the following term " (dentin* OR tooth OR teeth) AND (hypersensit* OR desensiti* OR desensitize*) NOT (toothpaste OR dentifrice) " , limited to " clinical trials " and " humans " ; no language restrictions were imposed. The reference lists of previously published reviews (Canadian Advisory Board on Dentin Hypersensitivity 2003, Orchardson & Gillam 2006, West 2008, Al-Sabbagh et al. 2009, Porto et al. 2009, Cunha-Cruz et al. 2011, He et al. 2011, Sgolastra et al. 2011) were crosschecked. The literature search and data extractions (Fig. 1) were undertaken in duplicate , and quality assessment of included studies, such as randomization , allocation concealment, blinding , intention to treat and sample size calculation, was carried out independently by three authors (PY Lin, YW Cheng, CY Chu). "
[Show abstract][Hide abstract] ABSTRACT: Aim:
Dentin hypersensitivity, caused by the exposure and patency of dentinal tubules, can affect patients' quality of life. The aim of this study was to undertake a systematic review and a network meta-analysis, comparing the effectiveness in resolving dentin hypersensitivity among different in-office desensitizing treatments.
Materials and methods:
A literature search was performed with electronic databases and by hand until December 2011. The included trials were divided into six treatment groups as placebo, physical occlusion, chemical occlusion, nerve desensitization, laser therapy and combined treatments. The treatment effects between groups were estimated with standardized mean differences by using a Bayesian network meta-analysis.
Forty studies were included. The standardized mean difference between placebo and physical occlusion was -2.57 [95% credible interval (CI): -4.24 to -0.94]; placebo versus chemical occlusion was -2.33 (95% CI: -3.65 to -1.04); placebo versus nerve desensitization was -1.72 (95% CI: -4.00 to 0.52); placebo versus laser therapy was -2.81 (95% CI: -4.41 to -1.24); placebo versus combined treatment was -3.47 (95% CI: -5.99 to -0.96). The comparisons of the five active treatments showed no significant differences.
The results from network meta-analysis showed that most active treatment options had significantly better treatment outcome than placebo.
[Show abstract][Hide abstract] ABSTRACT: Medline, Embase, the Cochrane Central database as well as the Cochrane Oral Health Group's Trials Register and the National Research Register. In addition relevant journals were hand searched from 2000 to 2010 (Lasers in Medical Sciences, Lasers in Surgery and Medicine, Photomedicine and Laser Surgery, Photodiagnosis and Photodynamic Therapy, Journal of Oral Rehabilitation, Journal of Periodontology, Journal of Clinical Periodontology, Journal of Endodontics, Clinical Oral Investigations, Journal of Dental Research, Journal of Oral Laser Applications, Journal of Periodontal Research and Periodontology 2000) together with the reference lists of relevant trials.
Randomised controlled trials (RCT) that included patients with two or more hypersensitive teeth confirmed by evaporative stimulus or tactile hypersensitivity assessment, comparing laser therapy versus other topical desensitising agents, such as fluoride varnish, dentine bonding agents etc, that were published in English.
Studies were assessed for quality by two reviewers independently and data were extracted using a standardised form. Because of heterogeneity of the studies meta-analysis was not performed, so a qualitative synthesis is presented.
Eight trials (234 participants) met the inclusion criteria. Half of the included studies compared GaALAS laser with topical desensitising agents, but the findings were conflicting. The remaining studies involved Nd:YAG laser, Er:YAG laser and CO2 laser, and all showed that the three types of lasers were superior to topical desensitising agents, but the superiority was slight.
The review suggests that laser therapy has a slight clinical advantage over topical medicaments in the treatment of dentine hypersensitivity. However more large sample-sized, long-term, high-quality randomised controlled clinical trials are needed before definitive conclusions can be made.
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