Effectiveness of laser therapy and topical desensitising agents in treating dentine hypersensitivity: a systematic review.
ABSTRACT 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.
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ABSTRACT: SUMMARY The aim of this study was to evaluate the efficacy of three desensitizing agents to provide relief to dentin hypersensitivity after one session in a four-week follow-up. Forty selected patients participated in a double-blind study following a split-mouth model. One application of the desensitizing agents (A, Admira Protect [Voco]; B, Bifluorid 12 [Voco]; and C, Colgate Pro-Relief in office [Colgate Palmolive]) was performed in three different quadrants for each patient. Each tooth was evaluated by tactile and evaporative stimuli, and the sensitivity response was measured using the Visual Analogue Scale. Evaluations were performed at baseline, immediately after treatment, and after one, two, three, and four weeks. The application of Kruskal-Wallis and Dunn multiple comparisons tests (5%) for both tactile and evaporative stimuli showed that all agents presented a significant desensitizing effect. In groups A and B this relief was maintained for four and three weeks, respectively, as measured by tactile stimulus and for four weeks with evaporative stimulus. The desensitizing effect for group C was maintained for two weeks for both tactile and evaporative stimuli. It is concluded that all desensitizing agents tested were effective in reducing sensitivity compared to baseline values. One application of Admira Protect and Bifluorid 12 presented a longer-lasting desensitizing effect than did Colgate Pro-Relief (applied in the office) on both tactile and evaporative stimuli.Operative Dentistry 04/2014; · 1.31 Impact Factor
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ABSTRACT: Objective. The aim of this study is to evaluate the effectiveness of Nd:YAP laser to seal dentinal tubules at different parameters. Material and Methods. 24 caries-free human wisdom impacted molars were used. The crowns were sectioned transversally in order to totally expose the dentin. The smear layer was removed by a 1 min application of EDTA. Each surface was divided into four quadrants, but only three quadrants were irradiated at a different output power setting (irradiation speed: 1 mm/sec; optical fiber diameter: 320 µm; tangential incidence of beam and in noncontact mode). Samples were smeared with a graphite paste prior to laser irradiation. All specimens were sent for SEM analysis. Pulp temperature increases in additional twenty teeth were measured by a thermocouple. Results. Morphological changes in dentin surfaces depend on the value of used energy density. Higher energy densities (2 W-4 W; 200-400 mJ; pulse duration: 100 m sec.; and 10 Hz) induce higher dentin modifications. Our results confirmed that Nd:YAP laser irradiations can lead to total or partial occlusion of dentin tubules without provoking fissures or cracks. Measurements of pulp temperature increases showed that Nd:YAP laser beam can be considered as harmless for pulp vitality for following irradiation conditions: 2 W (200 mJ) to 4 W (400 mJ) with an irradiation speed of 1 mm/sec; fiber diameter: 320 micrometers; 10 Hz; pulse duration: 100 m sec; noncontact mode and in tangential incidence to exposed dentin. The perpendicular incidence of the laser beam on exposed dentin may injure pulp vitality even at low output power of 3 W. Conclusions. Nd:YAP laser beam was able to seal the dentin tubules without damaging dentinal surfaces and without harming pulp vitality. Nd:YAP laser is effective and may be safely used for future in vivo treatments of dentinal hypersensitivity under certain conditions.TheScientificWorldJournal. 01/2014; 2014:323604.
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ABSTRACT: The aim of this study was to evaluate a new treatment modality for the occlusion of dentinal tubules (DTs) via the combination of 10.6 µm carbon dioxide (CO2) laser and nanoparticle hydroxyapatite paste (n-HAp). Forty-six sound human molars were used in the current experiment. Ten of the molars were used to assess the temperature elevation during lasing. Thirty were evaluated for dentinal permeability test, subdivided into 3 groups: the control group (C), laser only (L-), and laser plus n-HAp (L+). Six samples, two per group, were used for surface and cross section morphology, evaluated through scanning electron microscope (SEM). The temperature measurement results showed that the maximum temperature increase was 3.2°C. Morphologically groups (L-) and (L+) presented narrower DTs, and almost a complete occlusion of the dentinal tubules for group (L+) was found. The Kruskal-Wallis nonparametric test for permeability test data showed statistical differences between the groups (P < 0.05). For intergroup comparison all groups were statistically different from each other, with group (L+) showing significant less dye penetration than the control group. We concluded that CO2 laser in moderate power density combined with n-HAp seems to be a good treatment modality for reducing the permeability of dentin.TheScientificWorldJournal. 01/2014; 2014:798732.