Comparative evaluation of the effects of Nd:YAG laser and a desensitizer agent on the treatment of dentin hypersensitivity: a clinical study.

UNLABELLED Abstract Objective: The aim of this randomized longitudinal clinical study was to assess different treatment protocols for dentin hypersensitivity with high-power laser, desensitizing agent, and its association between high-power laser and desensitizing agent, for a period of 6 months. BACKGROUND DATA The literature shows a lack of treatment for dentin hypersensitivity, and lasers are contemporary alternatives. METHODS After inclusion and exclusion analysis, volunteers were selected. The lesions were divided into three groups (n=10): G1, Gluma Desensitizer (Heraeus Kulzer); G2, Nd:YAG Laser (Power Laser(™) ST6, Lares Research®) contact mode, laser protocol of 1.5 W, 10 Hz, and 100 mJ,≈85 J/cm(2), four irradiations performed, each for 15 sec, in mesiodistal and occluso-apical directions, totaling 60 sec of irradiation with intervals of 10 sec between them; G3, Nd:YAG Laser+Gluma Desensitizer. The level of sensitivity to pain of each volunteer was analyzed by visual analog scale (VAS) using cold air stimuli and exploratory probe 5 min, 1 week, and 1, 3, and 6 months after treatment. Data were collected and subjected to statistical analysis that detected statistically significant differences between the various studied time intervals of treatments (p>0.05). RESULTS For the air stimulus, no significant differences were found for each time interval. For the long-term evaluation, all groups showed statistical differences (p>0.05), indicating that for G2 and G3, this difference was statistically significant from the first time of evaluation (post 1), whereas in G1, the difference was significant from the post 2 evaluation (1 week). Comparison among groups using the probe stimulation showed significant differences in pain (p<0.001). Only in G1 and G3 did this difference become significant from post 01. CONCLUSIONS All protocols were effective in reducing dentinal hypersensitivity after 6 months of treatment; however, the association of Nd:YAG and Gluma Desensitizer is an effective treatment strategy that has immediate and long-lasting effects.

[1]  A. Moritz,et al.  In vitro evaluation of dentin tubule occlusion by Denshield and Neodymium-doped yttrium-aluminum-garnet laser irradiation. , 2012, Journal of endodontics.

[2]  C. Eduardo,et al.  In vitro effects of Er,Cr:YSGG laser on dentine hypersensitivity. Dentine permeability and scanning electron microscopy analysis , 2012, Lasers in Medical Science.

[3]  Carlos Paula Eduardo,et al.  Effects of Er:YAG and Er,Cr:YSGG lasers on dentine hypersensitivity. Short-term clinical evaluation , 2012, Lasers in Medical Science.

[4]  T. Gunjikar,et al.  Dentine Hypersensitivity: Preventive and Therapeutic Approaches to Treatment , 2011 .

[5]  Sevcan Kurtulmus-Yilmaz,et al.  Effectiveness of Er,Cr:YSGG laser on dentine hypersensitivity: a controlled clinical trial. , 2011, Journal of clinical periodontology.

[6]  R. Fekrazad,et al.  An evaluation of the occluding effects of Er;Cr:YSGG, Nd:YAG, CO₂ and diode lasers on dentinal tubules: a scanning electron microscope in vitro study. , 2011, Photomedicine and laser surgery.

[7]  Alparslan Dilsiz,et al.  Effects of the combined desensitizing dentifrice and diode laser therapy in the treatment of desensitization of teeth with gingival recession. , 2010, Photomedicine and laser surgery.

[8]  R. Obradović,et al.  The effects of low level laser irradiation on gingival inflammation. , 2010, Photomedicine and laser surgery.

[9]  L. Pimenta,et al.  Clinical evaluation of desensitizing treatments for cervical dentin hypersensitivity. , 2009, Brazilian oral research.

[10]  R. Orbak,et al.  Comparative evaluation of Nd:YAG laser and fluoride varnish for the treatment of dentinal hypersensitivity. , 2009, Journal of endodontics.

[11]  S. Baldochi,et al.  Evaluation of carbon dioxide laser irradiation associated with calcium hydroxide in the treatment of dentinal hypersensitivity. A preliminary study , 2009, Lasers in Medical Science.

[12]  D. Pashley,et al.  Discovering new treatments for sensitive teeth: the long path from biology to therapy. , 2008, Journal of oral rehabilitation.

[13]  J. Peřina,et al.  Suitable conditions for sealing of open dentinal tubules using a pulsed Nd:YAG laser. , 2007, Photomedicine and laser surgery.

[14]  N. Gutknecht,et al.  Comparative evaluation of the effects of Nd:YAG and Er:YAG laser in dentin hypersensitivity treatment , 2007, Lasers in Medical Science.

[15]  V. Arana-Chavez,et al.  Micromorphological analysis of dentinal structure after irradiation with Nd:YAG laser and immersion in acidic beverages. , 2006, Photomedicine and laser surgery.

[16]  R. Orchardson,et al.  Managing dentin hypersensitivity. , 2006, Journal of the American Dental Association.

[17]  D. Bartlett,et al.  A Critical Review of Non-carious Cervical (Wear) Lesions and the Role of Abfraction, Erosion, and Abrasion , 2006, Journal of dental research.

[18]  P. Preshaw,et al.  Comparison of two topical treatments for dentine sensitivity. , 2006, The European journal of prosthodontics and restorative dentistry.

[19]  N. Gutknecht,et al.  Effects of Er:YAG and Nd:YAG lasers on dentin permeability in root surfaces: a preliminary in vitro study. , 2005, Photomedicine and laser surgery.

[20]  D. Bartlett The role of erosion in tooth wear: aetiology, prevention and management. , 2005, International dental journal.

[21]  C. Eduardo,et al.  Treatment of cervical dentin hypersensitivity using neodymium: Yttrium–aluminum–garnet laser. Clinical evaluation , 2003, Lasers in surgery and medicine.

[22]  J. Egea,et al.  Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. , 2003, Journal.

[23]  W. Finger,et al.  Clinical evaluation of the role of glutardialdehyde in a one-bottle adhesive. , 2002, American journal of dentistry.

[24]  P. Gjermo,et al.  Treatment of dentin hypersensitivity by Nd:YAG laser. , 2002, Journal of clinical periodontology.

[25]  E. Reich,et al.  Desensitizing effects of an Er:YAG laser on hypersensitive dentine. , 2002, Journal of clinical periodontology.

[26]  M. Ide,et al.  The reproducibility of methods of assessment for cervical dentine hypersensitivity. , 2001, Journal of clinical periodontology.

[27]  K. Matsumoto,et al.  Treatment of dentine hypersensitivity by lasers: a review. , 2000, Journal of clinical periodontology.

[28]  G. Dondi dall'Orologio,et al.  Dentin desensitizing effects of Gluma Alternate, Health-Dent Desensitizer and Scotchbond Multi-Purpose. , 1999, American journal of dentistry.

[29]  A. Moritz,et al.  Long-term effects of CO2 laser irradiation on treatment of hypersensitive dental necks: results of an in Vivo study. , 1998, Journal of clinical laser medicine & surgery.

[30]  C. P. Lin,et al.  Sealing depth of Nd:YAG laser on human dentinal tubules. , 1997, Journal of endodontics.

[31]  G. R. Holland,et al.  Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. , 1997, Journal of clinical periodontology.

[32]  P. Schupbach,et al.  Closing of dentinal tubules by Gluma desensitizer. , 1997, European journal of oral sciences.

[33]  P. Schüpbach,et al.  Dentin bonding: effect of tubule orientation on hybrid-layer formation. , 1997, European journal of oral sciences.

[34]  A. Moritz,et al.  Treatment of hypersensitive teeth using neodymium:yttrium-aluminum-garnet lasers: a comparison of the use of various settings in an in vivo study. , 1997, Journal of clinical laser medicine & surgery.

[35]  S. Ebisu,et al.  Morphological characterization of tube-like structures in hypersensitive human radicular dentine. , 1996, Journal of dentistry.

[36]  L. Rimondini,et al.  Ultrastructure of hypersensitive and non-sensitive dentine. A study on replica models. , 1995, Journal of clinical periodontology.

[37]  W. Lan,et al.  SEALING OF HUMAN DENTINAL TUBULES BY ND:YAG LASER , 1995 .

[38]  S. Gelskey,et al.  The effectiveness of the Nd:YAG laser in the treatment of dental hypersensitivity. , 1993, Journal.

[39]  T D Myers,et al.  The pulsed Nd:YAG dental laser: review of clinical applications. , 1991, Journal of the California Dental Association.

[40]  R. Harris,et al.  Dentine hypersensitivity. , 1976, Australian dental journal.

[41]  M. Brännström,et al.  The hydrodynamics of the dentine; its possible relationship to dentinal pain. , 1972, International dental journal.

[42]  M. Brännström,et al.  Sensitivity of dentine. , 1966, Oral surgery, oral medicine, and oral pathology.

[43]  L. Grossman A Systematic Method for the Treatment of Hypersensitive Dentin , 1935 .