Laser therapy for dentinal hypersensitivity

Effect of photobiomodulation on dentin hypersensitivity: a randomized controlled double-blind clinical trial

OBJECTIVES

To investigate if photobiomodulation (PBM) can reduce dentin hypersensitivity (DH) through a randomized, controlled, double-blind clinical trial.

MATERIALS AND METHODS

One hundred and twelve patients experiencing DH after non-surgical scaling and root planing (SRP) were enrolled and divided into the Experimental Group - SRP + PBM (660 nm, 1.061 J/cm²) and the Control Group - SRP + PBM simulation. The primary outcome was the assessment of DH through tactile and thermal stimulation using the visual analog scale (VAS) after seven days. Additionally, paracetamol was prescribed and quantified as needed. Also, the impact of oral health on participants' quality of life using the Oral Health Impact Profile (OHIP-14) questionnaire was applied. Outcome assessments occurred seven days and one-month post-application.

RESULTS

In both 7 and 30 days, pain values were significantly lower in the experimental group compared to the control group (P = 0.001 and < 0.001, respectively). No differences were observed between the groups regarding analgesic usage. The experimental group also showed a significant improvement in the impact of oral health on participants' quality of life (P < 0.001), with lower OHIP-14 scores at all time points (P = 0.008).

CONCLUSIONS

These results suggest that photobiomodulation significantly reduces pain at 7- and 30-days following scaling and root planing. Additionally, it is associated with improvements in the oral health-related quality of life in patients with dentin hypersensitivity.

CLINICAL TRIAL REGISTRATION

NCT05946265.

Effect of Low- and High-Level Laser Therapy on the Treatment of Dentin Hypersensitivity: An Umbrella Review

Introduction: Dentin hypersensitivity (DH) is a prevalent unpleasant condition which might affect quality of life. Laser therapy is one of the non-invasive treatments for dentin hypersensitivity. The aim of this umbrella review was to assess the effect of lasers on the treatment of dentin hypersensitivity by analyzing the previously published systematic reviews and meta-analyses. Methods: Electronic databases (PubMed, Embase, Scopus, Cochrane, and ISI) were searched to identify relevant systematic reviews and meta-analyses based on the keyword search strategy. Two independent reviewers carried out the selection of studies, extraction of data, and assessment of methodological quality. The actual overlap of primary studies was measured through the visual tool known as the citation matrix and three indices of % overlaps, covered area (CA), and corrected covered area (CCA). The reviews were appraised for methodological quality through A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2, and the risk of bias was evaluated using the Risk of Bias in Systematic Reviews (ROBIS) tool. Results: Following eliminating duplicates, a total of 2,768 articles were found, and of them, 9 systematic reviews met the inclusion criteria. Six of them included a meta-analysis as well. The actual overlap of primary studies was low. The AMSTAR 2 tool classified one systematic review as high quality, three as moderate quality, three as low quality, and the remaining two as critically low quality. The results of the included reviews generally showed that all types of lasers reduced dentin hypersensitivity compared to placebo/no treatment. Conclusion: Lasers are effective in treating dentin hypersensitivity.

Utilizing Laser-Induced Fluorescence to Evaluate the Efficiency of Carbon Dioxide and Diode Lasers in Dentin Sealing after Tooth Preparation: An in-vitro Study

Adhesive dentistry has made it feasible to design restorations with high aesthetic qualities and little invasiveness. However, the freshly cut dentin after the tooth preparation needs to be sealed to prevent its contaminations, bacterial leakage, and hypersensitivity. Consequently, the immediate dentin sealing (IDS) method has been advised. This study examines different dentinal tubule sealing methods via CO2 laser, diode laser (980-nm) and a two-step self-etch adhesive system applied directly to the fresh cut dentin preceding the placement of the provisional phase. The sealing efficiency of each laser and bond system was evaluated based on the laser-induced fluorescence (LIF) properties and image analysis by scanning electron microscopy. Moreover, the obtained LIF spectra were evaluated using partial least square progression. A two-step adhesive containing a high concentration of S-PRG fillers produced a thick layer that was not perfectly uniform at all sites due to uneven filler distribution in the bond with totally and partially closed dentinal tubules. However, the peaks of the LIF spectra dropped after applying laser because of its sealing effectiveness. Accordingly, CO2 and diode lasers have strong evidence in dentinal tubule sealing and a definitive treatment modality for dentinal hypersensitivity. Moreover, IDS with an adhesive system is superior in occluding dentinal tubules in a biomimetic manner based on its filler content and bioactive properties.

A Comparative Study on the Safety and Efficacy of Erbium Laser Therapy Versus Traditional Treatments in Managing Dentin Hypersensitivity: An Observational Study

Background This study aimed to explore the potential efficacy and safety of laser therapy compared with traditional desensitizing treatments in the management of dentin hypersensitivity. Methodology A comprehensive observational study was conducted on 138 adult individuals aged 18-65 diagnosed with dentin hypersensitivity. Participants were allocated to either the laser therapy or traditional treatment group. The laser therapy group received treatment using the Fotona LightWalker® Erbium laser at 2,940 nm. The energy density was set at 20 J/cm² using continuous and contact modes, with the laser tip held perpendicularly to the irradiated site. Each session lasted five minutes, conducted bi-weekly for three months. Traditional treatment included the in-office application of 5% sodium fluoride varnish application once every 15 days for three months and the use of desensitizing toothpaste as part of regular oral hygiene routines. Follow-up assessments were conducted 6 and 12 months post-treatment to evaluate the longevity and stability of the treatment effects. Primary outcomes were assessed by dentin hypersensitivity reduction measured using Visual Analog Scale (VAS) scores and tactile hypersensitivity assessments. Results Laser therapy consistently surpassed traditional treatment in reducing dentin hypersensitivity, as reflected by the significantly lower VAS scores. Notably, at 3, 6, and 12 months, laser therapy demonstrated mean VAS scores of 2.5 (±1.5), 1.2 (±0.9), and 0.6 (±0.5), respectively, while the traditional treatment group exhibited higher scores (3.8 ± 1.2, 4.5 ± 1.0, and 4.0 ± 0.7, respectively). Statistical analysis revealed that these differences were highly significant (p < 0.001). Tactile hypersensitivity assessments echoed these findings, with laser therapy consistently maintaining lower scores (0.8 ± 0.7 at 6 months, 0.4 ± 0.3 at 12 months) compared to traditional treatment (3.5 ± 1.0 at 6 months, 4.0 ± 0.7 at 12 months) with statistical significance at all time points (p < 0.001). Conclusions Although this study lacks a randomized controlled design, the observed substantial reduction in VAS scores and tactile hypersensitivity assessments, along with the favorable safety profile of laser therapy, suggest its potential as an effective alternative for managing dentin hypersensitivity.

Mild heat stress promotes the differentiation of odontoblast-like MDPC-23 cells via yes-associated protein

PURPOSE

Dentin hypersensitivity (DH) is a prevalent condition, but long-term effective treatments are scarce. Differentiation of odontoblast-like cells is promising for inducing tertiary dentinogenesis and ensuring sustained therapeutic efficacy against DH. This study examined the effects and mechanism of action of mild heat stress (MHS) on the differentiation of odontoblast-like MDPC-23 cells.

METHODS

We used a heating device to accurately control the temperature and duration, mimicking the thermal microenvironment of odontoblast-like cells. Using this device, the effects of MHS on cell viability and differentiation were examined. Cell viability was assessed using the MTT assay. The expression and nucleoplasmic ratio of the yes-associated protein (YAP) were examined by western blotting and immunofluorescence. The gene expression levels of heat shock proteins (HSPs) and dentin matrix protein-1 (DMP1) were measured using qPCR. Dentin sialophosphoprotein (DSPP) expression was evaluated using immunofluorescence and immunoblotting. Verteporfin was used to inhibit YAP activity.

RESULTS

Mild heat stress (MHS) enhanced the odontoblast differentiation of MDPC-23 cells while maintaining cell viability. MHS also increased YAP activity, as well as the levels of HSP25 mRNA, HSP70 mRNA, HSP90α mRNA, DMP1 mRNA, and DSPP protein. However, after YAP inhibition, both cell viability and the levels of HSP90α mRNA, DMP1 mRNA, and DSPP protein were reduced.

CONCLUSION

YAP plays a crucial role in maintaining cell viability and promoting odontoblast differentiation of MDPC-23 cells under MHS. Consequently, MHS is a potential therapeutic strategy for DH, and boosting YAP activity could be beneficial for maintaining cell viability and promoting odontoblast differentiation.

Evaluation of dentinal tubule occlusion and pulp tissue response after using 980-nm diode laser for dentin hypersensitivity treatment

OBJECTIVES

To evaluate the effectiveness of the 980-nm diode laser for dentinal tubule occlusion, measure the intrapulpal temperature, and investigate the dental pulp response.

MATERIALS AND METHODS

The dentinal samples were randomly divided into G1-G7 groups: control; 980-nm laser irradiation (0.5 W, 10 s; 0.5 W, 10 s × 2; 0.8 W, 10 s; 0.8 W, 10 s × 2; 1.0 W, 10 s; 1.0 W, 10 s × 2). The dentin discs were applied for laser irradiation and analyzed by scanning electron microscopy (SEM). The intrapulpal temperature was measured on the 1.0-mm and 2.0-mm thickness samples, and then divided into G2-G7 groups according to laser irradiation. Moreover, forty Sprague Dawley rats were randomly divided into the laser-irradiated group (euthanized at 1, 7, and 14 days after irradiation) and the control group (non-irradiated). qRT-PCR, histomorphology, and immunohistochemistry analysis were employed to evaluate the response of dental pulp.

RESULTS

SEM indicated the occluding ratio of dentinal tubules in the G5 (0.8 W, 10 s × 2) and G7 (1.0 W, 10 s × 2) were significantly higher than the other groups (p < 0.05). The maximum intrapulpal temperature rises in the G5 were lower than the standard line (5.5 ℃). qRT-PCR showed that the mRNA expression level of TNF-α and HSP-70 upregulated significantly at 1 day (p < 0.05). Histomorphology and immunohistochemistry analysis showed that, compared with the control group, the inflammatory reaction was slightly higher at the 1 and 7 days (p < 0.05) and decreased to the normal levels at 14 days (p > 0.05).

CONCLUSIONS

A 980-nm laser at a power of 0.8 W with 10 s × 2 defines the best treatment for dentin hypersensitivity in terms of compromise between the efficacy of the treatment and the safety of the pulp.

CLINICAL RELEVANCE

The 980-nm laser is an effective option for treating dentin sensitivity. However, we need to ensure the safety of the pulp during laser irradiation.

Efficacy of 810 nm and 650 nm Diode Laser Alone and in Combination With Sodium Fluoride Gel in Treating Dentin Hypersensitivity: A Split-Mouth Randomized Clinical Study

Introduction Dentin hypersensitivity has been defined as a short, sharp pain caused by exposing naked dentin to external stimuli such as evaporation, heat, cold, osmotic liquids, and tactile effects. None of the available treatments has been considered the gold standard in treating dentin hypersensitivity. The use of laser has recently become more popular, and it is a promising treatment method in this field. The study aimed to compare the effectiveness of both 810 nm and 650 nm diode lasers in treating dentin hypersensitivity. Materials and methods This study was conducted on six patients who were referred to the Department of Oral Medicine, Faculty of Dental Medicine, Damascus University (4 females and 2 males) with 108 teeth suffering from generalized dentin hypersensitivity and were randomly divided into two groups. Group 1 consisted of three patients with 50 teeth treated with an 810 nm diode laser; it was divided by the split-mouth design into two subgroups. The first subgroup was treated by the application of the laser alone toward the target area with 1-watt power, continuous mode, and a total application time of 90 seconds, and the second subgroup was treated by applying sodium fluoride gel for one minute, then the laser was applied with the same settings as the first subgroup. Group 2 consisted of three patients with 58 teeth treated with a 650 nm diode laser; it was divided by the split-mouth design into two subgroups. The first subgroup was treated by the application of the laser alone toward the target area with 200 m watt power, continuous mode, and a total application time of 120 seconds, and the second subgroup was treated by applying sodium fluoride gel for one minute and then applying the laser with the same settings as the first subgroup. The pain was evaluated using a numeric rating scale (NRS) of 100 degrees before and immediately after treatment, and then after three to six and nine months by applying an air stream from a dental chair syringe at a distance of 0.5 cm from the target area. Results This study showed that both types of lasers were effective in treating pain caused by dentinal hypersensitivity. The average values ​​of pain reduction on the NRS showed the superiority of the 810 nm diode laser over the 650 nm after treatment and at all time points of pain assessment. No statistically significant differences were detected between applying laser alone and applying it combined with sodium fluoride gel in pain reduction values. Conclusions The application of an 810 nm diode laser either alone or in combination with sodium fluoride gel in treating dentin hypersensitivity is effective and better than the application of a 650 nm diode laser either alone or in combination with sodium fluoride gel. In addition, applying a 650 nm diode laser either alone or in combination with sodium fluoride gel has slight effectiveness in treating dentine hypersensitivity, and it is believed that a single treatment session with a 650 nm diode laser was not enough to obtain the required pain reduction.

Efficacy of GLUMA for the Treatment of Dentin Hypersensitivity Compared to Lasers: A Systematic Review

OBJECTIVE

Dentin hypersensitivity (DH) is characterized by a short, sharp pain in response to a thermal or tactile stimulus. The application of desensitizing agents such as GLUMA and laser is a non-invasive and safe approach to decrease sensitivity. The evidence for the efficacy of GLUMA desensitizer compared to laser desensitization in patients with DH was evaluated for 6 months.

DESIGN

In March 2022, an electronic search of PubMed, Scopus, and Web of Science databases was conducted. Articles published in English that compared GLUMA and laser in the treatment of DH with a follow-up of 6 months or more were included. Randomized, non-randomized controlled trials, and clinical trials were included. Risk of bias assessment tools developed by the Cochrane collaboration ROB 2 and ROBINS-I were used to assess the quality of studies. The GRADE assessment method was used to assess the certainty of evidence.

RESULTS

About 36 studies were identified in the search results. After applying the predefined eligibility criteria, eight studies with 205 participants and 894 sites were included in this review. Of the eight studies, four were judged to be at high risk of bias, three had some concerns, and one had a serious risk of bias. The certainty of the evidence was graded as low.

CONCLUSION

Based on limited evidence, GLUMA and laser appear to be equally effective in providing relief from DH. GLUMA showed an immediate effect and provided pain relief. Over the course of a week, laser showed long-term stable results. GLUMA is effective in providing immediate relief.

Effectiveness of surgical root coverage on dentin hypersensitivity: A systematic review and meta-analysis

AIM

To assess the effect of surgical root coverage (RC) on dentin hypersensitivity (DH) associated with gingival recession.

MATERIALS AND METHODS

Two independent reviewers conducted electronic literature searches in MEDLINE (PubMed), EMBASE, Cochrane Library, Web Of Science, Dentistry & Oral Sciences Source, ScienceDirect, and ClinicalTrials.gov databases as well as a manual search to identify eligible clinical studies from January 2000 to March 2022. Randomized controlled trials (RCTs) comparing two surgical RC techniques or a surgical RC technique with or without adjuvant were included. Meta-analyses were performed on data provided by RCTs.

RESULTS

Thirteen RCTs with a total of 701 patients (1086 recessions) were included. The percentage of DH suppression was 70.8% (95% confidence interval [CI] [64.4-76.6]; I²  = 39.2% [3.5-61.8], Q-test = 0.02) after surgical RC. Recession reduction and percentage of RC were both statistically significantly associated with DH suppression (estimate = 0.66 [0.10-1.23], p = .022, R²  = 14.45% and estimate = 0.04 [0.01-0.08], p = .012, R²  = 29.54%, respectively). Coronally advanced flap (CAF) + connective tissue graft showed results statistically more effective than CAF + xenogeneic collagen matrix in DH suppression (73.3% [65.6-79.8] and 61.4% [51.7-70.3], respectively; p = .048).

CONCLUSIONS

Success of surgical RC is associated with DH suppression.