Clinical evaluation of Er,Cr:YSGG and GaAlAs laser therapy for treating dentine hypersensitivity: A randomized controlled clinical trial

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.

The effect of laser therapy for the treatment of dentin hypersensitivity on surface roughness and bacterial adhesion

The aim of the study was to measure the degree of dentine surface roughness caused by five distinct lasers used to treat dentine hypersensitivity, as well as to evaluate the subsequent bacterial colonization on these irradiated surfaces. Sixty human maxillary premolar teeth without caries or restoration which were extracted for periodontal reasons were used in this study. Five different types of lasers were applied to the root dentin surface. Tested samples were divided into six groups of 10 samples each; control, diode (810 nm), diode (980 nm), Nd: YAG, Er: YAG, and Er, Cr: YSGG laser groups. The arithmetic mean of the surface roughness values (Ra) and the average roughness over a measurement area (Sa) were measured pre- and post-application using any of the laser types. Swab samples were then collected from the dentin surface. Following a 24-hour incubation period at 37 °C, the colony forming units were counted using a stereoscope. The results demonstrated a statistically significant difference in the surface roughness values pre- and post-application (Ra and Sa, respectively) in the Er, Cr: YSGG laser group (p = 0.037,p = 0.007). No significant difference was observed in the other groups (p > 0.05). There was no statistically significant difference in the number of bacterial colonies observed between the test and control groups. Diode and Nd: YAG lasers showed either a decrease or no change in surface roughness; however, the hard tissue lasers (Er: YAG, Er, Cr: YSGG) showed an increase. The Er: YAG and Nd: YAG laser groups exhibited decreased bacterial adhesion compared to the other groups.

Ozone and Laser Effects on Dentin Hypersensitivity Treatment: A Randomized Clinical Study

INTRODUCTION

The aim of this study was to evaluate and compare the clinical efficacy of diode laser and ozone gas in the treatment of dentin hypersensitivity (DHS).

METHODS

One hundred thirty-two teeth from 44 patients with moderate DHS were randomized into 3 groups according to a split-mouth design. In the diode laser group, the operator irradiated the superficial dentin exposed with an 808-nm wavelength and incremental power from 0.2 to 0.6 W with a 20-second interval. In the ozone gas group, the operator applied a high dose of ozone (32 g/m3) for 30 seconds using a silicon cup. In the placebo group, no therapy was applied. The dentin sensitivity level was evaluated upon enrollment (T0), immediately after treatment (T1), 3 months post-treatment (T2), and 6 months post-treatment (T3) with a cold air blast challenge and tactile stimuli. The pain severity was quantified according to the visual analogue scale. The Wilcoxon signed rank test was used to scrutinize potential statistical disparities among the treatments. Statistical significance was predetermined at P < .05.

RESULTS

A significant decrease of DHS was observed in the ozone gas group and the `diode laser group immediately after treatment and after 3 and 6 months of the therapy. After 6 months from the therapy, the sensitivity values in the teeth treated with ozone gas remained statistically lower than those treated with diode lasers (P < .05).

CONCLUSIONS

A laser diode and ozone gas are both efficient as dentin sensitivity treatment. Ozone maintains an invariable effectiveness after 6 months.

Photo biomodulation of dental derived stem cells to ameliorate regenerative capacity: In vitro study

Background

Dental regeneration benefits from improving the features of dental derived stem cells. Gallium-aluminum-arsenide laser had a significant role in modification of cell behavior in different cell lines and culture conditions. Hence, exploring its mechanism and effect on dental derived stem cells would benefit prospective regenerative dental therapies.

Objectives

To assess the impact of photo biomodulation by Low-Level-Laser on isolated Dental Pulp derived Stem Cells and Periodontal Ligament derived Stem Cells regarding their proliferation and osteogenic differentiation.

Methods

Isolated DPSCs and PDLSCs from impacted third molars were subjected to Gallium-aluminum-arsenide laser for 12 sec and 3.6 J/cm2. The proliferative capacity was evaluated via 3-(4,5-dimethylthiazol-2-yl),2,5-diphenyltetrazolium bromide (MTT) Assay and Trypan blue stain. Cell osteogenic differentiation potentials were assessed by alkaline phosphatase assay and alizarin red stain, polymerase chain reaction was performed to quantify Nuclear factor Kappa gene expression.

Results

DPSCs subjected to laser bio-stimulation showed the best results regarding cell viability (MTT) and osteogenic differentiation (ALP assay), and calcium deposition at 3 intervals (3, 7, 14 days), meanwhile, PDLSCs subjected to laser bio-stimulation showed better result than control but less than DPSCs. While NF-KB gene expression was proven to be approximately comparable for both groups. Generally, the Photo-bio modulated groups showed better results than their control groups.

Conclusion

Low-level laser bio-stimulation (LLL) therapy improves DPSC and PDLSC osteogenic differentiation and proliferation via the activation of the NF-KB pathway. Also, the DPSCs outperformed PDLSCs in terms of performance.

Clinical significance

These results can be beneficial information and a reference database for more research in tissue engineering, dental therapy, and regeneration.

Safe and Durable Treatment of Dentin Hypersensitivity via Nourishing and Remineralizing Dentin Based on β-Chitooligosaccharide Graft Derivative

Dentin hypersensitivity (DH) is a common symptom of various dental diseases that usually produces abnormal pain with external stimuli. Various desensitizers are developed to treat DH by occluding dentine tubules (DTs) or blocking intersynaptic connections of dental sensory nerve cells. However, the main limitations of currently available techniques are the chronic toxic effects of chemically active ingredients and their insufficiently durable efficacy. Herein, a novel DH therapy with remarkable biosafety and durable therapeutic value based on β-chitooligosaccharide graft derivative (CAD) is presented. Particularly, CAD indicates the most energetic results, restoring the amino polysaccharide protective membrane in DTs, significantly promoting calcium and phosphorus ion deposition and bone anabolism, and regulating the levels of immunoglobulin in saliva and cellular inflammatory factors in plasma. Exposed DTs are occluded by remineralized hydroxyapatite with a depth of over 70 µm, as shown in in vitro tests. The bone mineral density of Sprague-Dawley rats' molar dentin increases by 10.96%, and the trabecular thickness of bone improves to about 0.03 µm in 2 weeks in the CAD group compared to the blank group. Overall, the ingenious concept that modified marine biomaterial can be a safe and durable therapy for DH is demonstrated by nourishing and remineralizing dentin.

Oral Submucous Fibrosis: A Review of the Current Concepts in Management

Oral submucous fibrosis (OSMF) is a precancerous disorder of the submucosa that causes inflammation and progressive fibrosis, leading to pronounced stiffness and trismus. Chewing betel nuts is a significant risk factor for OSMF in India. Arecoline from betel nuts and copper, which causes fibroblast dysfunction and the development of fibrotic bands, are the main components of betel quid. OSMF is distinguished by fibrosis in the submucosal region, which affects the majority of the oral cavity and results in advanced lockjaw due to rigidity in the lips, pharynx, cheeks, and upper third of the oesophageal canal, which progresses to dysphagia. The prevalence of OSMF is rising, particularly among younger generations, as more commercially available areca nut products like gutka (chewing tobacco) and others are being introduced. The severity of OSMF develops as the practice continues and is permanent. It also persists even after chewing has been stopped. The hallmark of oral submucous fibrosis (OSF) is abnormal collagen deposition. It is a precancerous condition and progresses to malignant tumours. Symptoms include ulcers, xerostomia, submucous fibrosis, burning sensation, and a reduction in mouth opening. Each of these drastically reduces the patient's quality of life. In the past, many treatment modalities have been tried but none of them has resulted in a cure for the disease. The primary focus of the treatment is to reduce the signs and symptoms so that the patient can have a better quality of life. Along with principles, conservative, medical, and surgical management issues have also been covered.

Effect of Various Lasers With or Without Systemp.desensitizer on Dentine Tubules: An In Vitro Scanning Electron Microscopy Analysis

Objective: The current study was carried out to evaluate the effects of laser and Systemp.desensitizer therapy. Further, scanning electron microscopy (SEM) was used to determine the effects of individual or combined desensitizers on human dentinal tubules. Background: The most common clinical condition that makes people uncomfortable is dentin hypersensitivity (DH). Both lasers and drugs that reduce sensitivity have been used to treat DH. Materials and methods: A total of 100 dentinal samples were taken from newly extracted third molars (affected) and divided into 10 groups (A to J), that is, control (A); Systemp.desensitizer (B); diode laser (980 nm) (C); Nd:YAG laser (D); Er:YAG laser (E); Er,Cr:YSGG laser (F); Systemp.desensitizer + diode laser (G); Systemp.desensitizer + Nd:YAG laser (H); Systemp.desensitizer + Er:YAG laser (I); and Systemp.desensitizer + Er,Cr:YSGG laser (J). SEM was used to evaluate the dentinal specimens in each group (longitudinal and transverse portions), and then images of each sample were captured (20 images/sample). In addition, the number of open dentinal tubules was counted and then the occlusion depth in dentinal tubules was measured. Mann-Whitney and Kruskal-Wallis tests were employed to analyze the obtained data. Results: All treatment procedures and protocols were effective in blocking dentinal tubules (p < 0.05). Compared with the other groups, dentinal tubules in the laser and laser combination therapy groups were significantly obstructed (p < 0.05). Diode and Nd:YAG lasers with or without Systemp.desensitizer showed significantly more tubule occlusion and greater sealing depth than Er:YAG and Er,Cr:YSGG lasers with or without Systemp.desensitizer (p < 0.05). Conclusions: In summary, lasers alone or in combination can play a significant role in occluding the dentinal tubules. However, combining the diode or Nd:YAG laser with Systemp.desensitizers is a more effective treatment strategy and may have immediate and long-lasting effects.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

Phototherapy Using Er,Cr:YSGG Laser as a Definitive Treatment for Dentin Hypersensitivity: A Systematic Review

Purpose

To assess the efficacy of Er,Cr:YSGG lasers in reducing dentine hypersensitivity (DH).

Methods

Electronic literature were searched through various databases (MEDLINE, SCOPUS, ProQuest, LILACS and EBSCO) up to March 2022 for articles addressing the following focused question: “In patients with dentine hypersensitivity, does an Er,Cr:YSGG laser provide a better outcome in terms of pain reduction than other dentine desensitizer agents?”. The literature was searched using combinations of the following medical subject heading (MeSH) terms and keywords: (laser OR phototherapy OR Er,Cr:YSGG laser) AND (dentine hypersensitivity OR dentine sensitivity OR dental sensitivity).

Results

A total of 486 studies were found, of which 7 randomized controlled trials were included in the review. The Er,Cr:YSGG laser wavelengths, power density and duration of irradiation used in the studies were 2780 nanometers, 0.25–0.5 watts and 20–60 seconds, respectively. The follow-up assessments were conducted ranging from immediately to 3 months after treatment. All studies showed that the Er,Cr:YSGG laser was effective in alleviating DH.

Conclusion

This systematic review suggests that the application of an Er,Cr:YSSG laser is effective in alleviating DH and may have limited adverse effects if adequate parameters are followed.

Evaluation of Dentin Tubule Plugging Efficiencies and Effects on Dentin Surface Roughness of Dentin Desensitizing Agents, the Er,Cr:YSGG Laser, and Their Combination After Erosion-Abrasion Cycles: An In Vitro Study

OBJECTIVES

The purposes of this in vitro study were to evaluate the tubule plugging efficiencies and effects on the surface roughness of dentin of different dentin desensitizing agents (DDAs; Teethmate Desensitizer, Kuraray; Gluma Desensitizer, Kulzer; Clinpro White Varnish, 3M ESPE; Enamelast, Ultradent) and the Er,Cr:YSGG laser (Biolase, Waterlase), both alone and in combination with DDAs, after application and after an erosion-abrasion cycle.

METHODS AND MATERIALS

For surface roughness examinations, superficial buccal dentin specimens were divided into 10 groups: the control, Teethmate Desensitizer, Gluma Desensitizer, Enamelast, Clipro White Varnish, Er,Cr:YSGG Laser, Teethmate Desensitizer-Laser, Gluma Desensitizer-Laser, and Enamelast-Laser, and Clinpro White Varnish-Laser groups. Profilometric analyses and scanning electron microscopy (SEM) examinations were performed after applications and after a 5-day erosive-abrasive cycle. For the statistical analysis of surface roughness measurements, 2-way analysis of variance (ANOVA), 1-way ANOVA, and Tukey post hoc test were used.

RESULTS

Among the treatments, only DDAs alone did not cause increase in surface roughness after application. All of the laser applications increased the surface roughness of dentin, and after the erosion-abrasion cycle, all of the test groups had increased surface roughness. However, SEM images showed that morphological changes were less frequently observed in all of the experimental groups than in the control group. In addition, all of the laser-DDA combinations had stronger tubule occlusion effects than did DDAs alone, even after erosion-abrasion.

CONCLUSIONS

All of the test treatments showed protective effects on dentin surfaces against the negative effects of erosion-abrasion. The addition of the laser to DDA applications increased tubular plugging efficiencies of DDAs, and the tubule plugs of the combination treatments were resistant to the erosion-abrasion cycle.

Parameters Used With Diode Lasers (808-980 nm) in Dentin Hypersensitivity Management: A Systematic Review

Introduction: The present study aimed to describe parameters used with 808- to 980-nm wavelength diode lasers for managing dentin hypersensitivity and analyze their results. Methods: The inclusion criteria were based on randomized controlled clinical trials using diode lasers at an 808-980 nm wavelength range in patients with dentine hypersensitivity with a minimum of 1-month follow-up. An electronic search for articles on Medline, PubMed and Cochrane databases was performed. The risk of bias was assessed with the Cochrane collaboration tool. Results: Our electronic search resulted in 130 papers, of which 11 articles met the inclusion criteria. A majority of the studies assessed dentine hypersensitivity using the Visual Analogue Scale, which ranged between 2.3 and 8.8 before treatment and significantly reduced to a mean value of 0.45-3.7 after diode laser application. The power settings ranged between 1.5 mW and 3 W with an emission mode of continuous wave, except for 2 authors who used chopped mode. The energy density varied from 2.5 to 128 J/cm2, and the exposure time was between 10 and 120 seconds. The authors applied a minimum of 1 to 4 treatment sessions with a 2-day to 1-week interval between them. Most of the studies mentioned the tooth surface as the treatment site but without describing the specific irradiation points. Conclusion: Despite the heterogeneity of the analyzed variables, a statistically significant improvement in all laser groups was described. However, they cannot be compared homogenously.

Effects of low-level light therapy on dentin hypersensitivity: a systematic review and meta-analysis

OBJECTIVE

To investigate the treatment efficacy of low-level light therapy on dentin hypersensitivity.

MATERIALS AND METHODS

Following the PRISMA guideline, six electronic databases supplemented with bibliographies were searched till December 2020. Two reviewers performed the screenings independently with a reliability assessment. Studies fulfilling the pre-registered eligibility criteria were included for risk-of-bias assessment and data synthesis.

RESULTS

Thirty-five articles ultimately informed this systematic review based on the eligibility criteria and underwent risk-of-bias assessment (ĸ = 0.86). Quantitative results were deduced by meta-analysis of 20 randomised controlled trials: LLLT showed favourable outcomes compared to placebos for immediate (SMD: 1.09, 95% CI: 0.47 to 1.70), interim (SMD: 1.32, 95% CI: 0.41 to 2.23), and persistent efficacies (SMD: 2.86, 95% CI: 1.98 to 3.74). However, substantial heterogeneity existed among included studies (I2: 64-95%). Regarding comparisons with other desensitising strategies, LLLT showed no significant benefits in DH alleviation over others except fluorides for interim efficacy (SMD: 0.31, 95% CI: 0.10 to 0.52) and persistent efficacy (SMD: 0.45, 95% CI: 0.03 to 0.86).

CONCLUSIONS

This systematic review shows that LLLT has positive immediate, interim, and persistent DH-treatment efficacies compared with placebo. No superior treatment effects of LLLT were observed except fluoride agent use. Further studies are warranted-RCTs with low risk of bias, consistent technical settings, comprehensive assessments, and long follow-up periods.

CLINICAL RELEVANCE

This systematic review bridges a critical research gap by analysing clinical evidence in the DH-alleviating efficacy of LLLT in comparison with placebo and other in-office desensitising strategies.

Clinical Evaluation of 532-nm Green Laser on Dentin Hypersensitivity: A Randomized Double-Blind Clinical Trial

Objective: The aim of this study was to evaluate the therapies of low-level green laser and chemical desensitizer in the treatment of dentin hypersensitivity (DH). Methods: Forty-eight patients with 96 sensitive teeth were invited to participate in this clinical trial and were randomly divided into three groups. One group was treated with low-level green laser, the second group was treated with desensitizer [sodium fluoride (NaF)], and the third group acted as the placebo group and was treated with distilled water and placebo laser. The wavelength of green laser was 532 nm and the irradiance was 15 J/cm² per treatment site. Hypersensitivity was assessed by visual analogue scale (VAS) according to cold test and probing at baseline. Immediately, 2 weeks, and 3 months after the application of green laser, NaF, and placebo, the participants' sensitivity level was accessed by new VAS analysis. Results: Forty-five patients with 90 teeth (n = 15 patients/group; 30 teeth/group) were followed up for 2 weeks and 3 months after treatment. There were significant differences in VAS scores between the placebo group and intervention group (green laser group and NaF group; analysis of variance, p < 0.05) at all three time points. The mean pain scores in DH reduced significantly immediately after treatment in the green laser group and NaF group when stimulated by cold and probing, whereas no significant difference was observed with these two therapies after 2 weeks (p > 0.05). After 3 months, mean VAS scores of the NaF group were higher than those of the green laser group (p < 0.01). Conclusions: Therefore, the green laser displayed similar effectiveness as NaF in treatment of DH and could be a promising new therapy to reduce DH.

Comparison of the Effectiveness of Combined Diode Laser and GLUMA Bonding Therapy With Combined Diode Laser and 5% Sodium Fluoride Varnish in Patients With Dentin Hypersensitivity

Introduction: Dentin hypersensitivity (DH) is one of the most common complaints of patients referred to a dental office, so this study aimed to compare the effectiveness of combined diode laser and GLUMA bonding therapy with combined diode laser and 5% sodium fluoride varnish in patients with DH. Methods: Sixty patients were divided into three groups (bonding, laser-bonding, laser-varnish), and before the intervention, the amount of DH was measured with the visual analogue scale (VAS) scale. In the bonding group, GLUMA Desensitizer solution was applied and then air-dried. In the bonding-laser group, first bonding was used, and then the affected tooth was irradiated with a diode laser. In the varnish-laser group, 5% sodium fluoride varnish was coated and then the laser was irradiated with the said method. DH was measured immediately after the treatment and then 2, 7 and 30 days after the treatment. Results: Laser-varnish treatment was not different from laser-bonding treatment at all measurement times (P=1). Laser-varnish and bonding treatment were not significantly different up to one week after the intervention, but on the 30th day after the intervention, the difference in pain was significant (P=0.01). There was no significant difference in laser-bonding treatment up to one week after the intervention, but on the 30th day after the intervention, the difference in pain was significant (P=0.003). Conclusion: The combined treatment with GLUMA bonding and the 660 nm diode laser is effective in reducing DH and this is more effective than GLUMA bonding alone in the long term. However, it does not have a significant advantage over the combined varnish-laser method, but it seems that due to its ease of use, it can be a suitable alternative to the varnish-laser method.

Efficacy of near infrared dental lasers on dentinal hypersensitivity: a meta-analysis of randomized controlled clinical trials

Conventional therapies have aimed to try to help individuals suffering with dentine hypersensitivity (DH/DHS). A relatively new approach, laser therapy claims to be beneficial while having immediate and long-lasting effect. Therefore, our analysis aims to explore the immediate and 1-month efficacy of near-infrared laser (NIR) therapy in treating dentinal hypersensitivity. A systematic literature search conducted in databases, and analysis was undertaken utilizing a meta-analysis approach. Randomized controlled clinical trials comparing near-infrared lasers and placebo/no treatment in patients (> 18 years) were included. The risk of bias for included studies was assessed using Cochrane RoB tool (for randomized studies). Random effects meta-analyses model of standardized mean differences and 95% confidence intervals were performed using RevMan 5.4 software. A comprehensive electronic and manual search yielded a total of 1081 potential articles. Following the implementation of the inclusion and exclusion criteria, a total of 6 studies were included in the analysis. Near-infrared laser therapy led to statistical significant reduction in immediate and 1-month follow-up VAS (visual analog scale) scores compared to placebo/no treatment (p < 0.05). Statistical heterogeneity across the studies was high (I²-96%). The findings suggest that near-infrared laser therapy does have a significant immediate effect in reducing dentine hypersensitivity compared to placebo/no treatment. Furthermore, this effect is not diminished and endured at 1-month follow-up.

Laser therapy for dentinal hypersensitivity

BACKGROUND

Dentinal hypersensitivity is characterized by short, sharp pain from exposed dentine that occurs in response to external stimuli such as cold, heat, osmotic, tactile or chemicals, and cannot be explained by any other form of dental defect or pathology. Laser therapy has become a commonly used intervention and might be effective for dentinal hypersensitivity.

OBJECTIVES

To assess the effects of in-office employed lasers versus placebo laser, placebo agents or no treatment for relieving pain of dentinal hypersensitivity.

SEARCH METHODS

Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 October 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2020, Issue 9), MEDLINE Ovid (1946 to 20 October 2020), Embase Ovid (1980 to 20 October 2020), CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 20 October 2020), and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; from 1982 to 20 October 2020). Conference proceedings were searched via the ISI Web of Science and ZETOC, and OpenGrey was searched for grey literature. The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.

SELECTION CRITERIA

Randomized controlled trials (RCTs) in which in-office lasers were compared to placebo or no treatment on patients aged above 12 years with tooth hypersensitivity.

DATA COLLECTION AND ANALYSIS

Two review authors independently and in duplicate screened the search results, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. For continuous outcomes, we used mean differences (MD) and 95% confidence intervals (CI). We conducted meta-analyses only with studies of similar comparisons reporting the same outcome measures. We assessed the overall certainty of the evidence using GRADE.

MAIN RESULTS

We included a total of 23 studies with 936 participants and 2296 teeth. We assessed five studies at overall low risk of bias, 13 at unclear, and five at high risk of bias. 17 studies contributed data to the meta-analyses. We divided the studies into six subgroups based on the type of laser and the primary outcome measure. We assessed the change in intensity of pain using quantitative pain scale (visual analogue scale (VAS) of 0 to 10 (no pain to worst possible pain)) when tested through air blast and tactile stimuli in three categories of short (0 to 24 hours), medium (more than 24 hours to 2 months), and long term (more than 2 months). Results demonstrated that compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through air blast stimuli at short term (MD -2.24, 95% CI -3.55 to -0.93; P = 0.0008; 13 studies, 978 teeth; low-certainty evidence), medium term (MD -2.46, 95% CI -3.57 to -1.35; P < 0.0001; 11 studies, 1007 teeth; very low-certainty evidence), and long term (MD -2.60, 95% CI -4.47 to -0.73; P = 0.006; 5 studies, 564 teeth; very low-certainty evidence). Similarly, compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through tactile stimuli at short term (MD -0.67, 95% CI -1.31 to -0.03; P = 0.04; 8 studies, 506 teeth; low-certainty evidence) and medium term (MD -1.73, 95% CI -3.17 to -0.30; P = 0.02; 9 studies, 591 teeth; very low-certainty evidence). However, there was insufficient evidence of a difference in pain intensity for all types of lasers when tested through tactile stimuli in the long term (MD -3.52, 95% CI -10.37 to 3.33; P = 0.31; 2 studies, 184 teeth; very low-certainty evidence). Most included studies assessed adverse events and reported that no obvious adverse events were observed during the trials. No studies investigated the impact of laser treatment on participants' quality of life.

AUTHORS' CONCLUSIONS

Limited and uncertain evidence from meta-analyses suggests that the application of laser overall may improve pain intensity when tested through air blast or tactile stimuli at short, medium, or long term when compared to placebo/no treatment. Overall, laser therapy appears to be safe. Future studies including well-designed double-blinded RCTs are necessary to further investigate the clinical efficacy of lasers as well as their cost-effectiveness.

Low level laser therapy, Er,Cr:YSGG laser and fluoride varnish for treatment of dentin hypersensitivity after periodontal surgery: A randomized clinical trial

This clinical trial aimed to compare the effects of low-level laser therapy (LLLT), Er,Cr;YSGG laser, and fluoride varnish, as compared to the placebo laser on decreasing dentin hypersensitivity (DH). This randomized, double-blinded clinical trial included 60 jaw quadrants in 24 patients who underwent periodontal surgery. The quadrants were randomly assigned to 4 groups and received treatments as follows. Group 1: LLLT with a combination of red and infrared wavelengths, group 2: Er,Cr:YSGG laser (0.25 W and 0.5 W), group 3: fluoride varnish, and group 4: placebo laser. The sensitivity response to the cold spray was recorded using visual analogue scale (VAS) at baseline, immediately, and 1 week post-treatment. The data were analyzed by repeated measures analysis at the significance level of P<0.05. There was a significant reduction in DH after treatment by low-level lasers, Er,Cr:YSGG laser, or fluoride varnish compared to the baseline data (P<0.05), but the placebo group displayed no significant alteration in DH (P=0.069). At 1 week, the VAS score in the Er,Cr:YSGG laser group was significantly lower than that of the LLLT (P= 0.043) and placebo (P<0.001) groups. Furthermore, the subjects who received fluoride varnish exhibited significantly lower DH compared with the placebo group (P = 0.023). Er,Cr:YSGG laser was the most effective strategy in dealing with DH, as it caused the greatest pain reduction over the study period and showed a significant superiority over LLLT and placebo groups. Alternatively, the application of fluoride varnish could be recommended for attenuating DH following periodontal surgery.

Effect of COVID-19 Pandemic on the Levels of Empathy among Undergraduate Dental Students in Pakistan

Objective  The purpose of our study is to determine the effect of coronavirus disease 2019 (COVID-19) on the levels of empathy toward patients among undergraduate dental students in Pakistan.

Materials and Methods  A cross-sectional, survey-based study was conducted at Islamic International Dental College, Islamabad, Pakistan. After taking an informed consent, a validated and pretested Toronto Empathy Questionnaire (TEQ) was distributed amongst the undergraduate dental students at two points, one before the COVID-19 existed, and the other after August 7th, 2020, when the COVID-19 cases dropped in Pakistan. Responses were indicated on a five point Likert Scale.

Statistical Analysis  A one-way ANOVA (analysis of variance) was used to compare the TEQ scores between the different years of education at the dental school. Difference within the groups was analyzed using the post-hoc Tukey test. Pre- and post-COVID-19 comparison was done using the Chi-square test (significance level p < 0.05).

Results  A total of 221 out of 260 students in the pre-COVID-19 group, while 210 out of 260 students in the post-COVID-19 group enrolled in the dentistry program participated in the study. Significant difference in the empathy levels was observed in the pre- and post-COVID-19 groups of the same population, i.e., ( p < 0.05). The response rate was 85%.

Conclusions  This study showed an increase in mean empathy scores among the undergraduate dental students after COVID-19, indicating a significant improvement in their empathy levels during the time of COVID-19. It highlights the impact of the pandemic, whereby death and chaos seem to have brought about an improvement in interpersonal harmony.

A New Combined Protocol to Treat the Dentin Hypersensitivity Associated with Non-Carious Cervical Lesions: A Randomized Controlled Trial

The goal of this research is to assess the desensitizing effect of a diode laser on non-carious cervical lesions (NCCLs) responsible for dentin hypersensitivity (DH) in two separate output forces implemented both independently and in sequential combination modalities. A randomized controlled trial for this study was applied. Sixty-nine NCCLs responsible for DH pain with severity between 6 and 9 on the VAS scale were considered. Three study groups were developed using just one lesion from three different quadrants of the oral cavity of each patient. All treatment procedures were conducted using a laser diode (810 nm, 5 W) with varying power outputs used separately or in combination. The pain by DH was evaluated at baseline, at treatment completion, and at 15 days and 3 months after each laser procedure. Data analysis was performed using a Wilcoxon test for paired samples, a one-way ANOVA test, and an unpaired t-test. The significant reduction of the mean VAS score was estimated in each study group immediately and at 15 days and 3 months after the end of treatment and compared with the baseline mean VAS score (p-value < 0.0001). The best result concerning the improvement of DH symptomatology was assessed when a combined protocol of two different output powers of the diode laser was used. The authors conclude that the diode laser (810 nm) therapy procedure combining two separate output forces (low and high power) can improve the painful symptoms of DH from NCCLs.

Comparative evaluation of calcium phosphate-based varnish and resin-modified glass ionomer-based varnish in reducing dentinal hypersensitivity: A randomized controlled clinical trial

Objective:

The aim of this study was to evaluate the efficacy of MI varnish and Clinpro XT varnish in reducing dentinal hypersensitivity.

Materials and Methods:

Patients with cervical dentinal hypersensitivity were selected for the study. The teeth to be tested were isolated. Then, a blast of air and ice cold water was applied on the tooth surface, and the score was measured by visual analog scale. The patients were randomly assigned to one of the treatment groups (Group 1: MI varnish; Group 2; Clinpro XT varnish). The manufacturer's instructions were followed. The sensitivity scores were recorded immediately and after 1 week of therapy.

Statistical Analysis:

Mann–Whitney U-test and Wilcoxon-matched pairs test were used for the analysis.

Results and Conclusion:

Although both varnishes were shown to reduce the dentinal hypersensitivity in patients, according to statistics, MI Varnish was a better agent to reduce dentinal hypersensitivity than Clinpro XT varnish.

Grit blasted aggregates of hydroxyl apatite functionalized calcium carbonate in occluding dentinal tubules

Objectives

This study aimed to investigate the effects of using hydroxyl apatite functionalized calcium carbonate (FCC) particles on occluding dentinal tubules.

Methods

Dentine specimens extracted from eighteen human molars with exposed dentinal tubules were divided into three groups (n = 6/group): a) Cut surface with smear layer; b) EDTA (smear layer removed with 17% EDTA for 1 min); and c) Grit blasted functionalized calcium carbonate (FCC) with and air pressure of 280 kPa. Microscopic dentinal tubule occlusion, tubule diameter and tubule area were evaluated using scanning electron microscopy (SEM) before and after grit blasting. Biomineralization of specimens was carried out in a simulated body fluid (SBF). Elemental analysis of occluding materials was carried out using energy-dispersive X-ray spectroscopy (EDX). X-ray diffraction (XRD) analysis was performed to demonstrate the crystal structure of the biomineralized layer on dentine.

Results

FCC particles showed penetration into the dentinal tubules by breakage of their original particle shape and size. EDTA treated surface had higher number and larger size tubules than those with smear layer or grit blasted (p < 0.005). SEM-EDX analysis revealed mineral precipitation of calcium phosphate on the SBF immersed dentin specimens. XRD analysis showed typical crystal structure of hydroxyl apatite for the biomineralized surface layer on dentine.

Conclusions

Grit blasted FCC particles initially occluded effectively the opened dentinal tubules and biomineralization occurred in tubules primarily occluded by the FCC particles. However, in the optimal in vitro conditions in SBF, no difference between biomineralization was found between the grit blasted surface and the control surface.

Clinical significance

Several materials and methods have been established for treatment of dentinal hypersensitivity although a golden standard treatment has not been discovered. Grit blasted functionalized calcium carbonate has a potential to occlude and remineralize exposed dentinal tubules. This could offer a more biological approach on treatment of dentin hypersensitivity.

Comparative evaluation of neodymium-doped yttrium aluminum garnet laser with nanocrystalline hydroxyapatite dentifrices and herbal dentifrices in the treatment of dentinal hypersensitivity

Background

The aim of this study was to compare and evaluate the efficacy of neodymium-doped yttrium aluminum garnet laser with and without herbal and nanohydroxyapatite dentifrices in management of dentinal hypersensitivity (DH).

Materials and Methods

A total of 180 patients who responded to air-blast test and cold-water test using verbal rating scale (VRS) were included in this study. The patients were randomly assigned to six groups (n = 30): control group (CG), scaling and root planning (SRP) + nanocrystalline hydroxyapatite dentifrices, SRP + nanocrystalline hydroxyapatite dentifrices + laser, SRP + herbal dentifrices, SRP + herbal dentifrices + laser, and SRP + laser. Each group was evaluated at baseline, 1 week, 1 month, and 6 months. In every visit of each patient, their clinical examination was done.

Results

Among all groups', repeated ANOVA measures and Kruskal-Wallis test was performed in which laser groups showed maximum reduction in DH in all indices while the CG showed minimum reduction in DH. The VRS values showed maximum reduction in SRP + nanocrystalline hydroxyapatite dentifrices + laser group with mean of 0.3 ± 0.5 and minimum reduction in CG with mean of 3.0 ± 0.5 (P < 0.001).

Conclusion

Among all the groups, SRP + Nanocrystalline hydroxyapatite + Laser can be an effective treatment modality for DH.

Laser Effects on the Prevention and Treatment of Dentinal Hypersensitivity: A Systematic Review

Introduction: Dentinal hypersensitivity (DH) is an acute intensive tooth pain which can lead to dental annoyances during eating and drinking. Stimulating exposed dentinal tubules by either kind of thermal, tactile, chemical and/or osmotic stimuli is believed to be the cause of this pain. It is hypothesized that dentinal tubules' orifice occlusion (DOO) can help relieve such dental irritations. Thus, this systematic review was conducted to evaluate the effectiveness of laser application as a prevention and treatment modality on DH reduction. Methods: Electronic databases (MEDLINE, SCOPUS) were searched among randomized clinical trials from January 2007 to December 2016. The extraction of data and quality assessments were carried out by different independent observers. Results: A total of 499 items were found of which3 9 relevant articles were extracted. The profound findings proved lasers' effectiveness as a treatment of DH. Although some of the researches reported no significant difference between laser and other desensitizing agents, most of the studies suggested that better results (both rapid and long-lasting) were obtained in combined modalities. Furthermore, the preventive role of this new technology has been emphasized as well. Nd-YAG (neodymium-doped yttrium aluminum garnet) and diode lasers reduce DH after bleaching. Lasers can also protect cervical restorations from DH due to tubular occlusion. Moreover, it is suggested to apply lasers in relief of DH following scaling and root planning. Nevertheless, a few researchers dispute its beneficence as a result of placebo effect. Conclusion: The results obtained from several studies in the present review revealed that the application of lasers is effective not only in terms of treatment of DH, but also in the prevention of this intensive tooth pain. Among various types of lasers, the application of Nd:YAG laser has shown the best results in DH treatment.

Effect of photobiomodulation with low-level laser therapy combined with potassium nitrate on controlling post-bleaching tooth sensitivity: clinical, randomized, controlled, double-blind, and split-mouth study

OBJECTIVES

To evaluate the effect of photobiomodulation with low-level laser therapy (PBM-LLLT) combined with 5% potassium nitrate (KNO₃) on controlling tooth sensitivity (TS) after in-office tooth bleaching.

MATERIALS AND METHODS

Fifty volunteers were selected based on the inclusion and exclusion criteria and were randomly allocated into four groups: G1 (control): placebo gel application, 35% hydrogen peroxide bleaching (HP35) and mock PBM-LLLT without light emission; G2: placebo gel application, bleaching with HP35 and PBM-LLLT; G3: application of KNO₃, bleaching with HP35 and mock PBM-LLLT; and G4: application of KNO₃, bleaching with HP35 and PBM-LLLT. A pain assessment questionnaire was used to evaluate TS during the 21 days of treatment. The Friedman test was used for intragroup analysis, and the Wilcoxon and Mann-Whitney tests were used for intergroup comparisons.

RESULTS

The intragroup evaluation showed significant differences among the evaluation times in all groups (p ≤ 0.05). The highest pain sensitivity levels were recorded on the 1st, 8th, and 15th days. In G1, TS manifested for up to 3 days after each bleaching session, while G2, G3, and G4 presented TS only on the days of the bleaching sessions. Intergroup analysis showed that TS manifestation differed significantly between G1 and the other groups (p ≤ 0.05) but did not differ significantly among G2, G3, and G4 (p ≥ 0.05).

CONCLUSION

PBM-LLLT and KNO₃ are effective at reducing pain sensitivity after tooth bleaching, but no synergistic effect between these treatments was observed for the different evaluation periods.

CLINICAL RELEVANCE

The effect of PBM-LLLT combined with KNO₃ on post-bleaching tooth sensitivity is similar to their individual use alone.

Effect of low-level laser therapy combined with 5000 parts per million fluoride dentifrice on postbleaching sensitivity: A clinical, randomized, and double-blind study

OBJECTIVE

The aim of this double-blind, randomized, controlled clinical study was to assess the efficacy of low-level laser therapy (LLLT) combined with 5000 ppm fluoride dentifrice on postbleaching sensitivity in teeth exposed to 35% hydrogen peroxide for four weeks.

MATERIALS AND METHODS

Twenty-five volunteers were evaluated using the split-mouth model in which the right and left maxillary/mandibular quadrants were randomized and allocated to one of two groups: GPLACEBO, in which the laser tip was positioned without the emission of light (placebo effect) + 5000 ppm sodium fluoride, or GLASER, which comprised LLLT + 5000 ppm sodium fluoride. For both groups, LLLT and placebo were used before bleaching, whereas fluoride was applied after bleaching. LLLT was applied at two points: on the central cervical and medial regions of the incisors, canines, and premolars in the corresponding hemi-arch. At each point, 60 J/cm² was applied for 16 seconds with an irradiance of 3.75 W/cm² using the therapeutic infrared device. To assess tooth sensitivity, a modified visual analogue scale was used after an evaporative stimulus, and a daily pain questionnaire was also applied.

RESULTS

The Wilcoxon and Friedman tests demonstrated a significant difference in the incidence of sensitivity pain between GPLACEBO and GLASER (P ≤ .05), with different evaluation times.

CONCLUSION

Teeth treated with laser therapy in combination with the topical use of sodium fluoride at each bleaching session demonstrated less sensitivity compared with the application of sodium fluoride only.

CLINICAL SIGNIFICANCE

The use of a low-level laser therapy in combination with topical use of sodium fluoride improves symptoms of dentin sensitivity at each bleaching session.

Effect of combined application of high- and low-intensity lasers on dentin hypersensitivity: A randomized clinical trial

Background. Diode lasers (DLs) have demonstrated equal or better desensitizing effects than fluoride varnish, 10% potas-sium nitrate (NK) gel and Gluma. The current study evaluated the desensitizing effect of combined application of DLs with two different output powers and compared it with single DL therapy. Methods. Sixty-two hypersensitive teeth were allocated randomly into two groups: the single group was treated with 3-W DL beam once and in the combined group, the teeth were irradiated three times (the first time with 0.2-W and then with 3-W and the second and third times, 48 and 96 hours after the baseline visit, with 0.2-W DL beams). The amount of dentin hyper-sensitivity (DH) was evaluated, immediately before and after each visit, and 1 week and 1 and 3 months after the first visit. Data analysis was performed using chi-squared test, repeated measurement of ANOVA and Mann-Whitney U test. P<0.05 was considered statistically significant. Results. Statistically significant changes were observed in the means of VAS indices between all the measurement intervals and pretreatment measures, in both experimental groups (P<0.001). The difference in VAS reduction among the groups was not significant when the hypersensitive teeth were stimulated by a periodontal probe and a jet of air (P=0.63 and P=0.12). Conclusion. The results of the present study showed that using both high-intensity and combined DL beams gives rise to significant reductions in DH. There was no significant difference between combined and single laser therapies in the treatment of tooth hypersensitivity.

Comparative evaluation of a low-level laser and topical desensitizing agent for treating dentinal hypersensitivity: A randomized controlled trial

Aim

The aim of this randomized, controlled, double-blinded, clinical study is to evaluate and compare the clinical effectiveness of low-level diode GaAlAs laser and glutaraldehyde-based topical desensitizing agent on cervical dentin hypersensitivity with the help of visual analog scale (VAS).

Materials and Methods

Fifty teeth of patients aged between 20 and 50 years were included, and VAS was used to assess the dentin hypersensitivity. The teeth were randomly allocated to either Group 1 or 2 using flip coin technique. Group 1 received glutaraldehyde desensitizer and Group 2 received 905 nm low-level laser. The sensitivity scores were recorded, immediately, after1 week and 3 months after therapy. Data was analyzed using Mann-Whitney U test for intergroup comparison and Friedman's test for intragroup comparison.

Results

There was a significant reduction in pain in both the groups at 3 months evaluation (P = 0.001).However, Group 2 showed a significant decrease in mean VAS scores when compared with Group 1 at both the one week and three month follow ups (P = 0.04, P = 0.03, respectively).

Conclusion

Although topical desensitizer and Low Level Laser are both effective in reducing dentinal hypersensitivity, Low Level Lasers are comparatively more effective at the studied time intervals.

Erbium:Yttrium Aluminum Garnet Laser-Activated Sodium Hypochlorite Irrigation: A Promising Procedure for Minimally Invasive Endodontics

OBJECTIVE

This study was to evaluate the potential of Erbium:Yttrium Aluminum Garnet laser-activated sodium hypochlorite irrigation (Er:YAG + NaOCl) for minimally invasive endodontics (MIE).

BACKGROUND DATA

Er:YAG laser irradiation can dramatically enhance the penetration of NaOCl, which may be a promising protocol for MIE.

METHODS

Extracted human teeth were contaminated with Enterococcus faecalis for 4 weeks. The infected canals were then shaped to different apical terminal working widths (ATWW, 15#/0.04, 20#/0.04, 25#/0.04, 30#/0.04, and 40#/0.04) and treated with either Er:YAG + NaOCl (0.3 W, 20 sec) or NaOCl alone. Then, the ATWW were fixed at 15#/0.04, and the canals were treated with Er:YAG + NaOCl at 0.3 W for 40 and 60 sec, or at 0.5 and 1.0 W for 20 sec. Finally, bacterial reductions were evaluated using the cell count method.

RESULTS

Er:YAG + NaOCl showed a higher disinfection efficacy at each ATWW compared with NaOCl alone (p < 0.001). The maximum bacterial reduction was 99.9% for the 40#/Er:YAG + NaOCl group and 93.6% for the 40#/NaOCl group. To achieve similar disinfection efficacy, the Er:YAG + NaOCl group needed a smaller ATWW than the NaOCl group. At a fixed ATWW, increasing the output power of the Er:YAG laser was more effective than increasing the radiation time to improve the disinfection efficacy of Er:YAG + NaOCl. The 15#/Er:YAG + NaOCl group reached the maximum bacterial reduction of 99.2% when the Er:YAG laser was activated at 1.0 W for 20 sec.

CONCLUSIONS

The 15#/Er:YAG + NaOCl with the Er:YAG laser irradiation at 1.0 W for 20 sec may be considered a promising procedure for MIE.

Treatment of recurrent aphthous stomatitis with Er,Cr:YSGG laser irradiation: A randomized controlled split mouth clinical study

The present randomized controlled split mouth clinical study aimed to investigate the efficacy of Er,Cr:YSGG laser irradiation on pain reduction and healing rate of recurrent aphthous stomatitis. 40 patients with RAS were recruited for this study and RAS ulcerations of each patient were randomly assigned to the control or test group. In the test group, Er,Cr:YSGG laser with non-contact mode was used to irradiate RAS lesions. In the placebo group, RAS lesions were irradiated with the same device without laser emission. Pain was evaluated with visual analog scale (VAS) while a clinician graded healing of RAS (HRAS). In the placebo group at immediate; scores of VAS presented no statistically significance; in the test group, laser application showed significant pain reducing, at 1st day control. In the test group, a significantly healing effect at 1st day control was observed and this effect was maintained throughout the study. In the placebo group, scores of HRAS were statistically significant at controls on 3, 7, 10days. Statistically significant difference between the scores of VAS and HRAS was found for all control days except day 10 according to the intergroup comparisons. Based on these findings, Er,Cr:YSGG laser application at 0.25W without water may be appropriate to reduce pain and also accelerate the healing of RAS.

Efficacy of Diode Laser and Gluma on Post-Preparation Sensitivity: A Randomized Split-Mouth Clinical Study

OBJECTIVE

This study aimed to compare the efficacy of a 940-nm diode laser and Gluma desensitizer on post-preparation sensitivity of prepared teeth.

MATERIALS AND METHODS

Twenty patients with 76 teeth participated in the study. For each patient, prepared molar or premolar in one quadrant were individually irradiated by laser. In the symmetrical quadrant, Gluma was applied onto the prepared teeth. No treatment was performed in the control group. Temporary crowns were placed after preparation. Pain response to tactile stimulus was assessed at one day, one week, and two weeks using visual analog scale (VAS). Intergroup comparisons were made with Kruskal Wallis test (p < 0.05).

RESULTS

Mean VAS scores of the control group were statistically higher than laser and Gluma groups (p < 0.017). The difference between VAS scores of the laser and Gluma groups was statistically insignificant (p > 0.05).

CONCLUSIONS

A significant reduction in level of sensitivity after both treatments was observed. The reduction of sensitivity with Gluma was not significantly superior to laser. No significant additional reduction occurred in level of sensitivity from the first day to the second week after both treatments.

CLINICAL SIGNIFICANCE

The application of Gluma or a 940-nm diode laser may be considered as effective in reducing sensitivity after tooth preparation without superiority of either method. (J Esthet Restor Dent 28:405-411, 2016).

GaAlAs laser-induced pulp mineralization involves dentin matrix protein 1 and osteopontin expression

OBJECTIVES

GaAlAs lasers induce pulp mineralization by promoting reparative dentinogenesis. This study analyzed the expression of dentin matrix protein 1 (DMP1) and osteopontin in GaAlAs laser-irradiated rat molars, to examine the hypothesis that these proteins play a role in the laser-induced reparative dentinogenic process.

MATERIALS AND METHODS

The mesial surfaces of the upper first molars of 8-week-old Wistar rats were irradiated with a pulsed GaAlAs laser. After 1-14 days, mRNA expression of DMP1 and osteopontin in the coronal pulp was analyzed using real-time PCR. DMP1, osteopontin, and heat shock protein 25 (HSP25) were immunolocalized at 1-21 days.

RESULTS

The pulp exhibited a degenerative zone in its mesial portion on days 1-3, and progressive formation of reparative dentin lined with HSP25-immunoreactive odontoblast-like cells, from day 7 onwards. DMP1 and osteopontin mRNA expression were significantly upregulated on days 1-7 and 3-7, respectively. From day 7 onwards, DMP1 and osteopontin immunoreactivity colocalized along the boundary between the primary and reparative dentin.

CONCLUSION

GaAlAs laser irradiation of rat molars induced upregulated DMP1 and osteopontin mRNA expression in the coronal pulp, followed by the formation of reparative dentin and the colocalization of DMP1 and osteopontin immunoreactivity at the site at which this tissue first appeared.

Laser-assisted treatment of dentinal hypersensitivity: a literature review

The purpose of this literature review was to evaluate the effectiveness of the laser-assisted treatment of dentinal hypersensitivity. A review with inclusion and exclusion criteria was performed from January 2009 to December 2014 with electronic data-bases: MedLine via PubMed, Science Direct and Cochrane Library. Research of paper magazines by hand was not considered. Forty-three articles were selected between literature reviews, in vitro studies, clinical trials, pilot and preliminary studies. The items were divided into laser-used groups for an accurate description, and then the reading of results into various typologies. Laser-assisted treatment reduces dentinal hypersensitivity-related pain, but also a psychosomatic component must be considered, so further studies and more suitable follow-ups are necessary.

How can sensitive dentine become hypersensitive and can it be reversed?

This paper reviews a number of studies in oral biology and endodontics that deal with the reactivity of the pulpo-dentine complex in response to mechanical and immunological stimuli. It can be hypothesized that these reactions could also apply to changes in dentine sensitivity following periodontal procedures. Some of these changes involve neurogenic inflammation of the pulp under exposed open tubules; this increases the rate of outward fluid flow through the tubules, making the overlying exposed dentine more sensitive. Other changes may be due to inflammation-related nerve sprouting of pulpal nerves, which can lead to innervation of more tubules than normal. Changes may also involve upregulation of new, more sensitive ion channels in the membranes of these nerves. The goal of the paper is to increase awareness of the complex issues involved in dentine sensitivity, so that future investigators may develop agents or techniques to stimulate mechanisms that mitigate dentine sensitivity, or to block mechanisms that aggravate the condition, for therapeutic effect.

Dentine sensitivity: past, present and future

OBJECTIVE

This review defines dentine sensitivity (DS), its prevalence, its aetiology, the mechanism(s) responsible for DS, its diagnosis and its treatment. The review then examines the modes of action of various treatments for DS including potassium salts, strontium salts, bioglasses, arginine/calcium carbonate and professional treatments such as adhesives and oxalates. The methods used to evaluate the various treatment modalities are discussed, including laboratory studies and randomised controlled clinical trials.

DATA SOURCES AND STUDY SELECTION

A literature search was conducted using PubMed, Ovid Medline and Cochrane reviews for information on DS and its treatments, as well as laboratory and clinical studies used to evaluate the efficacy of various DS treatments. With regard to efficacy of treatments for DS only reports of clinical studies that were randomised, controlled and blinded were reviewed. The authors offer new insights into the shortcomings of the recent systematic review of the use of oxalates for DS.

CONCLUSION

The authors introduce the concept of a novel desensitising mouthrinse containing 1.4% potassium oxalate: Listerine® Advanced Defence Sensitive mouthrinse. Readers of this supplement issue of the Journal of Dentistry are invited to review the significance of managing the clinical problem of DS. They are also invited to assess data from laboratory and randomised controlled clinical studies in order to understand the advantages offered by regular use of 1.4% potassium oxalate-containing mouthrinse, Listerine Advanced Defence Sensitive, in particular its resistance to daily erosive and/or abrasive challenges.

A comparative evaluation of the effect of dentin desensitizers on the retention of complete cast metal crowns

CONTEXT

Desensitizers are used to reduce dentin hypersensitivity. They affect the surface texture of prepared dentin and may alter the retention of fixed restorations.

AIMS

The aim was to evaluate the effect of dentin desensitizers on the retention of complete cast metal crowns luted with glass ionomer cement.

SUBJECTS AND METHODS

Fifty freshly extracted human premolars were subjected to standardized tooth preparation (20° total convergence, 4 mm axial height) with a computer numerically controlled machine. Individual cast metal crowns were fabricated from a base metal alloy. Dentin desensitizers included none (control), a glutaraldehyde (GLU) based primer (Gluma desensitizer), casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) (GC Mousse), erbium, chromium: YSGG laser (Waterlase MD Turbo, Biolase) and Pro-Argin (Colgate Sensitive Pro-Relief desensitizing polishing paste). After desensitization, crowns were luted with glass ionomer cement and kept for 48 h at 37°C in 100% relative humidity. The samples were tested using a universal testing machine by applying a load at a crosshead speed of 0.5 mm/min.

STATISTICAL ANALYSIS USED

Statistical analysis included One-way ANOVA, followed by the Scheffe post-hoc test with P < 0.05.

RESULTS

All dentin desensitizers showed significantly different values: Pro-Argin (4.10 Megapascals [Mpa]) < CPP-ACP (4.01 mpa) < GLU based primer (3.87 Mpa) < Virgin dentin (3.65 Mpa) < LASER (3.37 Mpa).

CONCLUSIONS

On comparing the effect of prepared virgin dentin, GLU based primer, CPP-ACP, LASER and Pro-Argin on the retention of complete cast metal crowns luted with glass ionomer cement on prepared teeth, it can be concluded that Pro-Argin and CPP-ACP showed the best retention in this in vitro study.