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Majidinia S, Sarraf Shirazi A, Boruziniat A, Riahi N. Effect of Low- and High-Level Laser Therapy on the Treatment of Dentin Hypersensitivity: An Umbrella Review. J Lasers Med Sci 2024; 15:e41. [PMID: 39381788 PMCID: PMC11459257 DOI: 10.34172/jlms.2024.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/23/2024] [Indexed: 10/10/2024]
Abstract
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.
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Affiliation(s)
- Sara Majidinia
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Esthetic and Restorative Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sarraf Shirazi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Boruziniat
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Esthetic and Restorative Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negin Riahi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Parlar Oz O, Karagozoglu İ, Kocer I, Demırkol N, Zer Y. The effect of laser therapy for the treatment of dentin hypersensitivity on surface roughness and bacterial adhesion. Lasers Med Sci 2024; 39:212. [PMID: 39120679 PMCID: PMC11315743 DOI: 10.1007/s10103-024-04166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 07/31/2024] [Indexed: 08/10/2024]
Abstract
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.
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Affiliation(s)
- Ozge Parlar Oz
- Faculty of Dentistry, Department of Prosthodontics, Gaziantep University, Gaziantep, Turkey
| | - İrem Karagozoglu
- Faculty of Dentistry, Department of Prosthodontics, Gaziantep University, Gaziantep, Turkey.
| | - Ipek Kocer
- Faculty of medicine, Department of medical microbiology, Sanko University, Gaziantep, Turkey
| | - Nermin Demırkol
- Faculty of Dentistry, Department of Prosthodontics, Gaziantep University, Gaziantep, Turkey
| | - Yasemin Zer
- Faculty of Medicine, Department of medical microbiology, Gaziantep University, Gaziantep, Turkey
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Tolentino AB, Zeola LF, Fernandes MRU, Pannuti CM, Soares PV, Aranha ACC. Photobiomodulation therapy and 3% potassium nitrate gel as treatment of cervical dentin hypersensitivity: a randomized clinical trial. Clin Oral Investig 2022; 26:6985-6993. [PMID: 35871702 PMCID: PMC9309092 DOI: 10.1007/s00784-022-04652-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/16/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVES This randomized controlled trial aimed to evaluate different protocols for dentin hypersensitivity treatment with low-power lasers and desensitizing agents, and the association between low-power lasers and desensitizing agents. MATERIALS AND METHODS Fifty-four patients (303 teeth) were randomly allocated to three groups: G1, 3% nitrate potassium gel, UltraEZ (n = 17); G2, photobiomodulation therapy (PBM) with a low-level infrared laser (n = 17), 100 mW, spot size of 0.028 cm2, and dose of 1 J per point; and G3, nitrate potassium + PBM (n = 20). Treatments were applied to the buccal cervical region at intervals of 72 h, and all protocols were performed in three sessions. The patients' response to evaporative stimuli was rated using the visual analog scale (VAS). Re-evaluations were performed immediately after each application and 1 week, 1 month, and 3 months after treatment. A two-way repeated measures test and Tukey's post hoc test were used for multiple comparisons (α = 5%). RESULTS There was a reduction in pain levels at the end of treatment in all groups. There were no significant differences in VAS score changes between the groups immediately after treatment and after the third month, compared to the baseline (p > 0.05). CONCLUSION Under the limitations of this in vivo study, the proposed three-session protocol was effective in reducing dentin hypersensitivity after 3 months, regardless of the desensitization mechanism used. Conservative and long-term protocols are interesting for the control of pain caused by dentin hypersensitivity. CLINICAL RELEVANCE The increase in cervical dentin hypersensitivity prevalence warrants easy-to-apply and long-lasting desensitizing protocols for pain control.
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Affiliation(s)
- Andrea Barros Tolentino
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes 2227, São Paulo, 05508-000, Brazil
| | - Livia Favaro Zeola
- Department of Dentistry and Dental Materials, School of Dentistry, Federal University of Minas Gerais, Rua Prof. Moacir Gomes de Freitas, 688, Belo Horizonte, Minas Gerais, Brazil
| | - Marcella Rodrigues Ueda Fernandes
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes 2227, São Paulo, 05508-000, Brazil
| | - Claudio Mendes Pannuti
- Department of Periodontics, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, São Paulo, SP, 222705508-000, Brazil
| | - Paulo Vinícius Soares
- School of Dentistry, Department of Dental Materials, Federal University of Uberlândia, Av. Pará - 1720, Uberlândia, Minas Gerais, Brazil
| | - Ana Cecilia Correa Aranha
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes 2227, São Paulo, SP, 05508-000, Brazil.
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Abdelkarim-Elafifi H, Parada-Avendaño I, Arnabat-Domínguez J. Parameters Used With Diode Lasers (808-980 nm) in Dentin Hypersensitivity Management: A Systematic Review. J Lasers Med Sci 2022; 13:e3. [PMID: 35642238 PMCID: PMC9131297 DOI: 10.34172/jlms.2022.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/01/2021] [Indexed: 08/25/2024]
Abstract
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.
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Affiliation(s)
- Haitham Abdelkarim-Elafifi
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Master of Laser in Dentistry (EMDOLA) University of Barcelona, Barcelona, Spain
| | - Isabel Parada-Avendaño
- Master Degree in Analysis and Design in Clinical Investigation, University of Barcelona, Barcelona, Spain
| | - Josep Arnabat-Domínguez
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Researcher at the Idibell Institute, Barcelona, Spain
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Machado AC, Maximiano V, Yoshida ML, Freitas JG, Mendes FM, Aranha ACC, Scaramucci T. Efficacy of a calcium-phosphate/fluoride varnish and ionomeric sealant on cervical dentin hypersensitivity: A randomized, double-blind, placebo-controlled clinical study. J Oral Rehabil 2021; 49:62-70. [PMID: 34676918 DOI: 10.1111/joor.13270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/06/2021] [Accepted: 10/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dentin hypersensitivity (DH) is a common problem in the population that can have a significant impact on the quality of life of those who suffer from the condition. OBJECTIVES Compare the efficacy of two treatments for DH: Ca/PO4 - /F- varnish (Clinpro White Varnish) and ionomeric sealant (IS) (Clinpro XT Varnish) with a placebo. METHODS Participants (121) with at least one tooth with visual analogue scale (VAS) score of 4 and above were randomly and blindly allocated to the groups. Treatments were performed by a trained researcher. DH was evaluated by another blind researcher after the treatment and after 1 week, 4 weeks, 3 months and 6 months. After 4 weeks, placebo received the DH treatment with IS; thus, the participants were not assessed after 3 and 6 months. Primary outcome was DH reduction after 4 weeks. Differences in VAS scores in the other time intervals and entire values of VAS were considered secondary outcomes. Comparisons were made among the groups (α = 0.05). RESULTS IS showed the highest VAS value difference between baseline and 4 weeks (mean ± SD: 3.7 ± 2.2), differing significantly from placebo (2.3 ± 1.7) and Ca/PO4/F- varnish (2.6 ± 2.0). Ca/PO4- /F- varnish did not differ from placebo. In all time intervals, VAS values of all groups were significantly lower than the baseline value, without differences among groups. For the long-term differences in VAS values (3 and 6 months), the IS exhibited significantly higher values than Ca/PO4- /F- varnish. CONCLUSIONS The IS was the most efficacious product for reducing DH, whereas Ca/PO4- /F- varnish did not differ from placebo. Registered in ClinicalTrials.gov (NCT04591444).
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Affiliation(s)
- Alana Cristina Machado
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vinícius Maximiano
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mirian Lumi Yoshida
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Julia Gomes Freitas
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ana Cecilia Corrêa Aranha
- Special Laboratory of Lasers (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Taís Scaramucci
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Abstract
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.
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Affiliation(s)
- Mina Mahdian
- Department of Prosthodontics and Digital Technology, Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - Soodabeh Behboodi
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yumi Ogata
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Moeintaghavi A, Ahrari F, Nasrabadi N, Fallahrastegar A, Sarabadani J, Rajabian F. Low level laser therapy, Er,Cr:YSGG laser and fluoride varnish for treatment of dentin hypersensitivity after periodontal surgery: A randomized clinical trial. Lasers Med Sci 2021; 36:1949-1956. [PMID: 33881673 DOI: 10.1007/s10103-021-03310-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/29/2021] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Amir Moeintaghavi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran.
| | - Nahid Nasrabadi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Amir Fallahrastegar
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Javad Sarabadani
- Oral and Maxillofacial Disease Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Fatemeh Rajabian
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
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Galvão ADM, Zeola LF, Moura GF, Teixeira DNR, Gonzaga RCDQ, da Silva GR, Soares PV. A long-term evaluation of experimental potassium oxalate concentrations on dentin hypersensitivity reduction: A triple-blind randomized clinical trial. J Dent 2019; 89:103180. [DOI: 10.1016/j.jdent.2019.103180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/08/2019] [Accepted: 08/09/2019] [Indexed: 11/28/2022] Open
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