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

Felice Femiano,Rossella Sorice,Alessandro Antonelli,Francesco Bennardo,Selene Barone,Ludovica Nucci,Nicola Scotti,Giuseppe Minervini,Rossella Femiano,Vittoria Sorice,Luigi Femiano

doi:10.3390/app11010187

Abstract

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.

Highlights

An international workshop describes Dentin Hypersensitivity (DH) as follows: “DentinHypersensitivity is characterized by short, sharp pain arising from exposed dentin in response to stimuli, typically thermal, evaporative, tactile, osmotic or chemical and which cannot be ascribed to any other dental defect or pathology” [1]
The study findings showed that the dentin hypersensitivity (DH) reduction after an Er,Cr:YSGG laser application was considerably higher than that after a diode laser application at a 1-month postoperative interval [15]
The noncarious cervical lesions (NCCLs) excluded from the analysis presented the following: (1) an association of the NCCLs with periodontal pockets or gingival recession; (2) an additional presence of carious lesions on the affected tooth or a pre-existing restoration; (3) evidence of cracks; Appl

Summary

Introduction

An international workshop describes Dentin Hypersensitivity (DH) as follows: “DentinHypersensitivity is characterized by short, sharp pain arising from exposed dentin in response to stimuli, typically thermal, evaporative, tactile, osmotic or chemical and which cannot be ascribed to any other dental defect or pathology” [1]. DH frequently affects individuals aged 30 to 40 years old and is often associated with non-carious cervical lesions (NCCLs) [2,3,4] It occurs when dentinal tubules are exposed to the oral environment, and this is well explained by the hydrodynamic theory of Brännström [5]. Several treatments belonging to the tubule-occluding agent family [7] have been proposed including protein binding and calcium compounds deposition within tubules with casein phosphopeptide [8,9], peritubular mineral deposition, and sodium fluoride (NaF) Sometimes, these treatments, as well as the use of nerve depolarization therapies (topical potassium nitrate), could be ineffective or might produce short-lived desensitizing effects [10]. A recent systematic review comparing DH treatments on the based on its efficacy and effect duration confirms the following: for an immediate (until 7 days) DH reduction, the use of glutaraldehyde with

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