Comparative Evaluation of the Effects of 5% Sodium Fluoride Varnish and Neodymium-Doped Yttrium Aluminium Garnet (Nd:YAG) laser and their Combined Application on Dentin Hypersensitivity Treatment

Abstract

Introduction: Dentin hypersensitivity is one of the most common complications that patients suffer from after periodontal therapies. So far many investigators have used different types of fluoride and laser for treatment of this complication. The aim of this study was to evaluate the effects of 5% sodium fluoride varnish and (Neodymium-Doped Yttrium Aluminium Garnet) Nd:YAG laser and their combined application on dentin hypersensitivity treatment. Methods: The study is a prospective interventional clinical trial. We selected a group of 9 patients with a total of 60 hypersensitive teeth. Each patient had at least 4 hypersensitive teeth. These 4 teeth were randomly placed in 4 different groups. Group1 didn’t receive any treatment. Group2 was treated with 5% sodium fluoride varnish (A Durashield Company product). Group3 was irradiated with Nd: YAG laser (1w, 20Hz, 120s). Group4 was treated by 5% sodium fluoride varnish and Nd: YAG laser combined (same parameters as group3). The assessment of the patients’ pain was done with cold air blast test (CAB) and visual analyzing scale (VAS) after stimulation using a probe and cold air. Patients’ pain was assessed before and just after treatment, and also 2 hours, 1 week and 2 weeks after treatment. For the assessment of pulp vitality we used the electric pulp test (EPT) at each session. SPSS 11.5 was used to process the results obtained. For the CAB and VAS changes in different groups, two-way repeated-measures ANOVA as well as Post-Hoc-Tukey tests were used. For the comparison of the different treatment groups at each session, one-way ANOVA, Post-Hoc-Tukey and or Mann-Whitney and Kruskal-Wallis tests were used. Results: VAS and CAB scores didn’t show any significant difference between different groups before treatment. Analysis of results obtained with two-way ANOVA test for repeated measures showed significant statistical differences for CAB and VAS scores in all groups between before and after treatment except for CAB score in control group. In the comparison of the fluoride varnish group and laser group alone with fluoride varnish-laser combined group using VAS and CAB scores, we found a significant difference. But we didn’t find any significant difference for the comparison between the varnish fluoride group and the laser group using the same score. Conclusion: The use of 5% sodium fluoride varnish and laser for treatment of dentin hypersensitivity is accompanied by a placebo effect. Although it appears that, if we omit the placebo effect, we had an improvement in all 3 treatment groups. But this improvement was more obvious for the treatment group4 (fluoride –laser) compared to other groups.