Using Laser-Doppler Flowmetry to Evaluate the Therapeutic Response in Dentin Hypersensitivity.

Mariana Miron,Diana Lungeanu,Edmond Ciora,Emilia Ogodescu,Carmen Todea

doi:10.3390/ijerph17238787

Abstract

Dentin hypersensitivity (DH) is a common medical condition with underreported prevalence and it is difficult to quantify. This study aimed to investigate whether assessing dental pulp vascular micro-dynamics by laser-Doppler flowmetry (LDF) would be functional for therapeutic evaluation, in contrast to a verbal rating scale (VRS). A split-mouth single-blind randomized study was conducted on seven patients and a total of 36 teeth. Two DH therapeutic methods were employed: (i) fluoride gel; (ii) Nd:YAG radiation combined with fluoride gel. For each tooth, five consecutive LDF determinations of pulp blood flow were made (before and immediately after desensitizing treatment, then after 24 h, 7 days, and 1 month), and the VRS was applied each time. Spearman’s correlation was applied for concurrent validation. Two-way (treatment and patient) repeated measures ANOVA full factorial was applied, followed by Tukey’s post-hoc comparisons and Pillai’s trace multivariate statistic. While VRS scores had moderate reliability, LDF could objectively estimate treatment effects. Based on partial eta-squared values, treatment and patient characteristics were estimated to explain about 84% and 50% of the variability, respectively. In conclusion, LDF is an objective technique that can quantitatively assess DH evolution, and it is effective in reliably monitoring oral health therapeutic interventions.

Highlights

Introductiondentin hypersensitivity (DH) is rapidly triggered when dentinal tubules are exposed to mechanical, thermal, and/or chemical stimuli temporarily present in the oral cavity
According to international studies [1,2,3,4], dentin hypersensitivity (DH) is a complex condition with multi-factorial etiology and high prevalence in all age groups, which may severely affect quality of life [5].DH is rapidly triggered when dentinal tubules are exposed to mechanical, thermal, and/or chemical stimuli temporarily present in the oral cavity
In this study the correlation was lower in case of Nd:YAG laser treatment upon immediate assessment: the verbal rating scale (VRS) scores might have been impaired, while the laser-Doppler flowmetry (LDF) measurements reflected the microcirculation storm related to laser exposure

Summary

Introduction

DH is rapidly triggered when dentinal tubules are exposed to mechanical, thermal, and/or chemical stimuli temporarily present in the oral cavity. Brannstrom’s hydrodynamic theory [6,7] is widely accepted and states that when the dentin is exposed, the stimuli determine fluid movements in the open dentinal tubules, generating negative or positive pressures on the nerve endings of the plexus around the odontoblasts. This leads to nerve fibers’ mechanical deformation, Na+ ions channels’ broadening, and fibers’ depolarization, Int. J. Public Health 2020, 17, 8787; doi:10.3390/ijerph17238787 www.mdpi.com/journal/ijerph

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