Laser Relief: Clinical Study on 980 nm Diode Laser for Dentin Hypersensitivity | InformativeBD

Hareth A. Alrikabi, from the institute of Iraq. wrote a Research Article about, Laser Relief: Clinical Study on 980 nm Diode Laser for Dentin Hypersensitivity. Entitled, The effect of 980 nanometer diode laser in relieving dentin hypersensitivity: a clinical study. This research paper published by the International Journal of Biosciences (IJB). an open access scholarly research journal on Biodiversity. under the affiliation of the International Network For Natural Sciences| INNSpub. an open access multidisciplinary research journal publisher.

Abstract

Dentin hypersensitivity is a common issue happened due to exposure of the root surface. Patients with dentin hypersensitivity complain from sharp short pain that triggered by different stimuli, such as thermal changes, tactile stimuli and osmotic changes. This study aims to explore the effect of the 980 nanometer diode laser in treatment of the dental pain associated with dentin hypersensitivity over 4 weeks period. Ten patients with exposed root surfaces suffering from dentin hypersensitivity were subjected to treatment by using 980 nanometer diode laser, three treatment sessions for each patient. The pain severity evaluated before and after treatment.8 of the 10 patients participated in the study felt relived after three sessions of treatment. Only two patients still feeling a little discomfort for thermal changes. According to the result of this study, the diode laser (980 nanometer) has a very good effect in relieving the discomfort of the dentin hypersensitivity.

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 Introduction

Dentin hypersensitivity is a common clinical condition that is characterized by sharp pain arising from exposed dentin in response to various stimuli.the exposure of open dentinal tubules causes the transmission of the dentinal fluid with the change in stimuli pressure. It also can be defined as "a 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 disease (El Mobadder et al. 2023). 

Patients with Dentin hypersensitivity (DH) often report discomfort when consuming hot, cold, sweet, or acidic food and beverages. Moreover, simple everyday activities such as tooth brushing and even breathing in cold air through the mouth can provoke the pain associated with DH. Sensitive teeth most frequently result when the teeth lose their enamel protection or the gums recede, leaving the sensitive dentin layer exposed ( Fig.1). As a result, DH can have a significant negative impact on the quality of life and the oral health of the patients. For instant pain relief, over-the-counter desensitizing toothpastes or mouthwashes are often recommended by oral health professionals. However, the efficacy of these products in managing DH in the long term is still under debate (Irwin et al. 1997). This debate based on practical and clinical experiences that showed clearly gradual disappearance of the effect of these materials after several months. Theses materials will be wiped off by thewashing effect of saliva, the mechanical effect of mastication and the chemical nature of food (Davari et al. 2013). 

Many different causal agents, ranging from simply inhaling cold air to potentially serious underlying pathological conditions, can prompt symptoms of dentin hypersensitivity. This includes dietary erosion, bruxism, use of abrasive toothpaste, acidic mouthwash, harsh brushing, gingival recession due to periodontal disease, erosion by gastro-esophageal acids, and intrinsic methamphetamine abuse (Gillam et al. 2019).

From a literature review, it is generally agreed that treatment should firstly begin with the exclusion of plaque, calculus, and other periodontal-related disorders through proper differential diagnosis. Various clinical approaches including the application of oxalates, glutaraldehyde, resins, or dentine bonding agents are used to manage DH.These treatments aim to either physically occlude the patent dentinal tubules or prevent the neural transmission. Localized pain control through the application of lasers has been suggested as a new approach in managing DH more effectively. Different types of lasers including the low power diode, pulsed Nd:YAG, CO2, and Er: YAG lasers have been used in the clinical treatment of DH. The 980nm diode lasers is now designed to be the treatment of choice for clinical applications such as soft tissue surgery in periodontology and the relief of dentin hypersensitivity(Borges 2021). The wavelength that is output by a diode laser is a key determinant of the photo-biological reaction being sought in both the soft and hard tissue. The continuous mode diode laser operation provides uniform delivery of energy to the hard tissue. This will provide the opportunity for the effectiveness of the desensitizing result (Borges et al. 2021, Khoroushi et al. 2019).

First-generation lasers such as the Argon laser, NdYAG laser, and CO2 laser utilized thermal effects for the desensitization process, which could cause collateral damage to the cementum due to the existence of patent dentinal tubules in root surfaces. The newer lasers designed for desensitization, such as the 980 nm diode laser, do not rely on non-specific thermal effects. Instead, they use photonic energy to modify nerve function and produce a lasting effect on pain to eliminate the nerve response. The authors believe that, with the appropriate laser settings, the energy is absorbed by intratubular fluid, and it is this fluid in the dentinal tubules that is thought to mediate dentinal hypersensitivity (Qadri et al. 2005).

There are many studies used 980 nm diode laser as a treatment option in many countries over the world in different population. In Iraq, there is very little studies about this subject (especially in southern area). The objective of this clinical study is to investigate the efficacy of 980 nm diode laser in relieving DH over a period of 4weeks. 

The data was collected through a meticulous process. Subjects were tested using a compressed air source that was set to 80 psi (pounds per square inch) to deliver cold air at ambient temperature. A triple syringe (already attached to the dental chair) was used as a nozzle to direct the air onto the subject's teeth. The subjects received ten seconds of cold air stimulation. After stimulation, the subjects were asked to indicate the level of discomfort experienced and were given a score ranging from "no pain" to "unbearable." The scale was categorized into four levels; score 0 was defined as "no pain," score 1 was defined as "mild pain," score 2 was defined as "moderate pain," and score 3 was defined as "severe pain." If cold air stimulation results in a score less than 2, the subject would qualify to be a part of the study as he/she had to be experiencing dentin hypersensitivity condition. The qualified subjects attend treatments using 980 nm diode laser. During the treatment, the parameters and settings proposed by the laser manufacturer were used. The parameter settings were programmed onto the laser control unit and the treatment was started after the hand piece was being properly placed. All the enamel/dentine hypersensitivity parameters collected in this clinical study will be processed and analyzed using statistical software. By comparing the mean change of each parameter before and after the laser treatment, the effectiveness and efficiency of diode laser in treating dentin hypersensitivity can be identified. It is hoped that at the end of this clinical study, an objective assessment on the clinical value of 980 nm diode laser in treating dentin hypersensitivity can be provided.

Reference

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