Evaluation of potassium binoxalate gel and Nd:YAG laser in the management of dentinal hypersensitivity: a split-mouth clinical and ESEM study

Abstract

Dentinal hypersensitivity is one of the oldest recorded complaints of discomfort to mankind and yet there appears to be no permanent treatment for this clinical condition. This study was designed to evaluate the clinical efficacy of potassium binoxalate gel and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser on dentin hypersensitivity for a period of 9 months. Eighty teeth (20 subjects, 25-55 years old, M = F) were evaluated in a split-mouth design to receive potassium binoxalate (group A, 40 teeth) and Nd:YAG (group B, 40 teeth: 1 W, 10 Hz, and 60 s, irradiated twice). The diameter of output beam was about 300 μm with a distance of 2 mm between laser fiber or tip and tooth surface. The clinical efficacy was evaluated by air-blast test and cold-water test using visual analog scale. Electron microscopy photomicrographs were taken to confirm the results. Analysis was done at baseline; immediately post-treatment; and at 3, 6, 9 months post-treatment. Student's paired and unpaired T tests were used to evaluate the statistical analysis. Both treatment modalities were effective in reducing dentine hypersensitivity. However, Nd:YAG laser was better when intragroup comparison was made at 9 months post-treatment. Nd:YAG lasers is better in long-term treatment (up to 9 months) owing to the melting of dentinal tubules. However, due to depth of penetration of microcrystals, gel was better when ease of the procedure is considered. Nevertheless, both treatment modalities resulted in recurrence. Hence, further studies are needed to discover an agent, which can be considered as a "gold standard".

<i>In vivo</i> analyses of the effects of polyamidoamine dendrimer on dentin biomineralization and dentinal tubules occlusion

“…Currently, many strategies have been developed to deal with DH. For example, calcium-phosphate 5) , potassium oxalate 6) , bioactive glasses 7) , fluoride 8) , and other materials have been used either in dentifrices or as single or multiple application agents to occlude dentinal tubules. However, there are no single desensitizing agent that can be considered ideal for this condition, since these materials have difficulties in replicating the hierarchical structure of mineral within the collagen matrix and do not fit well with natural dentin tissue.…”

Dentine Hypersensitivity: Review of a Common Oral Health Problem

“…Laser treatment has also been recommended for treatment of DH. Studies have reported that the neodymium: yttrium-aluminum-garnet (YAG) laser, the erbium:YAG laser and galium-aluminium-arsenide low level laser all reduce DH [45][46][47]. A more recent literature review on the use of lasers in treatment of DH has suggested that though it has a slight clinical advantage over topical medicaments, further studies with larger samplesizes, long-term, high-quality randomised controlled clinical trials are needed before definitive conclusions can be made [48].…”

A utilização da laserterapia para o tratamento da hipersensibilidade dentinária

“…Um dente com dentina mais transparente absorve menos radiação pelo laser de Nd:YAG do que uma dentina com pigmentações marrons ou mais amareladas 14,28 . Para que o laser produza os efeitos desejáveis e para evitar danos térmicos, a irradiação deverá ser realizada com potências inferiores a 1,5W, pois valores superiores podem causar danos térmicos indesejáveis no tecido alvo, como rachaduras e carbonização, e na polpa dental 12,14,28 . Outros lasers bastante utilizados para o tratamento da hipersensibilidade dentinária são os lasers de érbio (Er:YAG e Er,Cr:YSGG) e CO 2 , que atuam de forma semelhante na dentina.…”

“…Talesara et al 28 estudaram a eficácia clínica de um gel a base de oxalato de potássio e do laser Nd: YAG para o tratamento da hipersensibilidade dentinária hipersensibilidade dentinária, durante um período de 9 meses. Após o tratamento de 20 pacientes de ambos os sexos, os autores concluíram que os dois tratamentos propostos foram efetivos para eliminar o desconforto dos pacientes imediatamente após a aplicação dos métodos citados.…”

“…Apesar dos estudos clínicos apontarem resultados bastante favoráveis, os lasers de alta intensidade apresentam algumas desvantagens quando comparados com tratamentos convencionais, como o alto custo e a complexidade de uso dos equipamentos 14,22,28 . Contudo, o conforto que esta técnica traz para o paciente, muitas vezes, supera estas desvantagens.…”