Evaluation of the Effects of 810 nm Diode Laser Alone and in Combination With Gluma^©and Chromophore on Dentinal Tubule Occlusion: A Scanning Electron Microscopic Analysis

Abstract

Introduction: Tooth hypersensitivity is among the most common patient complaints caused by the response of exposed dentin to external stimuli. No definite treatment has been suggested so far for dentin hypersensitivity (DH). This study aimed to compare the efficacy of the diode laser alone and in combination with Gluma and chromophore in occluding opened dentine tubules and the treatment of DH. Methods: This in vitro study was conducted on 30 extracted human third molars kept in 0.1% thymol solution. The teeth were mounted in transparent acrylic resin and the buccal enamel was cut to expose the outer third of dentin. The samples were then divided into 6 groups of negative control (no smear layer removal), positive control (smear layer removal with 6% citric acid application), 810 nm diode laser irradiation (energy density 55.55 J/cm2 , 1 W for 20 seconds in a continuous mode), chromophore (1 mg/mL indocyanine green, ICG) plus diode laser irradiation (1 W, 20 seconds), Gluma plus diode laser irradiation, and Gluma + chromophore + diode laser. Dentinal tubules were evaluated under a scanning electron microscope at x2000 magnification. The mean percentage of the obstruction of dentinal tubules was reported as mean and standard deviation. Considering the normal distribution of the data, two-way ANOVA was applied to compare the efficacy of treatments, and an independent-samples t test was used for pairwise comparisons at P<0.05 level of significance. Results: The highest mean percentage of the obstruction of dentinal tubules was noted in the diode laser/chromophore/Gluma group (65.68±12.31%) while the lowest value was noted in the diode laser/Gluma group (24.33±5.90%). Pairwise comparisons revealed significant differences between all groups (P<0.05) except for the difference between the laser/Gluma/chromophore and laser/ chromophore groups (P=0.20). Conclusion: It seems that chromophore increases the efficacy of the diode laser for the obstruction of dentinal tubules.

Assessment of Healing after Diode Laser Gingivectomy Prior to Prosthetic Procedures

“…The authors describe that in a group in which the surgery was performed with a diode laser with a wavelength of 980 nm, in 17.6% of the patients there was no bleeding, and it was self-limiting in the rest, 82.4%. It should be noted that the following additional characteristic of bleeding during the procedure was reported in our study-'requiring slight pressure to terminate it' (in 10 of the cases-24.4%)-and the abovementioned authors did not cite this variant of the indicator, due to which the comparison of the specific variable was not accurate enough [7][8][9][10]41]. Another intraoperative characteristic analyzed in our study was the tissue adherence to the instrument during the manipulation.…”

“…According to the data from our study, at the end of the 2nd week (on the 14th day) all gingival resected tissues were completely healed, which demonstrates an accelerated regeneration process after diode laser gingivectomy. In this case, we assume that during the manipulation, the laser beams were absorbed by the surrounding tissues and led to modified biotransformation, accelerating the healing processes [41].…”

“…According to some literature sources, wounds after gingivectomy with traditional instruments healed significantly faster if they were subsequently treated with low-level laser therapy (LLLT). This led to biostimulation and/or biomodulation in the biologic structures as a result of which it was possible to change the cellular behavior [41]. This effect was also achieved by acting on the mitochondrial respiratory chain and/or on the membrane calcium channels.…”

The Amelogenin-Derived Peptide TVH-19 Promotes Dentinal Tubule Occlusion and Mineralization

“…As a global challenge in dental clinics, dentin hypersensitivity (DH) is characterized by a transient, sharp pain originating from the exposure of dentin [1]. The prevalence of DH varies widely, depending on the mode of investigation Effective occlusion of dentin tubules to avoid exposure to stimuli from the external environment is considered to be a reliable strategy for avoiding the fluid movement and reducing dentin permeability, thereby alleviating DH and protecting the dental pulp [2][3][4]. Low remineralization efficiency with distributed minerals was observed on the dentin surface after immersion in a remineralizing solution, suggesting that it is ineffective for the initialization of hydroxyapatite (HA) nucleation and growth [5].…”

Comparative Efficacy of Diode, Nd:YAG and Er:YAG Lasers Accompanied by Fluoride in Dentinal Tubule Obstruction

“…Dentin hypersensitivity (DH) is a common clinical problem affecting all age groups. 1 It is more commonly seen in canine and premolar teeth of both jaws. 2 DH is determined with a short, sharp pain due to the reaction of exposed dentin to different stimuli such as heat, touch, osmotic pressure or chemical stimuli.…”