Short-term assessment of the Nd:YAG laser with and without sodium fluoride varnish in the treatment of dentin hypersensitivity--a clinical and scanning electron microscopy study.
BACKGROUND
The aim of the present study was to evaluate clinically and under scanning electron microscopy (SEM) the efficacy of Nd:YAG laser irradiation alone and in combination with 5% sodium fluoride varnish in the management of dentin hypersensitivity.


METHODS
The study was conducted on 40 patients divided into four groups who had at least one tooth of Grade III mobility with clinically elicitable dentin hypersensitivity. Following the pretreatment assessment of hypersensitivity using the visual analog scale (VAS) and cold air blast test, the selected tooth in all the groups received 1% citric acid treatment for 1 minute. Group 1 patients received no further treatment; group 2, 3, and 4 patients received additional treatment with 5% sodium fluoride varnish, Nd:YAG laser for 2 minutes, and a combination of 5% sodium fluoride varnish and Nd:YAG laser, respectively. Two hours following treatment, hypersensitivity was again assessed, and the teeth were extracted, sectioned, and scanned using scanning electron microscopy (SEM).


RESULTS
The mean VAS score in group 1 showed a 27% increase from baseline, but groups 2, 3, and 4 showed a decrease of 33%, 44%, and 62%, respectively. The mean cold air blast score showed a 22% increase in group 1, but values decreased by 43%, 50%, and 83% in groups 2, 3, and 4, respectively. The number of patent tubules also progressively decreased from group 1 through group 4.


CONCLUSIONS
The combination of Nd:YAG laser and 5% sodium fluoride varnish seems to show an impressive efficacy, when compared to either treatment alone, in treating dentin hypersensitivity. The SEM findings seem to relate to the clinical findings in that reduction in number/patency of tubules was associated with improvement in treatment efficacy.
Kumar
N Gautham
NG
Department of Periodontology and Implantology, Bapuji Dental College and Hospital, Davangere-577004, Karnataka State, India.
Mehta
D S
DS
D000328:Adult; D003131:Combined Modality Therapy; D003804:Dentin / Q000648:ultrastructure; D003806:Dentin Permeability; D003807:Dentin Sensitivity / Q000628:therapy*; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009354:Neodymium; D010147:Pain Measurement; D012969:Sodium Fluoride / Q000627:therapeutic use*; D018709:Statistics, Nonparametric
D005460:Fluorides, Topical; D009354:Neodymium; D012969:Sodium Fluoride