Study On Treatment Of Dentine Hypersensitivity With Diode Laser And Pro-Argin Desensitizing Toothpaste

Objective: To study the efficacy of diode laser(810nm)and Pro-Argin desensitizing paste on the treatment of dentine hypersensitivity and to observe changes in dentin surface.Materials and Methods:1.150 teeth of 30 patients,diagnosed with dentine hypersensitivity,were included.From each patient,one tooth per quadrant was allocated as experimental tooth and any one tooth irrespective of quadrant was selected as control tooth,and were randomly divided into 5 groups: 1.DP group(Pro-Argin desensitization paste),2.DL group(semiconductor laser),3.DL + DP group,4.DP + DL group and 5.NS group(0.9% Na Cl).Visual analogue scale(VAS)was recorded at baseline(t0),immediately after treatment(t1),2 weeks after treatment(t2),4 weeks(t3),and 8 weeks(t4)after air stimulation of selected teeth and statistically analyzed.2.6 freshly extracted caries free teeth were selected to prepare 6 dentine discs.Each dentin disc was randomly divided into 5 treatment groups.The treatment materials and methods were similar to the clinical experiment.Post intervention morphological changes of dentine surface were observed with scanning electron microscope(SEM)at(x3000),whereas scoring of occlusion of dentinal tubules were carried out at 90 images at(x5000).Three different sites were chosen for SEM,for every treatment group of each dentine disk,which was evaluated by three blinded trained reviewers.Scoring method was designated as follows: Score 4:occluded tubular area more than 75%;Score 3: occluded tubular area 50%-75%;Score 2:occluded tubular area 25%-50%;Score1:occluded tubular area less than 25%.After obtaining the average scores from the examiners for each image the calculated scores were statistically analyzed.Results: 1.1)Comparisons within the same treatment group at different time intervals showed that there was a statistically significant difference between DP,DL,DL+DP and DP+DL group at different time points(P<0.001),difference between baseline(t0)and scores of(t1,t2,t3,and t4)were statistically significant(P<0.001);immediately post treatment(t1)compared with time intervals after 2 weeks of treatment(t2,t3,t4),DL and DP+DL group were statistically significant(P<0.001)whilst DP and DL+DP group were not statistically significant(P>0.05).Scores for all four groups i.e.,DP group,DL,DL+DP and DP+DL group,were not significantly different after two weeks(t3,t4)after of treatment(P>0.05).2)Comparison between various treatment group at the same time intervals and baseline scores for showed that the difference between VAS scores at baseline(t0)and immediate post treatment(t1)was statistically significant(F=6.415,P<0.05);The difference between the NS group and treatment groups was statistically significant(P <0.05),where inter-group comparison between treatment groups was not statistically significant(P>0.05).2.2)SEM image of DP group displays a flat dentinal surface,while most of dentinal tubules have irregular edges and are covered by granular depositions;the images for DL group the dentinal surface to be smooth and flat,tubular edges are clear,and few of tubules are irregularly occluded and few of them show a formation of a ‘concentric layered’ like structures;in the DL+DP group,dentine surface is relatively flat,many tubules are partially occluded by amorphous depositions,tubular edges are clear and formation of ‘concentric layers’ is noticed;in the DP+DL group,dentine surface is uneven,most of them are fully or partially occluded,,tubular edges are irregular alike half moon or crescent shaped and collapsed.Micrographs of the NS control group showed that the surface of the dentin was flat and the dentinal tubules were completely open.The edges of the canal are sharp and demarcated.2)Dentinal tubule occlusion score was analyzed by randomized block ANOVA.There was significant difference between groups(F=30.058,P <0.05).After post –hoc analysis,it was found each treatment group had statistical significance compared to NS group(P <0.05)whilst no significant difference between the various treatment groups(P >0.05).Conclusion: The use of Diode laser and Pro-Argin desensitizing paste,alone or in combination,has immediate and short-term desensitization effects.The application of diode lasers and Pro-Argin desensitizing paste,alone and in combination,can effectively seal the dentinal tubules.