In my blog on 25th June 2011 we looked at a systematic review which aimed to assess whether laser therapy was more effective than desensitising agents for dentine hypersensitivity. This latest systematic review on the topic by Sgolastra et al aimed to assess the efficacy of lasers, stratified according to laser type, on changes in pain level, when compared with a placebo or no treatment, with safety and adverse events being a secondary aim
A wide range of databases were searched, Medline, Cochrane Controlled Clinical Trial Register, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), CINAHL, Science Direct, and SCOPUS. This was supplemented by a manual search of a number of relevant journals. There were no restrictions on language. Only randomised controlled trial in adults comparing lasers treatment versus placebo or no treatment were included.
- 13 studies were included ( 9 split-mouth, 4 parallel design)., 3 were considered to be at low risk of bias the rest at high risk.
- The meta-analysis results of the 4 types of laser were:-
- Er,Cr:YSSG vs. placebo [3 studies] a non-significant change SMD, 2.49; 95% CI, -0.25 to 5.22; p = .07).
- Er:YAG vs. placebo [4 studies] SMD, 2.65; 95% CI, 1.25 to 4.05; p = .0002
- Nd:YAG vs. placebo[ 3 studies] SMD, 3.59; 95% CI, 0.49 to 6.69; p = .02
- GaAlAs vs. placebo [8 studies] (SMD, 3.40; 95% CI, 1.93 to 4.87; p < .00001)
- Significant heterogeneity was present in all 4 comparisons
The authors concluded
Er:YAG, Nd:YAG, and GaAlAs lasers appear to be efficacious in reducing DH. However, given the high heterogeneity of the included studies, future randomized controlled clinical trials are needed to confirm these results.
This review included 13 studies compared with the He et al studies we looked at in 2011(Dental Elf 25th June 2011). As with that review the authors noted issues with the quality of the included studies including significant heterogeneity. In addition the majority of included studies involved a small number of participants, the largest study including 71 patients.
F. Sgolastra, A. Petrucci, M. Severino, R. Gatto and A. Monaco. Lasers for the Treatment of Dentin Hypersensitivity : A Meta-analysis. J Dent Res. published online 22 April 2013 DOI: 10.1177/0022034513487212