Review suggests that some lasers are effective in treatment of dentine hypersensitivity

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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.

Comment

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.

Links

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

 Dental Elf 25th June 2011  – Using lasers to treat dentine hypersensitivity suggests slight benefit.

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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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