Palazon Milena Traversa, Scaramucci Tais, Aranha Ana Cecilia Correa, Prates Renato Araújo, Lachowski Karina Monteleone, Hanashiro Fernando S, Youssef Michel Nicolau
Department of Restorative Dentistry, School of Dentistry, University of São Paulo São Paulo, SP, Brazil.
Photomed Laser Surg. 2013 Jun;31(6):274-82. doi: 10.1089/pho.2012.3405. Epub 2013 May 15.
The objective of this in vitro study was to evaluate the immediate and short-term effects of laser neodymium-doped yttrium aluminum garnet (Nd:YAG) irradiation and in-office desensitizing treatment on dentin tubule occlusion.
Literature shows a lack of long-lasting treatments for dentin hypersensitivity.
Forty-eight dentin slabs (4×4×2 mm) were ground flat, polished, and treated with 27% ethylenediaminetetraacetic acid (EDTA) to open the dentinal tubules. Specimens were randomly divided into the following experimental groups (n=12): Group 1: Control (no treatment); Group 2: Nd:YAG laser irradiation (100 mJ, 85 J/cm(2) per pulse with a quartz fiber of 400 μm, in scanning movements); Group 3: In-office prophylaxis with pumice; Group 4: In-office Colgate Sensitive Pro-Relief™ Desensitizing Paste. Treatments were performed according to the manufacturer's instructions. After treatment, the specimens were submitted to a sequence of erosive and abrasive challenges, twice a day for 5 days. The specimens were qualitatively and quantitatively evaluated by scanning electron microscopy immediately after treatment and after 4 and 5 days. The response variable was the amount of occluded dentin tubules per area, determined by three different examiners with the use of visual criteria, with a standardized grade created in the PowerPoint program. Data were compared with ANOVA and Tukey's test, considering a 5% significance level.
Immediately after treatment, a reduction in the number of opened dentin tubules was observed for the laser group when compared with the control group (p<0.05). After the experimental procedures, there were no quantitative differences between the amount of opened dentin tubules for all groups; however, micrographs showed some qualitative tubule occlusion for the laser group after the erosive/abrasive challenge.
only laser irradiation was capable of immediately sealing the dentinal tubules; however, none of the treatments showed efficacy in maintaining tubule occlusion after the chemical and mechanical challenges.
本体外研究的目的是评估掺钕钇铝石榴石（Nd:YAG）激光照射及诊室脱敏治疗对牙本质小管封闭的即刻和短期效果。
文献表明缺乏针对牙本质过敏的持久治疗方法。
将48个牙本质块（4×4×2毫米）磨平、抛光，并用27%乙二胺四乙酸（EDTA）处理以开放牙本质小管。样本随机分为以下实验组（n = 12）：第1组：对照组（未治疗）；第2组：Nd:YAG激光照射（100 mJ，每脉冲85 J/cm²，使用400μm石英纤维，扫描移动）；第3组：诊室用浮石进行预防性清洁；第4组：诊室使用高露洁敏感专业舒缓脱敏牙膏。治疗按照制造商说明进行。治疗后，样本每天接受两次侵蚀和磨损挑战，持续5天。治疗后即刻以及4天和5天后，通过扫描电子显微镜对样本进行定性和定量评估。反应变量是每单位面积封闭牙本质小管的数量，由三名不同检查者使用视觉标准确定，在PowerPoint程序中创建标准化等级。数据采用方差分析和Tukey检验进行比较，显著性水平为5%。
治疗后即刻，与对照组相比，激光组开放牙本质小管数量减少（p<0.05）。实验程序后，所有组开放牙本质小管数量无定量差异；然而，显微照片显示激光组在侵蚀/磨损挑战后有一些牙本质小管的定性封闭。
只有激光照射能够即刻封闭牙本质小管；然而，在化学和机械挑战后，没有一种治疗方法在维持小管封闭方面显示出效果。
