Objective: The aim of this randomized longitudinal clinical study was to assess different treatment protocols for dentin hypersensitivity with high-power laser, desensitizing agent, and its association between high-power laser and desensitizing agent, for a period of 6 months. Background data: The literature shows a lack of treatment for dentin hypersensitivity, and lasers are contemporary alternatives. Methods: After inclusion and exclusion analysis, volunteers were selected. The lesions were divided into three groups (n = 10): G1, Gluma Desensitizer (Heraeus Kulzer); G2, Nd:YAG Laser (Power Laser TM ST6, Lares ResearchÒ) contact mode, laser protocol of 1.5 W, 10 Hz, and 100 mJ, & 85 J/cm 2 , four irradiations performed, each for 15 sec, in mesiodistal and occluso-apical directions, totaling 60 sec of irradiation with intervals of 10 sec between them; G3, Nd:YAG Laser + Gluma Desensitizer. The level of sensitivity to pain of each volunteer was analyzed by visual analog scale (VAS) using cold air stimuli and exploratory probe 5 min, 1 week, and 1, 3, and 6 months after treatment. Data were collected and subjected to statistical analysis that detected statistically significant differences between the various studied time intervals of treatments ( p > 0.05). Results: For the air stimulus, no significant differences were found for each time interval. For the long-term evaluation, all groups showed statistical differences ( p > 0.05), indicating that for G2 and G3, this difference was statistically significant from the first time of evaluation (post 1), whereas in G1, the difference was significant from the post 2 evaluation (1 week). Comparison among groups using the probe stimulation showed significant differences in pain ( p < 0.001). Only in G1 and G3 did this difference become significant from post 01. Conclusions: All protocols were effective in reducing dentinal hypersensitivity after 6 months of treatment; however, the association of Nd:YAG and Gluma Desensitizer is an effective treatment strategy that has immediate and long-lasting effects.
This randomized and longitudinal in vivo study aimed to assess different protocols for the treatment of dentin hypersensitivity with low-power laser (with different doses), high-power laser, and a desensitizing agent, for a period of 12 and 18 months. The lesions from 32 patients (117 lesions), who were submitted to the inclusion and exclusion criteria, were divided into nine groups (n = 13): G1: Gluma Desensitizer (Heraeus Kulzer), G2: low-power laser with low dose (three points of irradiation in vestibular portion and an apical point 30 mW, 10 J/cm, 9 s per point with the wavelength of 810 nm, with three sessions with an interval of 72 h), G3: low-power laser with high dose (one point in the cervical area, and one apical point 100 mW, 40 J/cm, 11 s per point with the wavelength of 810 nm in three sessions with an interval of 72 h), G4: low-power laser with low dose + Gluma Desensitizer, G5: low-power laser with high dose + Gluma Desensitizer, G6: Nd:YAG laser (Power Laser™ ST6, Research® in contact 1.0 W, 10 Hz and 100 mJ, ≈85 J/cm, with the wavelength of 1064 nm), G7: Nd:YAG laser + Gluma Desensitizer, G8: low-power laser with low dose + Nd:YAG laser, and G9: low-power laser with high dose + Nd:YAG laser. The level of sensitivity of each volunteer was assessed by visual analog scale of pain (VAS) with the aid of air from the triple syringe and exploration probe, 12 and 18 months after treatment. All analyses were performed separately for air and probe stimulus. The level of significance was considered for values of p < 0.05. After statistical analysis, all treatments were shown to be effective in reducing dentinal hypersensitivity, and the results were considered not statistically different from those at 12 months. Therefore, until the 18-month evaluation, it could be said that no statistical differences were observed in the sensitivity levels for all treatments.
The aim of this randomized, longitudinal clinical study was to evaluate different protocols for dentin hypersensitivity treatment with low-power laser at different dosages, desensitizing agent, and associations, for a period of 6 months. After analysis of the inclusion and exclusion criteria of volunteer participants, those who present pain resulting from non-carious cervical lesions were selected. Twenty-seven patients participated in the study, and 55 lesions were recorded. The lesions were divided into five groups (n = 11), treated, and evaluated: G1: Gluma Desensitizer (Heraeus); G2: low-power laser (Photon Lase, DMC) at low dose (three vestibular points and one apical point of irradiation: 30 mW, 10 J/cm(2), 9 s per point with wavelength of 810 nm), three sessions were performed with an interval of 72 h between them; G3: low-power laser at high dose (application at one cervical and one apical point: 100 mW, 90 J/cm(2), 11 s per point with wavelength of 810 nm), three sessions were performed with an interval of 72 h between irradiations; G4: low-power laser at low dose + Gluma Desensitizer; and G5: low-power laser at high dose + Gluma Desensitizer, the level of sensitivity of each volunteer was evaluated with a visual analog scale of pain (VAS) with the use of air from a triple syringe and exploration with a probe after time intervals of 5 min, 1 week, and 1, 3, and 6 months after treatment. Data were collected and subjected to statistical analysis. Kolmogorov-Smirnov test was used to verify the distribution of the data, and nonparametric Kruskal-Wallis and Friedman tests were performed for comparison among the experimental groups and time intervals studied, respectively. Statistically significant differences between the studied time intervals (p < 0.05) were detected. From the difference in pain, it was observed that for both stimuli, the protocol with the Gluma desensitizing agent presented immediate effects of pain reduction. For low-level lasers, it was observed that there were distinct effects for the different doses; however, both were efficient in reducing pain up to the 6 months of clinical follow-up. Therefore, it could be concluded that all the desensitizing protocols were effective in reducing dentin hypersensitivity, but with different effects. The combination of protocols is an interesting alternative in the treatment of cervical dentin hypersensitivity.
AGRADECIMENTOSPrimeiramente gostaria de agradecer a Deus por todas as oportunidades da vida e por permitir que eu estivesse cercada de pessoas maravilhosas.A minha querida e amada família: meus padrinhos José Fernando Oliveira e Silvia Pires Oliveira, minha prima Glaucia Pires Oliveira; aos meus tios Elizabeth Lopes Silva e Hermínio Silva e aos meus primos Renato, Marcelo e Cristina juntamente com a Gabriela, e Glauco e Eloana juntamente com o Matheus. Obrigada por estarem presente em todos os momentos da minha vida. Amo muito vocês e tenho-os como exemplo de vida, de dedicação, superação, devoção e alegria.Á minha orientadora Profa. Dra. Ana Cecília Correa Aranha por ser mais que uma orientadora, ser uma amiga com quem pude dividir todas as minhas felicidades e angustias. Obrigada pelas risadas e pela força nos momentos das lágrimas. Não tenho como agradecer tudo que você fez e faz por mim. Você é uma inspiração de mulher, pessoa, mãe, profissional, professora e orientadora. Tenho muito orgulho de ser uma "Ciçet". Tomara que um dia eu consiga ser uma pequena parte do que você é.Aos queridos amigos, que considero como parte da minha família:Lourdes, Vó Judite, Mercedes, Noninha Mercedes, Matilde, Dennis, Toledo, Silvana e Marcos Viana (in memorian). Amo vocês.À minha família Arthur Cavalli, em especial a Cleuza e Carlos por todo apoio e carinho!Vocês são muito especiais! As queridas Thayanne, Cynthia, Tatiane e Mayra por todas as risadas e companheirismo. Sabemos das alegrias e dificuldades que passamos nesta fase... Sem vocês tudo seria muito mais difícil! Temos muita história pra contar nestes 5 anos juntas: risadas, dificuldades, viagens, jantares, almoços, festas e muitas conquistas... E muito mais virá! As queridas Thaysa, Livia e Bruna que fizeram e fazem muita falta, mas quando nos encontramos parece que nada mudou e a distancia seja de tempo ou espaço não importa! As queridas Ciçets Samira, Sandra e Raquel por todas as risadas e apoio que me deram.A todos os colegas de pós-graduação em especial a Camila, Andrea e Às amigas Bruna, Gabriela, Patrícia, Priscila, obrigada pelo apoio e por estarem ao meu lado em vários momentos da minha vida.Aos amigos Daniela, Bill, Nadja, Chayne, Fabiana, Thiago, Felipe e Michelle Sperandio, Gil Cesar, Marcelo Sirolli, Jum e Sergio por toda força e apoio.Ao amigo Fabio que me ajudou muito para a realização desta tese.Aos funcionários do LELO e da Dentística por toda ajuda para tornar esse momento possível.Aos pacientes por toda paciência e comprometimento. E a todos aqueles que de alguma forma colaboraram para que eu concluísse esse trabalho. AGRADECIMENTOS INSTITUCIONAIS
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