In Vitro Evaluation of Dentin Tubule Occlusion by Denshield and Neodymium-doped Yttrium-Aluminum-Garnet Laser Irradiation

Abstract: Introduction: This in vitro study evaluated the efficacy of bioglass (Denshield; Novamin Technology, Alachua, FL) and Neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser irradiation on dentinal tubuli orifice occlusion (DOO) by comparing samples examined under environmental scanning electron microscope (ESEM) after applying each desensitizing approach separately and in combination.Methods: Forty-eight human molars were collected, randomly organized in 4 equal groups, and had their cervical dentin exposed. Additionally, in half of the specimens of each experimental group, the smear layer was removed (subgroups A1, B1, C1, and D1). Group A received NovaMin paste treatment for 5 minutes (NM) to the experimental surface. Group B received Nd:YAG laser irradiation (0.5 w, 10 Hz, and 50 mJ) (L). Group C received NM followed by L. Group D was treated with L followed by NM. All specimens were stored for 24 hours and evaluated for DOO under ESEM by 4 blinded observers.Results: The presence of a smear layer significantly contributed to DOO regardless of the treatment modality (ordinal logistic regression, P < .001). Compared with group A, all other treatments delivered significantly more occluded dentin orifices (P < .001 for groups B and D and P < .05 for group C). A layer formation was observed in subgroups C2 and D2.Conclusions: Under these experimental conditions, a smear layer was essential for successful DOO. Laser irradiation alone and combined with NovaMin proved superior to NovaMin alone on DOO. This combined approach has the potential to improve the outcome of treatment for cervical dentin hypersensitivity. The biological significance of this newly formed layer needs to be elucidated.