69 - Dentin hypersensitivity after interproximal enamel reduction in patients treated with clear aligners: Desensitizing effect of diode laser vs sodium fluoride

Abstract

Background

Interproximal enamel reduction (IPR) is a common procedure in orthodontic treatment with clear aligners, but it may lead to dentin hypersensitivity (DH) and changes in gingival health.

Objective

This study evaluated dentin hypersensitivity and gingival health after IPR in patients treated with clear aligners and compared the desensitizing effect of laser diode versus sodium fluoride.

Methods

The study was a triple-blinded randomized controlled clinical trial. To be eligible for inclusion, patients had to respect for the following criteria: permanent dentition, good oral and general health. Previous history of hypersensitivity, enamel defects, cervical caries, periodontal disease, or pregnancy were excluded. A total of 45 patients with an orthodontic treatment plan including clear aligners and IPR (aged 14–63yrs) were randomly assigned to three groups: Group A (acidulated sodium fluoride gel: 0.33% NaF), Group B (diode laser: Soft Touch, 810 nm, 0,5W), and Group C (control, no treatment). In all groups, the response to air stimuli and the gingival indices were recorded before (T0) and immediately after IPR (T1), one week (T2), one month (T3), and three months post-treatment (T4). DH was assessed using a visual analog scale (VAS) by a blinded operator, while gingival health was evaluated using Silness and Löe Plaque and Gingivitis Indices.

Results

All groups showed an increase in DH immediately after IPR compared to baseline, which subsequently decreased at T2, T3, and T4. The laser group exhibited a statistically significant 10% reduction in DH, with rapid improvement one week post-treatment and sustained benefits over time. The gingival index improved or remained stable across all groups, with the laser group showing the most pronounced improvements. Moreover, the Plaque index was reduced in all groups.

Conclusion

The application of diode laser, after IPR, effectively reduced DH without adversely affecting gingival health. This finding supports the use of laser therapy to manage DH in orthodontic patients undergoing IPR.