Evaluation of Two Pain Assessment Methods (Tactile and Air blast) for Comparison the Effectiveness of Nd:YAG Laser Therapy and Non-Laser Therapy on Dentin Hyper Sensitivity Treatment: A Systematic Review and Meta-analysis.

Abstract

Statement of the problem: Dentin hypersensitivity (DH) is a common irritating condition. A precise sensitive test for its assessment can greatly aid in appropriate treatment planning.

Purpose: This meta-analysis aims to compare the air blast and tactile tests for assessment of the efficacy Nd:YAG laser therapy versus non-laser treatments for DH in short-term and long-term follow-ups.

Materials and method: For this review, an electronic search of the literature was carried out in three databases by two researchers for English articles published until March 10, 2021. Pooling of the data extracted from the selected articles was performed according to the PRISMA statement by the random-effect model. The mean difference (MD) and 95% confidence interval (CI) of pain score before the treatment onset and during the follow-up period according to the visual analog scale (VAS) were calculated. The level of heterogeneity was assessed by the I₂ test, and a funnel plot was drawn to assess the publication bias of the reviewed studies.

Results: Of 152 articles primarily retrieved, 9 randomized clinical trials (RCTs) using the air blast test and 4 RCTs using the tactile test were subjected to quantitative synthesis. In the short-term follow-up and immediately after treatment, the air blast test showed superiority of laser therapy compared with non-laser treatments (SMD: 0.55, 95% CI: 0.05-1.04, p= 0.03). However, this difference was not significant according to the tactile test (SMD: 0.48. 95% CI: 0.01-0.96, p= 0.06). In the long-term follow-up, the difference between laser therapy and non-laser modalities was not significant according to both air blast (SMD= -0.38, 95% CI: -1.43-0.67, p= 0.48) and tactile (SMD=0.0, 95% CI: -0.38-0.38, p= 0.99) tests.

Conclusion: Comparison of laser therapy and non-laser modalities in the short-term reveal-ed higher sensitivity of the air blast test due to its mechanism of action compared with the tactile test. Further studies are required to interpret the results in the long-term follow-up.