journal of dentistry 36 (2008) 392–395

available at www.sciencedirect.com

journal homepage: www.intl.elsevierhealth.com/journals/jden

Comparative study in desensitizing efficacy using the GaAlAs

laser and dentin bonding agent

Tasanee Tengrungsun a,*, Worawan Sangkla b

a
Department of Hospital Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Bangkok 10400, Thailand
b
Dental Division, Taksin Metropolitan Hospital, Bangkok, Thailand

article info abstract

Article history: Objective: To compare the clinical efficacy of the GaAlAs laser and dentin bonding agent in
Received 21 October 2007 treating dentin hypersensitivity.
Received in revised form Methods: One hundred and forty teeth from 70 patients diagnosed with dentin hypersensi-
11 February 2008 tivity, were divided into two groups: In group I, teeth were irradiated with 30 mW GaAlAs
Accepted 12 February 2008 laser for 1 min and in group II, teeth were applied with dentin bonding agent. Sensitivity was
assessed by tactile and thermal tests, measured with the criteria proposed by Uchida at
baseline and after treatment; immediately, at 15 and at 30 days.
Keywords: Results: The reduction of dentin hypersensitivity was observed in both treatments using the
Dentin hypersensitivity GaAlAs laser and dentin bonding agent. However, a greater reduction was observed over
Dentin bonding agent time up to day 15 and no significant change was observed between days 15 and 30.
GaAlAs laser Statistically significant differences in the level of dentin hypersensitivity between bonding
Desensitizing agent and the GaAlAs laser were found at each observation period ( p < 0.05).
Laser therapy Conclusion: The GaAlAs laser had less desensitizing efficacy compared with dentin bonding
agent. However, the desensitizing effect of the GaAlAs laser still could be considered an
effective therapy for treating dentin hypersensitivity.
# 2008 Elsevier Ltd. All rights reserved.

1. Introduction The application of resin to reduce dentin hypersensitivity

Dentin hypersensitivity is characterized by short, sharp pain
arising from exposed dentin in response to external stimuli,
typically thermal, evaporative, tactile, osmotic or chemical
and which cannot be described to any other form of dental
defect or pathology.1 Hypersensitivity can become a concern
because of the increased number of teeth with gingival
recession, erosion and attrition. This condition may disturb
the patient daily habits of eating, drinking, brushing and
sometimes even breathing.
Various treatments have been performed to reduce dentin
hypersensitivity utilizing different mechanisms such as the
GaAlAs laser and dentin bonding agent.
by facilitating the penetration of resin into dentinal tubules to
occlude the open orifices was initially proposed by Dayton
et al.2 and Nordenvall and Brannstrom.3,4 Several clinical
studies were conducted to test the efficacy of dentin bonding
agents.5–8 Most studies confirmed the efficacy of these
treatments. Recently, the GaAlAs laser was introduced in
treating dentin hypersensitivity by means of inducing changes
in neural transmission networks within the dental pulp,
which may stimulate the normal physiological cellular
functions. Therefore, at subsequent appointments, the pulpal
tissue was less injured or inflamed. In addition, the laser
stimulated the production of sclerotic dentin, thus promoting
the internal obliteration of dentinal tubules.9 For these

* Corresponding author. Tel.: +66 2 6448644 6x6530 1; fax: +66 2 2036530.

E-mail address: dtttr@mahidol.ac.th (T. Tengrungsun).
0300-5712/$ – see front matter # 2008 Elsevier Ltd. All rights reserved.
doi:10.1016/j.jdent.2008.02.012
 journal of dentistry 36 (2008) 392–395
reasons, dentin bonding agent was selected to evaluate their
effectiveness in patients compared with the GaAlAs laser. 10–13
2. Materials and methods
The research protocol was initially submitted for approval by
the Ethics Committee of the Bangkok Metropolitan Adminis-
tration, Thailand. Patients in the dental clinic at Taksin
Metropolitan Hospital, complaining of cervical dentin hyper-
sensitivity, were recruited for this study.
To participate in the study, patients were first screened by
periapical radiograph and visual inspection. The investigators
selected participants from individuals presenting dentin
hypersensitivity, whose probable etiologic factors included
parafunctional habits, gastric and/or emotional diseases or
frequent ingestion of acidic food. Exclusion criteria of this
study were evidence of carious lesion, defective restoration
and facets. After careful selection, 70 patients of both genders,
ranging from 20 to 60 years of age, were enrolled in the study. A
total of 140 teeth, with cervical dentin hypersensitivity, were
tested in this study.
Patients were required to be willing and able to return at
specified study intervals for follow-up examinations. The
objectives of the trial, as well as the possible discomfort and
risks, were fully explained and all participants signed the
appropriate, approved informed consent.
Prior to the application of desensitizing agents in both
groups, dentin hypersensitivity was assessed by thermal
stimulus. A cold air-blast from a three-way dental syringe was
directed to the exposed cervical area for five seconds under
relative isolation.
Data were standardized by scoring the degree of sensitivity
for each tooth according to the criteria proposed by Uchida
et al.,14 which establishes four degrees for sensitivity depending
on patient’s response to stimulation (Table 1). This study was
performed by one operator and one assessor responsible for the
measurement of the sensitivity level of the patients.
For each patient, half of sensitive teeth were irradiated with
the GaAlAs laser (Compact Laser, J. Morita Corp., Japan)
790 nm at 30 mW for 1 min and the remaining teeth were
applied with dentin bonding agent (ScotchbondTM, 3M Dental
Products, St. Paul, MN, USA). The effectiveness of both
treatments was assessed at three examination periods;
immediately, at 15 and at 30 days after treatment.
The data obtained were submitted to statistical analysis
using chi-square test for the categorical data and two-way
repeated measures analysis of variance (ANOVA) with post
hoc comparison Tukey Test for continuous data. The level of
significance for statistical analysis was set at p < 0.05.
Table 1 – Degree of cervical dentinal hypersensitivity
Degree Sensitivity
0 Without significant discomfort
1 Discomfort with mild pain
2 Sharp pain solely during the application of stimulus
3 Sharp pain during the application of stimulus and
continuous after its removal
393
3. Results
Seventy patients met the inclusion criteria and were enrolled
in the study. Their baseline demographic characteristics are
presented in Table 2.
The analysis of treatment results showed that prior to
desensitizing therapy, all tested teeth for both groups
presented cervical dentin hypersensitivity at various degrees
as shown in Table 3. None of the teeth from either group were
scored 0. After applying treatment, none of the teeth from
either group presented with sharp pain during thermal
stimulation and continuous discomfort after the removal of
stimulus or Uchida’s degree 3. Statistical analysis using chi-
square test revealed statistically significant differences in the
number of teeth for both groups in each time point and the
Uchida’s degree ranged from 0 to 3. It has been shown that
immediately and at 15 days after the application of both
treatments, the number of teeth with no report of significant
discomfort or degree 0 increased. However, 30 days after the
treatment was initiated, a slight decline in the relief/absence
of sensitivity was noticed when compared with 15 days for the
same degree.
In addition to differences in the number of teeth in each
treatment group, classified according to Uchida’s criteria,14
after the treatment, were assessed the changes in level of
sensitivity in both groups at baseline, immediately, at 15
days and at 30 days after treatment. The mean of the level of
dentin hypersensitivity in each group for each time point
was calculated; the level of dentin hypersensitivity at
baseline was 1.93  0.49 (mean  S.D.). The two-way
repeated measures ANOVA revealed a statistically signifi-
cant interaction between main effects of treatment type and
of time. A significant reduction was found after the
treatment at all observation periods. However, no signifi-
cantly additional reduction in level of hypersensitivity was
observed from day 15 to 30. Statistically significant
differences were found in the level of hypersensitivity
between dentin bonding agent and the GaAlAs laser at all
evaluation time points ( p < 0.05).
The statistical results of both treatments are illustrated in
Fig. 1.
Table 2 – Demographic characteristics of patients
Characteristics Data
Age (year):
Range 21–62
Mean 45.8
Standard deviation 10.0
Gender:
Male 15
Female 55
Occupation:
Unemployed 17
Government officer 34
Employee 12
Student 5
Other 2
394 journal of dentistry 36 (2008) 392–395

Table 3 – Degree of dentin hypersensitivity before and flow across dentin.16 Whereas, the GaAlAs laser blocks the
after both treatments depolarization of C-fiber afferents.17
Degree Baseline Immedi- 15 days 30 days Considering the treatment procedures between the two
ately tested methods, the treatment time was approximately the
I II I II I II I II same (about 1 min). However, the laser treatment seem to be
less complicated since the need to isolate the operation field
0 0 0 8 65 22 69 21 66 and keep it dry during dentin bonding agent application was
1 16 16 17 5 13 1 14 4
eliminated. Wigdor’s study18 observed that 50% of participants
2 44 44 45 0 35 0 35 0
stated that laser treatment was more comfortable and faster
3 10 10 0 0 0 0 0 0
than conventional method. Nevertheless, the GaAlAs laser
Group I = GaAlAs laser treatment; Group II = dentin bonding agent. and dentin bonding agent could be clinically advantageous
methods to reduce dentin hypersensitivity due to their rapid
clinical effectiveness with no adverse reactions observed. As
4. Discussion such, they could be suitable for routine clinical treatment for
dentin hypersensitivity.
The basic concepts in the treatments of dentin hypersensi- GaAlAs laser treatment seems to be beneficial and can be
tivity can be classified on the basis of the chemical and an alternative treatment for dentin hypersensitivity. However,
physical agents.15 In this study, both chemical and physical the laser is found only in some dental offices due to its high
agents (ScotchbondTM and the GaAlAs laser) were compared cost. Therefore, laser units in dental offices may become more
for desensitizing efficacy. The therapeutic aims of such widely used to relief orofacial pain, treat periodontal abscess
treatments are to either affect the pulpal response to and repair bone.
stimulation or block the sensitivity mechanism through The desensitizing effects of both treatments in this study
tubule occlusion. provide a significant relief in sharp painful symptoms and can
Reduction in sensitivity to thermal and tactile stimuli has be reapplied in case of recurrent discomfort. It would be
been reported using GaAlAs lasers10,13 and bonding agent.5,7,8 interesting to study the long term effects of reducing dentin
Accordingly, in the present investigation, the two treatment hypersensitivity from laser treatment since the mechanism
groups promoted a considerable decrease in sensitivity after induces the sclerotic dentin layer. Because the application of
15 days of the first application and continued desensitizing resin is to occlude dentin orifice, the loss of occluded resin
effects were observed at the last recall (30 days after the first from physical force such as brushing would result in less
application). effectiveness. Nevertheless, the optimal treatment modality
It is possible that the two treatments tested in this study of dentin hypersensitivity that neither irritates the pulp nor
may reduce dentin hypersensitivity by different mechanisms. causes pain should be an easy and practical treatment.
For dentin bonding agent, the formation of protein precipi- Therefore, variables such as severity of pain, age of the
tates transverse septa in the deeper part of the tubules and patient, dose and longer observation period are required for
formation of resin tags near the surface, thereby blocking fluid further evaluation.

5. Conclusion

From this study, it can be concluded that

1. A significant reduction of dentin hypersensitivity after both

treatments at all evaluation time points was observed.
( p < 0.05).
2. The reduction of dentin hypersensitivity by dentin bonding
agent was significantly superior to GaAlAs laser. ( p < 0.05).
3. After application of both treatments, all of the tested teeth
were absent from sharp pain and continuous discomfort
after the removal of stimulus.
4. No significantly additional reduction in level of hypersen-
sitivity from day 15 to 30 was observed.

Fig. 1 – Mean of dentin hypersensitivity levels at four Acknowledgements

observation periods comparing between GaAlAs laser and
dentin bonding agent. *Statistically significant difference
between laser and dentin bonding agent at each time
point. #Statistically significant difference between each
time point comparing to baseline for each treatment.
We thank Dr. M.L. Theerathavaj Srithavaj and Dr. Poompada
Jaojaksiri for their help with manuscript preparation and
review and Dr. Somsak Mitrirattanakul for his help with
statistical analysis.
 journal of dentistry 36 (2008) 392–395
references
1. Holland GR, Narhi MN, Addy M, Gangarosa L, Orchardson R.
Guidelines for the design and conduct of clinical trials on
dentine hypersensitivity. Journal of Clinical Periodontology
1997;24:808–13.
2. Dayton RE, DeMarco TJ, Swedlow D. Treatment of
hypersensitive root surface with dental adhesive materials.
Journal of Periodontology 1974;45:873–8.
3. Nordenvall KJ, Brannstorm M. In vivo resin impregnation of
dentin fractures. Swedish Dental Journal 1980;4:177–82.
4. Nordenvall KJ, Brannstorm M. Impregnation of ground, acid
etched dentin in vivo, using five commercial resins. Swedish
Dental Journal 1980;4:183–6.
5. Prati C, Pervellati F, Sanasi V, Montebugnoli L. Treatment of
cervical dentin hypersensitivity with resin adhesives: 4-
week evaluation. American journal of Dentistry 2001;14:378–82.
6. Duran I, Sengun A. The long-term effectiveness of five
current desensitizing products on cervical dentine
sensitivity. Journal of Oral Rehabilitation 2004;31:351–6.
7. Dondi dall’Orologio G, lorenzi R, Anselmi M, Grisso V. Dentin
desensitizing effects of Gluma Alternate Health-Dent
Desensitizer and Scotchbond Multi-purpose. American
Journal of Dentistry 1999;12:103–6.
8. Ferrari M, Cagidiaco MC, Kugel G, Davidson CL. Clinical
evaluation of a one-bottle bonding system for desensitizing
exposed roots. American Journal of Dentistry 1999;12:243–9.
9. Walsh LJ. The current status of low-level laser therapy in
dentistry Part 2. Hard tissue application. Australian Dental
Journal 1997;42:302–6.
10. Matsumoto K, Funai H, Wakabayashi H, Oyama T. Study on
the treatment of hypersensitivity dentine by GaAlAs laser
395
diode. Japanese Journal of Conservative Dentistry 1985;28:
766–71.
11. Gerchman JA, Ruben J, Gebart-Eaglemont J. Low-level laser
therapy for dentinal hypersensitivity. Australian Dental
Journal 1994;39:353–7.
12. Kimura Y, Wilder-smith P, Yonaga K, Matsumoto K.
Treatment of dentinal hypersensitivity by lasers: a review.
Journal of Clinical Periodontology 2000;27:715–21.
13. Corona SA, Nascimmto TN, Catirse ABE, Lizarelli RFZ,
Dinelli W, Palma-Dibb RG. Clinical evaluation of low-level
laser therapy and fluoride varnish for treating cervical
dentinal hypersensitivity. Journal of Oral Rehabilitation
2003;30:1183–9.
14. Uchida A, Wakano Y, Fukuyama O, Miki T, Iwayama Y,
Okada H. Controlled clinical evaluation of 10% strontium
chloride dentrifice in treatment of dentin hypersensitivity
following periodontal surgery. Journal of Periodontology
1980;51:578–81.
15. Scherman A, Jacobsen PL. Management dentin
hypersensitivity: What treatment to recommend to
patients. The Journal of the American Dental Association
1992;123:57–61.
16. Bergenholtz G, Jontell M, Tuttle A. Inhibition of serum
albumin flux across exposed dentin following conditioning
with Gluma primer, glutaraldehyde or potassium oxalate.
Journal of Dentistry 1993;21:220–7.
17. Wakabayashi H, Hamba M, Matsumoto K, Tachibana H.
Effect of irradiation by semiconductor laser on responses
evoked in trigeminal caudal neurons by tooth pulp
stimulation. Lasers in Surgery and Medicine 1993;13:
605–10.
18. Wigdor H. Patients’ perception of lasers in dentistry. Lasers
in Surgery and Medicine 1997;20:47–50.