Compared Efficacy Of Nd:YAG Laser And Topical Desensitizing Agents In The Treatment Of Dentin Hypersensitivity:A Meta-analysis

Objective:Dentin hypersensitivity?DH?is a common oral clinical uncomfortable condition affects severely the patients'oral health and quality of life.In recent years,lasers as a common treatment method for DH have acquired lots of attention from the stomatologists at home and abroad.Due to Nd:YAG laser's effect of melting and sealing dentinal tubules is the best among them,it is considered as the preferred laser type for treating DH.It is also better than topical desensitizing agents in vitro studies,but the multiple clinical factors influence their actual efficacy to result in differences of the outcomes of their clinical compared efficacy studies.Although the topical desensitizing agents are one of the common treatment methods for DH,they have always had the disadvantages of unstable clinical therapeutic efficacy and poor long-term efficacy.Some scholars believe Nd:YAG laser may replace topical desensitizing agents to obtain better long-term efficacy.But EBM study has also not systematically evaluated the clinical efficacy of both.Therefore,this study evaluated the clinical compared efficacy of Nd:YAG laser and topical desensitizing agents in the treatment for DH with systematic review and Meta-analysis.Methods:Thekeywordsof"laser","DentinHypersensitivity"or"Dentine Hypersensitivity"were searched in electronic database,including PubMed,Embase,Cochrane library,Web of science,Wiley Online Library,Scopus,Springer Link,ScienceDirect,CNKI,Wanfang,VIP and SinoMed,and the related articles were also manually searched.According to the pre-established inclusion and exclusion criteria,two researchers independently used Endnote X7 software screened articles,then recorded articles'messages and assessed risk of bias,and Meta-analysis was performed with RevMan5.3 software.Results:A total of 9 studies?6 RCT and 3 CCT?involved 4 parallel design studies and 5split-mouth design studies,which were performed Meta-analyzes according to different follow-up periods and study design types.The results indicated that the Nd:YAG laser compared with topical desensitizing agents showed significant difference in split-mouth subgroup[SMD_??=0.67,95%CI?0.09,1.26?,P=0.02],but there was no significant difference in the parallel subgroup[SMD_??=0.78,95%CI?-0.77,2.33?,P=0.32],and the overall effect showed no significant difference[SMD_??=0.67,95%CI?-0.05,1.40?,P=0.07].And in the different long-term follow-up time,both the parallel subgroup[SMD_1w=1.11,95%CI?-1.41,3.64?,P=0.39;SMD_1m=-0.01,95%CI?-1.07,1.05?,P=0.99;SMD_6m=1.18,95%CI?-0.49,2.86?,P=0.17]andthe split-mouth subgroup[SMD_1w=0.59,95%CI?-0.44,1.61?,P=0.26;SMD_1m=0.35,95%CI?-0.29,0.98?,P=0.28;SMD_3m=0.08,95%CI?-0.40,0.57?,P=0.74;SMD_6m=-0.16,95%CI?-0.45,0.13?,P=0.28]all showed no significant difference,is consistent with the overall effect[SMD_1w=0.70,95%CI?-0.08,1.48?,P=0.08;SMD_1m=0.23,95%CI?-0.23,0.68?,P=0.33;SMD_3m=0.08,95%CI?-0.40,0.57?,P=0.74;SMD_6m=0.40,95%CI?-0.47,1.28?,P=0.37].Conclusions:Current research evidences indicate that Nd:YAG laser compared with topical desensitizing agents may have advantages in the immediate treatment for DH,but their actual efficacy may be no difference,and there were no significant difference in their long-term follow-up time.Therefore,the recent evidences don't recommend Nd:YAG laser to replace topical desensitizing agents to treat DH.Due to the number of articles for long-term observations remains insufficient in our Meta-analysis,which may affect the outcome of long-term efficacy evaluation and produce bias.Therefore,the above conclusions still need more long-term follow-up studies and high-quality randomized controlled trials to confirm.