Effect of Diode Laser and Bioactive Glass on Dentinal Hypersensitivity

Dentinal hypersensitivity is a frequently encountered clinical condition characterized by a short, sharp pain arising from exposed dentin in response to thermal, tactile, osmotic, or evaporative stimuli. The condition is commonly associated with gingival recession, enamel loss, or dentin exposure due to abrasion, erosion, or periodontal therapy. Despite its high prevalence, the management of dentinal hypersensitivity remains challenging, and no single treatment approach has been universally accepted as the gold standard.

Conventional management strategies are primarily based on either neural desensitization or occlusion of dentinal tubules. Bioactive glass-based desensitizing agents, such as those containing calcium sodium phosphosilicate, act by releasing calcium and phosphate ions that form a hydroxycarbonate apatite-like layer, leading to physical occlusion of dentinal tubules. In contrast, diode laser therapy has been proposed to reduce dentinal hypersensitivity through mechanisms that may include alteration of nerve conduction, coagulation of dentinal proteins, and partial sealing of dentinal tubules. However, the comparative clinical effectiveness and durability of these treatment modalities remain unclear, particularly over long-term follow-up periods.

This randomized controlled clinical trial is designed to compare the effects of an 810-nm diode laser, a bioactive glass-based desensitizing agent, and a placebo intervention in the management of dentinal hypersensitivity. Eligible participants diagnosed with dentinal hypersensitivity based on clinical examination and positive response to standardized air stimulus testing will be randomly allocated into three parallel treatment groups. Randomization will be performed using an appropriate allocation method to ensure balanced group distribution.

Participants in the diode laser group will receive non-contact laser irradiation applied to exposed dentin surfaces using an 810-nm diode laser at a standardized power setting and exposure duration. Participants in the bioactive glass group will receive topical application of a bioactive glass-containing desensitizing agent according to manufacturer-recommended instructions. The placebo group will receive an inactive intervention designed to mimic the appearance and application procedure of the active treatments without containing therapeutic components.

Pain intensity will be assessed using a visual analog scale following standardized air stimulus testing. Outcome assessments will be conducted at baseline, immediately after treatment, and during follow-up visits at 1 month, 6 months, and 12 months. The primary outcome measure will be the change in dentinal hypersensitivity pain scores from baseline. Secondary outcomes will include the sustainability of pain reduction and participant-reported comfort over time.

All clinical procedures and assessments will be performed by trained personnel following standardized protocols to minimize variability. Ethical approval will be obtained from the appropriate institutional review board or ethics committee prior to study initiation, and written informed consent will be obtained from all participants. The results of this study are intended to provide clinically relevant evidence regarding the comparative performance of diode laser therapy and bioactive glass-based desensitizing agents for the management of dentinal hypersensitivity.

Inclusion criteria

• Adults aged 18 to 60 years
• Presence of clinically diagnosed dentinal hypersensitivity in at least one tooth
• Positive response to standardized air stimulus test
• Good general and oral health

Exclusion criteria

• Presence of dental caries, defective restorations, or cracked teeth in the study tooth
• Evidence of pulpal pathology or periapical disease
• Periodontal disease requiring active treatment
• Use of desensitizing agents or sensitivity treatments within the previous 4 weeks
• History of allergy or hypersensitivity to any study materials
• Systemic conditions or medications that may affect pain perception
• Pregnant or lactating women