Terapia laser per l’ipersensibilità dentinale: Una revisione cochrane

BACKGROUND Dentinal hypersensitivity is char-acterized by short, sharp pain from exposed dentine that occurs in response to external stimuli such as cold, heat, osmotic, tactile or chemicals, and cannot be ex-plained by any other form of dental defect or pathology. Laser therapy has become a commonly used intervention and might be eI-ective for dentinal hypersensitivity. OBJECTIVES To assess the effects of in-office employed lasers versus placebo laser, placebo agents or no treatment for relieving pain of dentinal hypersensitivity. SEARCH METHODS Cochrane Oral Health’s Information Specialist searched the following databases and platform until Octo-ber 2020: Cochrane Oral Health’s Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Em-base Ovid, CINAHL EBSCO, LILACS BIREME Virtual Health Library, ISI Web of Science, ZETOC, Open-Grey, US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and World Health Organization International Clinical Trials Registry Platform. SELECTION CRITERIA Randomized controlled trials (RCTs) in which in-office lasers were compared to placebo or no treatment on patients aged above 12 years with tooth hypersensitivity. MAIN RESULTS We included a total of 23 studies with 936 participants and 2296 teeth. We assessed five studies at overall low risk of bias, 13 at un-clear, and five at high risk of bias. Seventeen studies contributed data to the meta-analyses. We di-vided the studies into six sub-groups based on the type of laser and the primary outcome mea-sure. We assessed the change in intensity of pain using quantitative pain scale (visual analogue scale/ VAS of 0 to 10 [no pain to worst possible pain]) when tested through air blast and tactile stimu-li in three categories of short (0 to 24 hours), medium (more than 24 hours to 2 months), and long term (more than 2 months). Results demonstrated that compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through air blast stimuli at short term (low-certainty evi-dence), medium term (very low-cer-tainty evidence), and long term (very low-certainty evidence). Similarly, compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through tactile stimuli at short term (low-certainty evidence) and medium term (very low-certainty evidence). However, there was insufficient evidence of a difference in pain intensity for all types of lasers when tested through tactile stimuli in the long term (very low-certainty evidence). Most included studies assessed ad-verse events and reported that no obvious adverse events were ob-served during the trials. No studies investigated the impact of laser treat-ment on participants’ quality of life. AUTHORS’ CONCLUSIONS Limited and uncertain evidence from meta-analyses suggests that the application of laser overall may improve pain intensity when tested through air blast or tactile stimuli at short, medium, or long term when compared to placebo/ no treatment. Overall, laser therapy appears to be safe. Future studies including well-designed double-blinded RCTs are neces-sary to further investigate the clinical efficacy of lasers as well as their cost-effectiveness.