In vitro study of high-power Er: YAG laser parameters for the management of dentin hypersensitivity in hypomineralized permanent teeth

Abstract

Dentin hypersensitivity (DH) is characterized by intense, short-lasting pain, triggered by dentin exposure to different stimuli. It is often associated with hypomineralized teeth due to increased enamel porosity and exposed dentinal tubules. The high-power Er: YAG laser has emerged as a promising therapeutic strategy for the treatment of this condition. The aim of this in vitro study was to test different protocols for managing dentin hypersensitivity in hypomineralized teeth using a high-power Er: YAG laser. Six protocols were evaluated, varying in power, frequency, application mode, and the use of cooling. Qualitative analysis of morphological changes were evaluated by scanning electron microscopy (SEM). Further, the most promising protocol - 20 mJ, 10 Hz, 0.20 watts, applied in focused mode, without cooling - was selected for assessing intrapulpal temperature variation using thermocouples connected to a monitoring system. The SEM images showed that this protocol promoted homogeneous surface melting of dentin, effectively sealing the dentinal tubules without inducing a thermal increase greater than 2 degrees C. These findings support the feasibility of using the Er: YAG laser with conservative parameters and no cooling as a safe and effective alternative for the management of DH in hypomineralized teeth. However, clinical trials are recommended to validate its applicability in pediatric dentistry.