Effect of diode laser versus sodium fluoride on dentin hypersensitivity after interproximal enamel reduction during clear aligner treatment: A randomized controlled clinical trial

Background: To evaluate the dentin hypersensitivity (DH) after interproximal enamel reduction (IPR) in patients undergoing clear aligner (CA) treatment after using diode laser versus sodium fluoride. The secondary aim was to assess the gingival status in the three groups during treatment. Methods: This double-blinded randomized controlled clinical trial included patients with permanent dentition, aged between 15 and 35 years, good oral and general health, to be treated with CAs and IPR. Exclusion criteria were history of DH, enamel defects, cervical caries, periodontal disease, or pregnancy. 45 patients were randomly assigned to three groups: Group A (acidulated sodium fluoride gel: 0.33% sodium fluoride), Group B (diode laser: Soft Touch, 810 nm, 0.5 W), and Group C (control, no treatment). The response to air stimuli and the gingival indices were recorded before (T0), and after IPR (T1), one week (T2), one month (T3), and three months post-treatment (T4). DH was assessed using a visual analog scale by a blinded operator while gingival health was evaluated using Silness and Löe Plaque and Gingival Index. Results: All groups showed an increase in DH immediately after IPR compared to baseline, which subsequently decreased at T2, T3, and T4. The laser group exhibited a statistically significant reduction in DH, with rapid improvement at T1 and sustained benefits over time. The Gingival Index showed the most pronounced improvements in the laser group. Moreover, the Plaque Index was reduced in all groups. Conclusions: The application of a diode laser after IPR during CA treatment significantly reduced DH without adversely affecting gingival health.