Photobiomodulation versus direct restoration in a patient presenting with dentinal hypersensitivity: a 6-month follow-up.

Despite nearly a century of research, the treatment of cervical dentinal hypersensitivity (DH) remains challenging. This case report discusses the indications for different approaches to the treatment of DH in a single patient; the chosen alternatives took into account the different degrees of tooth wear and levels of pain at different sites. A 31-year-old woman reported DH in the maxillary right canine and first premolar and the maxillary left lateral incisor and canine in response to thermal, tactile, and osmotic stimuli. Clinical examination revealed that the teeth on the right side presented noncarious cervical lesions deeper than 1 mm, while the teeth on the left side presented only minimal wear. Therefore, the right canine and premolar were restored with composite resin to create a mechanical barrier against stimuli and reestablish form, function, and esthetics. Prior to restoration, the teeth on the right side were irradiated with a low-power laser (808 nm, 100 mW, 1.1 J/point, 10 seconds), which was applied in a single session at 2 locations on each tooth. In contrast, the left lateral incisor and canine were irradiated in 3 sessions with the low-power laser, which reduces pain levels and depolarizes nerve fibers by means of cell biomodulation, and received no restorations. A visual analog scale (0.0-10.0) was used to record the patient's pain, and it was found that pain levels for the restored teeth decreased from 9.4 initially to 0.0 immediately after restoration, and pain levels for the irradiated teeth decreased from 5.4 initially to 2.0 after 3 sessions. After 6 months of clinical evaluation, both sets of teeth showed scores of 0.0 (no pain). Based on the results presented, it can be concluded that both treatments provided satisfactory outcomes when applied for the appropriate indication.