Laser Therapy and Flouride Therapy in Desensibilization Hypomineralized Teeth
Condition: Hypomineralization Molar Incisor
Study type: Interventional

Summary: 
      To investigate the efficacy of laser therapy associated with fluorotherapy in the
      desensibitization of hypomineralized teeth in children 8 to 12 years of age. A randomized
      blinded clinical trial will be conducted. The instruments used will be a questionnaire
      general, clinical examination, dental air syringe (evaluation of dental sensitivity) and
      visual analogue scale (evaluation of the magnitude of dental sensitivity). Teeth with
      hypomineralization molar-incisor (HMI) and the results of sensitivity and magnitude of dental
      pain before and after the treatments will be recorded in a clinical record. The study groups
      will be: treatment with laser therapy (Group 1); treatment with fluorotherapy (Group 2) and
      treatment with laser therapy and fluorotherapy (Group 3).
    

Detailed description: 
      A blinded randomized clinical trial will be conducted. The study will be conducted with
      children attending the Pediatric Dentistry Clinic of the Florence Institute's undergraduate
      course, in São Luís, Maranhão, Brazil. As inclusion criteria, children from 8 to 12 years of
      age will be adopted, with at least one first permanent or incisive erupted incisor (with
      occlusal / incisal surface free of gingiva) present in the oral cavity and presenting
      sensitive hypomineralization lesions. Exclusion criteria will be children with enamel
      malformations linked to syndromes, with dental fluorosis, enamel hypoplasia or with imperfect
      amelogenesis, teeth with loss of structure dental and carious lesions, children in
      orthodontic treatment, children with cognition problems, children who used any type of
      analgesic / anti-inflammatory medication before treatment, children undergoing desensitizing
      treatment in the last 3 months, children with behavioral problems and children with occlusal
      problems such as tightening and bruxism.

      The instruments of data collection will be a general questionnaire (demographic,
      socioeconomic and etiological factors for HMI), clinical examination for diagnosis of HMI,
      dental sensitivity test with air syringe and visual analogue scale (to assess the magnitude
      of pain). In a clinical file will be recorded the teeth with HMI, the result of the
      sensitivity test and magnitude of dental pain before and after treatments. The general
      questionnaire will be answered by the parents / guardians. In cases of incomplete
      questionnaires, parents / guardians will be contacted by telephone.

      The diagnosis of HMI will be performed according to the criteria proposed by the European
      Academy of Child Dentistry (WEERHEIJM et al., 2003). The researcher will be calibrated for
      the application of the questionnaire and for the diagnosis of HMI lesions.

      The study groups will be: treatment with laser therapy (Group 1); treatment with
      fluorotherapy (Group 2) and treatment with laser therapy and fluorotherapy (Group 3). For the
      treatment of group 1, the low-power, infrared (808nm wavelength) diode laser with a power of
      100mW will be used. The mode of irradiation is punctual, in contact and perpendicular to the
      dental surface. Three points on the crown of multiradicular teeth (mesial and distal of the
      cervical region and central part of the tooth lesion) and two points on the crown of
      unirradicular teeth (central point of the cervical region and central part of the tooth
      lesion) will be irradiated for 10s per point , 1J per point, with a 72-hour interval between
      treatment sessions. The distance between the irradiation points will be about 2 mm. The tip
      of the laser equipment will be positioned perpendicular to the application site. The
      treatment of Group 2 will be carried out with the application of fluoride varnish, with the
      aid of a microbrush. After the application, water will be dripped onto the applied varnish in
      order to promote its drying. Fluorotherapy will be performed once a week, totaling 4
      sessions. Group 3 will be treated first with the laser (same specifications as Group 1),
      followed by application of fluoride varnish (same specifications as Group 2).
    

Intervention name(s): Laser therapy; Fluorotherapy; Laser therapy and Fluorotherapy
Intervention type(s): Radiation; Procedure; Combination Product
Intervention description(s): The low-power, infrared (808nm wavelength) diode laser with a power of 100mW will be used. The mode of irradiation is punctual, in contact and perpendicular to the dental surface. Three points on the crown of multiradicular teeth (mesial and distal of the cervical region and central part of the tooth lesion) and two points on the crown of unirradicular teeth (central point of the cervical region and central part of the tooth lesion) will be irradiated for 10s per point , 1J per point, with a 72-hour interval between treatment sessions. The distance between the irradiation points will be about 2 mm. The tip of the laser equipment will be positioned perpendicular to the application site.; The treatment will be carried out with the application of fluoride varnish, with the aid of a microbrush. After the application, water will be dripped onto the applied varnish in order to promote its drying. Fluorotherapy will be performed once a week, totaling 4 sessions.; This group will be treated first with the laser (same specifications as Laser therapy), followed by application of fluoride varnish (same specifications as Fluorotherapy).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Groups: treatment with laser therapy (Group 1); treatment with fluorotherapy (Group 2) and treatment with laser therapy and fluorotherapy (Group 3).
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: hypomineralization molar incisor; Child; Laser Therapy; Tooth Sensitivity