EC Dental Science

Background: Post-operative or post-restorative dentin hypersensitivity is a common complication following dental restorations, often attributed to open dentinal tubules and microleakage after bonding procedures. Various preventive strategies-ranging from novel nanoparticle-based dentin coatings to laser desensitization-have been proposed, but a definitive gold-standard protocol remains elusive. This systematic review evaluates the efficacy of nanoparticle tubule-occlusive coatings, compares laser-based versus chemical desensitization approaches, and examines the impact of these surface modifications on resin-dentin bond strength.

Methods: Following PRISMA guidelines, an extensive literature search was performed in PubMed, Scopus, Web of Science, and Cochrane Library (up to November 2025) for clinical trials, in vitro studies, and reviews related to dentin hypersensitivity after restorations. Key search terms included dentin hypersensitivity, nanoparticles (silver, zinc oxide, hydroxyapatite), laser desensitization (Er:YAG, Nd:YAG, diode), glutaraldehyde, oxalate desensitizer, and bond strength. Studies were screened and selected for inclusion based on relevance to the three predefined research questions. Data on tubule occlusion efficacy, clinical sensitivity outcomes, and bond strength metrics were extracted. A qualitative synthesis was undertaken due to heterogeneity of interventions.

Results: A total of 30 studies (including in vitro investigations, randomized clinical trials, and systematic reviews) met the inclusion criteria (Figure 1). Nanoparticle-based coatings (silver, ZnO, calcium phosphate/hydroxyapatite) demonstrated effective dentinal tubule occlusion and significant reductions in hypersensitivity in many reports. Nano-hydroxyapatite additives, in particular, showed superior clinical performance versus conventional fluoride treatments in reducing hypersensitivity. A novel titania nanoparticle-reinforced bonding agent significantly decreased immediate post-restorative sensitivity compared to a standard adhesive (p < 0.01). Comparisons of laser desensitization (e.g., low-level diode, Nd:YAG, Er:YAG) with chemical desensitizers (glutaraldehyde/HEMA, oxalate-based agents) revealed that both modalities achieve significant symptom relief. Several trials reported no significant difference between laser and chemical treatments in short- and long-term outcomes. In contrast, others noted enhanced or more sustained relief when combining lasers with chemical agents. Regarding bond strength, glutaraldehyde-based desensitizers were found to preserve or even improve resin-dentin bond durability by collagen cross-linking and MMP inhibition. Oxalate desensitizers, though reducing immediate bond strength by depositing insoluble crystals, mitigated long-term bond degradation. Properly applied laser treatment did not adversely affect bonding; Nd:YAG laser pre-treatment of hypersensitive dentin actually increased microtensile bond strength of a resin adhesive.

Conclusion: Nanoparticle dentin coatings (especially calcium/phosphate-based and metal-oxide nanoparticles) show promising efficacy in occluding tubules and reducing post-restorative sensitivity without deleterious effects on bonding. Laser desensitization methods provide comparable clinical outcomes to gold-standard chemical agents, with potential synergistic benefits when used in combination. Most desensitizing surface modifications can be integrated into the restorative workflow without compromising resin bond strength; in some cases, they confer protective effects on the bond. Owing to variations in study protocols and short follow-up durations, further well-controlled clinical trials are needed to establish optimized, long-lasting strategies for managing post-restorative hypersensitivity.

 Keywords: Post-Restorative Dentin Hypersensitivity; Nanoparticle-Based Coatings; Laser Desensitization; Chemical Desensitizers

1. Hamdy Ahmed Aly K., et al. “Assessment of the postoperative hypersensitivity following partial caries removal with application of nanosilver fluoride in deep carious lesions-a randomized controlled clinical trial”. Dental Science Updates2 (2024): 341-349.
2. Nabil N., et al. “The desensitizing effect of nanosilver fluoride compared to photobiomodulation therapy in molar-incisor hypomineralization: a randomized clinical trial”. Journal of Evidence-Based Dental Practice3 (2025): 102139.
3. Al Awdah AS. “Post-operative tooth hypersensitivity with different restorative materials. a literature review”. International Journal of Medical Dentistry2 (2021).
4. Alrawqi AR., et al. “Management of post-operative sensitivity following restorative procedures”. Journal of Healthcare Sciences12 (2024): 644-649.
5. Orchardson R and DG Gillam. “Managing dentin hypersensitivity”. The Journal of the American Dental Association7 (2006): 990-998.
6. Brännström M. “Etiology of dentin hypersensitivity”. Proceedings of the Finnish Dental Society. Suomen Hammaslaakariseuran Toimituksia 88 (1992): 7-13.
7. Calisir M. “Nanotechnology in dentistry: past, present, and future”. In: Nanomaterials for Regenerative Medicine (2019): 197-216.
8. Ahammadullah A. “Drug delivering properties of novel materials for dentinal desensitization”. University of South Dakota (2023).
9. Ferrando-Magraner E., et al. “Antibacterial properties of nanoparticles in dental restorative materials. A systematic review and meta-analysis”. Medicina2 (2020): 55.
10. Sooranagi R. “Comparative evaluation of efficacy of diode laser 980 nm with commercially available desensitising agent on dentinal tubule occlusion: an in vitro sem and energy dispersive x-ray (EDX) study”. Rajiv Gandhi University of Health Sciences (India) (2018).
11. Sethna G. “An evaluation of a chlorhexidine containing varnish (Cervitec) TM and a glutaraldehyde containing varnish (Gluma) TMas desensitizing agents-a clinical study”. Rajiv Gandhi University of Health Sciences (India) (2010).
12. Sauro S., et al. “Oxalate-containing phytocomplexes as dentine desensitisers: an in vitro study”. Archives of Oral Biology8 (2006): 655-664.
13. Elgamily HM., et al. “Influence of pre-treatment with diode laser and Nano silica coating crosslinking matrix metalloproteinase inhibitor on the stabilization of resin-dentine interfaces”. Lasers in Dental Science1 (2024): 30.
14. Alqahtani WM., et al. “Assessing precision in all-ceramic fixed restorations: unveiling the marginal fit through digital and traditional impressions-a comprehensive systematic review and meta-analysis”. European Journal of Dentistry4 (2025): 903-918.
15. Landmayer K., et al. “Effect of Nd:YAG laser irradiation, used as a desensitizing strategy, on bond strength to simulated hypersensitive dentin”. Clinical Oral Investigations5 (2022): 4109-4116.
16. Kung JC., et al. “The antibacterial and remineralization effect of silver-containing mesoporous bioactive glass sealing and Er-YAG laser on dentinal tubules treated in a Streptococcus mutans cultivated environment”. Pharmaceuticals (Basel)11 (2021): 1124.
17. Hassaan MH., et al. “Comparative analysis of hydroxyapatite and zinc oxide nanoparticles for effective dentinal tubule occlusion in dentin hypersensitivity management: a profilometric and scanning electron microscopic investigation”. BMC Oral Health1 (2025): 1718.
18. Hassaan M., et al. “Efficacy of hydroxyapatite nanoparticles in dentinal tubule occlusion and resistance to erosive wear (Scanning electron microscopic study)”. Alexandria Dental Journal1 (2024): 57-65.
19. Limeback H., et al. “Clinical evidence of biomimetic hydroxyapatite in oral care products for reducing dentin hypersensitivity: an updated systematic review and meta-analysis”. Biomimetics1 (2023): 23.
20. Corral C., et al. “Effect of oxalic acid-based desensitizing agent on cervical restorations on hypersensitive teeth: a triple-blind randomized controlled clinical trial”. Journal of Oral and Facial Pain and Headache4 (2016): 330-337.
21. Tivanani MVD., et al. “Antibacterial properties and shear bond strength of titanium dioxide nanoparticles incorporated into an orthodontic adhesive: A systematic review”. International Journal of Clinical Pediatric Dentistry1 (2024): 102-108.
22. Amir N., et al. “Clinical efficacy of a novel titania nanoparticle-reinforced bonding agent in reducing post-restorative sensitivity: a randomized clinical trial”. Pakistan Journal of Medical Sciences7 (2024): 1332-1337.
23. Mansoor A., et al. “Clinical efficacy of novel biogenically fabricated titania nanoparticles enriched mouth wash in treating the tooth dentine hypersensitivity: A randomized clinical trial”. Pakistan Journal of Medical Sciences6 (2025): 1743-1748.
24. Petrović D., et al. “Evaluation of bioactive glass treatment for dentin hypersensitivity: A systematic review”. Biomedicines7 (2023): 1992.
25. Al-Haddad A., et al. “Efficacy of bioactive glass-based desensitizer compared to other desensitizing agents or techniques in dentin hypersensitivity: a systematic review”. BMC Oral Health1 (2025): 899.
26. Besinis A., et al. “Review of nanomaterials in dentistry: interactions with the oral microenvironment, clinical applications, hazards, and benefits”. ACS Nano3 (2015): 2255-2289.
27. Praveen R., et al. “Comparative evaluation of a low-level laser and topical desensitizing agent for treating dentinal hypersensitivity: A randomized controlled trial”. Journal of Conservative Dentistry and Endodontics5 (2018): 495-499.
28. Alsulimani O., et al. “The effect of chewing simulation on flexural strength of different lithium disilicate ceramics”. Clinical, Cosmetic and Investigational Dentistry 31 (2025): 67-76.
29. Shan Z., et al. “Effects of low-level light therapy on dentin hypersensitivity: a systematic review and meta-analysis”. Clinical Oral Investigations12 (2021): 6571-6595.
30. Tabatabaei MH., et al. “Efficacy comparison of Nd:YAG laser, diode laser and dentine bonding agent in dentine hypersensitivity reduction: a clinical trial”. Laser Therapy 4 (2018): 265-270.
31. Mohammadian M., et al. “Comparison of the effectiveness of diode laser, fluoride varnish, and their combination in treatment of dentin hypersensitivity: a systematic review of randomized clinical trials”. Frontiers in Oral Health 6 (2025): 1550127.
32. Ishihata H., et al. “Effects of applying glutaraldehyde-containing desensitizer formulations on reducing dentin permeability”. Journal of Dental Sciences2 (2012): 105-110.
33. Chapman NR., et al. “The ability of a potassium oxalate gel strip to occlude human dentine tubules; a novel in vitro: in situ study”. Journal of Dentistry 100 (2020): 103437.
34. Cunha-Cruz J., et al. “Dentin hypersensitivity and oxalates: a systematic review”. Journal of Dental Research 3 (2011): 304-310.
35. Jiang R., et al. “Effectiveness and cytotoxicity of two desensitizing agents: a dentin permeability measurement and dentin barrier testing in vitro study”. BMC Oral Health1 (2022): 391.
36. Lopes AO., et al. “Clinical evaluation of low-power laser and a desensitizing agent on dentin hypersensitivity”. Lasers in Medical Science 2 (2015): 823-829.
37. Ishihata H., et al. “In vitro dentin permeability after application of Gluma^® desensitizer as aqueous solution or aqueous fumed silica dispersion”. Journal of Applied Oral Science2 (2011): 147-153.
38. Javed F., et al. “Effectiveness of lasers in managing dentine hypersensitivity: an umbrella review”. Lasers in Medical Science1 (2025): 454.
39. Mahdian M., et al. “Laser therapy for dentinal hypersensitivity”. Cochrane Database of Systematic Reviews7 (2021): CD009434.
40. Suri, I., et al. “A comparative evaluation to assess the efficacy of 5% sodium fluoride varnish and diode laser and their combined application in the treatment of dentin hypersensitivity”. Journal of Indian Society of Periodontology3 (2016): 307-314.
41. Asna Ashari M., et al. “Comparison of the effectiveness of combined diode laser and GLUMA bonding therapy with combined diode laser and 5% sodium fluoride varnish in patients with dentin hypersensitivity”. Journal of Lasers in Medical Sciences 12 (2021): e62.
42. Lestari V., et al. “Dentin hypersensitivity treatment with Nd: YAG laser: A systematic review”. Journal of Dentomaxillofacial Science2 (2023): 74-80.
43. Baghani Z and M Karrabi. “Evaluation of two pain assessment methods (Tactile and air blast) for comparison the effectiveness of Nd:YAG laser therapy and non-laser therapy on dentin hyper sensitivity treatment: a systematic review and meta-analysis”. Journal of Dentistry (Shiraz)2 (2023): 168-181.
44. Hanzen TA., et al. “Glutaraldehyde-based desensitizer does not influence postoperative sensitivity and clinical performance of posterior restorations: A 24-month randomized clinical trial”. Dental Materials10 (2023): 946-956.
45. Apparaju V. “Comparative evaluation of efficacy of diode laser (810 nm), and the dentifrice containing “calcium sodium phosphosilicate (Novamin)” for the treatment of dentinal hypersensitivity-a randomized clinical study”. Rajiv Gandhi University of Health Sciences (India) (2016).
46. Siddiqui S., et al. “Evaluation of the efficacy of laser, desensitizing agents, and their combined effect on dentinal hypersensitivity in bicuspids: in vitro study”. Journal of Pharmacy and Bioallied Sciences 1 (2024): S418-s422.
47. Mohammadian M., et al. “Comparison of the effectiveness of diode laser, fluoride varnish, and their combination in treatment of dentin hypersensitivity: a systematic review of randomized clinical trials”. Frontiers in Oral Health 6 (2025): 1550127.
48. Bedran‐Russo AKB., et al. “Changes in stiffness of demineralized dentin following application of collagen crosslinkers”. Journal of Biomedical Materials Research Part B: Applied Biomaterials2 (2008): 330-334.
49. Cilli R., et al. “Influence of glutaraldehyde priming on bond strength of an experimental adhesive system applied to wet and dry dentine”. Journal of Dentistry3 (2009): 212-218.
50. Mancuso E., et al. “Glutaraldehyde-based desensitizers’ influence on bonding performances and dentin enzymatic activity of universal adhesives”. Journal of Dentistry 136 (2023): 104643.
51. Richardson DW., et al. “Bond strengths of luting cements to potassium oxalate-treated dentin”. The Journal of Prosthetic Dentistry4 (1990): 418-422.
52. MS Alqahtani W., et al. “Biomechanics of central incisor endocrowns with different lengths and milled materials after static and vertical loading: a finite element study”. International Journal of Dentistry (2024): 4670728.
53. Alfaawaz YF., et al. “Adhesive bond integrity of experimental zinc oxide nanoparticles incorporated dentin adhesive: An SEM, EDX, μTBS, and rheometric analysis”. Scanning 1 (2022): 3477886.
54. de Melo Alencar C., et al. “Clinical efficacy of nano-hydroxyapatite in dentin hypersensitivity: A systematic review and meta-analysis”. Journal of Dentistry 82 (2019): 11-21.
55. Pushpalatha C., et al. “Zinc oxide nanoparticles: a review on its applications in dentistry”. Frontiers in Bioengineering and Biotechnology 10 (2022): 917990.
56. Schupbach P., et al. “Closing of dentinal tubules by Gluma desensitizer”. European Journal of Oral Sciences 5P1 (1997): 414-421.
57. Jayaram P., et al. “Evaluation of diode laser along with 1.23% acidulated phosphate fluoride gel on dentinal tubule occlusion: An in vitro study”. Journal of Indian Society of Periodontology3 (2020): 253-258.