Efficacy of advanced treatment modalities of dentin hypersensitivity: A systematic review and meta-analysis.

BACKGROUND: Dentin hypersensitivity (DH) is a prevalent clinical condition characterized by short, sharp pain arising from exposed dentin in response to thermal, tactile, osmotic, or chemical stimuli. Conventional desensitizing agents often provide temporary relief, with inconsistent long-term effectiveness, prompting growing interest in advanced treatment modalities. OBJECTIVE: To systematically evaluate and compare the efficacy of advanced treatment modalities with conventional or placebo interventions in reducing dentin hypersensitivity in adults. METHODS: This systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (Registration ID: CRD420250651753). Electronic searches were performed in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar, with the date of final search being 30 September 2025. Randomized controlled trials involving adults with clinically diagnosed dentin hypersensitivity affecting permanent teeth were included. Advanced interventions such as laser therapy, photobiomodulation, bioactive glass, nano-hydroxyapatite, CPP-ACP, iontophoresis, Resin and varnish systems, were assessed. The primary outcome was reduction in hypersensitivity measured using validated pain assessment scales. Risk of bias was evaluated using the Cochrane RoB 2.0 tool, and quantitative synthesis was performed using a RevMan 5.4. software. RESULTS: Thirty-one randomized controlled trials were included in the qualitative synthesis, and twenty-five studies were eligible for meta-analysis. Advanced treatment modalities demonstrated a statistically significant reduction in dentin hypersensitivity compared with conventional or placebo controls (pooled SMD = -1.02; 95% CI: -1.32 to -0.73; p < 0.001). Laser-based therapies showed the greatest effectiveness, followed by nano-hydroxyapatite and bioactive glass agents. Moderate heterogeneity was observed across studies. CONCLUSION: Advanced treatment modalities are more effective than conventional desensitizing agents in managing dentin hypersensitivity. Laser therapy provides the most consistent and sustained relief, supporting its clinical use, while further standardized long-term trials are recommended.