Background
The use of low level laser therapy (LLLT) to reduce injection pain associated with dental local anesthesia is reported in a limited number of studies in adults, but research on the effects of LLLT in children is needed.
Aim
This study aimed to evaluate the effects of topical anesthesia + LLLT on injection pain, anesthesia efficacy, and duration in local anesthesia of children who are undergoing pulpotomy treatment.
Design
The study was conducted as a randomized, controlled‐crossover, double‐blind clinical trial with 60 children aged 6–9 years. Before local infiltration anesthesia was administered, only topical anesthesia was applied in one side (control group/CG), and topical anesthesia plus LLLT (a diode laser: 810 nm; continuous mode; 0.3W; 20 s; 69 J/cm2) was applied in the contralateral side (LG) as pre‐anesthesia. The injection pain and anesthesia efficacy were evaluated subjectively and objectively using the Wong‐Baker Faces Pain Rating Scale (PRS) and the Face, Legs, Activity, Cry, Consolability (FLACC) scale respectively. Data were analyzed for statistical significance (p < .05).
Results
The “no pain” and “severe pain” rates in the PRS were 41.7% and 3.3% for the LG and 21.7% and 11.7% for the CG, respectively, during injection. Similarly, in the FLACC data, the number of “no pain” responses was higher for the LG than the CG (40%, 33.3%) and no “severe pain” rate was observed in both groups. The only statistically significant difference found for the PRS was p < .05. The median pain score was “0” for the LG and the CG in the FLACC data for the evaluation of anesthesia efficacy, and there was no statistically significant difference between the groups in terms of pain and anesthesia duration (p > .05). Also, most of the children preferred injection with topical anesthesia + LLLT (66.7%).
Conclusions
It has been determined that the application of topical anesthesia + LLLT with an 810‐nm diode laser before local infiltration anesthesia reduced injection pain and did not have an effect on anesthesia efficacy and duration in children.
Children experienced similar pain during SP anaesthesia administered with a TS and the DV, regardless of gender and jaw differences. DV was less preferred over the traditional procedure in children.
A 12-year-old boy with extrusion of the maxillary right central incisor, uncomplicated fracture of the left central incisor, avulsion of the mandibular right and left central incisors, and crown fracture of the mandibular right lateral incisor presented to the Kocaeli University Department of Pediatric Dentistry 20 days after sustaining the traumatic injuries. Orthodontic repositioning of the extrusive maxillary right central incisor was planned. Additionally, this tooth was necrotic and needed root canal treatment. The maxillary left central incisor and right mandibular lateral incisor were necrotic and needed root canal treatment. The orthodontic and endodontic treatments were successfully performed simultaneously. Restoration of the fractured mandibular right lateral incisor and maxillary left central incisor was completed with resin composite. Subsequent to orthodontic and endodontic treatment, prosthodontic rehabilitation was performed. At the two-year followup, the teeth appeared normal and the patient had no complaints.
The prevalence of signs and symptoms of TMDs and oral parafunctions differed significantly between CLCPI and CLWP groups, with children of the CLCPI group found to be significantly more prone to TMDs and oral parafunctions than children of the CLWP group.
The current literature suggests that low-level laser stimulation of the PC 6 acupuncture points may prevent gagging. This study aimed to determine if low-level laser therapy (LLLT) can reduce the gag reflex in children undergoing intraoral maxillary radiography. This randomized, controlled, double-blind clinical trial was conducted with 25 children with moderate-to-very severe gag reflexes who required bilateral periapical radiographic examination of the maxillary molar region. Children's anxiety levels were initially evaluated using Corah's Dental Anxiety Scale (DAS) to identify any possible relationship between gagging and anxiety. A control radiograph was taken of one randomly selected side in each patient after simulated laser application so that the patient was blinded to the experimental conditions (control group). Laser stimulation was then performed for the experimental side. A laser probe was placed on the Pericardium 6 (PC 6) acupuncture point on each wrist, and laser energy was delivered for 14 s (300 mW, energy density 4 J/cm(2)) at a distance of 1 cm from the target tissue. Following laser stimulation, the experimental radiograph was taken (experimental group). Gagging responses were measured using the Gagging Severity Criteria for each group. Data were analyzed using Spearman's rho correlations and Mann-Whitney U tests. Both mean and median gagging scores were higher in the control group than in the experimental group. Patients who were unable to tolerate the intraoral control radiography were able to tolerate the procedure after LLLT. Differences between gagging scores of the control and experimental groups were statistically significant (P = .000). There was no significant correlation between gagging severity and anxiety score (P > .05). A negative correlation was found between age and gagging score in the control group (P ˂ .05). Within the limitations of this study, LLLT of the PC 6 acupuncture points appears to be a useful technique for controlling the gag reflex in children during maxillary radiography.
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