Effects of photobiomodulation with different application parameters on injection pain in children: a randomized clinical trial

Abstract

Photobiomodulation (PBM) has gained increasing interest due to its effectiveness in pain reduction in various fields of dentistry. However, the number of studies evaluating the effect of PBM on injection pain in children is very limited. The aim of the study was to evaluate the efficacy of PBM with three different application parameters (doses) + topical anesthesia on reducing injection pain and to compare these results with the placebo PBM+ topical anesthesia in children during supraperiosteal anesthesia administration. 160 children were randomly divided into 4 groups, 3 experimental and 1 control, with 40 subjects in each. In the experimental groups, before the anesthesia administration, PBM with a power of 0.3 W was applied for 20, 30 and 40 s in groups 1, 2 and 3, respectively. In group 4, a placebo application of laser was performed. The pain felt during the injection was assessed using the Wong-Baker Faces Pain Rating Scale (PRS), and also the Face, Legs, Activity, Cry, Consolability (FLACC) Scale. Statistical analyses were performed to evaluate the data (p < 0.05). The mean FLACC Scale pain scores were 3.02 ± 2.93, 2.92 ± 2.54, 2.12 ± 1.89 and 1.77 ± 1.90 for the placebo group, and Groups 1, 2, and 3, respectively. Furthermore, the mean PRS scores were 1 ± 1.03, 0.95± 0.98, 0.80 ± 0.822 and 0.65 ± 0.921 for the placebo group, and Groups 1, 2 and 3, respectively. The “no pain response” rate was higher in Group 3 as compared to Groups 1, 2, and placebo according to the FLACC Scale and PRS; however, no difference was found between the groups (p = 0.109, p = 0.317). Injection pain in children did not differ with placebo and PBM applied with a power of 0.3 W for 20, 30 and 40 s.

The use of laser photobiomodulation as pre-anesthetic tissue management technique in reducing injection pain in children

“…Laser photobiomodulation has shown its effectiveness in reducing injection pain in some previous studies [ 15 – 19 ], however, there is a very limited number of studies that addressed this topic in children and each study adopted a different protocol regarding the method of application, the laser type, mode, parameters used, sample chosen, and anatomical site tested. Furthermore, previous studies on children included children six years and above who were more capable of controlling their feelings and response to pain.…”

“…Given that the effectiveness of laser PBM in alleviating pain is still being studied, some research tested the paired effect of both topical anesthetic gel and laser PBM [ 18 , 19 ]; while other trials studied only the effect of laser PBM exclusively [ 17 , 20 ]. This has rendered the results to be inconsistent, where topical anesthetic gel application may have camouflaged PBM’s genuine effectiveness.…”

“…They found no statistically significant difference between the two groups based on the objective measures, although there were higher ‘no pain scores’ in topical anesthesia coupled with PBM group. Additionally, EL Bay et al [ 19 ] who tested the effect of different PBM parameters using 940 nm diode laser in non-contact mode (with fluence 69 J/cm2, 103 J/cm2 and 138 J/cm 2 ), they reported that there was no statistically significant difference in pain experience between the groups that received PBM coupled with topical anesthesia and the group that received placebo PBM with topical anesthesia. This could be attributed to different impact of different laser parameters implemented by each study on the tissue.…”

Prevalence and Factors Influencing Post-Operative Complications following Tooth Extraction: A Narrative Review

“…Due to the lack of evidence available in the literature, future studies could investigate complication rates within a tertiary hospital setting to achieve this, and more research on the duration of physiological complications following tooth extraction would add to an apparent gap in the literature and consolidate what was provided in this narrative review. Furthermore, it has been demonstrated that recently introduced treatments such as ozone [ 155 ] and photobiomodulation [ 156 ] have a significant influence on oral environment. Therefore, it would be interesting to test in future reports the efficacy of these compounds and techniques also on post-operative complications following tooth extraction.…”

Mitochondrial Dysfunction in Periodontitis and Associated Systemic Diseases: Implications for Pathomechanisms and Therapeutic Strategies

“…However, as an infectious disease, the primary treatment for periodontitis remains the control of bacterial infection. Additionally, it would be intriguing to investigate the impact of combining preventive treatments, such as ozone and photobiomodulation, with mitochondrial therapy on oral microbiota in order to gain insights into their synergistic effects [137,138]. Moreover, elucidating the regulatory role of signaling pathways in mitochondriatargeted therapy is significant.…”