Efficiency of diode laser in control of post-endodontic pain: a randomized controlled trial

Abstract

Objectives As post-endodontic pain control is one of the main targeted addressed in endodontics, our aim was delignated to compare two different methods for low-level laser application utilizing diode laser: low-level laser therapy (LLLT) and laser-activated irrigation (LAI) in the control of post-endodontic pain. Materials and subjects A total of 180 patients received single-visit root canal treatment; they were randomly allocated into 3 equal groups. Group I received LAI, group II received LLLT, and group III served as control with normal root canal treatment and mock laser intervention (ML group). Postoperative pain was recorded using visual analogue scale (VAS) after 24, 48, and 72 h. Data were tabulated and statistically analyzed. Results At 24 h, there was a statistically significant difference between median pain scores in the three groups (P value < 0.001) with ML group scored highest score followed by LAI and then LLLT group. At 48 h, there was a statistically significant difference between the three groups (P value < 0.001), with ML group scoring highest median pain scores while LLLT and LAI showed statistical insignificant scores. At 72 h, there was no statistically significant difference between the 3 groups (P value = 0.179). Conclusion LLLT is superior to LAI and ML group in the control of immediate postoperative pain after 24 h while after 48 h both LAI and LLLT were equally effective, but they still showed significant differences when compared to ML group. Clinical relevance Diode laser can be used by clinicians as it decreases the post-endodontic pain in patients with symptomatic apical periodontitis undergoing endodontic treatment.

Can Diode Laser 810 decrease Post Endodontic Pain in Patients with Asymptomatic Necrotic Maxillary Incisors? A Four-Arm Randomized Controlled Trial

“…The previous result can be explained by the diameter of the optic ber of the device used (200 µm for the IAS group and 8 mm for the LLLT group), as the application of the laser in LLLT included a wider area than its application within the canal. The previous result differed from Ismail's study, where the previous study found that the application of the diode laser in LLLT was better than its application as an IAS only on the rst day of treatment [39].…”

“…Previous studies used a diode laser in wavelength between 808-910 as a non-invasive way to reduce PP [3]. A lot of studies have focused on the use of diode lasers in activating irrigants as a potential method for reducing PP [36] [37], other studies have concentrated on its use in the context of low-level laser therapy [11] [38], and one study has compared both of these techniques on the PP [39], but to the best of our knowledge, this is the rst study to compare the use of these two techniques together on PP.…”

Diode laser to enhance irrigation of the root canal system: systematic literature review

“…Estudios han demostrado que mediante la preparación quimiomecánica la mitad de las paredes dentinarias pueden permanecer intactas debido a la complejidad de los conductos radiculares a comparación de la desinfección con láser que tiene la capacidad de alcanzar áreas complejas que otras técnicas no podrían alcanzar, además es altamente efectiva contra las bacterias orales y tiene la ventaja de eliminar microorganismos periodontales y endodónticos casi sin efectos secundarios. (16) La terapia endodóntica busca el control del dolor post-endodóntico. Debido a los efectos secundarios indeseables que los AINES pueden ocasionar es necesario tener en cuenta otros métodos para el alivio del dolor; uno de los usos de la terapia con láser en odontología es su efecto antiinflamatorio para aliviar el dolor, mediante la diminución de bradicinina e histamina, otro de los usos que se le atribuye es la cicatrización de heridas.…”

“…(12,18) Eliminar el dolor es un objetivo central en la práctica de la endodoncia para mejorar la calidad de vida del paciente y preservar la estructura dental; de esta manera (Hend et al; Huang et al; Anagnostaki et al) manifiestan que la utilización del láser de diodo es eficaz para el control del dolor postoperatorio. (3,4,16) El tejido alrededor del diente puede estar inflamado como resultado de la infección antes del tratamiento y debido a la manipulación del tejido durante el procedimiento, uno de los beneficios que logra el láser de diodo en la terapia endodóntica es la disminución de mediadores proinflamatorios como la bradicinina e histamina, así lo manifiestan (Hend et al; Anagnostaki et al). (4,16) El hipoclorito de sodio (NaOCl), combinado con instrumentación mecánica ha representado el estándar en endodoncia; sin embargo, este compuesto tiene ciertas limitaciones, de esta manera, se debe potenciar la erradicación de bacterias mediante el uso de métodos físicos alternativos como las técnicas asistidas por láser, de manera que los autores (Dai et al; Hajjar et al) manifiestan que la combinación del láser de diodo con NaOCl proporciona un mayor efecto bactericida.…”

Current Applications and Future Directions of Lasers in Endodontics: A Narrative Review

“…Pre-operative pain and persistent pain are important factors related to endodontic treatment failure [ 74 ]. Meanwhile, as a common complication occurring after endodontic treatment, post-operative endodontic pain was reported to be at a prevalence of up to 40%, and the control of post-operative pain was regarded as a crucial target of endodontic therapies [ 75 , 76 ]. In addition, the etiology of pain is related to the chemical, mechanical, or microbial factors that could damage pulp or periapical tissue [ 77 ].…”