Evaluation of the effect of the photobiomodulation therapy on the pain related to dental injections: A preliminary clinical trial

Abstract

Background. Pain from dental injections is a common reason why people fear dentistry and avoid dental treatment. Thus, researchers have attempted to find methods to decrease dental injection pain. Objectives.Considering the analgesic effect of the photobiomodulation therapy (PBMT), the aim of this study was to evaluate the effects of PBMT on the pain caused by dental anesthetic injections.Material and methods. This randomized, split-mouth, triple-blind clinical trial evaluated 60 bilateral canine teeth in 30 dental students. After the random selection of the test (laser) quadrant, the injection site was irradiated with a 940 nm diode laser. Buccal infiltration anesthesia was then administered by injecting lidocaine plus epinephrine with a short needle. The level of pain experienced during the injection was determined using a 100-millimeter visual analog scale (VAS). The same procedure was performed for the control (no laser) quadrant, with the difference being that the laser handpiece was turned on, but no radiation was administered. The 2 groups were compared using the non-parametric Wilcoxon signed-rank test.Results. The mean VAS pain scores were 21.2 ±15.7 for the laser quadrant and 27.9 ±18.9 for the control quadrant; this difference was statistically significant (p = 0.030), but did not seem to be clinically relevant. Conclusions.The photobiomodulation therapy prior to dental anesthetic injections has no clinical advantage for reducing injection pain.

Effect of Photobiomodulation Therapy With an 810-nm Diode Laser on Pain Perception Associated With Dental Injections in Children: A Double-Blind Randomized Controlled Clinical Trial

“…37 The use of PBMT to decrease pain perception during the application of local anesthesia is an interesting topic, which has been discussed in a few studies. 25,26,29,30,[38][39][40] However, there is no agreement on the clinical efficacy of this pre-treatment or standard irradiation protocols. This may be related to several variations in PBMT protocols (wavelength, power, mode of irradiation, and energy density), sites of injection, pain assessment methods, and studied populations (adults or children) among these studies.…”

Use of photobiomodulation (880 nm) for anesthesia puncture pain reduction: A split‐mouth case report

“…The effectiveness of PBM is already proven, and numerous well-designed studies have obtained positive results, especially in pain control [9]. However, there are few studies on the relationship between PBM and its action in local anesthesia [10][11][12][13][14][15][16]. To date, there is no evaluation of PBM with 808 nm on pain control during pterygomandibular puncture for inferior alveolar nerve block.…”

“…Different radiant exposures were observed among studies [10][11][12][13][14][15][16]. Thus, the protocol of choice was adapted and described in Table 1 [10,11].…”

“…This technique is safe and lacks contraindications or adverse effects. Some wavelengths were tested for different anesthesia techniques [10][11][12][13][14][15]. It was observed that some studies used the infrared laser in pterygomandibular adults' anesthesia: 980 nm, 15 J/cm 2 for 20 s [10]; 980 nm, 75 J/cm 2 for 150 s 500 mW [11]; 980 nm, 15.62 J/cm 2 for 20 s, 300 mW [12].…”

“…It was observed that some studies used the infrared laser in pterygomandibular adults' anesthesia: 980 nm, 15 J/cm 2 for 20 s [10]; 980 nm, 75 J/cm 2 for 150 s 500 mW [11]; 980 nm, 15.62 J/cm 2 for 20 s, 300 mW [12]. Other studies use infrared, but for infiltration technique in the maxilla: 830 nm in palatal anesthesia, 4 J/cm 2 for 33 s,120 mW [13]; 915 nm in incisors anesthesia, 1.5 W, and 72 J/cm 2 [14], and 940 nm in canine anesthesia 15.28 J/cm 2 for 60 s, 200 mW [15] and infiltration in mandible 810 nm, 85 J/cm 2 for 30 s [16]. To date, there is no evaluation of PBM (808 nm) on pain control during pterygomandibular puncture for inferior alveolar nerve block.…”