Pain Reduction during Rapid Palatal Expansion Due to LED Photobiomodulation Irradiation: A Randomized Clinical Trial

Abstract

Objective: The purpose of this research is to assess the analgesic efficiency of Photobiomodulation (PBM) in pain reduction in young patients during rapid maxillary expansion therapy. Materials and Methods: Thirty patients were included and allocated to an experimental group [Rapid Palatal Expansion (RPE) and PBM] and a control group (RPE only) at random. Inclusion criteria were skeletal age from CVS1 to CVS3, examined on the cephalometric lateral teleradiography, with cervical vertebra staging and completed eruption of upper first molar. Exclusion criteria were previous orthodontic treatment, bone disease, disability, or skeletal age from CVS4. Patients referred the pain they felt using a Numerical scale rate (NRS), ranging from 0 to 10, with specific intervals of time: 6 h, 12 h, 24 h, and from days 2 to 7. The Wilcoxon-Mann-Whitney test was used to evaluate differences in NRS reported values between the two groups. Results: The final sample included 30 patients, 14 males and 16 females, with a mean age of 7.8 ± 1.2 years. The pain that was felt at each time interval and the maximum score of pain were significantly lower in the experimental group (p < 0.05) and decreased faster in the experimental group, with a score test near to 0 after 2/3 days. Conclusions: PBM is efficient in reducing the intensity and the time of pain felt by young patients that undergo rapid maxillary expansion.

Pain during Rapid Maxillary Expansion: A Systematic Review

“…The most recent study included was published in 2022 by Caccianiga et al [ 2 ], while the oldest one was published in 2000 by Needleman et al [ 10 ]. Regarding study design, five studies were randomized clinical trials [ 2 , 12 , 15 , 16 , 17 ], one was a prospective study [ 3 ], one was a parallel cohort study [ 1 ], and one was divided into two phases, the first of which was a randomized, controlled clinical trial and the second of which was a prospective case series (The authors decided to include the second part of this study in the review too because, although it was defined as a prospective case series, a statistical analysis of the data was still performed) [ 9 ]. For two studies, the study design was not clearly defined by the authors [ 5 , 10 ].…”

“…With regard to the studies’ methodological quality, four studies were classified as good [ 9 , 12 , 15 , 16 ], four as moderate [ 1 , 2 , 3 , 17 ], and two as poor [ 5 , 10 ].…”

“…Rapid maxillary expansion (RME) is an orthodontic–orthopedic treatment routinely performed worldwide in growing subjects with transversal deficiency of the maxillary arch, with or without a crossbite [ 1 , 2 , 3 , 4 ]. This treatment can be performed in primary, mixed, or permanent dentition [ 1 , 5 , 6 ].…”

“…Patients often report having pain or discomfort during the active phase of RME [ 3 , 5 ], especially during the first activations. The literature suggests that pain is the most commonly reported symptom, with a frequency of >90% among children [ 2 , 12 ].…”

Photobiomodulation Therapy for the Symptoms Related to Temporomandibular Joint Disk Displacement

“…Laser therapy, specifically photobiomodulation (PBM) using different laser wavelengths, has been used in various fields of medicine for the reduction of pain, modulation of inflammation, and acceleration of healing [9,[11][12][13]. PBM was proven to modulate inflammatory and antiinflammatory cytokines, stimulate osteoblasts, enhance perfusion to joint structures, and reduce nerve stimulation [14][15][16]. Laser light absorbed by tissue can also stimulate the lymphatic system and improve microcirculation [17].…”