A Randomized Triple-Blind Clinical Trial of the Effect of Low-Level Laser Therapy on Infiltration Injection Pain in the Anterior Maxilla

Abstract

Objective: To evaluate the level of pain experienced during infiltration anesthesia of the anterior maxilla following low-level laser therapy (LLLT) with 810-980 nm wavelengths. Material and Methods: In the current triple-blind clinical trial, 84 patients received a total of 168 infiltration anesthesia injections (1.8 mL of 2% lidocaine plus 1:100,000 epinephrine) in the anterior maxilla. Each patient received two injections into the buccal mucosa of the right and left central incisors with a two-week interval. One injection was performed after LLLT, while the other injection was administered conventionally without laser. The pain level was measured immediately after injection using a visual analog scale (VAS). Results: There was a significant difference in the pain level experienced with and without LLLT, such that the mean pain score following LLLT was significantly lower than that without LLLT (p<0.05). No significant difference was found in the pain level between laser and no laser groups in males, but the difference in this regard was significant in females (p<0.05) and female patients experienced a significantly lower level of pain following LLLT. Conclusion: The low-level laser therapy can be successfully used to decrease the level of pain experienced during infiltration anesthesia of the anterior maxilla.

The efficacy of photobiomodulation on dental injection pain: a systematic review of randomized clinical trials

“…Khan et al did not report the type of anesthesia used [ 24 ]. The injection was performed by different providers, clinicians injected the local anesthetic in two studies [ 30 31 ], pediatric dentists in three study [ 27 28 29 ], a blinded investigator in two studies [ 32 33 ], a principal investigator in one study [ 25 ], an oral and maxillofacial surgeon (OMFS) in one study [ 26 ], a senior post-graduate student of pediatric dentistry in one study [ 34 ], a general dentist in one study [ 35 ] and two RCTs did not indicate who performed the injections [ 22 24 ]. Eleven RCTs indicated the use of a 27-gauge needle, while two studies did not disclose the needle size [ 24 25 ].…”

“…All studies used only one injection; however, three did not report the number of injection used [ 24 25 32 ]. All studies used only one cartridge, and four did not report the number used [ 24 25 32 33 ]. There was a marked variety among the included studies concerning injection location ( Table 4 ).…”

“…Nine RCTs reported using continuous pulses [ 22 26 27 28 29 31 33 34 35 ], one study reported using pulsated [ 25 ], and three did not report the emission frequency [ 24 30 32 ]. Five RCTs reported that the laser treatment had contact with the injection site [ 22 30 31 32 33 ], six reported no contact [ 25 27 28 29 34 35 ], and this was not indicated in two studies [ 26 36 ]. The reported laser length varied from 20–40 seconds to 1–2 minutes.…”

“…The reported wavelengths ranged from 790 to 980 nm. Five studies reported a wavelength of 810 nm [ 25 26 29 33 34 ], one reported 915 mm [ 30 ], one reported 790 nm [ 35 ], three reported 940 nm [ 27 28 31 ], and three reported 980 nm [ 22 24 33 ]. All studies only used the laser on the buccal area, two on the buccal and palatal mucosa [ 26 34 ], and only one on the palatal region [ 35 ].…”

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

“…We also found one report of dual wavelength PBMT by an 810 + 980 nm (4 J/cm 2 ) laser that showed positive effects on pain experienced during infiltration anesthesia injection in the anterior maxilla. 44 In an interesting study, the effect of PBMT as an alternative to injection for the traditional injection of local anesthesia was evaluated. 45 They applied an 810-nm laser (200 mW, 6 J, 85 J/cm 2 ) in a punctual mode at the buccal cervical area of the tooth and on the gingiva.…”