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

Abstract

Background and aim: In light of the development of modern technologies and the insertion of laser in the context of endodontic treatment, this study aimed to find the best method for applying the 810 diode laser to relieve post-endodontic pain on necrotic maxillary incisors with periapical lesions within a single-visit treatment. Methods: Eighty patients with a necrotic incisor, diagnosed with asymptomatic periodontitis, received standardized cleaning and shaping procedures, then divided equally into four groups: G1: control group with no laser application, G2: applying the diode laser as an irrigation activation system (IAS), G3: applying the diode laser from the buccal and palatal mucosa, G4: applying the diode laser as an IAS and from buccal and palatal mucosa. The postoperative pain (PP) was assessed using the visual analog scale (VAS) 1, 3, 7, and 14 days after the treatment. The mean values of the VAS score were statistically analyzed. Results: During 14 days after treatment, there was a statistically significant difference between mean values of VAS scores in the four groups (P value < 0.05); G1 scored the highest score, whereas G4 showed the lowest one. Moreover, G4 showed favorable outcomes compared with G2 and G3 during the first three days after treatment. Conclusion: Diode laser reduced the PP after necrotic teeth with large-sized apical lesion treatment, whereas using diode laser either as an IAS or LLLT reduced the PP compared with the control group. Moreover, the usage of a diode laser in both previous techniques represents the best protocol for PP relieve during 14 days of treatment.