Effect of Low-Level Laser Therapy on Pain Experienced During Leveling and Alignment of Lower Anterior Teeth: A Randomized Controlled Clinical Study

Abstract

Objective: This randomized controlled clinical study investigated the effect of a 635 nm Gallium-Aluminum-Arsenide (Ga-Al-As) laser on pain perception during the leveling and alignment of lower anterior teeth. Subjects and Methods: Twenty eight orthodontic patients, 17 females and 11 males, were randomly selected who underwent leveling and alignment through a non-extraction approach. They were randomly divided according to into two groups: non-laser group and low-level laser therapy (LLLT) group. Both groups utilized the same leveling 0.012 inch Ni-Ti arch wires. The laser group was exposed to Ga-Al-As semiconductor diode laser with 635 nm wavelength, 6.5J/cm 2 energy density, for 10 seconds on 10 points distributed over the labial and lingual aspects of each root of the lower anterior teeth. This was applied immediately after archwire insertion and then at days 3,7,14, 28 of the first month. Each patient was provided with a Visual Analog Scale (VAS) to record the pain score at 4 hours, 6 hours, 24 hours, 3 days, 7 days, and 28 days. Results: In both laser and non-laser groups, there is a statistically non-significant increase of pain measurements at 6 and 24 hours and a non-significant decrease in mean of pain measurements after day 3. Conclusions: The LLLT, with current parameters and protocol, has a negligible effect on pain experienced during initial orthodontic leveling and alignment stage.

The Protocol of Low-level Laser Therapy in Orthodontic Practice

“…[ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 ] The pain reduction was assessed in 40 experiments. [ 18 20 , 21 23 , 24 28 , 37 38 39 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 ] Only five articles evaluated the impact of LLLT on root resorption. [ 17 73 74 75 76 ] The included experiments consisted of 24 parallel-group randomized control trials (RCTs), and 34 split-mouth RCTs, whereas two articles did not report how their subjects were allocated into each group.…”

“…Visual analog scales (VASs) appeared to be the most popular tool to gather self-perceived pain, which was used in 29 articles. [ 18 20 , 23 37 , 38 42 43 44 45 46 47 48 49 50 51 52 53 , 56 58 , 59 61 62 63 64 65 66 , 69 70 , 72 ] Eight articles employed numerical rating scales (NRS). [ 24 39 , 54 55 , 57 60 , 67 68 ] The Wong–Baker faces pain rating scale, used in three articles, could also be applied to collect self-reported pain.…”

“…The data summarized in Tables 1 – 3 of this review were analyzed from 60 articles listed in the reference section. [ 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 ]…”