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

Abstract

Introduction: This study investigated the photobiomodulation effect of an 810-nm diode laser in adjunction with topical anesthesia on pain perception during infiltration anesthesia of primary maxillary molars in children. Methods: This double-blind randomized controlled clinical trial was conducted on 64 children (aged 5-9 years) requiring extraction or stainless steel crown for their primary maxillary molars. The patients were randomly allocated into two groups (n=32) of laser and control. In the laser group, the injection site (buccal and palatal mucosa) was irradiated with an 810-nm laser (200 mW, 5.2 J/cm2 ) after 20% benzocaine topical anesthetic application, while the control group received a placebo laser following topical anesthesia. The pain intensity experienced by children during needle insertion into the buccal and palatal mucosa was determined using a visual analog scale (VAS) and modified behavioral pain scale (MBPS). Results: According to the results of the VAS and MBPS, no significant difference was detected in pain scores between the laser and control groups neither in the buccal nor in the palatal mucosa (P>0.05). Conclusions: Photobiomodulation therapy with an 810-nm laser with the current setting adjunct to topical anesthesia did not promote significant additional effects on the pain intensity.

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 ].…”

“…Eleven RCTs indicated the use of a 27-gauge needle, while two studies did not disclose the needle size [ 24 25 ]. The injection technique used was mostly buccal infiltration [ 22 25 30 31 34 ]; two studies reported using both buccal and palatal injection [ 26 34 ], one reported using palatal injection only [ 35 ] and one did indicate the injection technique [ 24 ]. All studies used only one injection; however, three did not report the number of injection used [ 24 25 32 ].…”

“…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 ].…”

“…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 ]. Significant differences were found among the included studies regarding diagnosis, number of teeth, laser type, laser power, energy density, and focal spot area ( Table 5 ).…”