Effect of Photobiomodulation Therapy with 915 nm Diode Laser on Pain Perception during Local Anesthesia of Maxillary Incisors: A Randomized Controlled Trial

Abstract

This study aimed to evaluate the effect of photobiomodulation therapy (PBMT) with 915 nm wavelength on pain reduction during maxillary incisors' local infiltration in a randomized clinical trial study. A prospective triple-blinded split-mouth clinical trial was designed to assess pain perception during needle insertion and local anesthetic injection in 32 healthy patients required operative caries management on contralateral maxillary incisors. After laser treatment (915 nm, power of 1.5 W, duty cycle of 60% and energy density of 72 J cm À2 ) in active group and no irradiation in sham group, the injection was performed. Patients' perception of pain was immediately assessed using numerical rating scale (NRS) for pain. Washout period between two appointments was one week. Wilcoxon signed-rank and Pearson correlation statistical analyses were used to assess the comparison of pain score between two appointments and the effect of anxiety level of previous dental injections. The mean scores of pain for the active laser and sham laser groups were 2.5 AE 2.19 and 4.34 AE 2.52, respectively, with a statistically significant higher NRS in the sham laser group (P ˂ 0.05). In this study's condition, diode PBMT reduced pain during infiltration on maxillary incisors. Anxiety experience of dental injection had no significant effect on pain perception scale (P ˃ 0.05).

Use of photobiomodulation (880 nm) for anesthesia puncture pain reduction: A split‐mouth case report

“…The effectiveness of PBM is already proven, and numerous well-designed studies have obtained positive results, especially in pain control [9]. However, there are few studies on the relationship between PBM and its action in local anesthesia [10][11][12][13][14][15][16]. To date, there is no evaluation of PBM with 808 nm on pain control during pterygomandibular puncture for inferior alveolar nerve block.…”

“…Different radiant exposures were observed among studies [10][11][12][13][14][15][16]. Thus, the protocol of choice was adapted and described in Table 1 [10,11].…”

“…This technique is safe and lacks contraindications or adverse effects. Some wavelengths were tested for different anesthesia techniques [10][11][12][13][14][15]. It was observed that some studies used the infrared laser in pterygomandibular adults' anesthesia: 980 nm, 15 J/cm 2 for 20 s [10]; 980 nm, 75 J/cm 2 for 150 s 500 mW [11]; 980 nm, 15.62 J/cm 2 for 20 s, 300 mW [12].…”

“…It was observed that some studies used the infrared laser in pterygomandibular adults' anesthesia: 980 nm, 15 J/cm 2 for 20 s [10]; 980 nm, 75 J/cm 2 for 150 s 500 mW [11]; 980 nm, 15.62 J/cm 2 for 20 s, 300 mW [12]. Other studies use infrared, but for infiltration technique in the maxilla: 830 nm in palatal anesthesia, 4 J/cm 2 for 33 s,120 mW [13]; 915 nm in incisors anesthesia, 1.5 W, and 72 J/cm 2 [14], and 940 nm in canine anesthesia 15.28 J/cm 2 for 60 s, 200 mW [15] and infiltration in mandible 810 nm, 85 J/cm 2 for 30 s [16]. To date, there is no evaluation of PBM (808 nm) on pain control during pterygomandibular puncture for inferior alveolar nerve block.…”

“Optoanesthesia”: The Application of Transcranial Photobiomodulation to General Anesthesia

“…With respect to regional analgesia, the local analgesic effects of PBM have been used in dental surgery to reduce injection pain [37] [38], and a positive analgesic outcome was noted [39]. Local anesthetic effects of PBM during pediatric dental procedures have also been confirmed [40].…”