The effect of low‐level laser therapy on the success rate of inferior alveolar nerve blocks in mandibular molars with symptomatic irreversible pulpitis: A randomized clinical trial

Abstract

Aim To evaluate the effect of low‐level laser therapy (LLLT) on the success rate of inferior alveolar nerve blocks (IANB) in mandibular molar teeth with symptomatic irreversible pulpitis (SIP). Methodology Eighty‐eight patients who were diagnosed with SIP were randomly divided into two groups: the group in which only IANB was applied and the group in which IANB + LLLT was applied. IANB was applied to patients in the control group with 4% articaine. LLLT was applied to the patients in the experimental group in addition to IANB. The pain experienced during the operation was evaluated using a visual analog scale. If the patients reported moderate or severe pain during the treatment, the IANB was defined as unsuccessful. Pearson's chi‐square test was used to analyse anaesthetic success rates. Results Whilst the anaesthesia success rate was 34% in the group where only IANB was applied, it was 57% in the group in which LLLT was applied in addition to IANB. There was a significant difference between the groups (p = .032). Conclusions The application of LLLT to support IANB in mandibular molar teeth with SIP increased the success of anaesthesia. However, it was insufficient for a complete pulpal anaesthesia.

Effect of photobiomodulation on the efficacy of anesthesia in maxillary permanent molar teeth with molar incisor hypomineralization: A randomized clinical trial

“…In contrast, two other studies on endodontic treatments in adults reported that low-level lasers increased the depth of anesthesia and reduced the need for additional anesthesia. 12,13 The only study in children reported by Uçar et al 9 evaluated the effect of PBMT on anesthesia and reported that PBMT had no negative effect on the anesthesia in primary teeth. Their primary research outcome related to PBMT, however, was to evaluate the possible negative effect of PBMT due to the change in microcirculation.…”

“…Nevertheless, in the same study, it was reported that 40 J/cm 2 PBMT did not have any effect on anesthesia depth. In contrast, two other studies on endodontic treatments in adults reported that low‐level lasers increased the depth of anesthesia and reduced the need for additional anesthesia 12,13 . The only study in children reported by Uçar et al 9 evaluated the effect of PBMT on anesthesia and reported that PBMT had no negative effect on the anesthesia in primary teeth.…”

“…8 Recently, low-level laser usage has gained popularity, as it is a safe, nonablative, noninvasive, nonthermogenic, and vibration-free method that can be used to accelerate and facilitate the healing process and reduce pain in dental practice. [9][10][11][12][13][14] Low-level laser application is also known as photobiomodulation therapy (PBMT) or biostimulation, and it works on the principle of administering biostimulative light energy to the cells. 10 This light energy applied to the cells undergoes absorption by photoreceptors such as cytochrome c oxidase, which is a critical chromophore responsible for the stimulation effect of irradiation using the infrared spectrum.…”

“…[9][10][11] Few studies have reported the effect of PBMT on the efficacy of anesthesia in both children and adults, and inconsistent results have been attained. [12][13][14] Topçuoğlu and Akpınar 12 and Ghabraei et al 13 reported that PBMT increased the effect of dental anesthesia in adults with irreversible pulpitis. In contrast, Ramalho et al 14 reported a negative effect and no effect of two different energy density levels of PBMT on anesthesia efficacy in adults.…”

Efficacy of four local anaesthesia protocols for mandibular first molars with symptomatic irreversible pulpitis: A randomized clinical trial

“…Various strategies have been used to increase the success rate of IANBs in these situations, such as using modified techniques targeting different anatomical landmarks (Khalil, 2014), changing the type and/or increasing the volume of the local anaesthetic solution (Aggarwal et al, 2012;Nagendrababu et al, 2020a;Visconti et al, 2016), using mepivacaine to overcome the TTX-resistant receptors (Brau et al, 2000), prescribing an oral premedication of NSAIDs or corticosteroids (Shahi et al, 2013), using carbonated solutions (Aulestia-Viera et al, 2018), cryotherapy (Topcuoğlu et al, 2019), low-level laser therapy (LLLT) (Topcuoğlu & Akpinar, 2021), and the administration of supplementary buccal and lingual infiltrations (BI/ LI) and/or intra-ligamentary (PDL), intra-osseous (IO) and intra-pulpal injections (Hargreaves et al, 2008;Zanjir et al, 2019). A recent systematic review with meta-analysis and trial sequential analysis concluded that 100% anaesthetic success was not achieved in teeth with SIP, and that supplemental techniques are recommended to achieve pulpal anaesthesia when IANB fails (Nagendrababu et al, 2021).…”