Influence of Photodynamic Therapy in the Control of Postoperative Pain in Endodontic Treatment: A Cross-Sectional Randomized Clinical Trial

Franciely Mariani Silva Yoshinari, Key Fabiano Souza Pereira, Daniele Zafalon Beraldo, Júlio César Leite da Silva, Edilson José Zafalon, Pedro Gregol da Silva

Abstract


Objective:To evaluate the postoperative pain at different times after endodontic treatment with and without the use of photodynamic therapy (PDT) of asymptomatic teeth with apical periodontitis. Material and Methods:In this cross-sectional randomized clinical trial, the treatment was performed in a single visit with and without the use of photodynamic therapy. The sample consisted of 10 patients with two teeth in the same jaw, but on different sides (split-mouth), subjected to the same endodontic treatment with reciprocating instrumentation in the apical foramen instrumentation limit. The teeth from each patient were randomly divided into two groups: G1 (Control): endodontic treatment without photodynamic therapy and G2 (PDT): received methylene blue 0.005% and irradiation with a low-level laser. The fillings were performed with a Touch'n Heat technical device and Ah Plus sealer. The treatments of G1 and G2 in the same patient were performed in an interval of 3 weeks between them and the blinding study was ensured during all long treatment. Postoperative pain was recorded using an adapted VAS scale in times of 6, 12, 24, 36, 48, and 72 hours. Results:In both groups, the highest value recorded at the VAS scale was 2 mm (no pain), and there were no statistically significant differences in postoperative pain between the groups at any observation times (p<0.05). Conclusion:The photodynamic therapy did not have advantages to control postoperative pain in endodontic treatments of asymptomatic teeth with apical periodontitis, since both groups showed low levels of pain in all patients evaluated.


Keywords


Laser Therapy; Low-Level Light Therapy; Endodontics; Toothache.

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References


Gama TG, de Oliveira JC, Abad EC, Rôças IN, Siqueira JF Jr. Postoperative pain following the use of two different intracanal medications. Clin Oral Invest 2008; 12(4):325-30. https://doi.org/10.1007/s00784-008-0199-3

Del Carpio-Perochena AE, Bramante CM, Duarte MA, Cavenago BC, Villas-Boas MH, Graeff MS, et al. Biofilm dissolution and cleaning ability of different irrigant solutions on intraorally infected dentin. J Endod 2011; 37(8):1134-8. https://doi.org/10.1016/j.joen.2011.04.013

Yaylali EI, Teke A, Tunca YM. The effect of foraminal enlargement of necrotic teeth with a continuous rotary system on postoperative pain: A randomized controlled trial. J Endod 2011; 43(3):359-63. https://doi.org/10.1016/j.joen.2016.11.009

Tirali RE, Bodur H, Sipahi B, Sungurtekin E. Evaluation of the antimicrobial activities of chlorhexidine gluconate, sodium hypochlorite and octenidine hydrochloride in vitro. Aust Endod J 2013; 39(1):15-8. https://doi.org/10.1111/j.1747-4477.2010.00266.x

Siqueira Jr JF, Barnett F. Interappointment pain: Mechanisms, diagnosis, and treatment. Endod Topics 2004; 7(1):93-109. https://doi.org/10.1111/j.1601-1546.2004.00062.x

Garcez AS, Ribeiro MS, Tegos GP, Núñez SC, Jorge AO, Hamblin MR. Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection. Lasers Surg Med 2007; 39(1):59-66. https://doi.org/10.1002/lsm.20415

Garcez AS, Nuñez SC, Hamblin MR, Ribeiro MS. Antimicrobial effects of photodynamic therapy on patients with necrotic pulps and periapical lesion. J Endod 2008; 34(2):138-42. https://doi.org/10.1016/j.joen.2007.10.020

Merli LA, Santos MT, Genovese WJ, Faloppa F. Effect of low-intensity laser irradiation on the process of bone repair. Photomed Laser Surg 2005; 23(2):212-5. https://doi.org/10.1089/pho.2005.23.212

Asnaashari M, Safavi N. Application of low level lasers in dentistry (endodontic). J Lasers Med Sci 2013; 4(2):57-66. https://doi.org/10.22037/2010.v4i2.4187

Gasperini G, Rodrigues de Siqueira IC, Rezende-Costa L. Does low-level laser therapy decrease swelling and pain resulting from orthognathic surgery? Int J Oral Maxillofac Surg 2014; 43(7):868-73. https://doi.org/10.1016/j.ijom.2014.02.015

Briteño-Vázquez M, Santillán-Díaz G, González-Pérez M, Gallego-Izquierdo T, Pecos-Martín D, Plaza-Manzano G, Romero-Franco N. Low power laser stimulation of the bone consolidation in tibial fractures of rats: A radiologic and histopathological analysis. Lasers Med Sci 2015; 30(1):333-8. https://doi.org/10.1007/s10103-014-1673-6

Soukos NS1, Chen PS, Morris JT, Ruggiero K, Abernethy AD, Som S, et al. Photodynamic therapy for endodontic disinfection. J Endod 2006; 32(10):979-84. https://doi.org/10.1016/j.joen.2006.04.007

Garcez AS, Nuñez SC, Hamblim MR, Suzuki H, Ribeiro MS. Photodynamic therapy associated with convencional endodontic treatment in patients with antibiotic-resistant microflora: A preliminar report. J Endod 2010; 36(9):1463-6. https://doi.org/10.1016/j.joen.2010.06.001

Garcez AS, Fregnani ER, Rodriguez HM, Nunez SC, Sabino CP, Suzuki H, Ribeiro MS. The use of optical fiber in endodontic photodynamic therapy. Is it really relevant? Lasers Med Sci 2013; 28(1):79-85. https://doi.org/10.1007/s10103-012-1073-8

Bumb SS, Bhaskar DJ, Agali CR, Punia H, Gupta V, Singh V, et al. Assessment of photodynamic therapy (PDT) in disinfection of deeper dentinal tubules in a root canal system: An in vitro study. J Clin Diag Res 2014; 8(11):ZC67-71. https://doi.org/10.7860/JCDR/2014/11047.5155

Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: A reanalysis of two clinical trials of postoperative pain. J Pain 2003; 4(7):407-14. https://doi.org/10.1016/S1526-5900(03)00716-8

Plotino G, Grande NM, Mercade M. Photodynamic therapy in endodontics. Int Endod J 2018; https://doi.org/10.1111/iej.13057

Lazzaretti DN, Bortoluzzi GS, Torres Fernandes LF, Rodriguez R, Grehs RA, Martins Hartmann MS. Histologic evaluation of human pulp tissue after orthodontic intrusion. J. Endod 2014; 40(10):1537-40. https://doi.org/10.1016/j.joen.2013.10.039

Rodrigues RCV, Zandi H, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, et al. Influence of the apical preparation size and the irrigant type on bacterial reduction in root canal-treated teeth with apical periodontitis. J Endod 2017; 43(7):1058-63. https://doi.org/10.1016/j.joen.2017.02.004

Paredes-Vieyra J, Enriquez FJJ. Sucess rate of single-versus two-visit root canal treatment of teeth with apical periodontitis: A randomized controlled trial. J Endod 2012; 38(9):1164-9. https://doi.org/10.1016/j.joen.2012.05.021

de Pablo OV, Estevez R, Péix Sánchez M, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: A systematic review. J Endod 2010; 36(12):1919-31. https://doi.org/10.1016/j.joen.2010.08.055

Arnold M, Ricucci D, Siqueira JF Jr. Infection in a complex network of apical ramifications as the cause of persistent apical periodontitis: A case report. J Endod 2013; 39(9):1179-84. https://doi.org/10.1016/j.joen.2013.04.036

Sakamoto M, Siqueira JF Jr, Rôças IN, Benno Y. Molecular analysis of the root canal microbiota associated with endodontic treatment failures. Oral Microbiol Immunol 2008; 23(4):275-81. https://doi.org/10.1111/j.1399-302X.2007.00423.x

Vieira GCS, Antunes HS, Pérez AR, Gonçalves LS, Antunes FE, Siqueira JF Jr, Rôças IN. Molecular analysis of the antibacterial effects of photodynamic therapy in endodontic surgery: A case series. J Endod 2018; 44(100:1593-7. https://doi.org/10.1016/j.joen.2018.06.012

Nair PNR, Henry S, Cano V, Vera J. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after ‘‘one-visit’’ endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 99(2):231-52. https://doi.org/10.1016/j.tripleo.2004.10.005

Seltzer S, Naidorf IJ. Flare-ups in endodontics: I. Etiological factors. J Endod 1985; 11(11):472-8. https://doi.org/10.1016/S0099-2399(85)80220-X

Ghoddusi J, Javidi M, Zarrabi MH, Bagheri H. Flare ups incidence and severity after using calcium hydroxide as an intracanal dressing. N Y State Dent J 2006; 72(4):24-8.

Spencer HR, Ike V, Brennan PA. Review: the use of sodium hypochlorite in endodontics - potential complications and their management. Br Dent J 2007; 202(9):555-9. https://doi.org/10.1038/bdj.2007.374

Figini L, Lodi G, Gorni F, Gagliani M. Single versus multiple visits for endodontic treatment of permanente teeth: A Cochrane systematic review. J Endod 2008; 34(9):1041-7. https://doi.org/10.1016/j.joen.2008.06.009

Zhu WC, Gyamfi J, Niu LN, Schoeffel GJ, Liu SY, Santarcangelo F, et al. Anatomy of sodium hypochlorite accidents involving facial ecchymosis - A review. J Dent 2013; 41(11):935-48. https://doi: 10.1016/j.jdent.2013.08.012

El Mubarak AHH, Abu-baks NH, Ibrabim YE. Posperative pain in multiple-visit root canal treatment. J Endod 2010; 36(1):36-9. https://doi.org/10.1016/j.joen.2009.09.003

Rao KN, Kandaswamy R, Umashetty G, Rathore VPS, Hotkar C, Patil BS. Post-obturation pain following one-visit and two-visit root canal treatment in necrotic anterior teeth. J Int Oral Health 2014; 6(2):28-32.

Asnaashari M, Mohebi S, Paymanpour P. Pain reduction using low-level laser irradiation in single-visit endodontic treatment. J Lasers Med Sci 2011; 2(4):139-43. https://doi.org/10.22037/2010.v2i4.2356

Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: A comparison of six methods. Pain 1986; 27(1):117-26. https://doi.org/10.1016/0304-3959(86)90228-9

Yildiz ED, Arslan H. Effect of low-level laser therapy on postoperative pain in molars with symptomatic apical periodontitis: A randomized placebo-controlled clinical trial. J Endod 2018; 44(11):1610-15. https://doi.org/10.1016/j.joen.2018.07.002

Alí A, Olivieri JG, Duran-Sindreu F, Abella F, Roig M, García-Font M. Influence of preoperative pain intensity on postoperative pain after root canal treatment: A prospective clinical study. J Dent 2016; 45:39-42. https://doi.org/10.1016/j.jdent.2015.12.002




DOI: http://dx.doi.org/10.4034/PBOCI.2019.191.43

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