Effect of Photobiomodulation on Pain Following Single Visit Non-surgical Root Canal Treatment of Molar Teeth with Symptomatic Irreversible Pulpitis

Narges Farhad-Mollashahi; Eshagh Ali Saberi; Bita Aramesh; Farnaz Faramarzian

Authors

Narges Farhad-Mollashahi
Eshagh Ali Saberi
Bita Aramesh
Farnaz Faramarzian

Keywords:

Root Canal Therapy, Pain, Low-Level Light Therapy

Abstract

Objective: To assess the effect of Photobiomodulation (PBM) on post-endodontic pain of mandibular molar teeth with symptomatic irreversible pulpitis. Material and Methods: In this clinical trial, mandibular molars with symptomatic irreversible pulpitis underwent primary endodontic treatment in 90 systemically healthy patients. After root canal treatment, the patients were randomly divided into two groups of PBM with diode laser at 940 nm wavelength and 200 mW output power and placebo (mock PBM therapy). Level of pain was recorded at 6, 12, 24, 48, and 72 hours postoperatively using a visual analog scale (VAS). The data were analyzed using the Mann-Whitney test and the Kruskal-Wallis test. Results: The results showed that post-endodontic pain at all time points was significantly lower in the PBM group compared with the placebo group. The pain score in the PBM group was significantly lower than the placebo group (p<0.05). However, this difference was not significant at 48 h (p=0.18) and 72 h (p=0.12) postoperatively. Also, the results showed that the mean pain score in males and females in the PBM group was significantly lower than in males and females in the placebo group. Conclusion: Photobiomodulation can effectively decrease post-endodontic pain in mandibular molar teeth with symptomatic irreversible pulpitis.

References

Sathorn C, Parashos P, Messer HJIej. The prevalence of postoperative pain and flare‐up in single‐and multiple‐visit endodontic treatment: a systematic review. Int Endod J 2008; 41(2):91-9. https://doi.org/10.1111/j.1365-2591.2007.01316.x

Lopes LPB, Herkrath FJ, Vianna ECB, Gualberto Júnior EC, Marques AAF, Sponchiado Júnior EC. Effect of photobiomodulation therapy on postoperative pain after endodontic treatment: a randomized, controlled, clinical study. Clin Oral Investig 2019; 23(1):285-92. https://doi.org/10.1007/s00784-018-2435-9

Anagha CS, Koshy M, Varghese R, Anirudhan S. Comparison of postoperative pain following single-visit and two-visit root canal therapy in controlled diabetic patients with irreversible pulpitis: A randomized control trial. J Conserv Dent 2022; 25(4):392-7. https://doi.org/10.4103/jcd.jcd_18_22

Fazlyab M, Esmaeili Shahmirzadi S, Esnaashari E, Azizi A, Moshari AA. Effect of low-level laser therapy on postoperative pain after single-visit root canal retreatment of mandibular molars: A randomized controlled clinical trial. Int Endod J 2021; 54(11):2006-15. https://doi.org/10.1111/iej.13608

Ryan JL, Jureidini B, Hodges JS, Baisden M, Swift JQ, Bowles WR. Gender differences in analgesia for endodontic pain. J Endod 2008; 34(5):552-6. https://doi.org/10.1016/j.joen.2008.01.021

Arslan H, Gündoğdu EC, Sümbüllü M. The effect of preoperative administration of antihistamine, analgesic and placebo on postoperative pain in teeth with symptomatic apical periodontitis: A randomized controlled trial. Eur Endod J 2016; 1(1):1-5. https://doi.org/10.5152/eej.2016.16012

Aneja K, Gupta A, Abraham D, Aggarwal V, Sethi S, Chauhan P, et al. Influence of vehicle for calcium hydroxide on postoperative pain: a scoping review. J Dent Anesth Pain Med 2022; 22(2):75-86. https://doi.org/10.17245/jdapm.2022.22.2.75

Tunc F, Yildirim C, Alacam T. Evaluation of postoperative pain/discomfort after intracanal use of Nd:YAG and diode lasers in patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps: a randomized control trial. Clin Oral Investig 2021; 25(5):2737-44. https://doi.org/10.1007/s00784-020-03588-8

Sadaf D, Ahmad MZ, Onakpoya IJ. Effectiveness of intracanal cryotherapy in root canal therapy: A systematic review and meta-analysis of randomized clinical trials. J Endod 2020; 46(12):1811-1823.e1. https://doi.org/10.1016/j.joen.2020.08.022

Ingle JI, Bakland LK, Baumgartner JC. Ingle's Endodontics 6. BC Decker; 2008. 1555p.

Huang YY, Sharma SK, Carroll J, Hamblin MR. Biphasic dose response in low level light therapy - an update. Dose Response 2011; 9(4):602-18. https://doi.org/10.2203/dose-response.11-009.Hamblin

Asnaashari M, Ashraf H, Daghayeghi AH, Mojahedi SM, Azari-Marhabi S. Management of post endodontic retreatment pain with low level laser therapy. J Lasers Med Sci 2017; 8(3):128-31. https://doi.org/10.15171/jlms.2017.23

Sipavičiūtė E, Manelienė R. Pain and flare-up after endodontic treatment procedures. Stomatologija 2014; 16(1):25-30.

Shahnaz N, Masoodi A, Amin K, Baba IA. Management of post endodontic pain following single visit endodontics: areview. Int J Dent Health Sci 2015; 2(2):396-405.

Alqaderi H, Lee CT, Borzangy S, Pagonis TC. Coronal pulpotomy for cariously exposed permanent posterior teeth with closed apices: A systematic review and meta-analysis. J Dent 2016; 44:1-7. https://doi.org/10.1016/j.jdent.2015.12.005

Domah F, Shah R, Nurmatov UB, Tagiyeva N. The use of low-level laser therapy to reduce postoperative morbidity after third molar surgery: A systematic review and meta-analysis. J Oral Maxillofac Surg 2021; 79(2):313.e1-313.e19. https://doi.org/10.1016/j.joms.2020.09.018

Kreisler MB, Haj HA, Noroozi N, Willershausen Bd. Efficacy of low level laser therapy in reducing postoperative pain after endodontic surgery--A randomized double blind clinical study. Int J Oral Maxillofac Surg 2004; 33(1):38-41. https://doi.org/10.1054/ijom.2002.0449

Doğanay Yıldız E, 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):1610-5. https://doi.org/10.1016/j.joen.2018.07.002

Alam MK. Laser-assisted orthodontic tooth movement in Saudi population: A prospective clinical intervention of low-level laser therapy in the 1st week of pain perception in four treatment modalities. Pain Res Manag 2019; 2019:6271835. https://doi.org/10.1155/2019/6271835

Biala M. Low-level laser therapy: A literature review of the prevention and reduction of oral mucositis in patients undergoing stem cell transplantation. Clin J Oncol Nurs 2022; 26(3):293-9. https://doi.org/10.1188/22.CJON.293-299

Bradly P, Heller GJP. The effect of 830 nmlaser on chronic myofacial pain. Pain 2006; 124(1):2.

Tunér J, Hosseinpour S, Fekrazad R. Photobiomodulation in temporomandibular disorders. Photobiomodul Photomed Laser Surg 2019; 37(12):826-36. https://doi.org/10.1089/photob.2019.4705

El Mobadder M, Namour A, Namour M, Dib W, El Mobadder W, Maalouf E, et al. Dentinal hypersensitivity treatment using diode laser 980 nm: In vivo study. Dent J 2019; 7(1):5. https://doi.org/10.3390/dj7010005

Pawar SS, Pujar MA, Makandar SD, Khaiser MI. Postendodontic treatment pain management with low-level laser therapy. J Dent Lasers 2014; 8(2):60-3. https://doi.org/10.4103/0976-2868.145141

Pires de Sousa MV, Ferraresi C, Kawakubo M, Kaippert B, Yoshimura EM, Hamblin MR. Transcranial low-level laser therapy (810 nm) temporarily inhibits peripheral nociception: photoneuromodulation of glutamate receptors, prostatic acid phophatase, and adenosine triphosphate. Neurophotonics 2016; 3(1):015003. https://doi.org/10.1117/1.NPh.3.1.015003

Baxter D, Walsh D, Wright A. A microneurographic investigation of the neurophysiological effects of low-intensity laser. Abstracts London Laser 1992; Second Meeting of the International Laser Therapy Association #30.

Honmura A, Yanase M, Obata J, Haruki E. Therapeutic effect of Ga-Al-As diode laser irradiation on experimentally induced inflammation in rats. Lasers Surg Med 1992; 12(4):441-9. https://doi.org/10.1002/lsm.1900120414

Barberis G, Gamron S, Acevedo G, Cadile I, Juri H, Campana V, et al. In vitro synthesis of prostaglandin E2 by synovial tissue after helium-neon laser radiation in rheumatoid arthritis. J Clin Laser Med Surg 1996; 14(4):175-7. https://doi.org/10.1089/clm.1996.14.175

Dorris SL, Peebles RS Jr. PGI2 as a regulator of inflammatory diseases. Mediators of inflammation 2012; 2012:926968. https://doi.org/10.1155/2012/926968

Khalighi HR, Anbari F, Beygom Taheri J, Bakhtiari S, Namazi Z, Pouralibaba F. Effect of low-power laser on treatment of orofacial pain. J Dent Res Dent Clin Dent Prospects 2010; 4(3):75-8. https://doi.org/10.5681/joddd.2010.019

Kisselev SB, Moskvin SV. the use of laser therapy for patients with fibromyalgia: A critical literary review. J Lasers Med Sci 2019; 10(1):12-20. https://doi.org/10.15171/jlms.2019.02

Shiroto C, Sugawara K, Kumae T, Ono Y, Sasaki M, Ohshiro TJLT. Effect of diode laser radiation in vitro on activity of human neutrophils. Laser Therapy 1989; 1(3):135.

Cheng Y, Cheung GS, Bian Z, Peng B. Incidence and factors associated with endodontic inter-appointment emergency in a dental teaching hospital in China. J Dent 2006; 34(7):516-21. https://doi.org/10.1016/j.jdent.2005.12.003

Alves Vde O. Endodontic flare-ups: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110(5):e68-72. https://doi.org/10.1016/j.tripleo.2010.05.014

de Oliveira AR, Vanin AA, Tomazoni SS, Miranda EF, Albuquerque-Pontes GM, De Marchi T, et al. Pre-exercise infrared photobiomodulation therapy (810 nm) in skeletal muscle performance and postexercise recovery in humans: What is the optimal power output? Photomed Laser Surg 2017; 35(11):595-603. https://doi.org/10.1089/pho.2017.4343

Coelho MS, Vilas-Boas L, Tawil PZ. The effects of photodynamic therapy on postoperative pain in teeth with necrotic pulps. Photodiagnosis Photodyn Ther 2019; 27:396-401. https://doi.org/10.1016/j.pdpdt.2019.07.002

Cruz Junior JA, Santos Coelho M, Shoji Kato A, Vivacqua-Gomes N, Fontana CE, Pedro Rocha DG, et al. The effect of foraminal enlargement of necrotic teeth with the reciproc system on postoperative pain: A prospective and randomized clinical trial. J Endod 2016; 42(1):8-11. https://doi.org/10.1016/j.joen.2015.09.018

Saini HR, Sangwan P, Sangwan A. Pain following foraminal enlargement in mandibular molars with necrosis and apical periodontitis: A randomized controlled trial. Int Endod J 2016; 49(12):1116-1123. https://doi.org/10.1111/iej.12583

Yaylali IE, Kurnaz S, Tunca YM. Maintaining apical patency does not increase postoperative pain in molars with necrotic pulp and apical periodontitis: A randomized controlled trial. J Endod 2018; 44(3):335-40. https://doi.org/10.1016/j.joen.2017.11.013