Efficacy of Er,Cr:YSGG laser-assisted delivery of topical anesthesia in the oral mucosa

The prophylactic effect of photobiomodulation therapy on pain perception due to infiltration injection: a randomized clinical trial

OBJECTIVES

Fear of pain in dentistry especially the injection involved in most of the processes has always been an important issue preventing the patients from consulting a dentist at the right time. This study aims to evaluate the effect of photobiomodulation therapy on reduction of pain in infiltration injection.

MATERIALS AND METHODS

This trial is a crossover study including 30 patients. The patients are divided into two groups (laser therapy in the first period and placebo effect in the next period or vice versa with split-mouth design) using the covariate adaptive randomization method. All the patients received bilateral maxillary canine anesthesia in two periods performed with an ICT injection device (amount of anesthesia solution loaded: 1.8 mL) at a speed of 1 mL/min and a temperature of the solution of 37 °C. In each period, patients received either a prophylactic dose of 940-nm laser (500 mW, 10 J/cm2) or its placebo effect before the injection. The degree of pain perception after each sort of treatment is evaluated by both SEM (Sound, Eye, Motor, and Pain) and VAS (Visual Analogue Scale) scales.

RESULTS

According to analysis, all the patients scored a VAS scale under 3 in the period they received intervention. Also considering the SEM scale, most of the patients scored 0 in the intervention period. No adverse effect was reported during or after the process.

CONCLUSIONS

The study showed a significant effect of photobiomodulation on reducing pain perception during infiltration injection.

CLINICAL RELEVANCE

This method can be useful in order to lower the pain for the patients consulting a dentist and therefore facilitate consulting at early stages of the dental issues.

TRIAL REGISTRATION

The registration number (date) of the clinical trial in a Primary Registry in the WHO Registry Network is IR.ARAKMU.REC.1398.248(13/03/2020). The related URL is https://en.irct.ir/trial/45362 .

Evaluating the Efficacy of the Er,Cr:YSGG Fractional Laser Before Treatment With Triamcinolone NN Ointment in Oral Lichen Planus Lesions

Introduction: It has been demonstrated that laser technology can enhance topical drug absorption. This study aimed to determine the effects of Er,Cr:YSGG laser radiation before the application of topical corticosteroids in the healing of oral lichen planus. Methods: In this double-blind split-mouth clinical trial, 32 lesions were chosen from eight patients affected by oral lichen planus (OLP). The oral lesions were randomly categorized into two groups. The first group had topical treatment with triamcinolone NN ointment and the second group had laser radiation (Er,Cr:YSGG) for eight weeks before starting the ointment. For each lesion, the irritating level based on the VAS score, the lesion level based on the Thongprasom scale score, and the healing time were measured, and the collected data were analyzed by the Friedman test and the Wilcoxon's statistical test. Results: The mean healing time based on the verbal analog scale (VAS) score was not significantly different between the two treatment groups (P>0.05). The mean healing time based on Thongprasom scale scores did not show any significant difference between the two treatment groups (P>0.05). Conclusion: The application of the Er,Cr:YSGG laser before treatment with triamcinolone NN ointment did not show any advantage for the average healing time compared to a medicine regimen with only triamcinolone NN ointment.

Evaluating the Preemptive Analgesic Effect of Photo-biomodulation Therapy on Pain Perception During Local Anesthesia Injection in Children: A Split-mouth Triple-blind Randomized Controlled Clinical Trial

To evaluate the impact of photobiomodulation therapy (PBMT) on injection pain perception and compare it with a topical oral anesthetic gel. A total of 30 patients of six to nine years old seeking pulpotomy treatment of maxillary secondary primary molars of both sides were considered for this split-mouth triple-blind randomized clinical trial. On one side of the maxilla, the low-level-laser (diode laser, 808 nm, 250 mW; 16.25 J; 32.5 J/cm² ) was irradiated upon the buccal gingiva of the tooth, while a Benzocaine 20% topical anesthetic gel was applied on the other side. A gel with the same taste (strawberry) was applied for the placebo. The Wong-Baker Faces Pain Rating Scale was used to evaluate the injection pain and post-operation pain at two timestamps, one hour and 24 hours after treatment. Patients' heart rate was also evaluated. Paired-T, Wilcoxon-signed-rank test, McNemar and Friedman tests were used for statistical analyses. Results demonstrated that PBMT could significantly decrease the injection pain perception and heart rate alternations compared to the topical anesthetic gels (P=0.000). However, no significant differences were documented between the two methods concerning the 1hour (P=0.26) and 24-hours (P=1.00) post-operation pain. PBMT can be an effective non-pharmacological technique for controlling injection pain.