Effect of Photobiomodulation Therapy With an 810-nm Diode Laser on Pain Perception Associated With Dental Injections in Children: A Double-Blind Randomized Controlled Clinical Trial Photobiomodulation on dental injections pain
Journal of Lasers in Medical Sciences,
Vol. 14 (2023),
29 Bahman 2023
,
Page e19
Abstract
Introduction: This study investigated the photobiomodulation effect of an 810-nm diode laser in adjunction with topical anesthesia on pain perception during infiltration anesthesia of primary maxillary molars in children.
Methods: This double-blind randomized controlled clinical trial was conducted on 64 children (aged 5-9 years) requiring extraction or stainless steel crown for their primary maxillary molars. The patients were randomly allocated into two groups (n=32) of laser and control. In the laser group, the injection site (buccal and palatal mucosa) was irradiated with an 810-nm laser (200 mW, 5.2 J/cm2) after 20% benzocaine topical anesthetic application, while the control group received a placebo laser following topical anesthesia. The pain intensity experienced by children during needle insertion into the buccal and palatal mucosa was determined using a visual analog scale (VAS) and modified behavioral pain scale (MBPS).
Results: According to the results of the VAS and MBPS, no significant difference was detected in pain scores between the laser and control groups neither in the buccal nor in the palatal mucosa (P>0.05).
Conclusions: Photobiomodulation therapy with an 810-nm laser with the current setting adjunct to topical anesthesia did not promote significant additional effects on the pain intensity.
Keywords:
- Child; Low-Level Light Therapy; Photobiomodulation Therapy, local Anesthesia; Pain
How to Cite
Seraj, B., Bavaghar, A., Hakimiha, N., Hosseini, Z. ., Kharazifard, M. J., & Ghadimi, S. (2023). Effect of Photobiomodulation Therapy With an 810-nm Diode Laser on Pain Perception Associated With Dental Injections in Children: A Double-Blind Randomized Controlled Clinical Trial: Photobiomodulation on dental injections pain. Journal of Lasers in Medical Sciences, 14, e19. Retrieved from https://journals.sbmu.ac.ir/jlms/article/view/41419
References
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11. Evans G, Nusstein J, Drum M, Reader A, Beck M. A prospective, randomized, double-blind comparison of articaine and lidocaine for maxillary infiltrations. Journal of endodontics. 2008;34(4):389-93.
12. Mikesell A, Drum M, Reader A, Beck M. Anesthetic efficacy of 1.8 mL and 3.6 mL of 2% lidocaine with 1: 100,000 epinephrine for maxillary infiltrations. Journal of Endodontics. 2008;34(2):121-5.
13. Treede R-D. The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. Pain reports. 2018;3(2).
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15. Sugiaman VK. Approach to clinical laser application in pediatric dentistry. Makassar Dental Journal. 2022;11(3):310-4.
16. Seraj B, Ghadimi S, Hakimiha N, Kharazifard MJ, Hosseini Z. Assessment of photobiomodulation therapy by an 8l0-nm diode laser on the reversal of soft tissue local anesthesia in pediatric dentistry: a preliminary randomized clinical trial. Lasers in medical science. 2020;35(2):465-71.
17. Chery J, Freitas V, Saman DM, Gupta A. Comparison of Cavity Preparation Times Using Conventional High-Speed Handpiece Versus Er, Cr: YSGG Laser: A Pilot Study with Pediatric Dental Residents. Pediatric Dentistry. 2022;44(2):90-4.
18. Zarabian T, Azadi Mood S, Kiomarsi N, Noorollahian H, Hakimiha N. Microshear Bond Strength of a Self-adhesive Composite to Erbium Laser-Treated Primary Enamel. Journal of lasers in medical sciences. 2020;11(2):181-6.
19. Igna A, Igna C, Miron MI, Schuszler L, Dascălu R, Moldovan M, et al. Assessment of Pulpal Status in Primary Teeth Following Direct Pulp Capping in an Experimental Canine Model. Diagnostics. 2022;12(8):2022.
20. Nascimento A, Di Francesco E, Navarro R, Baptista A, Pedron I. Lingual Frenectomy in a 60-days-old Infant: Case Report Using Diode Laser. SVOA Dentistry. 2022;3(3):143-7.
21. Fekrazad R, Fazilat F, Kalhori KA, Hakimiha N, Amirmoini M, Nikhalat Jahromi M. Juvenile Hyaline Fibromatosis Management With a Diode Laser: A Rare Case Report. Journal of lasers in medical sciences. 2020;11(1):104-7.
22. Hamblin MR. Photobiomodulation or low-level laser therapy. Journal of biophotonics. 2016;9(11-12):1122.
23. Dompe C, Moncrieff L, Matys J, Grzech-Leśniak K, Kocherova I, Bryja A, et al. Photobiomodulation—underlying mechanism and clinical applications. Journal of clinical medicine. 2020;9(6):1724.
24. Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS biophysics. 2017;4(3):337.
25. Uçar G, Şermet Elbay Ü, Elbay M. Effects of low level laser therapy on injection pain and anesthesia efficacy during local anesthesia in children: A randomized clinical trial. International Journal of Paediatric Dentistry. 2022;32(4):576-84.
26. Kermanshah H, Chiniforush N, Kolahdouz Mohammadi M, Motevasselian F. Effect of photobiomodulation therapy with 915 nm diode laser on pain perception during local anesthesia of maxillary incisors: A randomized controlled trial. Photochemistry and photobiology. 2022;98(6):1471-5.
27. Dehgan D, Şermet Elbay Ü, Elbay M. Evaluation of the effects of photobiomodulation with different laser application doses on injection pain in children: a randomized clinical trial. Lasers in medical science. 2023;38(1):1-11.
28. Jagtap B, Bhate K, Magoo S, S NS, Gajendragadkar KS, Joshi S. Painless injections-a possibility with low level laser therapy. Journal of dental anesthesia and pain medicine. 2019;19(3):159-65.
29. Ghaderi F, Ghaderi R, Davarmanesh M, Bayani M, Arabzade Moghadam S. Pain management during needle insertion with low level laser. European journal of paediatric dentistry. 2016;17(2):151-4.
30. Sattayut S. Low intensity laser for reducing pain from anesthetic palatal injection. Photomedicine and laser surgery. 2014;32(12):658-62.
31. Zein R, Selting W, Hamblin MR. Review of light parameters and photobiomodulation efficacy: dive into complexity. Journal of biomedical optics. 2018;23(12):1-17.
32. Lakhani B, Indushekar K, Garg S, Singh N, Tomer E. Behavior assessment using frankl rating scale and identification of personality in pediatric dental operatory. Journal of Child and Adolescent Behavior. 2017;5(5):1-5.
33. Ghaderi F, Banakar S, Rostami S. Effect of pre-cooling injection site on pain perception in pediatric dentistry:“A randomized clinical trial”. Dental research journal. 2013;10(6):790.
34. Crellin DJ, Babl FE, Santamaria N, Harrison D. The psychometric properties of the MBPS scale used to assess procedural pain. The Journal of Pain. 2018;19(6):660-9.
35. Odabaş ME, Çınar C, Deveci C, Alaçam A. Comparison of the anesthetic efficacy of articaine and mepivacaine in pediatric patients: a randomized, double-blind study. Pediatric Dentistry. 2012;34(1):42-5.
36. de Sousa MVP, Kawakubo M, Ferraresi C, Kaippert B, Yoshimura EM, Hamblin MR. Pain management using photobiomodulation: mechanisms, location, and repeatability quantified by pain threshold and neural biomarkers in mice. Journal of biophotonics. 2018;11(7):e201700370.
37. Tsuchiya K, Kawatani M, Takeshige C, Matsumoto I. Laser irradiation abates neuronal responses to nociceptive stimulation of rat-paw skin. Brain research bulletin. 1994;34(4):369-74.
38. Shekarchi F, Nokhbatolfoghahaei H, Chiniforush N, Mohaghegh S, Haeri Boroojeni HS, Amini S, et al. 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. Photochemistry and photobiology. 2022;98(5):1195-200.
39. Afkhami F, Ebrahimi H, Aghazadeh A, Sooratgar A, Chiniforush N. Evaluation of the effect of the photobiomodulation therapy on the pain related to dental injections: A preliminary clinical trial. Dental and medical problems. 2022;59(3):421-5.
40. Ghabraei S, Bolhari B, Nashtaie HM, Noruzian M, Niavarzi S, Chiniforush N. Effect of photobiomodulation on pain level during local anesthesia injection: a randomized clinical trial. Journal of Cosmetic and Laser Therapy. 2020;22(4-5):180-4.
41. Pirnat S. Versatility of an 810 nm diode laser in dentistry: An overview. J Laser Health Acad. 2007;4(2):1-9.
42. Joensen J, Ovsthus K, Reed RK, Hummelsund S, Iversen VV, Lopes-Martins R, et al. Skin penetration time-profiles for continuous 810 nm and Superpulsed 904 nm lasers in a rat model. Photomedicine and laser surgery. 2012;30(12):688-94.
43. AmruthaVarshini I, Vinay C, Uloopi KS, RojaRamya KS, Chandrasekhar R, Penmatsa C. Effectiveness of Pre-cooling the Injection Site, Laser Biostimulation, and Topical Local Anesthetic Gel in Reduction of Local Anesthesia Injection Pain in Children. Int J Clin Pediatr Dent. 2021;14(1):81-3.
44. Kermanshah H, Chiniforush N, Kolahdouz Mohammadi M, Motevasselian F. Effect of Photobiomodulation Therapy with 915 nm Diode Laser on Pain Perception during Local Anesthesia of Maxillary Incisors: A Randomized Controlled Trial. Photochemistry and photobiology. 2022;98(6):1471-5.
45. Sharifi R, Bahrami H, Safaei M, Mozaffari HR, Hatami M, Imani MM, et al. A Randomized Triple-Blind Clinical Trial of the Effect of Low-Level Laser Therapy on Infiltration Injection Pain in the Anterior Maxilla. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 2022;22.
46. Ebrahimi A, Marques MM, Miniello TG, Gutknecht N. Photobiomodulation therapy with 810-nm laser as an alternative to injection for anesthesia in dentistry. Lasers in Dental Science. 2021;5:117-23.
47. Sandhyarani B, Pawar RR, Patil AT, Kevadia MV. Effect of Low-level Laser on LI4 Acupoint in Pain Reduction during Local Anesthesia in Children. International Journal of Clinical Pediatric Dentistry. 2021;14(4):462.
48. Pooja B, Kamatham R, Anchala K, Avisa P. Effectiveness of low-level laser therapy in reducing pain perception of children during dental local anesthetic administration using laser acupuncture pen on the LI4 point: a randomized clinical trial. European Archives of Paediatric Dentistry. 2023:1-9.
49. Ghasemi D, Rajaei S, Aghasizadeh E. Comparison of inferior dental nerve block injections in child patients using 30-gauge and 27-gauge short needles. Journal of Dental Materials and Techniques. 2014;3(2):71-6.
2. Wahl MJ, Schmitt MM, Overton DA, Gordon MK. Injection pain of bupivacaine with epinephrine vs. prilocaine plain. The Journal of the American Dental Association. 2002;133(12):1652-6.
3. Yenisey M. Comparison of the pain levels of computer-controlled and conventional anesthesia techniques in prosthodontic treatment. Journal of Applied Oral Science. 2009;17:414-20.
4. Lirk P, Hollmann MW, Strichartz G. The science of local anesthesia: basic research, clinical application, and future directions. Anesthesia & Analgesia. 2018;126(4):1381-92.
5. Alam M, Geisler A, Sadhwani D, Goyal A, Poon E, Nodzenski M, et al. Effect of needle size on pain perception in patients treated with botulinum toxin type A injections: a randomized clinical trial. JAMA dermatology. 2015;151(11):1194-9.
6. Aggarwal V, Singla M, Miglani S, Kohli S, Irfan M. A prospective, randomized single-blind evaluation of effect of injection speed on anesthetic efficacy of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis. Journal of Endodontics. 2012;38(12):1578-80.
7. Usach I, Martinez R, Festini T, Peris J-E. Subcutaneous injection of drugs: literature review of factors influencing pain sensation at the injection site. Advances in therapy. 2019;36:2986-96.
8. Kaufman E, Epstein JB, Naveh E, Gorsky M, Gross A, Cohen G. A survey of pain, pressure, and discomfort induced by commonly used oral local anesthesia injections. Anesthesia progress. 2005;52(4):122-7.
9. Tirupathi S, Rajasekhar S. Topical anesthesia in pediatric dentistry: an update. Int J Clin Pediatr Dent. 2022;15:240-5.
10. Costa CG, Tortamano IP, Rocha RG, Francischone CE, Tortamano N. Onset and duration periods of articaine and lidocaine on maxillary infiltration. Journal of Prosthetic Dentistry. 2005;94(4):381.
11. Evans G, Nusstein J, Drum M, Reader A, Beck M. A prospective, randomized, double-blind comparison of articaine and lidocaine for maxillary infiltrations. Journal of endodontics. 2008;34(4):389-93.
12. Mikesell A, Drum M, Reader A, Beck M. Anesthetic efficacy of 1.8 mL and 3.6 mL of 2% lidocaine with 1: 100,000 epinephrine for maxillary infiltrations. Journal of Endodontics. 2008;34(2):121-5.
13. Treede R-D. The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. Pain reports. 2018;3(2).
14. Peters ML. Emotional and cognitive influences on pain experience. Pain in psychiatric disorders. 2015;30:138-52.
15. Sugiaman VK. Approach to clinical laser application in pediatric dentistry. Makassar Dental Journal. 2022;11(3):310-4.
16. Seraj B, Ghadimi S, Hakimiha N, Kharazifard MJ, Hosseini Z. Assessment of photobiomodulation therapy by an 8l0-nm diode laser on the reversal of soft tissue local anesthesia in pediatric dentistry: a preliminary randomized clinical trial. Lasers in medical science. 2020;35(2):465-71.
17. Chery J, Freitas V, Saman DM, Gupta A. Comparison of Cavity Preparation Times Using Conventional High-Speed Handpiece Versus Er, Cr: YSGG Laser: A Pilot Study with Pediatric Dental Residents. Pediatric Dentistry. 2022;44(2):90-4.
18. Zarabian T, Azadi Mood S, Kiomarsi N, Noorollahian H, Hakimiha N. Microshear Bond Strength of a Self-adhesive Composite to Erbium Laser-Treated Primary Enamel. Journal of lasers in medical sciences. 2020;11(2):181-6.
19. Igna A, Igna C, Miron MI, Schuszler L, Dascălu R, Moldovan M, et al. Assessment of Pulpal Status in Primary Teeth Following Direct Pulp Capping in an Experimental Canine Model. Diagnostics. 2022;12(8):2022.
20. Nascimento A, Di Francesco E, Navarro R, Baptista A, Pedron I. Lingual Frenectomy in a 60-days-old Infant: Case Report Using Diode Laser. SVOA Dentistry. 2022;3(3):143-7.
21. Fekrazad R, Fazilat F, Kalhori KA, Hakimiha N, Amirmoini M, Nikhalat Jahromi M. Juvenile Hyaline Fibromatosis Management With a Diode Laser: A Rare Case Report. Journal of lasers in medical sciences. 2020;11(1):104-7.
22. Hamblin MR. Photobiomodulation or low-level laser therapy. Journal of biophotonics. 2016;9(11-12):1122.
23. Dompe C, Moncrieff L, Matys J, Grzech-Leśniak K, Kocherova I, Bryja A, et al. Photobiomodulation—underlying mechanism and clinical applications. Journal of clinical medicine. 2020;9(6):1724.
24. Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS biophysics. 2017;4(3):337.
25. Uçar G, Şermet Elbay Ü, Elbay M. Effects of low level laser therapy on injection pain and anesthesia efficacy during local anesthesia in children: A randomized clinical trial. International Journal of Paediatric Dentistry. 2022;32(4):576-84.
26. Kermanshah H, Chiniforush N, Kolahdouz Mohammadi M, Motevasselian F. Effect of photobiomodulation therapy with 915 nm diode laser on pain perception during local anesthesia of maxillary incisors: A randomized controlled trial. Photochemistry and photobiology. 2022;98(6):1471-5.
27. Dehgan D, Şermet Elbay Ü, Elbay M. Evaluation of the effects of photobiomodulation with different laser application doses on injection pain in children: a randomized clinical trial. Lasers in medical science. 2023;38(1):1-11.
28. Jagtap B, Bhate K, Magoo S, S NS, Gajendragadkar KS, Joshi S. Painless injections-a possibility with low level laser therapy. Journal of dental anesthesia and pain medicine. 2019;19(3):159-65.
29. Ghaderi F, Ghaderi R, Davarmanesh M, Bayani M, Arabzade Moghadam S. Pain management during needle insertion with low level laser. European journal of paediatric dentistry. 2016;17(2):151-4.
30. Sattayut S. Low intensity laser for reducing pain from anesthetic palatal injection. Photomedicine and laser surgery. 2014;32(12):658-62.
31. Zein R, Selting W, Hamblin MR. Review of light parameters and photobiomodulation efficacy: dive into complexity. Journal of biomedical optics. 2018;23(12):1-17.
32. Lakhani B, Indushekar K, Garg S, Singh N, Tomer E. Behavior assessment using frankl rating scale and identification of personality in pediatric dental operatory. Journal of Child and Adolescent Behavior. 2017;5(5):1-5.
33. Ghaderi F, Banakar S, Rostami S. Effect of pre-cooling injection site on pain perception in pediatric dentistry:“A randomized clinical trial”. Dental research journal. 2013;10(6):790.
34. Crellin DJ, Babl FE, Santamaria N, Harrison D. The psychometric properties of the MBPS scale used to assess procedural pain. The Journal of Pain. 2018;19(6):660-9.
35. Odabaş ME, Çınar C, Deveci C, Alaçam A. Comparison of the anesthetic efficacy of articaine and mepivacaine in pediatric patients: a randomized, double-blind study. Pediatric Dentistry. 2012;34(1):42-5.
36. de Sousa MVP, Kawakubo M, Ferraresi C, Kaippert B, Yoshimura EM, Hamblin MR. Pain management using photobiomodulation: mechanisms, location, and repeatability quantified by pain threshold and neural biomarkers in mice. Journal of biophotonics. 2018;11(7):e201700370.
37. Tsuchiya K, Kawatani M, Takeshige C, Matsumoto I. Laser irradiation abates neuronal responses to nociceptive stimulation of rat-paw skin. Brain research bulletin. 1994;34(4):369-74.
38. Shekarchi F, Nokhbatolfoghahaei H, Chiniforush N, Mohaghegh S, Haeri Boroojeni HS, Amini S, et al. 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. Photochemistry and photobiology. 2022;98(5):1195-200.
39. Afkhami F, Ebrahimi H, Aghazadeh A, Sooratgar A, Chiniforush N. Evaluation of the effect of the photobiomodulation therapy on the pain related to dental injections: A preliminary clinical trial. Dental and medical problems. 2022;59(3):421-5.
40. Ghabraei S, Bolhari B, Nashtaie HM, Noruzian M, Niavarzi S, Chiniforush N. Effect of photobiomodulation on pain level during local anesthesia injection: a randomized clinical trial. Journal of Cosmetic and Laser Therapy. 2020;22(4-5):180-4.
41. Pirnat S. Versatility of an 810 nm diode laser in dentistry: An overview. J Laser Health Acad. 2007;4(2):1-9.
42. Joensen J, Ovsthus K, Reed RK, Hummelsund S, Iversen VV, Lopes-Martins R, et al. Skin penetration time-profiles for continuous 810 nm and Superpulsed 904 nm lasers in a rat model. Photomedicine and laser surgery. 2012;30(12):688-94.
43. AmruthaVarshini I, Vinay C, Uloopi KS, RojaRamya KS, Chandrasekhar R, Penmatsa C. Effectiveness of Pre-cooling the Injection Site, Laser Biostimulation, and Topical Local Anesthetic Gel in Reduction of Local Anesthesia Injection Pain in Children. Int J Clin Pediatr Dent. 2021;14(1):81-3.
44. Kermanshah H, Chiniforush N, Kolahdouz Mohammadi M, Motevasselian F. Effect of Photobiomodulation Therapy with 915 nm Diode Laser on Pain Perception during Local Anesthesia of Maxillary Incisors: A Randomized Controlled Trial. Photochemistry and photobiology. 2022;98(6):1471-5.
45. Sharifi R, Bahrami H, Safaei M, Mozaffari HR, Hatami M, Imani MM, et al. A Randomized Triple-Blind Clinical Trial of the Effect of Low-Level Laser Therapy on Infiltration Injection Pain in the Anterior Maxilla. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 2022;22.
46. Ebrahimi A, Marques MM, Miniello TG, Gutknecht N. Photobiomodulation therapy with 810-nm laser as an alternative to injection for anesthesia in dentistry. Lasers in Dental Science. 2021;5:117-23.
47. Sandhyarani B, Pawar RR, Patil AT, Kevadia MV. Effect of Low-level Laser on LI4 Acupoint in Pain Reduction during Local Anesthesia in Children. International Journal of Clinical Pediatric Dentistry. 2021;14(4):462.
48. Pooja B, Kamatham R, Anchala K, Avisa P. Effectiveness of low-level laser therapy in reducing pain perception of children during dental local anesthetic administration using laser acupuncture pen on the LI4 point: a randomized clinical trial. European Archives of Paediatric Dentistry. 2023:1-9.
49. Ghasemi D, Rajaei S, Aghasizadeh E. Comparison of inferior dental nerve block injections in child patients using 30-gauge and 27-gauge short needles. Journal of Dental Materials and Techniques. 2014;3(2):71-6.
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