Photobiomodulation and Pain Reduction in Patients Requiring Orthodontic Band Application: Randomized Clinical Trial

Maria Francesca Sfondrini, Marina Vitale, Antonio Luiz Barbosa Pinheiro, Paola Gandini, Lorenzo Sorrentino, Ugo Matteo Iarussi, Andrea Scribante, Maria Francesca Sfondrini, Marina Vitale, Antonio Luiz Barbosa Pinheiro, Paola Gandini, Lorenzo Sorrentino, Ugo Matteo Iarussi, Andrea Scribante

Abstract

Purpose: The aim of this study was to investigate the effect of Photobiomodulation (PBM) in managing orthodontic pain intensity over time in patients requiring band application on upper first molars.

Methods: Maxillary first molars were banded. In the trial group, each molar received single-session PBM on two buccal and two palatal points (λ = 830 ± 10 nm; 150 mW, 7.5 J/cm2; spot of 0.1 cm2; 5 sec per point), while the control group received a placebo treatment. All patients were asked to answer five pain rating scales to assess pain intensity at 5 minutes and 1, 12, 24, and 72 hours and completed a survey describing the type of pain and its temporal course in the next 7 days.

Results: 26 patients (mean age 11.8 years) were randomly assigned to a control or a trial group. The trial group showed significantly lower pain intensities (p < 0.05) at 5 min (M = 0.92, SD = 1.32), 1 h (M = 0.77, SD = 1.01), and 12 h (M = 0.77, SD = 1.54) after band application compared to the control group (5 min: M = 1.62, SD = 1.26; 1 h: M = 1.77, SD = 1.92; and 12 h: M = 1.77, SD = 2.17), whereas no difference between groups (p > 0.05) was found at 24 h (trial: M = 0.62, SD = 1.71; control: M = 1.08, SD = 1.75) and 72 h (trial: M = 0.31, SD = 0.75; control: M = 0.15, SD = 0.55). Patients in the control group reported more frequently the presence of "compressive pain" (58.8%, p < 0.05) from the appliance during the week after the application, while the trial group showed higher frequency of "no pain" (46.2%, p < 0.05). However, PBM did not affect the pain onset (trial: M = 10.86, SD = 26.97; control: M = 5.25, SD = 7.86), peak (trial: M = 15.86, SD = 26.29; control: 6.17, SD = 7.96), and end time (trial: 39.57, SD = 31.33; control: M = 22.02, SD = 25.42) reported by the two groups (p > 0.05).

Conclusions: PBM might be considered a promising alternative to decrease general pain intensity, although not affecting the typical pain cycle, in terms of the onset, peak, and ending times.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Copyright © 2020 Maria Francesca Sfondrini et al.

Figures

Figure 1
Figure 1
Participants' flow.
Figure 2
Figure 2
Irradiation points of buccal (a) and palatal sites (b).
Figure 3
Figure 3
The Wong-Baker faces pain rating scale used in the present report, with the corresponding values of the conventional VAS scores.
Figure 4
Figure 4
WBS values (mean and CI) of the two groups.

References

    1. Merskey H. The taxonomy of pain. The Medical Clinics of North America. 2007;91(1):13–20. doi: 10.1016/j.mcna.2006.10.009.
    1. Bergius M., Broberg A. G., Hakeberg M., Berggren U. Prediction of prolonged pain experiences during orthodontic treatment. American Journal of Orthodontics and Dentofacial Orthopedics. 2008;133(3):339.e1–339.e8. doi: 10.1016/j.ajodo.2007.09.013.
    1. Krishnan V. Orthodontic pain: from causes to management-a review. European Journal of Orthodontics. 2007;29(2):170–179. doi: 10.1093/ejo/cjl081.
    1. Krishnan V., Davidovitch Z. Cellular, molecular, and tissue-level reactions to orthodontic force. American Journal of Orthodontics and Dentofacial Orthopedics. 2006;129(4):469.e1–469.32. doi: 10.1016/j.ajodo.2005.10.007.
    1. Farzanegan F., Zebarjad S. M., Alizadeh S., Ahrari F. Pain reduction after initial archwire placement in orthodontic patients: a randomized clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics. 2012;141(2):169–173. doi: 10.1016/j.ajodo.2011.06.042.
    1. Nóbrega C., da Silva E. M. K., de Macedo C. R. Low-level laser therapy for treatment of pain associated with orthodontic elastomeric separator placement: a placebo-controlled randomized double-blind clinical trial. Photomedicine and Laser Surgery. 2013;31(1):10–16. doi: 10.1089/pho.2012.3338.
    1. Bird S. E., Williams K., Kula K. Preoperative acetaminophen vs ibuprofen for control of pain after orthodontic separator placement. American Journal of Orthodontics and Dentofacial Orthopedics. 2007;132(4):504–510. doi: 10.1016/j.ajodo.2006.11.019.
    1. Polat O., Karaman A. I. Pain control during fixed orthodontic appliance therapy. The Angle Orthodontist. 2005;74:214–219. doi: 10.1043/0003-3219(2005)075<0210:PCDFOA>;2.
    1. Walker J. B., Buring S. M. NSAID impairment of orthodontic tooth movement. The Annals of Pharmacotherapy. 2016;35(1):113–115. doi: 10.1345/aph.10185.
    1. Lobre W. D., Callegari B. J., Gardner G., Marsh C. M., Bush A. C., Dunn W. J. Pain control in orthodontics using a micropulse vibration device: a randomized clinical trial. The Angle Orthodontist. 2016;86(4):625–630. doi: 10.2319/072115-492.1.
    1. Zheng Q., Zhang L. H., Huang L., Wang G. P., Yuan X. P., Xu X. M. Effects of different psychological interventions on relieving orthodontic pain in patients with different personalities: a preliminary study. Shanghai Kou Qiang Yi Xue. 2016;25(1):91–96.
    1. de Carvalho F. B., Barbosa A. F. S., Zanin F. A. A., Júnior A. B., Júnior L. S., Pinheiro A. L. B. Use of laser fluorescence in dental caries diagnosis: a fluorescence x biomolecular vibrational spectroscopic comparative study. Brazilian Dental Journal. 2013;24(1):59–63. doi: 10.1590/0103-6440201302123.
    1. Vitale M. C., Sfondrini M. F., Croci G. A., et al. Diode laser-assisted surgical therapy for early treatment of oral mucocele in a newborn patient: case report and procedures checklist. Case Reports in Dentistry. 2018;2018:6. doi: 10.1155/2018/3048429.3048429
    1. Galafassi D., Scatena C., Galo R., Curylofo-Zotti F. A., Corona S. A. M., Borsatto M. C. Clinical evaluation of composite restorations in Er: YAG laser-prepared cavities re-wetting with chlorhexidine. Clinical Oral Investigations. 2017;21(4):1231–1241. doi: 10.1007/s00784-016-1897-x.
    1. Sfondrini M. F., Calderoni G., Vitale M. C., Gandini P., Scribante A. Is laser conditioning a valid alternative to conventional etching for aesthetic brackets? European Journal of Paediatric Dentistry. 2018;19(1):61–66. doi: 10.23804/ejpd.2018.19.01.11.
    1. Ize-Iyamu I. N., Saheeb B. D., Edetanlen B. E. Comparing the 810nm diode laser with conventional surgery in orthodontic soft tissue procedures. Ghana Medical Journal. 2013;47(3):107–111.
    1. Sfondrini M. F., Gatti S., Scribante A. Effect of blood contamination on shear bond strength of orthodontic brackets and disinclusion buttons. The British Journal of Oral & Maxillofacial Surgery. 2011;49(5):404–408. doi: 10.1016/j.bjoms.2010.06.011.
    1. Scribante A., Sfondrini M. F., Gatti S., Gandini P. Disinclusion of unerupted teeth by mean of self-ligating brackets: effect of blood contamination on shear bond strength. Medicina Oral, Patología Oral y Cirugía Bucal. 2013;18(1):e162–e167. doi: 10.4317/medoral.18246.
    1. Merigo E., Rocca J. P., Pinheiro A. L. B., Fornaini C. Photobiomodulation therapy in oral medicine: a guide for the practitioner with focus on new possible protocols. Photobiomodulation, Photomedicine, and Laser Surgery. 2019;37:669–680. doi: 10.1089/photob.2019.4624.
    1. Abtahi S. M., Mousavi S. A., Shafaee H., Tanbakuchi B. Effect of low-level laser therapy on dental pain induced by separator force in orthodontic treatment. Dental Research Journal. 2013;10(5):647–651.
    1. AlShahrani I., Togoo R. A., Hosmani J., Alhaizaey A. Photobiomodulation in acceleration of orthodontic tooth movement: a systematic review and meta analysis. Complementary Therapies in Medicine. 2019;47, article 102220 doi: 10.1016/j.ctim.2019.102220.
    1. Artés-Ribas M., Arnabat-Dominguez J., Puigdollers A. Analgesic effect of a low-level laser therapy (830 nm) in early orthodontic treatment. Lasers in Medical Science. 2013;28(1):335–341. doi: 10.1007/s10103-012-1135-y.
    1. Cordeiro J. M., Sahad M. G., Cavalcanti M. F. X. B., et al. Laser photobiomodulation over teeth subjected to orthodontic movement. Photomedicine and Laser Surgery. 2018;36(12):647–652. doi: 10.1089/pho.2018.4532.
    1. Cronshaw M., Parker S., Anagnostaki E., Lynch E. Systematic review of orthodontic treatment management with photobiomodulation therapy. Photobiomodulation, Photomedicine, and Laser Surgery. 2019;37(12):862–868. doi: 10.1089/photob.2019.4702.
    1. Doshi-Mehta G., Bhad-Patil W. A. Efficacy of low-intensity laser therapy in reducing treatment time and orthodontic pain: a clinical investigation. American Journal of Orthodontics and Dentofacial Orthopedics. 2012;141(3):289–297. doi: 10.1016/j.ajodo.2011.09.009.
    1. Furquim R. D., Pascotto R. C., Rino Neto J., Cardoso J. R., Ramos A. L. Low-level laser therapy effects on pain perception related to the use of orthodontic elastomeric separators. Dental Press Journal of Orthodontics. 2015;20(3):37–42. doi: 10.1590/2176-9451.20.3.037-042.oar.
    1. Ortega S. M., Gonçalves M. L. L., da Silva T., et al. Evaluation of the use of photobiomodulation following the placement of elastomeric separators: protocol for a randomized controlled clinical trial. Medicine. 2019;98(43, article e17325) doi: 10.1097/md.0000000000017325.
    1. Hopkinsm J. T., McLoda T. A., Seegmiller J. G., David Baxter G. Low-level laser therapy facilitates superficial wound healing in humans: a triple-blind, sham-controlled study. Journal of Athletic Training. 2004;39:223–229.
    1. Bjordal J. M., Johnson M. I., Iversen V., Aimbire F., Lopes-Martins R. A. Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomedicine and Laser Surgery. 2006;24(2):158–168. doi: 10.1089/pho.2006.24.158.
    1. Deana N. F., Zaror C., Sandoval P., Alves N. Effectiveness of low-level laser therapy in reducing orthodontic pain: a systematic review and meta-analysis. Pain Research & Management. 2017;2017, article 8560652:1–18. doi: 10.1155/2017/8560652.
    1. Sun G., Tunér J. Low-level laser therapy in dentistry. Dental Clinics of North America. 2004;48(4):1061–1076. doi: 10.1016/j.cden.2004.05.004.
    1. Chow R. T., David M. A., Armati P. J. 830 nm laser irradiation induces varicosity formation, reduces mitochondrial membrane potential and blocks fast axonal flow in small and medium diameter rat dorsal root ganglion neurons: implications for the analgesic effects of 830 nm laser. Journal of the Peripheral Nervous System. 2007;12(1):28–39. doi: 10.1111/j.1529-8027.2007.00114.x.
    1. Chow R. T., Armati P. J. Photobiomodulation: implications for anesthesia and pain relief. Photomedicine and Laser Surgery. 2016;34(12):599–609. doi: 10.1089/pho.2015.4048.
    1. Turhani D., Scheriau M., Kapral D., Benesch T., Jonke E., Bantleon H. P. Pain relief by single low-level laser irradiation in orthodontic patients undergoing fixed appliance therapy. American Journal of Orthodontics and Dentofacial Orthopedics. 2006;130(3):371–377. doi: 10.1016/j.ajodo.2005.04.036.
    1. Chagas L. R., Silva J. A., Jr., de Almeida Pires J., Costa M. S. Expression of mPGES-1 and IP mRNA is reduced by LLLT in both subplantar and brain tissues in the model of peripheral inflammation induced by carrageenan. Lasers in Medical Science. 2015;30(1):83–88. doi: 10.1007/s10103-014-1622-4.
    1. Kingsley J. D., Demchak T., Mathis R. Low-level laser therapy as a treatment for chronic pain. Frontiers in Physiology. 2014;5:p. 306. doi: 10.3389/fphys.2014.00306.
    1. Mizutani K., Musya Y., Wakae K., et al. A clinical study on serum prostaglandin E2 with low-level laser therapy. Photomedicine and Laser Surgery. 2004;22(6):537–539. doi: 10.1089/pho.2004.22.537.
    1. Bicakci A. A., Kocoglu-Altan B., Toker H., Mutaf I., Sumer Z. Efficiency of low-level laser therapy in reducing pain induced by orthodontic forces. Photomedicine and Laser Surgery. 2012;30(8):460–465. doi: 10.1089/pho.2012.3245.
    1. Jawaid M., Qadeer T. A., Fahim M. F. Pain perception of orthodontic treatment–a cross-sectional study. Pakistan Journal of Medical Sciences. 2019;36(2):160–165. doi: 10.12669/pjms.36.2.619.
    1. Martins I. P., Martins R. P., Caldas S. G. F. R., dos Santos-Pinto A., Buschang P. H., Pretel H. Low-level laser therapy (830 nm) on orthodontic pain: blinded randomized clinical trial. Lasers in Medical Science. 2019;34(2):281–286. doi: 10.1007/s10103-018-2583-9.
    1. Marini I., Bartolucci M. L., Bortolotti F., Innocenti G., Gatto M. R., Alessandri Bonetti G. The effect of diode superpulsed low-level laser therapy on experimental orthodontic pain caused by elastomeric separators: a randomized controlled clinical trial. Lasers in Medical Science. 2015;30(1):35–41. doi: 10.1007/s10103-013-1345-y.
    1. AlSayed Hasan M. M. A., Sultan K., Hamadah O. Evaluating low-level laser therapy effect on reducing ortho-dontic pain using two laser energy values: a split-mouth randomized placebo-controlled trial. European Journal of Orthodontics. 2018;40(1):23–28. doi: 10.1093/ejo/cjx013.
    1. Davidovitch M., Papanicolaou S., Vardimon A. D., Brosh T. Duration of elastomeric separation and effect on interproximal contact point characteristics. American Journal of Orthodontics and Dentofacial Orthopedics. 2008;133(3):414–422. doi: 10.1016/j.ajodo.2006.02.036.
    1. Sfondrini M. F., Gandini P., Malfatto M., di Corato F., Trovati F., Scribante A. Computerized casts for orthodontic purpose using powder-free intraoral scanners: accuracy, execution time, and patient feedback. BioMed Research International. 2018;2018:8. doi: 10.1155/2018/4103232.4103232
    1. Garra G., Singer A. J., Taira B. R., et al. Validation of the Wong-Baker FACES pain rating scale in pediatric emergency department patients. Academic Emergency Medicine. 2010;17(1):50–54. doi: 10.1111/j.1553-2712.2009.00620.x.
    1. Garra G., Singer A. J., Domingo A., Thode H. C. The Wong-Baker pain FACES scale measures pain, not fear. Pediatric Emergency Care. 2013;29(1):17–20. doi: 10.1097/PEC.0b013e31827b2299.
    1. Dalaie K., Hamedi R., Kharazifard M. J., Mahdian M., Bayat M. Effect of low-level laser therapy on orthodontic tooth movement: a clinical investigation. Journal of Dentistry. 2015;12(4):249–256.
    1. Guram G., Reddy R. K., Dharamsi A. M., Ismail P. M. S., Mishra S., Prakashkumar M. D. Evaluation of low-level laser therapy on orthodontic tooth movement: a randomized control study. Contemporary Clinical Dentistry. 2018;9(1):105–109.
    1. Harazaki M., Isshiki Y. Soft laser irradiation effects on pain reduction in orthodontic treatment. The Bulletin of Tokyo Dental College. 1997;38:291–295.
    1. Tortamano A., Lenzi D. C., Haddad A. C., Bottino M. C., Dominguez G. C., Vigorito J. W. Low-level laser therapy for pain caused by placement of the first orthodontic archwire: a randomized clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics. 2009;136(5):662–667. doi: 10.1016/j.ajodo.2008.06.028.
    1. Li F. J., Zhang J. Y., Zeng X. T., Guo Y. Low-level laser therapy for orthodontic pain: a systematic review. Lasers in Medical Science. 2015;30(6):1789–1803. doi: 10.1007/s10103-014-1661-x.
    1. Ren C., McGrath C., Yang Y. The effectiveness of low-level diode laser therapy on orthodontic pain management: a systematic review and meta-analysis. Lasers in Medical Science. 2015;30(7):1881–1893. doi: 10.1007/s10103-015-1743-4.
    1. Eslamian L., Borzabadi-Farahani A., Hassanzadeh-Azhiri A., Badiee M. R., Fekrazad R. The effect of 810-nm low-level laser therapy on pain caused by orthodontic elastomeric separators. Lasers in Medical Science. 2014;29(2):559–564. doi: 10.1007/s10103-012-1258-1.
    1. Heravi F., Moradi A., Ahrari F. The effect of low level laser therapy on the rate of tooth movement and pain perception during canine retraction. Oral Health and Dental Management. 2014;13(2):183–188.
    1. Bayani S., Rostami S., Ahrari F., Saeedipouya I. A randomized clinical trial comparing the efficacy of bite wafer and low level laser therapy in reducing pain following initial arch wire placement. Laser Therapy. 2016;25(2):121–129. doi: 10.5978/islsm.16-or-10.
    1. Domínguez A., Velásquez S. A. Effect of low-level laser therapy on pain following activation of orthodontic final archwires: a randomized controlled clinical trial. Photomedicine and Laser Surgery. 2013;31(1):36–40. doi: 10.1089/pho.2012.3360.
    1. Hamblin M. R. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophysics. 2017;4(3):337–361. doi: 10.3934/biophy.2017.3.337.
    1. Fujiyama K., Deguchi T., Murakami T., Fujii A., Kushima K., Takano-Yamamoto T. Clinical effect of CO2 laser in reducing pain in orthodontics. The Angle Orthodontist. 2008;78(2):299–303. doi: 10.2319/033007-153.1.
    1. Almalla M. M., Almahdi W. H., Hajeer M. Y. Evaluation of low level laser therapy on pain perception following orthodontic elastomeric separation: a randomized controlled trial. Journal of Clinical and Diagnostic Research. 2016;10:ZC23–ZC28. doi: 10.7860/jcdr/2016/22813.8804.
    1. Huang I. I., Sharma S. K., Carroll J., Hamblin M. R. Biphasic dose response in low level light therapy- an update. Dose-Response. 2011;9(4) doi: 10.2203/dose-response.11-009.hamblin.
    1. Esper M. A., Nicolau R. A., Arisawa E. A. The effect of two phototherapy protocols on pain control in orthodontic procedure—a preliminary clinical study. Lasers in Medical Science. 2011;26(5):657–663. doi: 10.1007/s10103-011-0938-6.
    1. Bergius M., Kiliaridis S., Berggren U. Pain in orthodontics. Journal of Orofacial Orthopedics. 2000;61(2):125–137. doi: 10.1007/BF01300354.
    1. Ngan P., Kess B., Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. American Journal of Orthodontics and Dentofacial Orthopedics. 1989;96(1):47–53. doi: 10.1016/0889-5406(89)90228-x.
    1. Erdinç A. M. E., Dinçer B. Perception of pain during orthodontic treatment with fixed appliances. European Journal of Orthodontics. 2004;26(1):79–85. doi: 10.1093/ejo/26.1.79.

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