A Comparative Assessment of Pain Caused by the Placement of Banded Orthodontic Appliances with and without Low-Level Laser Therapy: A Randomized Controlled Prospective Study

Carmelo Nicotra, Alessandro Polizzi, Graziano Zappalà, Alessandro Leonida, Francesco Indelicato, Gianluigi Caccianiga, Carmelo Nicotra, Alessandro Polizzi, Graziano Zappalà, Alessandro Leonida, Francesco Indelicato, Gianluigi Caccianiga

Abstract

Patients still refuse or discontinue orthodontic treatment due to related pain and discomfort. In this study, we investigate if low-level laser therapy (LLLT) can reduce pain caused by orthodontic bands. Sixty subjects who needed bands placed on the upper permanent first molars were assigned randomly to the LLLT group, placebo, and control groups. Inclusion criteria were: age range 10-14 years, fully erupted upper first molars in healthy condition, presence of tight mesial proximal contact. Exclusion criteria were: systemic or metabolic diseases, chronic pain or neurological or psychiatric disorders, use of pharmacological agents interfering with pain perception, previous orthodontic treatment or the simultaneous presence of other devices in the patient's mouth. The assessment of pain was performed by using a numeric rating scale (NRS) considering different time intervals, i.e., immediately after bands placement, 6 h, 24 h, and from day 2 to day 5. Differences in the maximum pain and in pain experienced at each time-point, among the three groups, was assessed by using the Kruskal-Wallis H. The final sample included 56 patients, 29 males, and 27 females, with a mean age of 12.03 ± 1.3 years. Patients were randomly allocated into three groups (tested, control, and placebo group) with each group consisting respectively of 19, 20, and 17 individuals. Subjects in the LLLT experienced less pain at each time interval as well as the maximum pain score being lower in the LLLT compared to control and placebo groups. These findings were all statistically significant (p < 0.05). LLLT can alleviate the intensity of pain after the placement of orthodontic bands.

Keywords: dental materials; dental pain; laser; low-level laser therapy; orthodontic tooth movement; orthodontics.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Low-level laser therapy (LLLT) administration. The optical fiber tip was moved from vestibular toward the palatal side of the upper first molar for 10 s (each session).
Figure 2
Figure 2
CONSORT flowchart.
Figure 3
Figure 3
Graphic representation of the level of pain experienced at each time interval in both treatment group (TG), control group (CG), and placebo group (PG).

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