Evaluation of the use of low-level laser therapy in pain control in orthodontic patients: A randomized split-mouth clinical trial

Rodrigo Duarte Farias, Luciane Quadrado Closs, Sergio Augusto Quevedo Miguens Jr, Rodrigo Duarte Farias, Luciane Quadrado Closs, Sergio Augusto Quevedo Miguens Jr

Abstract

Objective: To evaluate the effect of using low-level laser therapy (LLLT) to control pain and discomfort during orthodontic treatment.

Materials and methods: A randomized, split-mouth clinical trial was conducted with 30 volunteers in need of orthodontic treatment, of both genders, aged between 18 and 40 years, who were randomly divided into two groups. One hemiarch was considered the exposed group (EG) and the other, the placebo group (PG). Both groups had elastic separators placed mesially and distally to the first molars of the two hemiarches at different times. The EG received an AIGaAs diode LLLT (810 nm, 100 mW, 2J/cm(2)) application for 15 seconds per point (interdental papilla at the mesial, distal, and near the root apex) immediately after separator placement on the maxillary right side. The PG also had elastics placed around the maxillary right molars, but received only simulated LLLT application. The elastics were left in place for 5 days, and after a waiting period of 1 week, they were inserted on the left side in both groups; however, the order of laser application was changed. While the separator remained in place, the patient marked his degree of perceived discomfort on a Visual Analog Scale (VAS) at 5 minutes (T0), 24 hours (T1), and 120 hours (T2), after LLLT application.

Results: A statistically significant difference was observed (P < .005) in reducing discomfort in the exposed group compared with the placebo group. This reduction of discomfort in the EG was observed at all time intervals.

Conclusions: A sincle AIGaAs diode LLLT application may be indicated for the control or reduction of pain in the early stages of orthodontic treatment.

Keywords: Clinical trial; Low level laser therapy; Orthodontics; Pain.

Figures

Figure 1.
Figure 1.
Flowchart representing strategies and follow-up of the study.

References

    1. Kvam E, Bondevik O, Gjerdet NR. Traumatic ulcers and pain in adults during orthodontic treatment. Community Dent Oral Epidemiol. 1989;17:154–157.
    1. Bergius M, Kiliaridis S, Berggren U. Pain in orthodontics. A review and discussion of the literature. J Orofac Orthop. 2000;61:125–137.
    1. Polat O, Karaman AI. Pain control during fixed orthodontic appliance therapy. Angle Orthod. 2005;75:214–219.
    1. Krishnan V. Orthodontic pain: from causes to management—a review. Eur J Orthod. 2007;29:170–179.
    1. Polat O. Pain and discomfort after orthodontic appointments. Semin Orthod. 2007;13:292–300.
    1. Youssef M, Ashkar S, Hamade E, Gutknecht N, Lampert F, Mir M. The effect of low-level laser therapy during orthodontic movement: a preliminary study. Lasers Med Sci. 2008;23:27–33.
    1. Lim HM, Lew KK, Tay DK. A clinical investigation of the efficacy of low level laser therapy in reducing orthodontic postadjustment pain. Am J Orthod Dentofacial Orthop. 1995;108:614–622.
    1. He WL, Li CJ, Liu ZP, et al. Efficacy of low-level laser therapy in the management of orthodontic pain: a systematic review and meta-analysis. Lasers Med Sci. 2013;28:1581–1589.
    1. Holmberg PF, Zaror SC, Fabres SR, Sandoval VP. Use the laser therapy in orthodonthic pain control. Rev Clin Periodoncia Implantol Rehabil Oral. 2011;4:114–116.
    1. Pallotta RC, Bjordal JM, Frigo L, et al. Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation. Lasers Med Sci. 2012;27:71–78.
    1. Silveira PC, Silva LA, Freitas TP, Latini A, Pinho RA. Effects of low-power laser irradiation (LPLI) at different wavelengths and doses on oxidative stress and fibrogenesis parameters in an animal model of wound healing. Lasers Med Sci. 2011;26:125–131.
    1. Sakurai Y, Yamaguchi M, Abiko Y. Inhibitory effect of low-level laser irradiation on LPS-stimulated prostaglandin E2 production and cyclooxygenase-2 in human gingival fibroblasts. Eur J Oral Sci. 2000;108:29–34.
    1. Doshi-Mehta G, Bhad-Patil WA. Efficacy of low-intensity laser therapy in reducing treatment time and orthodontic pain: a clinical investigation. Am J Orthod Dentofacial Orthop. 2012;141:289–297.
    1. Abtahi SM, Mousavi SA, Shafaee H, Tanbakuchi B. Effect of low-level laser therapy on dental pain induced by separator force in orthodontic treatment. Dent Res J (Isfahan) 2013;10:647–651.
    1. Domínguez A, Velásquez SA. Effect of low-level laser therapy on pain following activation of orthodontic final archwires: a randomized controlled clinical trial. Photomed Laser Surg. 2013;31:36–40.
    1. Esper MA, Nicolau RA, Arisawa EA. The effect of two phototherapy protocols on pain control in orthodontic procedure—a preliminary clinical study. Lasers Med Sci. 2011;26:657–663.
    1. Kim WT, Bayome M, Park JB, Park JH, Baek SH, Kook YA. Effect of frequent laser irradiation on orthodontic pain. A single-blind randomized clinical trial. Angle Orthod. 2013;83:611–616.
    1. Nóbrega C, da Silva EM, de Macedo CR. Low-level laser therapy for treatment of pain associated with orthodontic elastomeric separator placement: a placebo-controlled randomized double-blind clinical trial. Photomed Laser Surg. 2013;31:10–16.
    1. Marini I, Bartolucci ML, Bortolotti F, Innocenti G, Gatto MR, 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 Med Sci. 2015;30:35–41.
    1. Eslamian L, Borzabadi-Farahani A, Hassanzadeh-Azhiri A, Badiee MR, Fekrazad R. The effect of 810-nm low-level laser therapy on pain caused by orthodontic elastomeric separators. Lasers Med Sci. 2014;29:559–564.
    1. Li FJ, Zhang JY, Zeng XT, Guo Y. Low-level laser therapy for orthodontic pain: a systematic review. Lasers Med Sci. 2014 [Epub ahead of print]
    1. CONSORT.
    1. Scheurer PA, Firestone AR, Burgin WB. Perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod. 1996;18:349–357.
    1. Fernandes LM, Ogaard B, Skoglund L. Pain and discomfort experienced after placement of a conventional or a superelastic NiTi aligning archwire. A randomized clinical trial. J Orofac Orthop. 1998;59:331–339.
    1. Grieve WG, III, Johnson GK, Moore RN, Reinhardt RA, DuBois LM. Prostaglandin E (PGE) and interleukin-1 beta (IL-1 beta) levels in gingival crevicular fluid during human orthodontic tooth movement. Am J Orthod Dentofacial Orthop. 1994;105:369–374.
    1. Chow RT, David MA, Armati PJ. 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. J Peripher Nerv Syst. 2007;12:28–39.
    1. Jones M, Chan C. The pain and discomfort experienced during orthodontic treatment: a randomized controlled clinical trial of two initial aligning arch wires. Am J Orthod Dentofacial Orthop. 1992;102:373–381.
    1. Artes-Ribas M, Arnabat-Dominguez J, Puigdollers A. Analgesic effect of a low-level laser therapy (830 nm) in early orthodontic treatment. Lasers Med Sci. 2013;28:335–341.
    1. Kawasaki K, Shimizu N. Effects of low-energy laser irradiation on bone remodeling during experimental tooth movement in rats. Lasers Surg Med. 2000;26:282–291.
    1. Shirani AM, Gutknecht N, Taghizadeh M, Mir M. Low-level laser therapy and myofacial pain dysfunction syndrome: a randomized controlled clinical trial. Lasers Med Sci. 2009;24:715–720.
    1. Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G. Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther. 1983;34:234–239.
    1. Fujiyama K, Deguchi T, Murakami T, Fujii A, Kushima K, Takano-Yamamoto T. Clinical effect of CO2 laser in reducing pain in orthodontics. Angle Orthod. 2008;78:299–303.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel