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A randomized placebo-blind study of the effect of low power laser on pain caused by irreversible pulpitis

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Abstract

This randomized placebo-blind study aimed to evaluate the effect of laser phototherapy (LPT) on pain caused by symptomatic irreversible pulpitis (SIP). Sixty patients diagnosed with SIP were randomly assigned to treatment groups (n = 15): G1 (control), G2 (laser placebo—sham irradiation), G3 (laser irradiation at 780 nm, 40 mW, 4 J/cm2), and G4 (laser irradiation at 780 nm, 40 mW, 40 J/cm2). Spontaneous pain was recorded using a VAS score before (T0), immediately after (T1), and 15 min after treatment (T2). Local anesthetics failure during emergency endodontic treatment was also assessed. There was no pain difference in T1 and T2 between the experimental laser groups (G3 and G4) and the placebo group (G2). The 4-J/cm2 (G3) irradiation resulted in significant increase in the local anesthetics failure in lower jar teeth. This effect could be suggested as consequence of the LPT improvement in local circulation and vasodilatation that would result in the increase of local anesthetic agent absorption. The application of 780-nm diode laser irradiation, at 4 and 40 J/cm2, showed no effect in reducing the pain in SIP in comparison to the placebo group. The fluence of 4 J/cm2 showed a negative effect in local anesthetics, resulting in significant increase of complimentary local anesthesia during emergency endodontic treatment. This work provides evidence of the consequence of LPT application on teeth with symptomatic irreversible pulpitis. LPT should be avoided in teeth with pain due to irreversible pulpitis.

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References

  1. Seltzer S, Bender IB, Ziontz M (1963) The dynamics of pulp inflammation: correlations between diagnostic data and actual histologic findings in the pulp. Oral Surg Oral Med Oral Pathol 16:969–977

    Article  CAS  PubMed  Google Scholar 

  2. Fulop AM, Dhimmer S, Deluca JR, Johanson DD, Lenz RV, Patel KB, Douris PC, Enwemeka CS (2010) A meta-analysis of the efficacy of laser phototherapy on pain relief. The clinical journal of pain 26(8):729–736. doi:10.1097/AJP.0b013e3181f09713

    PubMed  Google Scholar 

  3. Enwemeka CS, Parker JC, Dowdy DS, Harkness EE, Sanford LE, Woodruff LD (2004) The efficacy of low-power lasers in tissue repair and pain control: a meta-analysis study. Photomed Laser Surg 22(4):323–329. doi:10.1089/1549541041797841

    Article  PubMed  Google Scholar 

  4. Tsuchiya K, Kawatani M, Takeshige C, Sato T, Matsumoto I (1993) Diode laser irradiation selectively diminishes slow component of axonal volleys to dorsal roots from the saphenous nerve in the rat. Neurosci Lett 161 (1):65-68. doi:0304-3940(93)90141-7

  5. Ferreira DM, Zangaro RA, Villaverde AB, Cury Y, Frigo L, Picolo G, Longo I, Barbosa DG (2005) Analgesic effect of He-Ne (632.8 nm) low-level laser therapy on acute inflammatory pain. Photomed Laser Surg 23(2):177–181. doi:10.1089/pho.2005.23.177

    Article  CAS  PubMed  Google Scholar 

  6. Honmura A, Ishii A, Yanase M, Obata J, Haruki E (1993) Analgesic effect of Ga-Al-As diode laser irradiation on hyperalgesia in carrageenin-induced inflammation. Lasers Surg Med 13(4):463–469

    Article  CAS  PubMed  Google Scholar 

  7. Sakurai Y, Yamaguchi M, Abiko Y (2000) Inhibitory effect of low-level laser irradiation on LPS-stimulated prostaglandin E2 production and cyclooxygenase-2 in human gingival fibroblasts. Eur J Oral Sci 108(1):29–34

    Article  CAS  PubMed  Google Scholar 

  8. Sousa LR, Cavalcanti BN, Marques MM (2009) Effect of laser phototherapy on the release of TNF-alpha and MMP-1 by endodontic sealer-stimulated macrophages. Photomed Laser Surg 27 (1):37-42. doi:10.1089/pho.2007.2220

  9. Hagiwara S, Iwasaka H, Hasegawa A, Noguchi T (2008) Pre-Irradiation of blood by gallium aluminum arsenide (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Anesth Analg 107 (3):1058-1063. doi:107/3/1058

  10. Braverman B, McCarthy RJ, Ivankovich AD, Forde DE, Overfield M, Bapna MS (1989) Effect of helium-neon and infrared laser irradiation on wound healing in rabbits. Lasers Surg Med 9(1):50–58

    Article  CAS  PubMed  Google Scholar 

  11. Mester E, Spiry T, Szende B, Tota JG (1971) Effect of laser rays on wound healing. Am J Surg 122 (4):532-535. doi:0002-9610(71)90482-X

  12. Maegawa Y, Itoh T, Hosokawa T, Yaegashi K, Nishi M (2000) Effects of near-infrared low-level laser irradiation on microcirculation. Lasers Surg Med 27(5):427–437. doi:10.1002/1096-9101(2000)27:5<427::AID-LSM1004>3.0.CO;2-A

    Article  CAS  PubMed  Google Scholar 

  13. Urbaniak GC, Plous S (2013) Research Randomizer (Version 4.0) [Computer software]. Retrieved on June 22, 2013, from http://www.randomizer.org/

  14. Yoo YJ, Shon WJ, Baek SH, Kang MK, Kim HC, Lee W (2014) Effect of 1440-nanometer neodymium:yttrium-aluminum-garnet laser irradiation on pain and neuropeptide reduction: a randomized prospective clinical trial. J Endod 40 (1):28-32

  15. Schulz KF, Altman DG, Moher D (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol 63 (8):834-840

  16. Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA (2006) Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg 24(2):158–168. doi:10.1089/pho.2006.24.158

    Article  CAS  PubMed  Google Scholar 

  17. Li C, Yang X, Ma X, Li L, Shi Z (2012) Preoperative oral nonsteroidal anti-inflammatory drugs for the success of the inferior alveolar nerve block in irreversible pulpitis treatment: a systematic review and meta-analysis based on randomized controlled trials. Quintessence Int 43 (3):209-219. doi:22758

  18. Hargreaves KM, Keiser K (2002) Local anesthetic failure in endodontics: mechanisms and management. Endod Top 1(1):26–33

    Article  Google Scholar 

  19. Bigby J, Reader A, Nusstein J, Beck M (2007) Anesthetic efficacy of lidocaine/meperidine for inferior alveolar nerve blocks in patients with irreversible pulpitis. J Endod 33 (1):7-10. doi:S0099-2399(06)00810-7

  20. Claffey E, Reader A, Nusstein J, Beck M, Weaver J (2004) Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. J Endod 30 (8):568-571. doi:00004770-200408000-00002

  21. Cohen HP, Cha BY, Spangberg LS (1993) Endodontic anesthesia in mandibular molars: a clinical study. J Endod 19 (7):370-373. doi:S0099-2399(06)81366-X

  22. Lindemann M, Reader A, Nusstein J, Drum M, Beck M (2008) Effect of sublingual triazolam on the success of inferior alveolar nerve block in patients with irreversible pulpitis. Journal of endodontics 34(10):1167–1170. doi:10.1016/j.joen.2008.07.013

    Article  PubMed  Google Scholar 

  23. Sampaio RM, Carnaval TG, Lanfredi CB, Horliana AC, Rocha RG, Tortamano IP (2012) Comparison of the anesthetic efficacy between bupivacaine and lidocaine in patients with irreversible pulpitis of mandibular molar. J Endod 38 (5):594-597

  24. Tortamano IP, Siviero M, Costa CG, Buscariolo IA, Armonia PL (2009) A comparison of the anesthetic efficacy of articaine and lidocaine in patients with irreversible pulpitis. J Endod 35 (2):165-168

  25. Jeske AH (2002) Selecting new drugs for pain control: evidence-based decisions or clinical impressions? J Am Dent Assoc 133 (8):1052-1056; quiz 1093-1054

  26. Cohen JS, Reader A, Fertel R, Beck M, Meyers WJ (1985) A radioimmunoassay determination of the concentrations of prostaglandins E2 and F2alpha in painful and asymptomatic human dental pulps. J Endod 11(8):330–335

    Article  CAS  PubMed  Google Scholar 

  27. Walker J (1983) Relief from chronic pain by low power laser irradiation. Neurosci Lett 43(2-3):339–344

    Article  CAS  PubMed  Google Scholar 

  28. Gibson KF, Kernohan WG (1993) Lasers in medicine—a review. J Med Eng Technol 17(2):51–57

    Article  CAS  PubMed  Google Scholar 

  29. Aggarwal V, Singla M, Kabi D (2010) Comparative evaluation of effect of preoperative oral medication of ibuprofen and ketorolac on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial. J Endod 36 (3):375-378

  30. Vase L, Riley JL, 3rd, Price DD (2002) A comparison of placebo effects in clinical analgesic trials versus studies of placebo analgesia. Pain 99 (3):443-452

  31. Price DD, Milling LS, Kirsch I, Duff A, Montgomery GH, Nicholls SS (1999) An analysis of factors that contribute to the magnitude of placebo analgesia in an experimental paradigm. Pain 83 (2):147-156

  32. Beecher HK (1955) The powerful placebo. J Am Med Assoc 159(17):1602–1606

    Article  CAS  PubMed  Google Scholar 

  33. Aras MH, Omezli MM, Gungormus M (2010) Does low-level laser therapy have an antianesthetic effect? A review. Photomed Laser Surg 28(6):719–722. doi:10.1089/pho.2008.2430

    Article  CAS  PubMed  Google Scholar 

  34. Yamaguchi H, Kobayashi K, Sato Y, Osada R, Sakuraba E, Nomura T, Arai T, Nakamura J, Cox CF (2000) Nd:YAG laser irradiation of the human dental pulp: implications as a predictor of pulp hemodynamics. Lasers Surg Med 26 (3):270-276. doi:10.1002/(SICI)1096-9101(2000)26:3<270::AID-LSM4>3.0.CO;2-9

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Acknowledgments

This study was supported by grants from the State of São Paulo Research Foundation (FAPESP) (# 2012/21670-1; #2013/12317-9).

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Authors and Affiliations

  1. Department of Stomatology (Integrated Clinic), School of Dentistry, University of São Paulo, Av. Professor Lineu Prestes, 2227 – Cidade Universitária, São Paulo, SP, 05508-000, Brazil

    Karen Müller Ramalho, Isabel Peixoto Tortamano, Carlos Alberto Adde & Rodney Garcia Rocha

  2. Special Laboratory for Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, Av. Professor Lineu Prestes, 2227 – Cidade Universitária, São Paulo, SP, 05508-000, Brazil

    Lárissa Marcondes Paladini de Souza & Carlos de Paula Eduardo

Authors
  1. Karen Müller Ramalho
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  2. Lárissa Marcondes Paladini de Souza
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  3. Isabel Peixoto Tortamano
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  4. Carlos Alberto Adde
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  5. Rodney Garcia Rocha
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  6. Carlos de Paula Eduardo
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Corresponding author

Correspondence to Karen Müller Ramalho.

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Ethical approval and informed consent

This clinical trial was approved by the ethical committee of the School of Dentistry, University of Sao Paulo (#.08509912.3.0000.0075). Each patient signed a written informed consent to participate in the study, which was registered within ClinicalTrials.gov (NCT02169102).

Conflict of interest

The authors declare that they have no conflict of interest.

Role of funding source

Research grants from the State of São Paulo Research Foundation (FAPESP) # 2012/21670-1 (undergraduate grant); #2013/12317-9 (postdoctoral grant).

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Ramalho, K.M., de Souza, L.M.P., Tortamano, I.P. et al. A randomized placebo-blind study of the effect of low power laser on pain caused by irreversible pulpitis. Lasers Med Sci 31, 1899–1905 (2016). https://doi.org/10.1007/s10103-016-2068-7

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  • DOI: https://doi.org/10.1007/s10103-016-2068-7

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