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Low-level laser therapy and laser acupuncture therapy for pain relief after initial archwire placement

A randomized clinical trial

Die Auswirkungen von Low-Level-Lasertherapie und Laser-Akupunkturtherapie auf Schmerzlinderung nach Ersteinsatz von Bogendrähten

Eine randomisierte klinische Studie

  • Original Article
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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Objective

Pain is among the most unpleasant experience during fixed orthodontic therapy. This study compared the effectiveness of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in pain reduction after initial archwire placement.

Methods

This randomized, parallel-group, single-blind clinical trial included 60 female patients who required four premolar extractions to relieve crowding. The subjects were randomly designated into four groups of 15. After placement of the initial orthodontic archwire, patients in group 1 took ibuprofen (400 mg), whereas those in group 2 received LLLT (808 nm, 200 mW, 2 J/cm2) on both buccal and lingual sides of the teeth. In group 3 (LAT), the laser (808 nm, 200 mW, 24 J/cm2) was applied bilaterally to acupuncture points (SI 18, ST 6, LI 4, SJ 2, and SJ 5). Subjects in group 4 received placebo laser treatment. Patients were requested to record the intensity of spontaneous pain, pain while biting with anterior teeth, and pain while biting with posterior teeth at different times using a visual analogue scale (VAS).

Results

The intensity of spontaneous and biting pain increased up to the first or second days following initial archwire placement and diminished to a negligible value by the seventh day. No significant difference was found between the study groups concerning spontaneous and biting pain at any timepoint of investigation (P > 0.05).

Conclusions

With the protocols used in the study, low-level laser therapy and laser acupuncture therapy were as effective as ibuprofen and placebo laser treatment for pain reduction in orthodontic patients.

Trial registration

IRCT, IRCT20200622047886N1. Registered 2020-06-29; https://www.irct.ir/trial/49121

Zusammenfassung

Ziele

Diese Studie verglich die Wirksamkeit von Low-Level-Lasertherapie (LLLT) und Laser-Akupunkturtherapie (LAT) bei der Schmerzreduktion nach dem Ersteinsatz von Bogendrähten.

Methoden

Die unizentrische, randomisierte, parallele, einfach verblindete klinische Studie. umfasste 60 Patientinnen, die zur Behebung von Zahnengständen 4 Prämolarenextraktionen benötigten. Die Probandinnen wurden randomisiert einer von 4 Gruppen zu je 15 zugeteilt. Nach Einsetzen des ersten kieferorthopädischen Bogendrahtes nahmen die Patientinnen in Gruppe 1 Ibuprofen (400 mg), während diejenigen in Gruppe 2 LLLT (808 nm, 200 mW, 2 J/cm2) an den bukkalen und lingualen Seiten der Zähne erhielten. In Gruppe 3 (LAT) wurde der Laser (808 nm, 200 mW, 24 J/cm2) bilateral auf Akupunkturpunkten inklusive S I18, ST 6, Li 4, SJ 2 und SJ 5 eingesetzt. Die Probandinnen in Gruppe 4 erhielten eine Placebo-Lasertherapie. Die Patientinnen wurden gebeten, die Intensität von spontanen Schmerzen, Schmerzen beim Beißen mit den vorderen Zähnen und Schmerzen beim Beißen mit den hinteren Zähnen zu verschiedenen Zeiten mittels einer visuellen Analogskala (VAS) aufzuzeichnen.

Ergebnisse

Die Intensität von spontanen Schmerzen und Schmerzen beim Beißen stieg bis zum ersten oder zweiten Tag nach Einsetzen des Bogendrahtes an und verringerte sich bis zum 7. Tag auf einen vernachlässigbaren Wert. Zwischen den Studiengruppen wurde zu keinem der Bewertungszeitpunkte ein signifikanter Unterschied bei spontanen Schmerzen und Schmerzen beim Beißen festgestellt (p > 0,05).

Schlussfolgerungen

LLLT und LAT waren mit den in der Studie verwendeten Protokollen ebenso wirksam wie Ibuprofen und Placebo-Laser zur Schmerzreduktion bei kieferorthopädischen Patientinnen.

Studienregistrierung

IRCT, IRCT20200622047886N1. Registriert am 29.06.2020; https://www.irct.ir/trial/49121

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Data Availability

The individual patient’s data would be available upon request from the corresponding author.

References

  1. Celebi F, Bicakci AA, Kelesoglu U (2021) Effectiveness of low-level laser therapy and chewing gum in reducing orthodontic pain: a randomized controlled trial. Korean J Orthod 51(5):313–320

    Article  PubMed  PubMed Central  Google Scholar 

  2. Li FJ, Zhang JY, Zeng XT, Guo Y (2015) Low-level laser therapy for orthodontic pain: a systematic review. Lasers Med Sci 30(6):1789–1803

    Article  CAS  PubMed  Google Scholar 

  3. Celebi F, Turk T, Bicakci AA (2019) Effects of low-level laser therapy and mechanical vibration on orthodontic pain caused by initial archwire. Am J Orthod Dentofacial Orthop 156(1):87–93

    Article  PubMed  Google Scholar 

  4. AlSayed Hasan MMA, Sultan K, Ajaj M, Voborná I, Hamadah O (2020) Low-level laser therapy effectiveness in reducing initial orthodontic archwire placement pain in premolars extraction cases: a single-blind, placebo-controlled, randomized clinical trial. BMC Oral Heal 20(1):209

    Article  Google Scholar 

  5. Bayani S, Rostami S, Ahrari F, Saeedipouya I (2016) A randomized clinical trial comparing the efficacy of bite wafer and low level laser therapy in reducing pain following initial arch wire placement. Laser Ther 25(2):121–129

    Article  PubMed  PubMed Central  Google Scholar 

  6. Farzanegan F, Zebarjad SM, Alizadeh S, Ahrari F (2012) Pain reduction after initial archwire placement in orthodontic patients: a randomized clinical trial. Am J Orthod Dentofacial Orthop 141(2):169–173

    Article  PubMed  Google Scholar 

  7. Qamruddin I, Alam MK, Abdullah H, Kamran MA, Jawaid N, Mahroof V (2018) Effects of single-dose, low-level laser therapy on pain associated with the initial stage of fixed orthodontic treatment: a randomized clinical trial. Korean J Orthod 48(2):90–97

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ahrari F, Eshghpour M, Zare R, Ebrahimi S, Fallahrastegar A, Khaki H (2020) Effectiveness of low-level laser irradiation in reducing pain and accelerating socket healing after undisturbed tooth extraction. J Lasers Med Sci 11(3):274–279

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bidar M, Moushekhian S, Gharechahi M, Talati A, Ahrari F, Bojarpour M (2016) The effect of low level laser therapy on direct pulp capping in dogs. J Lasers Med Sci 7(3):177–183

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sardari F, Ahrari F (2016) The effect of low-level helium-neon laser on oral wound healing. Dent Res J 13(1):24–29

    Article  Google Scholar 

  11. Lu DP, Lu GP (2003) Anatomical relevance of some acupuncture points In the head and neck region that dictate medical OR dental application depending ON depth of needle insertion. Acupunct Electro Therapeutics Res 28(3):145–156

    Article  Google Scholar 

  12. Madani A, Ahrari F, Fallahrastegar A, Daghestani N (2019) A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders. Lasers Med Sci 35(1):181–192

    Article  PubMed  Google Scholar 

  13. Chon TY, Mallory MJ, Yang J, Bublitz SE, Do A, Dorsher PT (2019) Laser acupuncture: a concise review. Med Acupunct 31(3):164–168

    Article  PubMed  PubMed Central  Google Scholar 

  14. AlSayed Hasan MMA, Sultan K, Hamadah O (2017) Evaluating low-level laser therapy effect on reducing orthodontic pain using two laser energy values: a split-mouth randomized placebo-controlled trial. Eur J Orthod 40(1):23–28

    Article  Google Scholar 

  15. Heravi F, Moradi A, Ahrari F (2014) The effect of low level laser therapy on the rate of tooth movement and pain perception during canine retraction. Oral Health Dent Manag 13(2):183–188

    PubMed  Google Scholar 

  16. Deana NF, Zaror C, Sandoval P, Alves N (2017) Effectiveness of low-level laser therapy in reducing orthodontic pain: a systematic review and meta-analysis. Pain Res Manag 2017:

  17. Eslamipour F, Motamedian SR, Bagheri F (2017) Ibuprofen and low-level laser therapy for pain control during fixed orthodontic therapy: a systematic review of randomized controlled trials and meta-analysis. J Contemp Dent Pract 18(6):527–533

    Article  PubMed  Google Scholar 

  18. Fleming PS, Strydom H, Katsaros C, MacDonald L, Curatolo M, Fudalej P et al (2016) Non-pharmacological interventions for alleviating pain during orthodontic treatment. Cochrane Database Syst Rev 12(12):CD10263-CD

    Google Scholar 

  19. Martins IP, Martins RP, Caldas SGFR, dos Santos-Pinto A, Buschang PH, Pretel H (2018) Low-level laser therapy (830 nm) on orthodontic pain: blinded randomized clinical trial. Lasers Med Sci 34(2):281–286

    Article  PubMed  Google Scholar 

  20. Murdock S, Phillips C, Khondker Z, Hershey HG (2010) Treatment of pain after initial archwire placement: a noninferiority randomized clinical trial comparing over-the-counter analgesics and bite-wafer use. Am J Orthod Dentofacial Orthop 137(3):316–323

    Article  PubMed  Google Scholar 

  21. Patel S, McGorray SP, Yezierski R, Fillingim R, Logan H, Wheeler TT (2011) Effects of analgesics on orthodontic pain. Am J Orthod Dentofacial Orthop 139(1):e53–e58

    Article  PubMed  Google Scholar 

  22. Salmassian R, Oesterle LJ, Shellhart WC, Newman SM (2009) Comparison of the efficacy of ibuprofen and acetaminophen in controlling pain after orthodontic tooth movement. Am J Orthod Dentofacial Orthop 135(4):516–521

    Article  PubMed  Google Scholar 

  23. Domínguez Camacho A, Bravo Reyes M, Velasquez Cujar SA (2020) A systematic review of the effective laser wavelength range in delivering photobiomodulation for pain relief in active orthodontic treatment. Int Orthod 18(4):684–695

    Article  PubMed  Google Scholar 

  24. Sousa MVS, Pinzan A, Consolaro A, Henriques JFC, de Freitas MR (2014) Systematic literature review: influence of low-level laser on orthodontic movement and pain control in humans. Photomed Laser Surg 32(11):592–599

    Article  PubMed  Google Scholar 

  25. Matys J, Jaszczak E, Flieger R, Kostrzewska-Kaminiarz K, Grzech-Leśniak K, Dominiak M (2019) Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch—a randomized clinical controlled trial. Lasers Med Sci 35(2):487–496

    Article  PubMed  Google Scholar 

  26. Giudice LA, Nucera R, Perillo L, Paiusco A, Caccianiga G (2019) Is low-level laser therapy an effective method to alleviate pain induced by active orthodontic alignment archwire? A randomized clinical trial. J Evid Based Dent Pract 19(1):71–78

    Article  PubMed  Google Scholar 

  27. Nahin J, Arshad F, Srinivas BV, Kumar S, Lokesh NK (2018) The efficacy of low-level laser therapy on pain caused by placement of the first orthodontic archwire: a clinical study. J Contemp Dent Pract 19(4):450–455

    Article  PubMed  Google Scholar 

  28. Irnich D (2013) Guide to the book. Myofascial trigger points. Elsevier, pp 3–4

    Book  Google Scholar 

  29. Armond ACV, Glória JCR, dos Santos CRR, Galo R, Falci SGM (2019) Acupuncture on anxiety and inflammatory events following surgery of mandibular third molars: a split-mouth, randomized, triple-blind clinical trial. Int J Oral Maxillofac Surg 48(2):274–281

    Article  CAS  PubMed  Google Scholar 

  30. Rosted P (1998) The use of acupuncture in dentistry: a review of the scientific validity of published papers. Oral Dis 4(2):100–104

    Article  CAS  PubMed  Google Scholar 

  31. Grillo CM, Wada RS, Sousa ML (2014) Acupuncture in the management of acute dental pain. J Acupunct Meridian Stud 7(2):65–70

    Article  PubMed  Google Scholar 

  32. Murugesan H, Venkatappan S, Renganathan SK, Narasimhan S, Sekar M (2017) Comparison of acupuncture with ibuprofen for pain management in patients with symptomatic irreversible pulpitis: a randomized double-blind clinical trial. J Acupunct Meridian Stud 10(6):396–401

    Article  PubMed  Google Scholar 

  33. Jia Y, Chen B, Cai S, Hu T (2016) TEAS for prevention and treatment of orthodontic toothache and oral dysfunction: a randomized controlled trial. Zhongguo Zhen Jiu 36(5):485–490

    PubMed  Google Scholar 

  34. Joshi N, Araque H (2009) Neurophysiologic basis for the relief of human pain by acupuncture. Acupunct Electro Therapeutics Res 34(3):165–174

    Article  Google Scholar 

  35. Tavares MG, Machado AP, Motta BG, Borsatto MC, Rosa AL, Xavier SP (2007) Electro-acupuncture efficacy on pain control after mandibular third molar surgery. Braz Dent J 18(2):158–162

    Article  PubMed  Google Scholar 

  36. Vase L, Baram S, Takakura N, Yajima H, Takayama M, Kaptchuk TJ et al (2013) Specifying the nonspecific components of acupuncture analgesia. Pain 154(9):1659–1667

    Article  PubMed  PubMed Central  Google Scholar 

  37. Moeintaghavi A, Ahrari F, Nasrabadi N, Fallahrastegar A, Sarabadani J, Rajabian F (2021) Low level laser therapy, Er,Cr:YSGG laser and fluoride varnish for treatment of dentin hypersensitivity after periodontal surgery: a randomized clinical trial. Lasers Med Sci 36(9):1949–1956

    Article  PubMed  Google Scholar 

  38. Bausell RB, Lao L, Bergman S, Lee W‑L, Berman BM (2005) Is Acupuncture analgesia an expectancy effect? Eval Health Prof 28(1):9–26

    Article  PubMed  Google Scholar 

  39. Madani AS, Ahrari F, Nasiri F, Abtahi M, Tunér J (2014) Low-level laser therapy for management of TMJ osteoarthritis. Cranio 32(1):38–44

    Article  PubMed  Google Scholar 

  40. Mohammadipour HSS, Bagheri H, Khorshid M, Akbari M, Akhlaghi S, Samareh khammar M (2023) Tooth sensitivity and whitening effect of an in-office bleaching gel containing sodium hexametaphosphate: A randomized triple-blind clinical trial. J Dent Mater Tech 12(1):1–9

    Google Scholar 

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Acknowledgements

The results presented in this work have been taken from a student thesis (thesis number 3093). The authors wish to thank the vice-chancellor of research of Mashhad University of Medical Sciences, for supporting this study.

Funding

The authors would like to thank the vice-chancellor for research of Mashhad University of Medical Sciences for the financial support of this project (grant number 971833).

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Authors and Affiliations

  1. Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd Melat Park Square, Mashhad, Iran

    Farzaneh Ahrari DDS MS,  Hooman Shafaee DDS MS & Erfan Bardideh DDS MS

  2. Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

    Melika Haghpanahi DDS

Authors
  1. Farzaneh Ahrari DDS MS
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  2. Hooman Shafaee DDS MS
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  3. Melika Haghpanahi DDS
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  4. Erfan Bardideh DDS MS
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Corresponding author

Correspondence to Hooman Shafaee DDS MS.

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Conflict of interest

F. Ahrari, H. Shafaee, M. Haghpanahi and E. Bardideh declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The protocol of the study was reviewed and approved by the ethics committee of Mashhad University of Medical Sciences (approval number: IR.Mums.Dentistry.REC.1398.103.), and it was also registered in the Iranian Registry of Clinical Trials (IRCT) with the identification number IRCT20200622047886N1. Informed consent was obtained from all individual participants included in the study.

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Ahrari, F., Shafaee, H., Haghpanahi, M. et al. Low-level laser therapy and laser acupuncture therapy for pain relief after initial archwire placement. J Orofac Orthop (2024). https://doi.org/10.1007/s00056-024-00526-1

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