Dental school, Federal University of Amazonas, R Mins Waldemar Pedrosa, n. 1539., Praça 14 de Janeiro, Manaus, AM, Brazil.
Clin Oral Investig. 2019 Jan;23(1):285-292. doi: 10.1007/s00784-018-2435-9. Epub 2018 Apr 16.
The aim of this prospective, randomized, clinical study was to assess the effect of photobiomodulation therapy (PBM) with low-level laser irradiation (LLLI) on postoperative pain after endodontic treatment.
Sixty patients, diagnosed with irreversible pulpitis in lower molar teeth, participated in the study. All treatments were performed by a single operator. Participants were randomly divided into two groups: in the experimental group (EG), endodontic treatment was performed with a reciprocating system, immediately followed by PBM with LLLI; and only endodontic treatment was performed in the control group (CG). Postoperative pain was assessed by a second examiner, who was blinded, using two scales: verbal rating scale (VRS) and numerical rating scale (NRS). Assessment was carried out at 6, 12, and 24 h after treatment. Data were analyzed using chi-squared, Fisher's exact, Mann-Whitney tests, ordinal, and non-parametric regression analyses.
For the prevalence of pain, the difference between the groups was significant for the evaluations performed after 6 h (p = 0.04) and 24 h (p = 0.02). The difference after 24 h remained significant after stratification by sex and extrusion of filling material. Increased pain intensity was associated with extrusion of root canal filling material to the periapical region in the two scales used.
The effect of PBM therapy after endodontic treatment showed a significant decreasein prevalence of postoperative pain.
The PBM reduces the prevalence of postoperative pain and may benefit patients who need endodontic treatment.
本前瞻性、随机、临床研究旨在评估低水平激光照射(LLLI)的光生物调节疗法(PBM)对根管治疗术后疼痛的影响。
60 名患有下颌磨牙不可逆性牙髓炎的患者参与了这项研究。所有治疗均由一名操作人员进行。参与者被随机分为两组:实验组(EG)采用往复式系统进行根管治疗,随后立即进行 LLLI 的 PBM;对照组(CG)仅进行根管治疗。由第二位盲法检查者使用两种量表(视觉模拟评分量表(VRS)和数字评分量表(NRS))评估术后疼痛。治疗后 6、12 和 24 小时进行评估。使用卡方检验、Fisher 确切检验、Mann-Whitney 检验、有序和非参数回归分析进行数据分析。
对于疼痛的发生率,两组在治疗后 6 小时(p=0.04)和 24 小时(p=0.02)的评估中存在显著差异。在性别和根管填充材料外溢分层后,24 小时后的差异仍然显著。两种量表均显示,根尖周区域根管填充材料外溢与疼痛强度增加相关。
根管治疗后 PBM 治疗的效果显著降低了术后疼痛的发生率。
PBM 可降低术后疼痛的发生率,可能使需要根管治疗的患者受益。