Annu Ankita, Paranna Sujatha, Patil Anil T, B Sandhyarani, Prakash Adhithi, Bhurke Renuka Rajesh
Department of Pediatric & Preventive Dentistry, Bharati Vidyapeeth Dental College & Hospital, Bharati Vidyapeeth (Deemed to be) University, Sangli, Maharashtra, India.
J Dent Anesth Pain Med. 2023 Aug;23(4):229-236. doi: 10.17245/jdapm.2023.23.4.229. Epub 2023 Jul 29.
Local anesthesia has been reliably used to control pain during dental procedures and is important in pediatric dentistry. However, children occasionally complain of prolonged numbness after dental treatment, leading to several problems. Studies conducted to reverse the effect of local anesthesia using phentolamine mesylate and photobiomodulation therapy (PBM) are encouraging but limited. PBM is a type of light therapy that utilizes visible and near-infrared non-ionizing electromagnetic spectral light sources. Hence, this study used this modality to compare the reversal of local anesthesia at two different wavelengths. This study compared the effect of PBM at 660 and 810 nm wavelengths on the reversal of soft tissue local anesthesia using a diode LASER in pediatric dentistry.
Informed consent and assent were obtained, and the participants were then divided randomly into three groups of 20 children each: control group-without LASER irradiation, LASER irradiation at 660 nm, and LASER irradiation at 810 nm. Sixty children aged 4-8 years with deciduous mandibular molars indicated for pulp therapy were administered an inferior alveolar nerve block. After 45 min of injection, a duration that was similar to the approximate duration of treatment, they were exposed to 660- and 810-nm LASER irradiation according to their groups until reversal of local anesthesia was achieved. The control group did not undergo LASER irradiation. The reversal of the soft tissue local anesthetic effect was evaluated using palpation and pin prick tests every 15 min, and the LASER irradiation cycle continued until reversal of the soft tissue local anesthesia was achieved.
A significant reduction of 55.5 min (27.6%) in the mean soft tissue local anesthesia reversal time was observed after the application of 810 nm wavelength PBM and 69 min (34.7%) after 660 nm wavelength LASER irradiation.
PBM with a 660 nm wavelength was more effective in reducing the mean soft tissue local anesthesia reversal duration, and thus can be used as a reversal agent for soft tissue local anesthesia in pediatric dentistry.
局部麻醉已被可靠地用于控制牙科手术过程中的疼痛,在儿童牙科中很重要。然而,儿童在牙科治疗后偶尔会抱怨麻木时间延长,这会导致一些问题。使用甲磺酸酚妥拉明和光生物调节疗法(PBM)来逆转局部麻醉效果的研究令人鼓舞,但很有限。PBM是一种光疗法,利用可见光和近红外非电离电磁光谱光源。因此,本研究使用这种方式比较两种不同波长下局部麻醉的逆转情况。本研究比较了660和810纳米波长的PBM在儿童牙科中使用二极管激光对软组织局部麻醉逆转的效果。
获得知情同意和同意后,将参与者随机分为三组,每组20名儿童:对照组——不进行激光照射、660纳米激光照射组和810纳米激光照射组。对60名年龄在4至8岁、有乳牙下颌磨牙需要进行牙髓治疗的儿童进行下牙槽神经阻滞。注射45分钟后(这一持续时间与大致治疗持续时间相似),根据分组情况对他们进行660纳米和810纳米的激光照射,直到局部麻醉逆转。对照组不进行激光照射。每15分钟使用触诊和针刺试验评估软组织局部麻醉效果的逆转情况,激光照射周期持续进行,直到软组织局部麻醉逆转。
应用810纳米波长的PBM后,平均软组织局部麻醉逆转时间显著缩短55.5分钟(27.6%),660纳米波长激光照射后缩短69分钟(34.7%)。
660纳米波长的PBM在缩短平均软组织局部麻醉逆转持续时间方面更有效,因此可作为儿童牙科软组织局部麻醉的逆转剂。