Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, P.O. Box 346, Ajman City, UAE.
Center of Medical and Bio-allied Health Sciences Research, Ajman University, PO Box 346, Ajman, UAE.
Sci Rep. 2024 Oct 29;14(1):26028. doi: 10.1038/s41598-024-74998-x.
Postoperative pain is a common concern following root canal treatments (RCT), impacting both patients and oral health practitioners. This systematic review and meta-analysis aimed to evaluate the effectiveness of laser treatment modalities in reducing postoperative pain compared to conventional methods after primary and secondary RCT in permanent mature teeth. A search of three electronic databases (PubMed, ScienceDirect, and The Cochrane Library) was conducted, using a broad range of keywords and terms. Gray literature and manual searches were conducted to complement the search. The inclusion criteria included randomized clinical trials based on the objective of the secondary study. A minimum sample size of 10 participants per group and a clearly defined criterion for postoperative pain assessment were required. The characteristics of the included studies were presented as tables. The Cochrane collaboration tool RoB 2.0 was used to assess the risk of bias within each study. Two reviewers extracted the data and assessed the studies independently, and discrepancies were resolved through consultation with a third reviewer. A random-effects model was employed for meta-analysis to estimate the overall effect measure. Heterogeneity was evaluated using Cochran's Q test and the I index. Publication bias was explored via Funnel plots and Egger's test. Subgroup analyses and meta-regression were conducted to assess variations among laser methods and examine the influence of independent factors. The significance threshold for all analyses was set at 5% (α = 0.05). Intraoral laser therapy demonstrated no significant advantage over conventional treatments but consistently outperformed placebo, particularly from 4 to 72 h post-treatment. Low-level laser therapy provided slight pain reduction in the first 8 h, though its effectiveness diminished in retreatment scenarios. Photodynamic therapy and laser disinfection showed marginal benefits, especially shortly after treatment, with reduced efficacy in longer-term or retreatment contexts. Further research is needed to explore different applications of laser modalities and assess distinct prognostic factors in more detail.
根管治疗（RCT）后，术后疼痛是一个常见的关注点，影响着患者和口腔健康从业者。本系统评价和荟萃分析旨在评估与传统方法相比，激光治疗在减轻原发性和继发性 RCT 后恒牙术后疼痛方面的有效性。通过广泛的关键词和术语，对三个电子数据库（PubMed、ScienceDirect 和 The Cochrane Library）进行了搜索。通过灰色文献和手动搜索对搜索结果进行了补充。纳入标准包括基于二次研究目标的随机临床试验。每个组需要至少有 10 名参与者，并且有明确的术后疼痛评估标准。纳入研究的特征以表格形式呈现。Cochrane 协作工具 RoB 2.0 用于评估每项研究的偏倚风险。两名评审员独立提取数据并评估研究，通过与第三名评审员协商解决分歧。使用随机效应模型进行荟萃分析，以估计总体效应量。使用 Cochran's Q 检验和 I 指数评估异质性。通过漏斗图和 Egger 检验探索发表偏倚。进行亚组分析和荟萃回归分析，以评估激光方法之间的差异，并研究独立因素的影响。所有分析的显著性阈值均设定为 5%（α=0.05）。口内激光治疗与常规治疗相比没有显著优势，但始终优于安慰剂，尤其是在治疗后 4 至 72 小时。低水平激光治疗在最初的 8 小时内提供了轻微的疼痛缓解，但在重复治疗情况下其效果减弱。光动力疗法和激光消毒显示出微小的益处，尤其是在治疗后不久，在长期或重复治疗情况下效果降低。需要进一步研究来探索激光模式的不同应用，并更详细地评估不同的预后因素。
