Shekarchi Fatemeh, Hartoonian Serlie, Fekrazad Reza, Mirebeigi-Jamasbi Seyed Sepehr
Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Republic of Islamic, Iran.
Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Lasers Med Sci. 2025 Jul 16;40(1):318. doi: 10.1007/s10103-025-04569-7.
This systematic review aims to evaluate the efficacy of laser-based photobiomodulation therapy (PBMT) in reducing pain associated with dental injections. The review addresses the research question: "What is the effect of PBMT on pain levels during local anesthetic injections in dental patients compared to control interventions?". A comprehensive search was conducted across PubMed, Scopus, Embase, Web of Science, and Cochrane Library databases. Studies included were prospective or retrospective clinical trials involving PBMT for pain control during dental injections. The quality of studies was assessed using the revised Cochrane Risk of Bias 2 tool. Data were extracted on patient demographics, laser parameters, and pain outcomes. A total of 14 studies were included in this systematic review, with 6 focusing on children and 8 on adults. In children, three studies indicated that PBMT effectively reduced pain, with a significant difference according to the Wong-Baker FACES Pain Rating Scale (WFPRS) but not on the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Conversely, three studies found no significant differences between PBMT and topical anesthesia. In adults, five studies demonstrated a pain-reducing effect of PBMT, though one study reported a statistically significant difference that did not achieve clinical significance. The meta-analysis revealed a statistically significant overall effect of PBMT on pain reduction in both children and adults (p < 0.05). This systematic review of the literature suggests that PBMT may help reduce discomfort associated with dental injections in both adults and children. Nonetheless, further investigation is warranted to arrive at a more definitive conclusion on this topic.
本系统评价旨在评估基于激光的光生物调节疗法（PBMT）在减轻牙科注射相关疼痛方面的疗效。该评价解决的研究问题是：“与对照干预措施相比，PBMT对牙科患者局部麻醉注射时的疼痛水平有何影响？”。我们在PubMed、Scopus、Embase、Web of Science和Cochrane图书馆数据库中进行了全面检索。纳入的研究为前瞻性或回顾性临床试验，涉及使用PBMT控制牙科注射时的疼痛。使用修订后的Cochrane偏倚风险2工具评估研究质量。提取了患者人口统计学、激光参数和疼痛结局的数据。本系统评价共纳入14项研究，其中6项关注儿童，8项关注成人。在儿童中，三项研究表明PBMT有效减轻了疼痛，根据面部表情疼痛评分量表（WFPRS）有显著差异，但在面部、腿部、活动、哭闹和安慰性（FLACC）量表上无显著差异。相反，三项研究发现PBMT与局部麻醉之间无显著差异。在成人中，五项研究证明了PBMT的止痛效果，尽管一项研究报告的统计学显著差异未达到临床意义。荟萃分析显示，PBMT对儿童和成人的疼痛减轻均有统计学显著的总体效果（p < 0.05）。对文献的本系统评价表明，PBMT可能有助于减轻成人和儿童牙科注射相关的不适。尽管如此，仍有必要进行进一步研究，以就该主题得出更明确的结论。
