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Original Research

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Effects of photobiomodulation with different application parameters on injection pain in children: a randomized clinical trial

  • Mesut Elbay1,*,
  • Ülkü Şermet Elbay1
  • Emine Kaya2
  • Özlem Peyman Kalkan1

1Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, 41190 Kocaeli, Turkey

2Department of Pediatric Dentistry, Faculty of Dentistry, Okan University, 34959 İstanbul, Turkey

DOI: 10.22514/jocpd.2023.035 Vol.47,Issue 4,July 2023 pp.54-62

Submitted: 29 November 2022 Accepted: 28 February 2023

Published: 03 July 2023

*Corresponding Author(s): Mesut Elbay E-mail: mesut.elbay@kocaeli.edu.tr

Abstract

Photobiomodulation (PBM) has gained increasing interest due to its effectiveness in pain reduction in various fields of dentistry. However, the number of studies evaluating the effect of PBM on injection pain in children is very limited. The aim of the study was to evaluate the efficacy of PBM with three different application parameters (doses) + topical anesthesia on reducing injection pain and to compare these results with the placebo PBM+ topical anesthesia in children during supraperiosteal anesthesia administration. 160 children were randomly divided into 4 groups, 3 experimental and 1 control, with 40 subjects in each. In the experimental groups, before the anesthesia administration, PBM with a power of 0.3 W was applied for 20, 30 and 40 s in groups 1, 2 and 3, respectively. In group 4, a placebo application of laser was performed. The pain felt during the injection was assessed using the Wong-Baker Faces Pain Rating Scale (PRS), and also the Face, Legs, Activity, Cry, Consolability (FLACC) Scale. Statistical analyses were performed to evaluate the data (p < 0.05). The mean FLACC Scale pain scores were 3.02 ± 2.93, 2.92 ± 2.54, 2.12 ± 1.89 and 1.77 ± 1.90 for the placebo group, and Groups 1, 2, and 3, respectively. Furthermore, the mean PRS scores were 1 ± 1.03, 0.95± 0.98, 0.80 ± 0.822 and 0.65 ± 0.921 for the placebo group, and Groups 1, 2 and 3, respectively. The “no pain response” rate was higher in Group 3 as compared to Groups 1, 2, and placebo according to the FLACC Scale and PRS; however, no difference was found between the groups (p = 0.109, p = 0.317). Injection pain in children did not differ with placebo and PBM applied with a power of 0.3 W for 20, 30 and 40 s.


Keywords

Photobiomodulation; Children; Parameters; Injection pain; Dose


Cite and Share

Mesut Elbay,Ülkü Şermet Elbay,Emine Kaya,Özlem Peyman Kalkan. Effects of photobiomodulation with different application parameters on injection pain in children: a randomized clinical trial. Journal of Clinical Pediatric Dentistry. 2023. 47(4);54-62.

References

[1] Shetty V, Suresh LR, Hegde AM. Effect of virtual reality distraction on pain and anxiety during dental treatment in 5- to 8-year-old children. Journal of Clinical Pediatric Dentistry. 2019; 43: 97–102.

[2] Garret-Bernardin A, Cantile T, D’Antò V, Galanakis A, Fauxpoint G, Ferrazzano GF, et al. Pain experience and behavior management in pediatric dentistry: a comparison between traditional local anesthesia and the wand computerized delivery system. Pain Research and Management. 2017; 2017: 1–6.

[3] Rangel CRG, Pinheiro SL. Laser acupuncture and intravascular laser irradiation of blood for management of pediatric dental anxiety. Journal of Oral Science. 2021; 63: 355–357.

[4] Ribeiro MKA, Alcântara-Silva TRM, Oliveira JCM, Paula TC, Dutra JBR, Pedrino GR, et al. Music therapy intervention in cardiac autonomic modulation, anxiety, and depression in mothers of preterms: randomized controlled trial. BMC Psychology. 2018; 6: 57.

[5] Uçar G, Şermet Elbay Ü, Elbay M. Effects of low level laser therapy on injection pain and anesthesia efficacy during local anesthesia in children: a randomized clinical trial. International Journal of Paediatric Dentistry. 2022; 32: 576–584.

[6] Hamblin MR. Photobiomodulation or low-level laser therapy. Journal of Biophotonics. 2016; 9: 1122–1124.

[7] Heiskanen V, Hamblin MR. Photobiomodulation: lasers vs. light emitting diodes? Photochemical & Photobiological Sciences. 2018; 17: 1003–1017.

[8] Jagtap B, Bhate K, Magoo S, S N S, Gajendragadkar KS, Joshi S. Painless injections-a possibility with low level laser therapy. Journal of Dental Anesthesia and Pain Medicine. 2019; 19: 159–165.

[9] Sattayut S. Low intensity laser for reducing pain from anesthetic palatal injection. Photomedicine and Laser Surgery. 2014; 32: 658–662.

[10] Tuk JGC, van Wijk AJ, Mertens IC, Keleş Z, Lindeboom JAH, Milstein DMJ. Analgesic effects of preinjection low-level laser/light therapy (LLLT) before third molar surgery: a double-blind randomized controlled trial. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2017; 124: 240–247.

[11] Ayyildiz S, Emir F, Sahin C. Evaluation of low-level laser therapy in TMD patients. Case Reports in Dentistry. 2015; 2015: 1–6.

[12] Topçuoğlu HS, Akpınar B. The effect of low‐level laser therapy on the success rate of inferior alveolar nerve blocks in mandibular molars with symptomatic irreversible pulpitis: a randomized clinical trial. International Endodontic Journal. 2021; 54: 1720–1726.

[13] Ghabraei S, Chiniforush N, Bolhari B, Aminsobhani M, Khosarvi A. The effect of photobiomodulation on the depth of anesthesia during endodontic treatment of teeth with symptomatic irreversible pulpitis (double blind randomized clinical trial). Journal of Lasers in Medical Sciences. 2018; 9: 11–14.

[14] Chow RT, Armati PJ. Photobiomodulation: implications for anesthesia and pain relief. Photomedicine and Laser Surgery. 2016; 34: 599–609.

[15] Chen Y, Chen XL, Zou XL, Chen SZ, Zou J, Wang Y. Efficacy of low-level laser therapy in pain management after root canal treatment or retreatment: a systematic review. Lasers in Medical Science. 2019; 34: 1305–1316.

[16] Hamblin MR. Mechanisms and mitochondrial redox signaling in photobiomodulation. Photochemistry and Photobiology. 2018; 94: 199–212.

[17] Zein R, Selting W, Hamblin MR. Review of light parameters and photobiomodulation efficacy: dive into complexity. Journal of Biomedical Optics. 2018; 23: 1–17.

[18] Ramalho KM, de Souza LMP, Tortamano IP, Adde CA, Rocha RG, de Paula Eduardo C. A randomized placebo-blind study of the effect of low power laser on pain caused by irreversible pulpitis. Lasers in Medical Science. 2016; 31: 1899–1905.

[19] Shekarchi F, Nokhbatolfoghahaei H, Chiniforush N, Mohaghegh S, Haeri Boroojeni HS, Amini S, et al. Evaluating the preemptive analgesic effect of photo-biomodulation therapy on pain perception during local anesthesia injection in children: a split-mouth triple-blind randomized controlled clinical trial. Photochemistry and Photobiology. 2022; 98: 1195–1200.

[20] AmruthaVarshini I, Penmatsa C. Effectiveness of pre-cooling the injection site, laser biostimulation, and topical local anesthetic gel in reduction of local anesthesia injection pain in children. International Journal of Clinical Pediatric Dentistry. 2021; 14: 81–83.

[21] Frankl S, Shiere F, Fogels H. Should the parent remain with the child in the dental operatory? ASDC Journal of Dentistry for Children. 1962; 29: 150–163.

[22] Murphy L. Pediatric laser dentistry: a user’s guide. British Dental Journal. 2011; 211: 613.

[23] American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. The reference manual of pediatric dentistry. American Academy of Pediatric Dentistry: Chicago, Ill. 2022; 321–339.

[24] Schwartz S, Kupietzky A. Local anesthesia. In Wright GZ, Kupietzky A (ed.). Behavior management in dentistry for children (pp. 107–124). 2nd edn. Wiley: New York. 2014.

[25] Willis MH, Merkel SI, Voepel-Lewis T, Malviya S. FLACC behavioral pain assessment scale: a comparison with the child’s self-report. Pediatric Nursing. 2003; 29: 195–198.

[26] Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatric Nursing. 1988; 14: 9–17.

[27] Tsai S, Hamblin MR. Biological effects and medical applications of infrared radiation. Journal of Photochemistry and Photobiology B: Biology. 2017; 170: 197–207.

[28] Cronshaw M, Parker S, Arany P. Feeling the heat: evolutionary and microbial basis for the analgesic mechanisms of photobiomodulation therapy. Photobiomodulation, Photomedicine, and Laser Surgery. 2019; 37: 517–526.

[29] de Sousa MVP, Kawakubo M, Ferraresi C, Kaippert B, Yoshimura EM, Hamblin MR. Pain management using photobiomodulation: Mecha-nisms, location, and repeatability quantified by pain threshold and neural biomarkers in mice. Journal of Biophotonics. 2018; 11: e201700370.

[30] Ghabraei S, Bolhari B, Nashtaie HM, Noruzian M, Niavarzi S, Chiniforush N. Effect of photobiomodulation on pain level during local anesthesia injection: a randomized clinical trial. Journal of Cosmetic and Laser Therapy. 2020; 22: 180–184.

[31] Ghaderi F, Ghaderi R, Davarmanesh M, Bayani M, Arabzade Moghadam S. Pain management during needle insertion with low level laser. European Journal of Paediatric Dentistry. 2016; 17: 151–154.

[32] Kermanshah H, Chiniforush N, Kolahdouz Mohammadi M, Motevas-selian F. Effect of photobiomodulation therapy with 915 nm diode laser on pain perception during local anesthesia of maxillary incisors: a randomized controlled trial. Photochemistry and Photobiology. 2022; 98: 1471–1475.

[33] Huang YY, Chen AC, Carroll JD, Hamblin MR. Biphasic dose response in low level light therapy. Dose-Response. 2009; 7: 358–383.

[34] Seraj B, Ghadimi S, Hakimiha N, Kharazifard MJ, Hosseini Z. Assessment of photobiomodulation therapy by an 8l0-nm diode laser on the reversal of soft tissue local anesthesia in pediatric dentistry: a preliminary randomized clinical trial. Lasers in Medical Science. 2020; 35: 465–471.

[35] Elbay ÜŞ, Elbay M, Kaya E, Cilasun Ü. Intraligamentary and supraperiosteal anesthesia efficacy using a computer controlled delivery system in mandibular molars. Journal of Clinical Pediatric Dentistry. 2016; 40: 193–199.


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