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

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.

The comparison of calcium hydroxide + biostimulation, calcium hydroxide, formocresol, and MTA pulpotomies without biostimulation in primary teeth: 12-months clinical and radiographic follow-up.

This study has aimed to evaluate the clinical and radiographic success rates of calcium hydroxide pulpotomy (CH) with biostimulation (PBMT) and compare them to that of CH, formocresol (FC), mineral trioxide aggregate (MTA) pulpotomies without PBMT in primary molars. A total of 172 pulpotomies were performed on primary first or second mandibular molars in 94 children who were 5-8 years old. The pulpotomy procedure was performed with four different techniques. In the PBMT group, before the CH placement, 820-nm diode laser radiation was applied to each pulp-stump for 12 s (10 mW, 2.5 J/cm2). The clinical (lack of spontaneous pain, abscess or fistula, and pathological mobility) and radiographic success (lack of periapical/furcal lesions and internal/external resorption) were recorded at 6 and 12 months. The data was statistically evaluated. p value < 0.05 was considered as significant. After 12 months, the clinical and radiographic success rate (a tooth with at least one of the findings was considered unsuccessful) was 97%/92% for FC and 97%/95%, 87%/73%, and 71%/45% for MTA, CH + PBMT, and CH, respectively. There was no significant difference between the CH + PBMT and the other groups in clinical success, while a significant difference was found between CH and FC, MTA groups. In radiographic success, there was a significant difference between the CH and the other groups. No significant difference was found between the 6th- and 12th-month results in clinical success for all the groups. A decrease in success over time was seen only in the CH group for radiographic results. CH without PBMT showed the worst clinical and radiographic results among the groups. CH + PBMT showed similar clinical success compared to the MTA and FC groups. In radiographic success, CH + PBMT showed higher success compared to CH, but this success was not high as compared to MTA and FC.

Effects of Two Different Anesthetic Solutions on Injection Pain, Efficacy, and Duration of Soft-Tissue Anesthesia with Inferior Alveolar Nerve Block for Primary Molars.

OBJECTIVES: The purpose of the study was to compare the efficacy, injection pain, duration of soft tissue anesthesia, and postoperative complications of two different anesthetics (2% lidocaine with 1:80,000 epinephrine and 3% plain mepivacaine) in pediatric patients in inferior alveolar nerve block (IANB) administered by a computer-controlled delivery system (CCDS). STUDY DESIGN: The study was conducted as a randomized, controlled-crossover, double-blind clinical trial with 60 children requiring bilateral pulpotomy or extraction of primary mandibular molars. A CCDS was used to deliver 3% mepivacaine to 1 primary tooth and 2% lidocaine to the contralateral tooth with an IANB technique. Severity of pain and efficacy of anesthesia were evaluated using the Face, Legs, Activity, Cry, Consolability Scale, and comfort and side effects were assessed using a questionnaire. Data were analyzed using the Mann-Whitney U, Wilcoxon t, and Fisher exact tests. RESULTS: Patients receiving 2% lidocaine experienced significantly less pain during injection than those receiving 3% mepivacaine, and no significant differences were found in the pain scores during treatments or in postoperative complications between the two anesthetics. The mean durations of anesthesia for 3% mepivacaine and 2% lidocaine were 139.68 minutes and 149.10 minutes, respectively. CONCLUSIONS: Plain mepivacaine and 2% lidocaine were similarly effective in pulpotomy and the extraction of primary mandibular molars. Although the use of 3% mepivacaine provided a shorter duration of anesthesia than 2% lidocaine, both solutions showed similar results in terms of postoperative complications.

Intraligamentary and Supraperiosteal Anesthesia Efficacy Using a Computer Controlled Delivery System in Mandibular Molars.

PURPOSE: The purpose of this study was to compare pain, efficacy and postoperative complications of anesthesia in first primary mandibular molars anesthetized with either intraligamentary (IL) or supraperiosteal (SP) anesthesia using a computer-controlled delivery system (CCDS). STUDY DESIGN: This randomized, controlled-crossover, blind clinical trial was conducted with 90 children requiring bilateral extraction, pulpotomy or restorative treatment of first mandibular primary molars. A CCDS was used to deliver IL anesthesia to 1 deciduous tooth and SP anesthesia to the contralateral tooth in each patient. Severity of pain and efficacy of anesthesia during the treatments were evaluated using the Wong-Baker Faces Pain Rating Scale (PRS) and comfort and side effects were assessed using post-injection and post-treatment questionnaires. Data were analyzed using χ2 and Mann-Whitney U tests. RESULTS: According to PRS scores, pain levels during extraction were significantly higher with IL when compared to SP. Patients reported significantly less pain during needle insertion with SP when compared to IL; however, rates of postoperative complications were significantly higher with SP when compared to IL. CONCLUSIONS: CCDS-administered IL anesthesia and SP anesthesia were similarly effective when used during restorative treatment and pulpotomy of primary mandibular molars; however, SP was more effective than IL when used during extraction procedures.

Efficacy of Low-Level Laser Therapy in the Management of Postoperative Pain in Children After Primary Teeth Extraction: A Randomized Clinical Trial.

OBJECTIVE: This study evaluated the effect of low-level laser therapy (LLLT) on postoperative pain in children undergoing primary molar extraction. MATERIALS AND METHODS: This randomized, controlled-crossover, double-blind clinical trial was conducted with 37 children requiring bilateral extraction of primary molars. In one tooth (LLLT group), a GaAlAs diode laser (wavelength, 810 nm; continuous mode, output power 0.3 W; 180 sec, 4 J/cm(2)) was applied intraorally 1 cm from the target tissue immediately following extraction. In the contralateral tooth (control group), the hand piece was applied, but without laser activation. Children and parents rated postoperative pain on the first three evenings following extraction using, respectively, the Wong-Baker FACES(®) Pain Rating Scale (PRS) and the Visual Analogue Scale (VAS). Parents also reported if their children received analgesics. Data were analyzed using χ(2) and Mann-Whitney U tests. RESULTS: Mean VAS scores were higher for the control group than for the LLLT group on the first and second evenings, and PRS scores were higher for the control group than for the laser group on the first evening, but the differences were not statistically significant (p > 0.05). More analgesics were given to children in the control group on the first evening; however, both groups received equal amounts on the next two evenings (p > 0.05). CONCLUSIONS: Within the limitations of this study, LLLT application following primary molar extraction was not found to affect postoperative pain in children.