The prophylactic effect of photobiomodulation therapy on pain perception due to infiltration injection: a randomized clinical trial.

OBJECTIVES: Fear of pain in dentistry especially the injection involved in most of the processes has always been an important issue preventing the patients from consulting a dentist at the right time. This study aims to evaluate the effect of photobiomodulation therapy on reduction of pain in infiltration injection. MATERIALS AND METHODS: This trial is a crossover study including 30 patients. The patients are divided into two groups (laser therapy in the first period and placebo effect in the next period or vice versa with split-mouth design) using the covariate adaptive randomization method. All the patients received bilateral maxillary canine anesthesia in two periods performed with an ICT injection device (amount of anesthesia solution loaded: 1.8 mL) at a speed of 1 mL/min and a temperature of the solution of 37 °C. In each period, patients received either a prophylactic dose of 940-nm laser (500 mW, 10 J/cm2) or its placebo effect before the injection. The degree of pain perception after each sort of treatment is evaluated by both SEM (Sound, Eye, Motor, and Pain) and VAS (Visual Analogue Scale) scales. RESULTS: According to analysis, all the patients scored a VAS scale under 3 in the period they received intervention. Also considering the SEM scale, most of the patients scored 0 in the intervention period. No adverse effect was reported during or after the process. CONCLUSIONS: The study showed a significant effect of photobiomodulation on reducing pain perception during infiltration injection. CLINICAL RELEVANCE: This method can be useful in order to lower the pain for the patients consulting a dentist and therefore facilitate consulting at early stages of the dental issues. TRIAL REGISTRATION: The registration number (date) of the clinical trial in a Primary Registry in the WHO Registry Network is IR.ARAKMU.REC.1398.248(13/03/2020). The related URL is https://en.irct.ir/trial/45362 .

The salivary exosomal microRNA as a potential biomarker in patients with periodontitis and oral cancers.

Periodontitis and oral cancers are the most common oral diseases in the human population. The early diagnosis of oral diseases allows the efficient therapy of the patient. During oral diseases, resident cells in the affected tissue secrete exosomal microRNAs (miRNAs) into saliva. As these miRNAs have a crucial role in the pathogenesis of oral diseases, they have been suggested as non-invasive and validated biomarkers in predicting periodontitis severity and cancer progression. Several attempts have been performed to evaluate the expression of salivary exosomal miRNAs in patients with periodontitis and oral cancers. Some miRNAs are differentially expressed in the saliva of the affected patients when compared to healthy individuals. These miRNAs are reviewed in this narrative review. Collectively, it seems that salivary exosomal microRNAs could be used as a diagnostic biomarker in oral diseases. However, further studies are required to validate them.