Laser adjuvant therapies positively impact postoperative endodontic pain intensity, suggests research

A new study by Zhiqiang Luo and team showed that laser adjuvant treatments, including diode laser therapy, low-level laser therapy, and photodynamic therapy, can help to reduce postoperative endodontic discomfort. The findings of this study were published in the International Endodontic Journal.

A frequent side effect of endodontic therapy is postoperative endodontic pain (PEP), which has a high frequency of 40% within 24 hours and 11% after a week. After a few hours or days, the patient has discomfort or swelling that necessitates an urgent visit to the dentist, greatly impairing their quality of life. Additionally, the inflammatory process is responsible for the traumatization of the pulp and periapical tissues, which is a result of localized mechanical, chemical, and microbiological factors. Additionally, there is a possibility that tooth debris, intracanal medications, root canal irrigation solutions, and microorganisms will be extruded through the apical foramen.

In practice, pain control following endodontic therapy is crucial. The effectiveness of diode laser therapy, low-level laser therapy (LLLT), and a few other laser adjuvant treatments for PEP control has been studied throughout the last ten years. Thus, the purpose of this study was to evaluate how well laser adjuvant therapy works to control pain following endodontic treatments. Thorough search of the Cochrane Library, Embase, PubMed, Scopus, and Web of Science databases was carried out to find publications published up until February 12, 2023.

The key findings of this study were:

• 22 studies were considered in this analysis; 15 of them included 892 patients with pain ratings on the visual analogue scale, and 7 of them enrolled 422 patients with prevalence of pain. Out of the 22 studies, 5 had a high risk of bias, 10 had a moderate risk, and 7 had a low risk.
• The combined results showed that all laser adjuvant therapies, such as low-level laser therapy, diode laser therapy, and photodynamic treatment, decreased pain ratings.
• A noteworthy association was noted between decreased rates of postoperative pain incidence in the photodynamic treatment group and no reduction in pain incidence in the low-level laser therapy group.

Overall, the meta-analysis revealed a significant reduction in PEP intensity in the LLLT, diode laser treatment, and photodynamic therapy (PDT) groups, as well as a decrease in PEP occurrence in the PDT group.

Source:

Luo, Z., He, Y., Wu, H., Li, Y., Shen, L., Cheng, L., Zhou, X., He, L., & Chen, J. (2024). Efficacy of laser adjuvant therapy in the management of post‐operative endodontic pain: A systematic review and meta‐analysis. In International Endodontic Journal. Wiley. https://doi.org/10.1111/iej.14140