Analgesic effect of photobiomodulation after placement of elastomeric separators: randomized controlled clinical trial

Authors

DOI:

https://doi.org/10.33448/rsd-v11i2.25979

Keywords:

Pain; Photobiomodulation; Orthodontics; Elastomeric separators.

Abstract

Objective: Pain resulting from the positioning of elastomeric separators is a strong reason for abandoning orthodontic treatment. So, this study aims to verify the analgesic effects of photobiomodulation (PBM) in participants submitted to orthodontics with elastomeric separators. Methods: Participants were individuals who received separators on the mesial and distal surfaces of the first molars. They were randomly separated into two groups: an experimental group that received photobiomodulation (PBM) (n=22) and a placebo group (n=22). After the positioning of the separators, the PBM group received one application of PBM (2 J of energy applied in 20 seconds per point, adding up to 12 J per molar (6 J on the vestibular surface and 6 J on the lingual surface) over the cervical portion and the apical third of the tooth. Pain was measured one hour after placement, with the aid of a visual analog scale (VAS). Statistical analysis involved the Mann-Whitney, Fisher’s Exact and chi-square tests. Results: Reports of severe pain only occurred in the placebo group. However, a larger percentage of the individuals in the PBM group reported feeling moderate pain compared to this same intensity in the placebo group. No significant differences among groups were found with regards to reports of mild pain and no pain. An association was found between pain and the female sex in both groups. Conclusion: Significant difference was found in severe pain sensitivity when PBM was applied after the positioning of elastomeric separators, favoring the irradiated participants. Thus, PBM may be a useful tool in orthodontic treatment. Clinical Trials Reference Number (www.ClinicalTrials.gov), NCT03939988.

References

Abtahi, S. M., Mousavi, S. A., Shafaee, H., & Tanbakuchi, B. (2013). Effect of low-level laser therapy on dental pain induced by separator force in orthodontic treatment. Dental research journal, 10(5), 647–651.

Almallah, M. M., Almahdi, W. H., & Hajeer, M. Y. (2016). Evaluation of Low Level Laser Therapy on Pain Perception Following Orthodontic Elastomeric Separation: A Randomized Controlled Trial. Journal of clinical and diagnostic research: JCDR, 10(11), ZC23–ZC28. https://doi.org/10.7860/JCDR/2016/22813.8804.

Artés-Ribas, M., Arnabat-Dominguez, J. & Puigdollers, A. (2013). Analgesic effect of a low-level laser therapy (830 nm) in early orthodontic treatment. Lasers in Medical Science, 28, 335–341. https://doi.org/10.1007/s10103-012-1135-y.

Basso, F.G., Soares, D.G., de Souza Costa, C.A., Hebling J. (2016). Low-level laser therapy in 3D cell culture model using gingival fibroblasts. Lasers in Medical Science, 31, 973–978. https://doi.org/10.1007/s10103-016-1945-4.

Bayani, S., Rostami, S., Ahrari, F., & Saeedipouya, I. (2016). A randomized clinical trial comparing the efficacy of bite wafer and low level laser therapy in reducing pain following initial arch wire placement. Laser therapy, 25(2), 121–129. https://doi.org/10.5978/islsm.16-OR-10.

Caccianiga, G., Paiusco, A., Perillo, L., Nucera, R., Pinsino, A., Maddalone, M., Cordasco, G., Lo Giudice, A. (2017). Does Low-Level Laser Therapy Enhance the Efficiency of Orthodontic Dental Alignment? Results from a Randomized Pilot Study. Photomedicine Laser Surgery, 35(8), 421-426. 10.1089/pho.2016.4215.

Cronshaw, M., Parker, S., Anagnostaki, E., Lynch, E. (2019). Systematic Review of Orthodontic Treatment Management with Photobiomodulation Therapy. Photobiomodulation, Photomedicine, and Laser Surgery, 37(2), 862–868 10.1089/photob.2019.4702.

Dalaie, K., Hamedi, R., Kharazifard, M. J., Mahdian, M., & Bayat, M. (2015). Effect of Low-Level Laser Therapy on Orthodontic Tooth Movement: A Clinical Investigation. Journal of dentistry (Tehran, Iran), 12(4), 249–256.

de Sousa, M., Kawakubo, M., Ferraresi, C., Kaippert, B., Yoshimura, E. M., & Hamblin, M. R. (2018). Pain management using photobiomodulation: Mechanisms, location, and repeatability quantified by pain threshold and neural biomarkers in mice. Journal of biophotonics, 11(7), e201700370. https://doi.org/10.1002/jbio.201700370.

Dalaie, K., Hamedi, R., Kharazifard, M. J., Mahdian, M., & Bayat, M. (2015). Effect of Low-Level Laser Therapy on Orthodontic Tooth Movement: A Clinical Investigation. Journal of dentistry (Tehran, Iran), 12(4), 249–256.

Domínguez, A., Gómez, C. & Palma, J. C. (2015). Effects of low-level laser therapy on orthodontics: rate of tooth movement, pain, and release of RANKL and OPG in GCF. Lasers in Medical Sciences, 30, 915–923. https://doi.org/10.1007/s10103-013-1508-x.

Domínguez Camacho, A., Montoya Guzmán, D., Velásquez Cujar, S. A. (2020). Effective Wavelength Range in Photobiomodulation for Tooth Movement Acceleration in Orthodontics: A Systematic Review. Photobiomodulation, Photomedicine and Laser Surgery, 38(10), 581-590. 10.1089/photob.2020.4814.

Eslamian, Ladan & Borzabadi-Farahani, Ali & Hassanzadeh-Azhiri, Aidin & Badiee, Mohammad & Fekrazad, Reza. (2014). The effect of 810-nm low-level laser therapy on pain caused by orthodontic elastomeric separators. Lasers in medical science, 29, 559–564. 10.1007/s10103-012-1258-1.

Farias, R. D., Closs, L. Q., & Miguens, S. A., Jr (2016). Evaluation of the use of low-level laser therapy in pain control in orthodontic patients: A randomized split-mouth clinical trial. The Angle orthodontist, 86(2), 193–198. https://doi.org/10.2319/122214-933.1.

Farzanegan, F., Zebarjad, S.M., Alizadeh, S., Ahrari, F. (2012). Pain reduction after initial archwire placement in orthodontic patients: A randomized clinical Trial. American Journal of Orthodontics and Dentofacial Orthopedics, 141(2), 169-73. 10.1016/j.ajodo.2011.06.042.

Huang, T. H., Liu, S. L., Chen, C. L., Shie, M. Y., & Kao, C. T. (2013). Low-level laser effects on simulated orthodontic tension side periodontal ligament cells. Photomedicine and laser surgery, 31(2), 72–77. https://doi.org/10.1089/pho.2012.3359.

Kim, W.T., Bayome, M., Park, J.B., Park, J.H., Baek, S.H., Kook, Y.A. (2013). Effect of frequent laser irradiation on orthodontic pain. A single-blind randomized clinical Trial. Angle Orthodontics, 83(4), 611-6. 10.2319/082012-665.1.

Lee, J. H., Chiang, M. H., Chen, P. H., Ho, M. L., Lee, H. E., & Wang, Y. H. (2018). Anti-inflammatory effects of low-level laser therapy on human periodontal ligament cells: in vitro study. Lasers in medical science, 33(3), 469–477. https://doi.org/10.1007/s10103-017-2376-6.

Li, J., Ge, X., Guan, H., Jia, L., Chang, W., Ma, W. (2021). The Effectiveness of Photobiomodulation on Accelerating Tooth Movement in Orthodontics: A Systematic Review and Meta-Analysis. Photobiomodulation, Photomedicine and Laser Surgery, 39(4), 232-244. 10.1089/photob.2020.4954.

Lo Giudice, A., Nucera, R., Leonardi, R., Paiusco, A., Baldoni, M., & Caccianiga, G. (2020). A Comparative Assessment of the Efficiency of Orthodontic Treatment With and Without Photobiomodulation During Mandibular Decrowding in Young Subjects: A Single-Center, Single-Blind Randomized Controlled Trial. Photobiomodulation, photomedicine, and laser surgery, 38(5), 272–279. https://doi.org/10.1089/photob.2019.4747.

Marini, I., Bartolucci, M. L., Bortolotti, F., Innocenti, G., Gatto, M. R., Alessandri Bonetti, G. (2015). The effect of diode superpulsed lowlevel laser therapy on experimental orthodontic pain caused by elastomeric separators: a randomized controlled clinical trial. Lasers in medical science, 30(1), 35-41. 10.1007/s10103-013-1345-y.

Mohammad-Hoseyni, A., Pirmoradian-Najafabadi, M., Ashnagar, S., Nokhbatolfoghahaei, H., Fekrazad, R. (2015). Effect ofLow Level Laser Therapy on Pain Reduction After Midpalatal Expansion in Rats. J Dent (Tehran), 12(9), 655-61.

Murakami-Malaquias-Silva, F., Rosa, E. P., Almeida, P. A., Schalch, T. O., Tenis, C. A., Negreiros, R. M., Horliana, R. F., Garcez, A. S., Fernandes, M., Tortamano, A., Motta, L. J., Bussadori, S. K., & Horliana, A. (2020). Evaluation of the effects of photobiomodulation on orthodontic movement of molar verticalization with mini-implant: A randomized double-blind protocol study. Medicine, 99(13), e19430. https://doi.org/10.1097/MD.0000000000019430.

Nadhreen, A. A., Alamoudi, N. M., Elkhodary, H. M. (2019). Low‑level Laser Therapy in Dentistry: Extra‑oral Applications. Nigerian Journal of Clinical Practice, 22(10), 1313-1318.

Paulos, R. S., Seino, P. Y., Fukushima, K. A., Marques, M. M., de Almeida, F. C. S., Ramalho, K. M., de Freitas, P. M., Brugnera, A Junior., Moreira, M. S. (2017). Effect of Nd:YAG and CO2 Laser Irradiation on Prevention of Enamel Demineralization in Orthodontics: In Vitro Study. Photomedicine and Laser Surgery, 35(5), 282-286. 10.1089/pho.2016.4235.

Qamruddin, I., Alam, M. K., Fida, M., Khan, A. G. (2016). Effect of a single dose of low-level laser therapy on spontaneous and chewing pain caused by elastomeric separators. American Journal of Orthodontics and Dentofacial Orthopedics, 149(1), 62-66.

1016/j.ajodo.2015.06.024.

Ren, K., Torres, R. (2009). Role of interleukin 1beta during pain and inflammation. Brain Research, 60(1), 57-64.

Ren, C., McGrath, C., Yang, Y. (2015). The effectiveness of low-level diode laser therapy on orthodontic pain management: a systematic review and meta-analysis. Lasers in medical science, 30(7), 1881-93. 10.1007/s10103-015-1743-4.

Shi, Q., Yang, S., Jia, F. and Xu, J. (2015). Does low level laser therapy relieve the pain caused by the placementof the orthodontic separators? – A meta – analysis. Head & Face Medicine 11:28.

Sobouti, F., Khatami, M., Chiniforush, N., Rakhshan, V., & Shariati, M. (2015). Effect of single-dose low-level helium-neon laser irradiation on orthodontic pain: a split-mouth single-blind placebo-controlled randomized clinical trial. Progress in orthodontics, 16, 32. https://doi.org/10.1186/s40510-015-0102-0.

Sousa, M. V., Pinzan, A., Consolaro, A., Henriques, J. F., de Freitas, M. R. (2014). Systematic Literature Review: Influence of Low-Level Laser on Orthodontic Movement and Pain Control in Humans. Photomedicine and Laser Surgery, 32(11), 592-9. 10.1089/pho.2014.3789.

Topolski, F., Moro, A., Correr, G. M., & Schimim, S. C. (2018). Optimal management of orthodontic pain. Journal of pain research, 11, 589–598. https://doi.org/10.2147/JPR.S127945.

Tripathi, T., Singh, N., Rai, P., & Khanna, N. (2019). Separation and pain perception of Elastomeric, Kesling and Kansal separators. Dental press journal of orthodontics, 24(2), 42–48. https://doi.org/10.1590/2177-6709.24.2.042-048.oar.

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Published

04/02/2022

How to Cite

ORTEGA, S. M.; GONÇALVES, M. L. L.; SCHALCH, T. O. .; SILVA, T.; GALLO, J. M. A. S. .; ALTAVISTA, O. M.; DEANA, A. M.; MOTTA, L. J. .; FERNANDES, K. P. S. .; MESQUITA-FERRARI, R. A.; BRUGNERA JÚNIOR, A. .; HORLIANA, A. C. R. T.; BUSSADORI, S. K. Analgesic effect of photobiomodulation after placement of elastomeric separators: randomized controlled clinical trial . Research, Society and Development, [S. l.], v. 11, n. 2, p. e50911225979, 2022. DOI: 10.33448/rsd-v11i2.25979. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/25979. Acesso em: 25 apr. 2024.

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Health Sciences