Photobiomodulation and Pain Reduction in Patients Requiring Orthodontic Band Application: Randomized Clinical Trial

Abstract

Purpose. The aim of this study was to investigate the effect of Photobiomodulation (PBM) in managing orthodontic pain intensity over time in patients requiring band application on upper first molars. Methods. Maxillary first molars were banded. In the trial group, each molar received single-session PBM on two buccal and two palatal points (λ=830±10 nm; 150 mW, 7.5 J/cm2; spot of 0.1 cm2; 5 sec per point), while the control group received a placebo treatment. All patients were asked to answer five pain rating scales to assess pain intensity at 5 minutes and 1, 12, 24, and 72 hours and completed a survey describing the type of pain and its temporal course in the next 7 days. Results. 26 patients (mean age 11.8 years) were randomly assigned to a control or a trial group. The trial group showed significantly lower pain intensities (p<0.05) at 5 min (M=0.92, SD=1.32), 1 h (M=0.77, SD=1.01), and 12 h (M=0.77, SD=1.54) after band application compared to the control group (5 min: M=1.62, SD=1.26; 1 h: M=1.77, SD=1.92; and 12 h: M=1.77, SD=2.17), whereas no difference between groups (p>0.05) was found at 24 h (trial: M=0.62, SD=1.71; control: M=1.08, SD=1.75) and 72 h (trial: M=0.31, SD=0.75; control: M=0.15, SD=0.55). Patients in the control group reported more frequently the presence of “compressive pain” (58.8%, p<0.05) from the appliance during the week after the application, while the trial group showed higher frequency of “no pain” (46.2%, p<0.05). However, PBM did not affect the pain onset (trial: M=10.86, SD=26.97; control: M=5.25, SD=7.86), peak (trial: M=15.86, SD=26.29; control: 6.17, SD=7.96), and end time (trial: 39.57, SD=31.33; control: M=22.02, SD=25.42) reported by the two groups (p>0.05). Conclusions. PBM might be considered a promising alternative to decrease general pain intensity, although not affecting the typical pain cycle, in terms of the onset, peak, and ending times.