The Effect of Single Versus Double Application of Photobiomodulation Therapy on Pain Reduction Caused by Orthodontic Elastomeric Separators: A Randomized Clinical Study.

Abstract

Background Periodontal ligament (PDL) pain, associated with the insertion of elastomeric separators, is one of the most annoying experiences at the beginning of orthodontic treatment. Photobiomodulation has recently been suggested as a method of controlling this pain.

Objectives The aim of this study was to evaluate the efficacy of photobiomodulation in controlling the pain caused by elastomeric separators and to compare a single irradiation dose 1 h before the insertion of elastomeric separators vs double irradiation, conducted 1 h before and immediately after the insertion, in terms of pain reduction.

Material and methods This randomized controlled trial was conducted at the Department of orthodontics at Bharti Vidyapeeth (Deemed to be university) Dental College and Hospital, Sangli. The sample population was comprised of 24 patients, aged between 12 and 25 years, and the patients were randomly divided into 2 groups. A split-mouth design was employed. One group received 1 dose of photobiomodulation 1 h before the insertion of elastomeric separators, whereas the other one received 2 doses of photobiomodulation 1 h before and immediately after the insertion of elastomeric separators. Eight points will be irradiated: mesial and distal of the first molar, distal of the second premolar, and mesial of the second molar, on both the buccal and lingual sides. A diode laser with a wavelength of 810 nm, an energy density of 6 J/cm2 and a power output of 300 mW will be used for an automated duration of 20 s per point. The pain levels were recorded using the Visual Analog Scale (VAS) after 1, 6, 24, 48, and 96 h. Student’s t-test and the repeated measures analysis of variance (ANOVA) were employed to detect significant differences.

Results Photobiomodulation significantly reduced post-separation pain when the experimental side was compared to the placebo side in the single-irradiation group (p 0.05).

Conclusions Photobiomodulation had a positive effect on reducing the pain associated with elastomeric separation, whether it was applied as a single dose before elastomeric separation or as a double dose before and after this procedure.