Effect of photobiomodulation on postoperative symptoms in teeth with asymptomatic apical periodontitis treated with foraminal enlargement: a randomized clinical trial.

Abstract

AIM\nTo assess the efficacy of photobiomodulation in reducing postoperative symptoms and use of analgesics in teeth with asymptomatic apical periodontitis treated with foraminal enlargement in a single visit.\n\n\nMETHODOLOGY\nThis prospective double-blind randomized controlled superiority clinical trial enrolled 70 patients requiring root canal treatment of one single-rooted tooth with asymptomatic apical periodontitis. The participants were randomized into one of the following two groups: 35 patients in control group (C.G) - root canal treatment with foraminal enlargement, without any additional treatment, and 35 patients in the photobiomodulation group (PBM.G) - root canal treatment with foraminal enlargement associated with photobiomodulation (antimicrobial photodynamic therapy and low-level laser therapy). The outcome variables were postoperative pain, tenderness, oedema, and the use of analgesics. Pain intensity was measured using a visual analogue scale (recorded every day for 7 days, then the 14th and 30th days after root canal treatment). Facial oedema was assessed subjectively by two independent evaluators using photographs taken by one of the researchers at 48 h, 72 h, and 7 days after the procedures. Data were tabulated and analyzed using the Mann-Whitney U, Chi-Square, Fisher`s Exact, Student T, and Ordinal Logistic Regression by Generalized Estimating Equations tests in SPSS software.\n\n\nRESULTS\nThere were no significant differences in postoperative pain and tenderness between the groups at any observation period (p > 0.05). Photobiomodulation (beta = -0.77 / p = 0.01), time (beta = -0.23 / p < 0.01), and male gender (beta = -1.20 / p < 0.01) were associated with decreased postoperative pain. Only time (beta: -0.10; p < 0.01) and male gender (beta: -1.04; p < 0.01) were associated with decreased tenderness. For oedema and use of analgesics, there was no difference between the groups (p > 0.05).\n\n\nCONCLUSIONS\nPhotobiomodulation had no significant effect on postoperative pain, tenderness, oedema and the use of analgesics after root canal treatment with foraminal enlargement, in single-rooted teeth treated in a single visit.