LOW-LEVEL LASER THERAPY AND DENTAL INJECTION PAIN IN CHILDREN: A SYSTEMATIC REVIEW AND META-ANALYSIS

Area of Science:

• Dentistry
• Pain Management
• Biomedical Engineering

Background:

• Effective pain management is crucial for pediatric dental procedures, particularly during local anesthetic injections.
• Low-level laser therapy (LLLT), also known as photobiomodulation therapy (PBMT), is an emerging non-invasive technique explored for pain reduction.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) evaluating the efficacy of PBMT in reducing pain associated with local anesthetic injections in children.
• To assess the quality of evidence and identify specific parameters of PBMT that are most effective for pain relief.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Scopus, Cochrane Library, Embase, Web of Science) up to June 2024.
• Study quality was assessed using the Cochrane Risk of Bias Assessment Tool 2 (RoB2).
• Meta-analysis was performed using a random-effects model, with heterogeneity assessed using standard statistical measures. Publication bias was evaluated using funnel plots and Egger's test.

Main Results:

• Eight articles met the inclusion criteria, with six included in the meta-analysis.
• PBMT significantly reduced Wong-Baker pain scores in children compared to control groups (MD = -1.25, 95% CI: -2.43 to -0.07, P = .039).
• Subgroup analysis using 960 nm wavelength and a gel-inactive laser control demonstrated significant reductions in both Wong-Baker (MD = -1.30, 95% CI: -2.17 to -0.43, P < .001) and FLACC scores (MD = -1.06, 95% CI: -1.68 to -0.45, P < .001).

Conclusions:

• PBMT is an effective intervention for reducing pain during local anesthetic injections in pediatric patients.
• The use of PBMT at 960 nm wavelength, compared to a gel-inactive laser control, shows significant promise for pain reduction as measured by Wong-Baker and FLACC scales.