Pulsed Nd:YAG versus continuous-wave laser photobiomodulation for orthodontic pain: a split-mouth RCT

Area of Science:

• Biomedical Engineering
• Dental Science
• Pain Management

Background:

• Local pain after orthodontic tooth movement impacts patient experience and compliance.
• Photobiomodulation therapy (PBMT) using pulsed lasers offers a potential solution for pain relief.

Purpose of the Study:

• To evaluate the analgesic efficacy of pulsed Nd:YAG laser at various frequencies for orthodontic pain.
• To determine optimal laser parameters for pain management during orthodontic treatment.

Main Methods:

• A randomized, double-blind, controlled trial involving 96 patients undergoing orthodontic treatment.
• Comparison of pulsed Nd:YAG laser (10, 15, 20 Hz) and continuous-wave semiconductor laser groups.
• Assessment of pain using digital pressure algometry (pressure-pain thresholds) and visual analogue scales (VAS).

Main Results:

• Pulsed Nd:YAG laser, particularly at 15 Hz, significantly increased pressure-pain thresholds compared to the semiconductor laser.
• The 15 Hz pulsed Nd:YAG group showed significantly lower VAS scores and shorter pain duration.
• All laser treatments resulted in higher pressure-pain thresholds and lower VAS scores on the treated side compared to the non-treated side.

Conclusions:

• Both pulsed Nd:YAG and continuous-wave semiconductor lasers effectively alleviate orthodontic pain.
• The 15 Hz pulsed Nd:YAG laser (at 60 J total energy) appears optimal for reducing tooth sensitivity and pain duration.
• Optimal laser parameters, such as 15 Hz frequency, 150 µs pulse duration, and 0.5 W power, warrant further investigation for orthodontic pain relief.