head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2019, vol. 25, issue1
Subject Area: Dental Medicine
DOI: 10.5272/jimab.2019251.2343
Published online: 30 January 2019

Case report

J of IMAB. 2019 Jan-Mar;25(1):2343-2348
Elitsa VenevaORCID logo Corresponding Autoremail, Ani BelchevaORCID logo,
Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University - Plovdiv, Bulgaria.

BACKGROUND: Pre-emptive laser analgesia (LA) is considered as bio-photomodulation of pulpal reactivity aiming reduction of nociceptive impulse formation and thus presenting a current non-pharmacological mean for painless conservative treatment. The aim of this investigation is efficacy approbation of a modified protocol for LA with Er:YAG laser.
CASE DESCRIPTION: A 12 y.o. female patient underwent two single-visit treatments, receiving LA and placebo analgesia (PA) prior to laser ablation of similar carious lesions in two permanent maxillary first molars bilaterally. Efficacy of analgesic protocol was assessed by following outcomes: primary – self-reported pain felt during treatment on VAS; secondary: changes in pulpal sensibility to electrical and cold-stimuli via EPT and Cold-test; pain-related behavior on FLACC-scale; pulse frequency. Subjective and objective pain evaluation revealed no pain during caries ablation after LA and little pain after PA. Pulp sensibility towards electrical and thermal stimulation decreased more significantly after LA induction.
DISCUSSION: Results suggest that Er:YAG therapy under applied parameters may be effective in achieving pulpal analgesia. The aforementioned tests could be valuable means for investigating the occurrence of any pulpal analgesic effect obtained by dental lasers.
CONCLUSION: Assessment of results of this case report should facilitate development of a laser analgesia protocol. The clinical adequacy of proposed protocol is to be separately estimated as part of a currently conducted double-blind randomized clinical trial with split-mouth design.

Keywords: laser analgesia, er:yag laser, low level laser therapy, laser dentistry, photobiomodulation, photomodulation, pulp testing,

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Please cite this article as: Veneva E, Belcheva A. Placebo-controlled subjective and objective evaluation of laser analgesia efficacy – a case report. J of IMAB. 2019 Jan-Mar;25(1):2343-2348. DOI: 10.5272/jimab.2019251.2343

Corresponding AutorCorrespondence to: Elitsa Veneva, Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University – Plovdiv; 3, Hristo Botev Blvd., Plovdiv, Bulgaria; E-mail: elitza.veneva@gmail.com

1. Walsh LJ. Laser Analgesia with Pulsed Infrared Lasers: Theory and Practice. J Oral Laser Appl. 2008; 8(1):7-16.
2. Orchardson R, Whitters CJ. Effect of HeNe and pulsed Nd:YAG laser irradiation on intradental nerve responses to mechanical stimulation of dentine. Lasers Surg Med. 2000;26(3):241-249. [Crossref]
3. Orchardson R, Peacock JM, John Whitters C. Effect of pulsed Nd:YAG laser radiation on action potential conduction in isolated mammalian spinal nerves. Lasers Surg Med. 1997;21(2):142-148.
4.  Chen E, Abbott PV. Dental pulp testing: a review. Int J Dent. 2009;2009:365785. [PubMed] [Crossref]
5. Bender I. Pulpal Pain Diagnosis--a review. J Endod. 2000 Mar;26(3):175-9. [PubMed] [Crossref]
6. Abd-Elmeguid A, Yu DC. Dental pulp neurophysiology: part 1. Clinical and diagnostic implications. J Can Dent Assoc. 2009 Feb;75(1):55-9. [PubMed]
7. Walsh LJ. Technical brief: Laser analgesia with the Er:YAG laser. 1990:1-11.
8. Genovese MD, Olivi G. Laser in paediatric dentistry: patient acceptance of hard and soft tissue therapy. Eur J Paediatr Dent. 2008 Mar;9(1):13-7. [PubMed]
9. Poli R, Parker S. Achieving Dental Analgesia with the Erbium Chromium Yttrium Scandium Gallium Garnet Laser (2780 nm): A Protocol for Painless Conservative Treatment. Photomed Laser Surg. 2015 Jul;33(7):364-71. [PubMed] [Crossref]
10. Fulop AM, Dhimmer S, Deluca JR, Johanson DD, Lenz RV, Patel KB, et al. A Meta-analysis of the Efficacy of Laser Phototherapy on Pain Relief. Clin J Pain. 2010 Oct;26(8):729-36.. [PubMed] [Crossref]
11. Whitters CJ, Hall A, Creanor SL, Moseley H, Gilmour WH, Strang R, et al. A clinical study of pulsed Nd: YAG laser-induced pulpal analgesia. J Dent. 1995 Jun;23(3):145-50. [PubMed] [Crossref]
12.  Chan A, Punnia-Moorthy A, Armati P. Low-power pulsed Nd:YAG laser irradiation for pre-emptive anaesthesia: A morphological and histological study. Laser Ther. 2014 Dec;23(4):255-62. [PubMed] [Crossref]
13. Gopikrishna V, Pradeep G, Venkateshbabu N. Assessment of pulp vitality: a review. Int J Paediatr Dent. 2009 Jan;19(1):3-15. [PubMed] [Crossref]
14. Trowbridge HO, Franks M, Korostoff E, Emling R. Sensory response to thermal stimulation in human teeth. J Endod. 1980 Jan;6(1):405-12. [PubMed] [Crossref]
15. Veneva E, Raycheva R, Belcheva A. Efficacy of erbium-doped yttrium aluminium garnet for achieving pre-emptive dental laser analgesia in children: A study protocol for a randomized clinical trial. Medicine (Baltimore). 2018 Dec;97(51):e13601.[PubMed] [Crossref]..

Received: 10 September 2018
Published online: 30 January 2019

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