Applicability of photobiomodulation and antimicrobial photodynamic therapy for pain management after endodontic treatment: a randomized clinical trial

Aim: To evaluate the use of photobiomodulation (PBM), alone or combined with antimicrobial photodynamic therapy (aPDT), for pain management after endodontic treatment.

Methodology: Randomized parallel-group superiority trial. The allocation sequence was generated using an online true random number generator. To ensure blinding, participants were informed about the study and the devices that would be used, but not about group allocation. Ninety mandibular molars diagnosed with symptomatic irreversible pulpitis were selected and randomly divided into three groups (n=30): Group 1, control (CT); Group 2, photobiomodulation (PBM); and Group 3, PBM + aPDT. All canals were instrumented by the Reciproc system in a single visit. The incidence and intensity of pain were evaluated before and 6, 12, 24, and 48 hours after endodontic treatment, using a visual analogue scale (VAS). The results were analysed using the Kruskal–Wallis test followed by Dunn’s test.

Results: The combination of PBM and aPDT after conventional endodontic treatment resulted in a significant reduction in pain compared to conventional endodontic treatment alone or followed by PBM alone (p<0.05). Preoperative pain was significantly greater than pain at 6, 12, 24, and 48 hours after endodontic treatment (p<0.05) in all groups. There were no adverse effects attributable to low-level light therapy in any participants.

Conclusion: Our findings suggest that the combination of photobiomodulation and photodynamic therapy is a promising alternative for this purpose.