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Seyyedi, et al.: Effect of photobiomodulation on postoperative endodontic pain
One of the most well‑known complications of medicines and postoperative analgesics. The
[15]
endodontic treatment is postoperative pain. Not only pharmaceutical remedies include the prescription
does it bring distress to patients but also it can lead to of nonsteroidal anti‑inflammatory drugs (NSAIDs),
visiting emergency rooms. Pain symptomatology may acetaminophen, antihistamines, steroidal
exist in around 40% of the instances after endodontic anti‑inflammatory drugs, long‑lasting anesthesia,
treatment, regardless of the instrumentation approach narcotic analgesics, and intracanal medicine. [15,19‑21]
utilized. [2,3] This may also influence patients’ lifestyles Nonpharmacological techniques contain protocols
[22]
after endodontic treatment. [4,5] One of the predominant for decreasing nervousness, laser treatment, and
reasons for behavioral changes is odontogenic cryotherapy. [23]
pain because it impacts the mood and capability of Photobiomodulation (PMB) is commonly used in
performing daily routines, for example, working, clinical practice and is defined by various parameters:
doing household chores, sleeping, eating, and even (1) Laser power (10 – 10 W); (2) wavelength
‑3
‑1
speaking. [6‑8] The pain following endodontic treatment (300–10,600 nm); (3) pulse rate (0–5000 Hz); (4)
can be classified into two specific groups: Common intensity (10 – 10 J/cm ); and (5) electromagnetic
‑2
2
2
postoperative pain and flare‑up. Flare‑up can be seen spectrum (630–980 nm from visible red to nearly
as swelling and/or torment within a couple of hours visible red). The use of PMB has been shown to be
or days after treatment, which is often more severe effective in pain relief, wounds, and nerve damage.
[24]
than the common postoperative pain. Due to its ability to facilitate wound healing, function
The postoperative pain due to root canal treatment in root canal disinfection, pain relief, and the lack
is associated with an inflammatory reaction of adverse events, PMB was applied to endodontic
within periapical tissues. This reaction activates therapy. [25,26] Although the basic components of pain
[9]
nociceptors through inflammatory mediators, for reduction through PMB have not been completely
example, serotonin, bradykinin, leukotrienes, and understood, theories have hypothesized that PMB
prostaglandins, resulting in pain after the procedure. may diminish pain through biochemical components
Chemical, mechanical, and microbial elements are based on increased adenosine triphosphates (ATPs)
the main links to periapical inflammation following and decreased oxidative stress. The generally
the root canal treatment, indeed, when the root canal accepted mechanism of action is that absorbed light
preparation does not surpass the apical foramen from the laser on the target tissue creates reactive
throughout the treatment. Extrusion of tooth debris, oxygen species which leads to gene transcription and
cellular healing. Mitochondria are very receptive to
intracanal medicaments, root canal irrigation solutions, this process and the near‑infrared light is absorbed
and microorganisms may still happen, accompanied and the energy is converted into ATP for cellular
by sudden inflammation and pain. [10,11]
functions. [27,28]
Research must evaluate the factors mediating Reducing pain after endodontic treatment has
postoperative pain after root canal treatment. invariably been a popular area of research. [15‑18,29]
Preoperative pain is extensively recommended to be Nonetheless, just a few papers have systematically
linked significantly to postoperative pain severity. Law reviewed the impacts of PMB on postoperative
et al. showed that pain interfered with daily activities endodontic pain. Thus, this review aimed to
[30]
and intensified by tension. A diagnosis of symptomatic perform a complete evaluation of the impact of PMB
apical periodontitis can be considered an independent on postoperative endodontic pain.
risk factor for postoperative pain severity. [12‑14] The
frequency and severity of postoperative pain can be MATERIALS AND METHODS
influenced by distinct instrumentation strategies for
root canal preparation, for example, reducing the The PRISMA checklist was used as a guideline to
occlusion, working length determination methods, perform this comprehensive review. [18]
cold lateral compaction irrigation system, and
shuttering procedures. [15‑18] Eligibility criteria
The inclusion criteria consisted of the following:
Many treatment procedures have been suggested Studies assessing the effectiveness of lasers in
to control postendodontic pain; most of them are relieving postendodontic pain, randomized clinical
pharmaceutical remedies, prescribed as prophylactic trials (RCTs), or controlled clinical trials, and

2 Dental Research Journal / 2024