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Seyyedi, et al.: Effect of photobiomodulation on postoperative endodontic pain
fibers; they also prompt nociceptors and may enhance As with other fields (e.g., orthodontics), PMB has
neurogenic inflammation. The authors of this clinical been recognized as an efficient and noninvasive tool
trial observed that unintentional cement extravasation for managing pain in orthodontic patients. In addition,
into the periapical region were a high risk for PMB has been widely used to relieve pain in different
postoperative pain in both groups. In a systematic fields of dentistry. [29]
review of Rosen et al.’s case reports, the extrusion Laser parameters can have an impact on the pain
[41]
of obturating materials worsened postoperative outcome
pain induced by nerve cell damage as soon as the One of the factors preventing a quantitative study is
substances came into contact. They found out that the extensive heterogeneity of the laser parameters
in both groups, accidental extrusion of cement into among the covered studies, which may play a critical
the periapical area posed a high risk of postoperative role in the pain outcome. The outcome of PMB
pain. can be influenced by laser type, emission mode,
Nitzan et al. identified several instances such that energy density, energy output, wavelength, and laser
[42]
the extrusion of root canal filling material should exposure time. Except for three studies that failed to
be avoided as this event brings about inessential describe the exact type of laser used, all lasers used in
chemical and mechanical annoyance, hampering the included studies were diode laser, with one study
the regeneration of periapical tissues. As a result, describing it to be indium‑gallium‑aluminum diode
how endodontists carry out root canal therapy is a laser. [44]
really critical factor that can impact the severity of Over time, different laser types have been developed
postendodontic pain. and used in various dentistry fields. Diode lasers
[45]
Six out of nine articles reviewed in this study [16‑18,28,33,34] are the most commonly used among various lasers.
carried out single‑visit root canal therapy, two The 980‑nm diode laser active medium is a solid‑state
studies [15,31] performed two‑visit endodontic semiconductor made up of gallium, indium, and
treatments, and Ramalho et al. did an emergency arsenide. Lasers with diode have many benefits
[32]
endodontic treatment. The number of treatment such as extreme compactness, operation simplicity,
sessions may influence postoperative pain. Thus, this affordability, convenient setting‑up, flexibility, and
element should also be included in future studies. In small size. The wavelengths related to diode lasers
[46]
addition, some of the studies included in this review are highly soluble in melanin and hemoglobin and
used laser after root canal treatment, [16‑18,41] and some poorly absorbed in dental hard tissues. They are also
used it before root canal obturation [15,31,33,42] or during absorbed by water, providing the laser with the
[47]
endodontic emergency treatment. [32] benefit of acting selectively and accurately. [46]
PMB can decrease the amount of pain through Radiation of diode laser has some bactericidal impact
different biological pathways, as shown in Figure 2. [43] by modifying the bacterial cell wall. Microbiologists

Figure 2: Impact paths of photobiomodulation concerning pain.

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