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Seyyedi, et al.: Effect of photobiomodulation on postoperative endodontic pain
discuss permanent cell membrane loss, usually in systems and thereby suggested that sex hormones
conjunction with direct heat. The diode laser affect pain tolerance and threshold. This literature
[48]
applies a photothermal impact on the bacteria and a disparity can be clarified because women show a
photo‑disruptive impact on the unreachable bacteria. [49] higher incidence of pain than men. Nevertheless,
[56]
[17]
Gutknecht et al. showed that diode laser light could the inference of Lopes et al. could be inaccurate
[50]
penetrate the dentin by up to >1000 μm. Therefore, it since it relies on the pain stimulus. Women appear to
can be an efficient way to clean the root canals along experience more pain than men in brief and intense
with traditional biomechanical procedures, penetrating stimuli, but it has been found that they feel greater
areas that were previously unattainable. In addition pain adaptation to persistent painful stimuli. [57]
to traditional methods of cleaning and forming, the Photobiomodulation in comparison with
application of appropriate wavelengths can efficiently nonsteroidal anti‑inflammatory drugs
sterilize the dentin, root canals, and periapical areas This research suggests that pain substantially
and reduce bacterial recolonization. Therefore, based decreased postoperatively in all treatment groups.
on Morsy et al.’s study, it can be inferred that the Ibuprofen demonstrated significant pain relief at
[31]
980‑nm diode laser may be utilized as an alternative 4–8‑h intervals compared to the control group. In this
to traditional endodontic therapy. research, a prophylactic dose of 400 mg was used.
[18]
Age and gender These findings are consistent with those of Dionne
[59]
[58]
In six studies, [16‑18,28,31,33] there was no significant and Cooper Lately, Arslan et al. also found that
relationship between the age of the patient and ibuprofen is more efficient in postendodontic pain
postoperative pain. This observation supports the reduction at a 6‑h interval. Prophylactic ibuprofen
results of studies by Ng et al. and Polycarpou et al. administration before RCT (Root canal therapy)
[52]
[51]
However, these studies disagree with Ali et al., who blocks the Cox pathway, and the sense of pain can be
[53]
believed that in older age groups, postoperative pain blocked by this procedure. [18]
would be more severe in comparison with younger In addition, using a placebo as a control, one of
ones. Ali et al. categorized patients into two groups the included studies also assessed the discrepancies
[53]
and found that postoperative pain was higher in the between the effectiveness of PMB and ibuprofen, a
older age group (41–65 years old) than the younger type of NSAID. In this analysis, PMB indicated
[18]
age group (15–40 years old). In Arslan’s study, significant effectiveness in pain control at intervals of
[15]
the age range was 18–46 years, which may explain 4–8 h and showed a significant pain intensity reduction
the differences between study results. The simple after RCT (Root canal therapy) at 12‑, 24‑, and 48‑h
randomization technique used in this study resulted in intervals compared to the ibuprofen group. PMB
an unequal distribution of age among the groups, and paired with preoperative NSAIDs led to a greater pain
the difference was statistically significant. However, reduction than using NSAIDs or PMB alone. NSAIDs
the mean age of the patients in the two groups was are commonly used in pain management after
25.76 and 32.62 years; this category is typically endodontic treatment, relieving pain by decreasing
considered one group. Therefore, this age difference chemical inflammatory mediators in peripheral
does not have any clinical significance. nociceptors and thus triggering the associated

Although some studies concluded that postoperative subsequent events. In addition, NSAIDs are noted
[60]
pain in females was more prevalent than in males, [20‑23] for their side effects, i.e., wound healing delay, which
five studies have concluded that sex did not have a is undesirable for restoring postendodontic tissues.
[61]
significant effect. [15,16,18,31,41] Also, in Lopes’s study, PMB has a significant effect, along with the ability to
[17]
stratifying by sex showed that differences between mediate tissue repair; it could be an alternative to the
genders persisted after 24 h. traditional treatment choice based on NSAIDs in pain
control after RCT (Root canal therapy). [44]
In a clinical study, Ostrom et al. showed that
[54]
women had higher sensitivity to pain than men, Of the nine studies included in the systematic analysis,
measured as follows: Sensitivity to pressure and seven studies [15‑18,28,31,33] indicated that PMB could
mechanical and thermal pain. Wiesenfeld‑Hallin, efficiently alleviate postoperative endodontic pain, and
[55]
however, attributed the difference in sensitivity two studies did not indicate it. [32,34] Ramalho suggested
between men and women to the innate biological a high standard deviation in the results since pain

8 Dental Research Journal / 2024