A systematic review and meta-analysis on the effects of phototherapy on postoperative pain in conventional endodontic reintervention.

Abstract

This systematic review and meta-analysis (SRM) aimed to evaluate the efficacy of laser phototherapy (LPT) on the reduction in postoperative pain (PP) of endodontic origin after conventional/non-surgical reintervention of root canals. This SRM was registered with PROSPERO (CRD42021243500) and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Meta-analysis was conducted using R software with the "META" package, the mean difference (MD) measure of effect was calculated, and the fixed effect model was applied with a 95% confidence interval (CI). The Cochrane collaboration scale was used to assess the risk of bias and the GRADE tool to assess the quality of evidence. Initially, 1028 articles were found, and five articles were included. Most studies were classified as "low" risk of bias. Of the five clinical studies, four showed a significant decrease in PP after endodontic reintervention in the LPT groups compared to the control group, especially in the first four days after the intervention. In symptomatic teeth with multiple roots, LPT led to less PP at 24h (MD -0.52 [-1.03; -0.02] p = .04). However, no significant difference between the groups was found at 48 and 72h (p > .05). The certainty of the evidence was classified as low. Despite the limitations of this SRM, LPT was shown to be a promising alternative for reducing and controlling PP in conventional endodontic reintervention. The use of LPT in endodontic reintervention may be a safe and promising alternative to clinically efficacious agent for use in the management of PP in this procedure.