Effect of Low Level Laser Therapy, Dex-amethasone, and Lornoxicam on Post-Operative Pain after Periapical surgery: A comparative clinical study

Waqass Thanoon,Omer Majid

doi:10.33899/rden.2014.89255

Abstract

To compare the effect of low level laser therapy ( LLLT), submucosal lornoxicam, and submucosal dexamethasone to control postoperative pain after periapical surgery of upper anterior teeth. Materials and Methods: This randomized, double- blind, controlled trial was performed on patients who required surgical endodontics of single upper anterior tooth under local anesthesia. A case form was used. Standardized surgical procedure was followed. Patients were categorized into 6 groups; LLLT, lornoxicam, LLLT+ lornoxicam , dexamethasone, placebo, and control groups. Measurements of pain were undertaken at days 1-7. Results: : Pain on Visual Analog Scale (VAS) also reached it's peak on 6 hours and faded away by day 7. With respect to pain (on VAS), dexamethasone treated group continued to be the best at all intervals (P<0.05) followed by LLLT+lornoxicam group, Placebo group, lornoxicam group, LLLT group, and control group in a descending order. There were significant differences for all treated groups on (6 hours) post operatively as compared with control group. Laser treated group showed significant reduction in pain at 6 hours, lornoxicam group showed significant reduction in pain at day 2 as compared with other tereated groups. Dexamethasone and placebo groups showed significant reduction in pain at day 3 as compared with other tereated groups. Up to the end of follow up period, no cases of wound infection were reported. No side effects of drugs and treatments used in the trial were demonstrated. Conclusion: Submucosal dexamethasone 4mg injection is an effective therapy for reducing postoperative pain after periapical surgery. The treatment offers a simple, safe, painless, noninvasive and cost therapeutic option for moderate and severe cases. LLLT and submucosal lornoxicam seem to have little effect in this regard and found to be associated with some discomfort and inconvenience in many cases.

Highlights

(2) It has been demonstrated that pain following periapical surgery tends to peak on the operational day, whereas swelling has been found to be most pronounced 1 to 2 days postoperatively. [3,4,5,6] Several studies have found that non prescriptive analgesics were sufficient to control postoperative pain after apicectomy. [4, 6,7,8] some have suggested the use of steroids to minimize pain and swelling. [7,9] Dexamethasone is one of the most common corticosteroids in oral surgery
It allows parametric tests in statistics to be used as it Effect of LLLT, dexamethasone, and lornonxicam in periapical surgery
Objective assessment of pain by counting the number of rescue painkiller provided additional information to support the subjective measurements of pain . ( 16,17) Regarding pain, there were significant differences for all treated groups on (6 hours) post operatively as compared with control group except LLLT group

Summary

Introduction

Apicectomy is the excision of the apical portion of the tooth root and attached soft tissues during periradicular surgery. [1] The main goal is to perform a resection of the apical portion of the root of 3 mm, which reduces up to 93% of the lateral canals. [2] It has been demonstrated that pain following periapical surgery tends to peak on the operational day, whereas swelling has been found to be most pronounced 1 to 2 days postoperatively. [3,4,5,6] Several studies have found that non prescriptive analgesics were sufficient to control postoperative pain after apicectomy. [4, 6,7,8] some have suggested the use of steroids to minimize pain and swelling. [7,9] Dexamethasone is one of the most common corticosteroids in oral surgery. [7,9] Dexamethasone is one of the most common corticosteroids in oral surgery. [2] It has been demonstrated that pain following periapical surgery tends to peak on the operational day, whereas swelling has been found to be most pronounced 1 to 2 days postoperatively. A significant pain-reducing effect of prophylactic oral lornoxicam has been shown in minor surgery by Hein et al [12] Another method to minimize pain is the use LLLT. [13] Many studies investigating the potential of LLLT in reducing postoperative sequelae after impacted third molar removal revealed non uniform results. LLLT was used to reduce the postoperative pain level after periapical surgery. [13]

Methods

Results

Conclusion