Evaluation of Postoperative Pain in Periodontal Flap Surgery with and without Photobiomodulation using Diode LASER: A Split-mouth Randomised Controlled Study
ZC68-ZC72
Correspondence
Neeraj Chandrahas Deshpande,
Room No. 7, Department of Periodontology, K.M. Shah Dental College and Hospital, Piparia, Waghodia, Vadodara-391760, Gujarat, India.
E-mail: drneeraj78@gmail.com
Introduction: Flap surgery is used to treat deep periodontal pockets and recent innovations like Low-level LASER Therapy (LLLT), or Photobiomodulation (PBM), help reduce postsurgical pain. LLLT works by emitting red or infrared light at wavelengths between 660 and 940 nm, which penetrates tissues and interacts with cytochrome c oxidase to modulate immune responses, reduce inflammation and ease pain, promoting faster healing.
Aim: To evaluate and compare postoperative pain in periodontal flap surgery with and without PBM using a diode laser.
Materials and Methods: A split-mouth randomised controlled study was carried out in the Department of Periodontology at KM Shah Dental College and Hospital, Vadodara, Gujarat, India. The study took place from August 2023 to January 2024. Based on the inclusion and exclusion criteria, 14 participants (28 sites) with bilateral pocket probing depths of 5-7 mm diagnosed with generalised periodontitis stage II grade A were treated with open flap debridement. After open flap debridement, the test group (Group A) received PBM using a diode LASER (940 nm in a continuous mode with 0.5 W for 112 seconds) applied with a whitening handpiece at a 3 mm distance to the flap surfaces, whereas the contralateral arch, or control group (Group B), received no LASER treatment. The parameters assessed for postoperative pain following flap surgery included the Visual Analogue Scale (VAS) to track the patients’ pain levels and the amount of analgesics they took throughout the first week following surgery. For inter group comparison of the amount of analgesics taken and assessing the VAS score, the Mann-Whitney U test was used. Data analysis was done using IBM Statistical Package for Social Sciences (SPSS) Statistics 20.0 (IBM Corporation, Armonk, NY, USA), with the level of significance set at p=0.05.
Results: The mean age of the participants was 41.14±2.95 years. Patients in the test group had statistically significant differences in their VAS scores from the day of surgery (day 0) to day 7 compared to the control group. The number of analgesics taken on day 1 postsurgery did not show statistically significant results, as the number of analgesics taken was similar in both the control group as well as LASER group (p-value 0.063). However, patients receiving LASER treatment used fewer analgesics on days 2, 3, 4, 5 and 6 than the control group, with a p-value of less than 0.05, indicating statistically significant findings in this regard.
Conclusion: Based on the present study’s findings, it can be concluded that the 940 nm diode LASER has the potential to greatly minimise postoperative discomfort and reduce the quantity of analgesics that patients require following flap surgery.