Effect of photobiomodulation with low-level laser therapy in prevention orthodontic pain: Case reports

In clinical practice and research studies, there is almost a consensus that photobiomodulation therapy with low level laser causes analgesic effect. In this way, the laser can clinically contribute to postoperative pain management after the start of orthodontic treatment. Case Report: the following case reports demonstrate the application of photodynamic therapy in 2 cases immediately after the installation of the orthodontic appliance. The aim of low-level laser treatment would be to reduce possible postoperative pain. The diode laser was employed to irradiate maxillary teeth, immediately after installing an orthodontic appliance for traction. The painful sensitivity decurrent from this procedure was evaluated by a visual scale (Visual Analogue Scale – VAS) 4, 24, 72h and one week after the laser application. The diode laser with light emission at 808 nm wavelength was employed in 12 teeth, 4 points per tooth (2 bucally and 2 lingually, 20 seconds per point), resulting in the total energy was 8 J per tooth. The irradiation protocol were performed by only one operator, per points, employing light beam focused perpendicularly and in contact with the mucosa, which was kept clean and dry, through relative isolation. It appears that there are still few studies which investigated the effects of low level laser for suppressing pain in orthodontics, and the protocols for laser application are still very variable. The evaluated patients showed a low incidence of pain shortly after 24 hours after the installation of the orthodontic appliance. Based on the cases reports, it was observed that laser diode irradiation 808 nm wave- length, energy density 8 J per tooth, was enough to decrease pain, due to installation of the orthodontic appliance. Thus, additional studies are necessary in order to check the best application protocol.