Pulsed Nd: YAG laser induces pulpal analgesia: a randomized clinical trial.
This double-blind, randomized, clinical trial investigated the effectiveness and underlying mechanism of neural inhibition of pulsed Nd:YAG laser induction of pulpal analgesia compared with 5% EMLA anesthetic cream. Forty-four paired premolars from 44 orthodontic patients requiring bilateral premolar extraction from either dental arch were randomly assigned to the 'Laser plus Sham-EMLA' or 'EMLA plus Sham-Laser' treatment group. Analgesia was tested by an Electric Pulp Tester (EPT) and the cutting of a standardized cavity, which was terminated when participants reported sensitivity, and Visual Analogue Scale (VAS) and numbness were recorded. Statistical analyses were done by paired t test, McNemar's test, and a chi-squared test (p < 0.05). Sixty-eight percent of laser- and 59% of EMLA-treated teeth had completed cavities with statistically significant EPT increases above baseline. No significant within-patient differences were found for either group. No laser-treated participants reported numbness. The trial confirmed that the pulsed Nd:YAG laser effectively induced pulpal analgesia, by suppression of intradental nerve responses to electrical and mechanical stimuli. Such a laser provides an alternative for dental pain management (ANZ-Clinical Trial Registry: N12611001099910).
Brain & Mind Research Institute, Nerve Research Foundation, Level 7, Building F, Brain and Mind Research Institute, the University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia. ambrose.chan@sydney.edu.au
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D000293:Adolescent; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D001641:Bicuspid / Q000294:innervation / Q000528:radiation effects; D003737:Dental Cavity Preparation / Q000295:instrumentation; D003782:Dental Pulp / Q000294:innervation / Q000528:radiation effects*; D003791:Dental Pulp Test / Q000295:instrumentation; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008012:Lidocaine / Q000008:administration & dosage; D000077442:Lidocaine, Prilocaine Drug Combination; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D009433:Neural Inhibition; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D011318:Prilocaine / Q000008:administration & dosage; D009435:Synaptic Transmission / Q000528:radiation effects; D014081:Tooth Extraction
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine