Effectiveness of Laser photobiomodulation using confluence of two wavelength photons in inhibiting pain and enhancing extraction wound healing compared to sham Laser in 6 to 25 year old individuals: A double blind randomized controlled trial

Local anesthesia is pivotal in inhibiting pain during dental procedures, yet the pain induced by needle insertion often leads to non-compliance in the children, apprehension in the adolescents and young adults. Traditional approaches like topical local anesthetics, cryo-anesthesia, and acupressure may not adequately alleviate pain or promote optimal wound healing, necessitating the exploration of alternative strategies. Laser photobiomodulation (PBM) therapy is non-invasive and effective in enhancing the tissue regeneration and wound healing. It also decreases the pain and edema through anti-inflammatory effect. Harnessing the therapeutic potential of confluent use of red and near infrared spectrum laser PBM is least researched. Hence, this study is designed to evaluate the effectiveness of laser PBM using confluence of 640nm and 810nm wavelength photons in inhibiting pain and enhancing extraction wound healing in 6 to 25 year old individuals. It is a split mouth double blind randomized controlled trial. Thirty participants each, in the age groups of 6-12 years, 12-18 years and 18-25 years fulfilling the inclusion and exclusion criteria will be enrolled in to the study after parental consent and participant’s consent/assent. The allocation of the side and test or control sub-group will be done with lottery method, followed by allocation concealment for blinding purpose. The test side will receive confluent laser PMB of 640nm and 810nm (100mW 640nm + 100mW of 810nm) using continuous wave in contact mode for 60 seconds (The energy delivered will be 12J) at the injection site before inferior alveolar nerve block (IANB) anesthesia and the control side will receive sham laser. Similarly, the test side will receive confluent laser PBM after extraction of mandibular tooth at 3 to 4 points with same Laser parameters in non-contact mode and the control side will receive sham laser after tooth extraction. The pain of injection will be evaluated by Wong-Baker faces pain rating scale and Face, Legs, Activity, Cry, Consolability (FLACC) scale. The pulse rate will be evaluated before during and after the IANB anesthesia as biological indicator. The postoperative pain will be evaluated by Wong-Baker faces pain rating scale and healing of extraction wound by Healing index of Landry, Turnbull and Howley in the follow-up visits at 3, 7 and 15 days. The data will be complied and analyzed using appropriate statistical tests. The confluent laser PBM is expected to be effective in pain control and enhancing extraction wound healing.