Effect of photobiomodulation on the efficacy of anesthesia in maxillary permanent molar teeth with molar incisor hypomineralization: A randomized clinical trial

BACKGROUND

Difficulty in anesthetizing teeth that have been diagnosed with molar incisor hypomineralization (MIH) is a frequently reported clinical problem. The effects of low-level laser application (photobiomodulation) on the efficacy of anesthesia during the dental treatment of patients with MIH have not yet been studied.

AIM

To assess the effects of photobiomodulation therapy (PBMT) on the efficacy of anesthesia in maxillary permanent molar teeth with MIH.

DESIGN

This prospective, parallel-arm control, randomized, triple-blind clinical trial included children aged 7-12 years. Maxillary permanent first molar teeth with MIH that required pulpotomy treatment were included. Seventy participants were randomly divided into two groups: experimental (with PBMT) and control (placebo). In the experimental group, before the administration of local infiltration anesthesia, PBMT (diode laser: 940 nm; continuous mode; 0.5 W; 78 J/cm2) was applied to the oral mucosa for 60 s each. In the control group, the laser probe was channeled toward the mucosa but was not activated. Pain scores were evaluated during the access cavity preparation of the pulpotomy treatment (when using the dentin cutting handpiece and while entering into the pulp) using the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Additional anesthesia requirements were assessed in both groups. The data obtained were analyzed for statistical significance (p < .05). The chi-squared test was used to determine the effect of PBMT on categorical outcomes.

RESULTS

The no-pain scores of the experimental group were higher than those of the control group (29% vs. 20%). Moderate-to-high pain was more frequent in the control group than in the experimental group (43% vs. 20%). While 31% of the experimental group required supplemental anesthesia, 49% of the control group required supplemental anesthesia during pulpotomy of the tooth with MIH. No statistical difference, however, was found between the two groups in terms of pain scores and the need for supplemental anesthesia (p = .235, p = .143).

CONCLUSIONS

Anesthesia with and without PBMT caused no difference in pain during the treatment of maxillary molar teeth with MIH.

Dental lead levels in children from two different urban and suburban areas of Turkey

The lead content of shed primary teeth has proved to be a reliable measure of cumulative lead exposure in children as it is an indicator of the degree of exposure over several years, from in utero life to loss of the tooth. Totally 297 shed deciduous teeth were collected from 263 children between ages 4 and 15 to determine the level of lead exposure in Ankara and Balikesir in Turkey. Ankara is the capital of Turkey and characterized by heavy traffic and high air pollution. On the other hand, Balikesir has less traffic. Balikesir-Centre (R) had the highest mean (SD) lead level (1.77+/-1.03microg/g) whereas Ankara-Centre (U) had the lowest level (1.30+/-0.59microg/g). We could not observe a statistically significant difference between urban and suburban regions (Table 1), and in terms of type of tooth, incisors had a statistically significant higher lead level than canines and molars (p<0.05, Table 2). No difference was observed between boys and girls and the accumulation of lead in teeth (p<0.05, ).