Effect of Low Level Laser Therapy, Dex-amethasone, and Lornoxicam on Post-Operative Pain after Periapical surgery: A comparative clinical study

Abstract

To compare the effect of low level laser therapy ( LLLT), submucosal lornoxicam, and submucosaldexamethasone to control postoperative pain after periapical surgery of upper anterior teeth.Materials and Methods: This randomized, double- blind, controlled trial was performed on patientswho required surgical endodontics of single upper anterior tooth under local anesthesia. A case formwas used. Standardized surgical procedure was followed. Patients were categorized into 6 groups;LLLT, lornoxicam, LLLT+ lornoxicam , dexamethasone, placebo, and control groups. Measurementsof pain were undertaken at days 1-7. Results: : Pain on Visual Analog Scale (VAS) also reached it'speak on 6 hours and faded away by day 7. With respect to pain (on VAS), dexamethasone treatedgroup continued to be the best at all intervals (P<0.05) followed by LLLT+lornoxicam group, Placebogroup, lornoxicam group, LLLT group, and control group in a descending order. There were significantdifferences for all treated groups on (6 hours) post operatively as compared with control group. Lasertreated group showed significant reduction in pain at 6 hours, lornoxicam group showed significantreduction in pain at day 2 as compared with other tereated groups. Dexamethasone and placebo groupsshowed significant reduction in pain at day 3 as compared with other tereated groups. Up to the end offollow up period, no cases of wound infection were reported. No side effects of drugs and treatmentsused in the trial were demonstrated. Conclusion: Submucosal dexamethasone 4mg injection is an effectivetherapy for reducing postoperative pain after periapical surgery. The treatment offers a simple,safe, painless, noninvasive and cost therapeutic option for moderate and severe cases. LLLT and submucosallornoxicam seem to have little effect in this regard and found to be associated with some discomfortand inconvenience in many cases.