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.

Low-Level Laser Therapy for Management of Hypersensitivity in Molar-Incisor Hypomineralization and Oral Health-Related Quality of Life: Case Report.

The aim was to report the use low-level laser therapy (LLLT) in the management of hypersensitivity in an adolescent with molar incisor hypomineralization (MIH) and the impact of LLLT on his oral health-related quality of life (OHRQoL). Clinical examination revealed severe MIH with hypersensitivity, in all first permanent molars and incisors. The treatment proposed was desensitization with fluoride and esthetic rehabilitation of the affected teeth. Then, LLLT was applied perpendicularly in a continuous mode (wavelength of 808 nm, power of 100 mW, dose of 1 J, and fluence of 35 J/cm2). The visual analogue scale was applied each session of LLLT. The child perceptions questionnaire (CPQ11-14) was administered at the beginning and the end of the treatment. It was concluded that LLLT can be indicated in the management of hypersensitivity in an adolescent with severe MIH to control pain and to improve his OHRQoL.

[Prosthetic rehabilitation in ectodermal dysplasia. Case report]. / Prothetische Rehabilitation bei Ektodermaler Dysplasie. Ein Fallbericht.

The oral and dental rehabilitation of patients with ectodermal dysplasia is a demanding and complex process. Close cooperation of medical and dental specialists is is mandatory. The individual age related situation and aspects of social integration have to be considered, when doing treatment planning for these patients. A major problem is the highly reduced number of teeth, the impaired development of the jaws and the dysplastic alteration of the teeth. The prosthodontic rehabilitation of a young girl with the congenital disease of ectodermal dysplasia is presented and discussed.