Comparative assessment of the effectiveness of low-level laser therapy and chitosan in postoperative pain and bleeding management after primary molar extraction: A randomized clinical study.

Abstract

Background: Dental caries, the leading cause of dental pain and the most prevalent chronic childhood disease globally, significantly impacts children's oral health, with prevalence ranging from 16% to 92.2% in India. Untreated caries in deciduous teeth can lead to pain, dietary changes, sleep disturbances, and enamel defects in permanent teeth. Pediatric dentists manage infected pulp with pulp therapy or extraction. Postoperative complications, such as discomfort and bleeding, are common in extraction cases.

Aim: This study aims to compare the analgesic and hemostatic efficacy of chitosan and low-level laser therapy (LLLT) in pediatric extractions, hypothesizing no significant difference between the two.

Materials and methods: This crossover randomized clinical trial was carried out within 87 primary molars from 29 participants. The study participants were randomized into three distinct groups, each with a specific order of interventions: Group A first received the control, followed by laser, and then chitosan; Group B first underwent the laser intervention, followed by chitosan, and finally the control; and Group C first experienced the chitosan intervention, followed by the control, and then laser. After extraction of the primary molar, properly shaped gauze piece, a 940-nm wavelength diode laser (diode Epic, BioLase, USA) was used in a continuous mode with 400 um diameter fiber tip at an approximately 8 mm away from the teeth socket without contact until 1 min, chitosan Sponge of 7 mm was measured using a periodontal probe and was placed into the extraction socket, respectively. Statistical analyses were performed using SPSS version 23 (IBM), with a significance level set at 5%.

Results: The mean pain score was least for the LLLT group, followed by the Chitosan group and the maximum mean pain score was recorded for the control group and this difference was statistically significant, whereas there was no significant difference regarding the postoperative bleeding after 15 min between three groups. Chitosan was the intervention of choice for both the children and their guardians.

Conclusion: Soft-tissue diode lasers can be utilized for postoperative pain management subsequent to deciduous tooth extraction in children. This would reduce the reliance on analgesic medication and eliminate the possibility of adverse effects. Chitosan can serve as a highly effective, dependable, and cost-effective substitute in case of the diode laser's inaccessibility.