Abstract
To compare the effect of low level laser therapy ( LLLT), submucosal lornoxicam, and submucosal dexamethasone to control postoperative pain after periapical surgery of upper anterior teeth. Materials and Methods: This randomized, double- blind, controlled trial was performed on patients who required surgical endodontics of single upper anterior tooth under local anesthesia. A case form was used. Standardized surgical procedure was followed. Patients were categorized into 6 groups; LLLT, lornoxicam, LLLT+ lornoxicam , dexamethasone, placebo, and control groups. Measurements of pain were undertaken at days 1-7. Results: : Pain on Visual Analog Scale (VAS) also reached it's peak on 6 hours and faded away by day 7. With respect to pain (on VAS), dexamethasone treated group continued to be the best at all intervals (P<0.05) followed by LLLT+lornoxicam group, Placebo group, lornoxicam group, LLLT group, and control group in a descending order. There were significant differences for all treated groups on (6 hours) post operatively as compared with control group. Laser treated group showed significant reduction in pain at 6 hours, lornoxicam group showed significant reduction in pain at day 2 as compared with other tereated groups. Dexamethasone and placebo groups showed significant reduction in pain at day 3 as compared with other tereated groups. Up to the end of follow up period, no cases of wound infection were reported. No side effects of drugs and treatments used in the trial were demonstrated. Conclusion: Submucosal dexamethasone 4mg injection is an effective therapy 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 submucosal lornoxicam seem to have little effect in this regard and found to be associated with some discomfort and inconvenience in many cases.
