Comparison of Diode Laser Photobiomodulation and Ibuprofen for Postoperative Pain after Endodontic Treatment: A Randomized Controlled Trial

Abstract

Background: Postoperative pain is a common complication following endodontic treatment, particularly in teeth diagnosed with symptomatic irreversible pulpitis. While ibuprofen is routinely prescribed for pain control, Photobiomodulation (PBM) therapy has emerged as a potential non-pharmacological alternative with analgesic and anti-inflammatory effects. Methods: This randomized controlled clinical trial was carried out at Fatima Jinnah Dental College and Hospital, from January 2024 till June 2024. Sixty patients aged 18–65 years diagnosed with symptomatic irreversible pulpitis in mandibular molars were randomly allocated into two groups (n=30 each). Group A received ibuprofen 600 mg postoperatively, while Group B received Photobiomodulation therapy using a 635-nm diode laser (LASOTRONIX). Postoperative pain was assessed at 24 and 72 hours using the Numerical Rating Scale (NRS) and Verbal Rating Scale (VRS). Rescue analgesic (paracetamol 500 mg) consumption was documented as a secondary outcome. Data were analyzed using non-parametric statistical tests, with significance set at p < 0.05. Results: Baseline demographic and Preoperative Pain characteristics were comparable between the groups (median baseline NRS: 6 [IQR 5–7]; p > 0.05). The PBM group reported significantly lower pain scores than the ibuprofen group at both 24 and 72 hours postoperatively on both NRS and VRS scales (p < 0.001). At 24 hours, the median NRS score was 1.0 in the PBM group compared to 2.0 in the ibuprofen group. At 72 hours, the median NRS score was 0.0 for the PBM group and 1.0 for the ibuprofen group. Similar trends were observed for VRS scores. Conclusion: Photobiomodulation therapy demonstrated significant reduction in postoperative pain as compared to ibuprofen, suggesting its potential as an effective non-pharmacological alternative.