Preemptive photobiomodulation therapy for reducing pain during local anesthetic needle puncture in dental and craniomaxillofacial procedures: a systematic review and meta-analysis of randomized clinical trials
Nascimento MFDS, Almeida JES, Gomes MCM, Costa LSD, Silva PGB, Damasceno JX, Verde MEQL
Journal of dentistry · 0 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2026-06-07 · J Dent · vol. 173 · p. 106823
- Publisher
- Elsevier BV
- Cited
- 0 citations · more than 38% of similar papers · 0.0× the field average
- References
- 37 works
- Access
- Paywalled
- Research areas
- Laser Applications in Dentistry and Medicine · Dental Anxiety and Anesthesia Techniques · Oral health in cancer treatment
- Keywords
- Confidence interval, Randomized controlled trial, Local anesthetic, FLACC scale, Anesthetic, Meta-analysis, Relative risk, Clinical trial, Local anesthesia
- MeSH
- humans, pain, anesthetics, local, pain measurement, punctures, anesthesia, local, anesthesia, dental, needles, randomized controlled trials as topic, pain management, low-level light therapy, procedural pain
7 authors
From BR
- Maria Fernanda da Silva NascimentoUnichristus
- João Emanuel Sousa de AlmeidaUnichristus
- Maria Clara Mendes GomesUnichristus
- Lucas Santos da CostaUnichristus
- Paulo Goberlânio de Barros SilvaUnichristus
- Juliana Ximenes Damasceno · correspondingUnichristus
Abstract
Objectives
To evaluate the effectiveness of preemptive photobiomodulation therapy (PBMT) in reducing pain during local anesthetic needle puncture in dental and craniomaxillofacial procedures.
Data sources
A systematic search of electronic databases was conducted through November 2025 in accordance with PRISMA 2020 guidelines. Review protocol was registered in PROSPERO (CRD42025641468).
Study selection/results
Randomized controlled clinical trials comparing PBMT with placebo, sham, topical anesthetic, or no intervention were included. Twenty-seven studies (n = 1519 participants) met the eligibility criteria, and 25 were included in the meta-analysis. Random-effects meta-analyses with Hartung-Knapp adjustment and subgroup analyses (topical anesthetic use) were performed. Mean differences (MD) with 95% confidence intervals (CI) and prediction intervals were calculated. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE. Heterogeneity was evaluated using I² and between-study standard deviation (τ). PBMT significantly reduced pain scores measured by VAS (MD-1.72; CI -2.87 to -0.57), PRS (MD -0.89; CI -1.59 to -0.20), and FLACC (MD -1.14; CI-1.90 to -0.37) whereas SEM showed no significant effect (MD -0.56; CI -1.72 to 0.60). Substantial heterogeneity was observed (I² = 96.7%-98.9%; τ = 0.93-1.97). Most studies presented low risk or some concerns, mainly related to deviations from intended interventions, outcome measurement, and selective reporting. GRADE certainty was rated as very low across all outcomes.
Conclusions
PBMT may reduce pain during local anesthetic needle puncture. However, substantial heterogeneity, wide prediction intervals, and methodological limitations reduce confidence in the findings. Further standardized trials are needed to confirm efficacy and establish optimal parameters.
Clinical significance
Preemptive PBMT may represent a promising noninvasive adjunctive strategy to reduce pain during anesthetic needle puncture, potentially improving patient comfort and cooperation, particularly in anxious and pediatric individuals. However, the current evidence remains limited by substantial heterogeneity, methodological variability, and very low certainty of evidence, highlighting the need for standardized irradiation protocols and well-designed clinical trials before routine clinical implementation can be recommended.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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