Comparative Analysis of Laser-Activated and Ultrasonic Irrigation on Postoperative Pain in Root Canal Therapy: A Systematic Review

To compare the efficacy of laser-activated irrigation (LAI) and ultrasonic irrigation (UI) in reducing postoperative pain during root canal therapy (RCT). A systematic review was conducted using eight randomized controlled trials published between 2010 and 2025. Studies included evaluated LAI and UI techniques, focusing on postoperative pain reduction, pain intensity measured using the Visual Analog Scale (VAS), and analgesic intake. Comparisons with conventional needle irrigation (CNI) were also included. Statistical analyses of pain scores and analgesic consumption were reviewed. Both LAI and UI demonstrated significant reductions in postoperative pain compared to CNI. LAI was more effective in reducing pain in the first 6-12 h postoperatively, attributed to its superior irrigant penetration and photoacoustic streaming capabilities. UI also showed significant pain reduction, particularly in terms of debris removal and biofilm disruption, with pain scores converging with LAI by 24-48 h. Analgesic intake was lower in LAI patients during the immediate postoperative period. No adverse effects were reported with either technique. LAI and UI are effective irrigation activation techniques for minimizing postoperative pain in RCT, with LAI providing faster initial pain relief. These advanced techniques enhance patient outcomes and offer superior clinical efficacy compared to conventional methods. Further research is recommended to optimize their clinical application.