Postoperative pain after emergency pulpectomy with or without photobiomodulation in symptomatic irreversible pulpitis A randomized clinical trial

To evaluate postoperative pain following emergency pulpectomy in permanent teeth diagnosed with symptomatic irreversible pulpitis and to compare outcomes with or without adjunctive low-level laser therapy (LLLT). This parallel, randomized, single-blind clinical trial included 70 patients with permanent teeth diagnosed with symptomatic irreversible pulpitis. Patients were randomly assigned to two groups (n = 35 each): the experimental group received gallium-aluminum-arsenide laser therapy (808 nm, 100 mW), while the control group received no laser intervention. Postoperative pain was assessed using the Numerical Rating Scale (NRS-10) and the Visual Analogue Scale (VAS). Bite sensitivity was evaluated before and after emergency treatment. Demographic characteristics and analgesic intake were recorded. The primary outcome was postoperative spontaneous pain assessed at multiple time points. Secondary outcomes included bite sensitivity and analgesic intake. Time-dependent reductions in postoperative pain were observed in both groups. Inter-group comparisons showed statistically significant differences at isolated time points (12 and 24 h), with higher pain scores in the experimental group; however, these differences did not translate into a significant overall treatment effect. Longitudinal analysis accounting for repeated measures demonstrated a significant effect of time (p = 0.001), while treatment group was not a significant determinant of postoperative pain. Effect estimates are presented with 95% confidence intervals. Within the limitations of this pragmatic emergency-care study, adjunctive low-level laser therapy was not associated with a reduction in postoperative pain in permanent teeth with symptomatic irreversible pulpitis.