University of Minnesota
This randomized, double-blind controlled clinical trial will evaluate whether adjunctive photobiomodulation improves recovery after nonsurgical root canal treatment in adults with teeth diagnosed with symptomatic apical periodontitis. Participants will receive standard nonsurgical root canal treatment and will be randomized to adjunctive photobiomodulation using the Fotona LightWalker Nd:YAG laser or to an identical simulated laser procedure without laser energy delivery. The study will evaluate mechanical allodynia using maximum occlusal force measurements comparing the treated tooth with the contralateral asymptomatic tooth. Postoperative pain will also be assessed using the Numeric Rating Scale after percussion testing.
Postoperative pain and mechanical allodynia are common concerns after nonsurgical root canal treatment, particularly in teeth diagnosed with symptomatic apical periodontitis. Mechanical allodynia may reduce functional biting capacity and contribute to discomfort even after endodontic treatment. Photobiomodulation is a noninvasive therapeutic approach using low-level laser energy to stimulate cellular responses without producing thermal tissue damage. It has been studied for analgesic and anti-inflammatory effects, but prior endodontic studies have mainly relied on subjective pain measures. Th…
Inclusion Criteria: * Adults 18 years of age or older * Able to understand the study procedures and provide written informed consent * Presenting for primary nonsurgical root canal treatment at the University of Minnesota School of Dentistry Graduate Endodontic Clinic * A tooth diagnosed with symptomatic apical periodontitis * A pulpal diagnosis of symptomatic irreversible pulpitis or pulp necrosis * Study tooth is restorable and appropriate for completion of nonsurgical root canal treatment in a single visit * Presence of a functional opposing tooth suitable for reproducible maximum occlusal…
Adjunctive photobiomodulation will be delivered using the Fotona LightWalker laser system in Nd:YAG mode immediately after completion of nonsurgical root canal treatment and obturation. The laser will be applied intraorally over the mucosa corresponding to the periapical region using a standardized protocol.
The sham procedure will simulate photobiomodulation treatment. The laser handpiece will be positioned in the same manner and all aspects of the laser procedure will be replicated, but laser energy will not be delivered. Protective eyewear or a visual barrier will be used to maintain participant blinding.
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