Effectiveness of phentolamine mesylate, vibration and photobiomodulation in reducing pain and the reversal of local anesthesia: A systematic review.

BACKGROUND: Dental anesthesia administration often triggers unpleasant sensations, particularly needle injection-related pain, which can evoke fear among patients, especially in the pediatric population. Vibration and low-level laser therapy (LLLT) have been extensively studied as potential methods for alleviating pain. Additionally, phentolamine mesylate (PM) has shown promise in reducing the duration of anesthesia. From a clinical perspective, inadequate control over the persistence of the anesthetic effect may lead to complications associated with its prolonged duration, such as self-injuries or functional impairments. OBJECTIVES: This review aimed to systematically summarize and compare methods of alleviating pain during local anesthesia and reducing its duration. MATERIAL AND METHODS: In November 2023, an electronic search was systematically conducted across PubMed, Web of Science, and Scopus databases using keywords (pain) AND (anesthesia) AND ((phentolamine) or (vibration) or (LLLT) OR (PBM)). The initial pool consisted of 495 records, from which 241 duplicates were eliminated. After careful examination of the remaining articles, 40 were included. The study adhered to the PRISMA guidelines. RESULTS: Most studies reported beneficial effects of LLLT and vibration; however, some did not corroborate these findings. Four studies had inconclusive results. Regarding anesthesia duration involving PM and LLLT, the majority of studies exhibited notable reductions, although no significant differences were revealed in 1 study. CONCLUSION: Vibration and LLLT appear to be advantageous methods in alleviating pain associated with local anesthesia administration. Phentolamine mesylate and LLLT are efficient in reversing local anesthesia.