Comparative evaluation of the effectiveness of transcutaneous electric nerve stimulation and photobiostimulation using diode laser prior to local anesthesia administration in children undergoing bilateral orthodontic extraction- a randomized controlled clinical trial.

This study aimed to evaluate and compare the effectiveness of transcutaneous electric nerve stimulation (TENS) and photobiostimulation using diode LASER, prior to local anaesthesia administration in children undergoing bilateral orthodontic extractions. A split-mouth, parallel arm, Double blinded, randomized clinical trial was conducted on children (12 - 16 yrs) undergoing bilateral orthodontic extractions. Patients were randomly assigned to receive either TENS or PBST. Subjective and Objective parameters for anxiety and pain were assessed, and evaluated for statistical significance (p < 0.05). In this study with 104 patients (mean age 13.59), the TENS group showed significantly lower mean pain scores (WBPRS) for needle insertion (2.30 +/- 2.7) versus PBST (5.03 +/- 3.1, p < 0.01), LA administration (2.11 +/- 2.8 vs. 4.84 +/- 2.7, p < 0.01), and extraction (1.92 +/- 2.6 vs. 3.23 +/- 5.1, p < 0.01). TENS also led to a faster onset of local anesthesia (96.15 s +/- 13.9) compared to PBST (155.38 s +/- 91, p < 0.05), indicating enhanced efficacy for pain reduction and anesthesia speed. Physiological parameters like pulse rate and salivary pH also showed significant improvements with TENS. Hence TENS and PBST both came out as effective alternatives for topical anesthesia. Both TENS and PBST proved to be effective alternatives to topical anesthesia, TENS therapy with the Synapse Dental Pain Eraser (DPE) demonstrated greater effectiveness in reducing pain and anxiety, reflecting it as a promising option for pediatric patients. However further research is needed to refine and optimize pain management strategies using these alternatives in pediatric dentistry. CTRI Number- CTRI/2022/09/045460 [Registered on: 13/09/2022] Trial Registered Prospectively.