Non-Cochrane · intervention · PM41640722
Effect of photobiomodulation on pain perception during local anesthesia in children: a systematic review and meta-analysis.
Zanchetta Peron Fernanda, Ribeiro Mauro Cardoso, da Costa Vanessa Polina Pereira, et al. · Journal of dental anesthesia and pain medicine · 2026 · PubMed · doi:10.17245/jdapm.2026.26.1.1
Findings
7 findings
| Population | ||||
|---|---|---|---|---|
| Children and adolescents receiving dental local anesthesia | Photobiomodulation (low-level laser) before injection | Placebo (sham laser) | Pain perception (WBFPRS and FLACC combined) At needle insertion · Pediatric dental local anesthesia injection | SMD -0.44 [-0.59, -0.29] GRADE not reported 3 studies · 880 participants |
| Children and adolescents (5 to 13 years) receiving dental local anesthesia injection | Photobiomodulation (low-level laser) before local anesthetic injection | Placebo (sham) laser | Pain perception during local anesthetic injection (needle insertion) At needle insertion · Pediatric dental treatment · Sensitivity analysis: one comparison per study when a control group was shared | When only one comparison per study was selected in cases of shared control groups, the pooled estimates remained unchanged GRADE not reported 3 studies |
| Children and adolescents (5 to 13 years) receiving dental local anesthesia injection | Photobiomodulation (low-level laser) before local anesthetic injection | Placebo (sham) laser | Pain perception during local anesthetic injection (needle insertion) At needle insertion · Pediatric dental treatment · Sensitivity analysis: fixed-effect versus random-effects model | Analyses conducted using both the fixed- and random-effects models produced similar results GRADE not reported 3 studies |
| Children and adolescents (5 to 13 years) receiving dental local anesthesia injection | Photobiomodulation (low-level laser) before local anesthetic injection | Placebo (sham) laser | Pain perception during local anesthetic injection (needle insertion) At needle insertion · Pediatric dental treatment · Faces, Legs, Activity, Cry, Consolability (FLACC) | SMD -0.41 [-0.62, -0.20] GRADE not reported 3 studies · 440 participants |
| Children and adolescents (5 to 13 years) receiving dental local anesthesia injection | Photobiomodulation (low-level laser) before local anesthetic injection | Placebo (sham) laser | Pain perception during local anesthetic injection (needle insertion) At needle insertion · Pediatric dental treatment · Wong-Baker Faces Pain Rating Scale (WBFPRS) | SMD -0.47 [-0.68, -0.26] GRADE not reported 3 studies · 440 participants |
| Children and adolescents (5 to 13 years) receiving dental local anesthesia injection | Photobiomodulation (low-level laser) before local anesthetic injection | Topical anesthetic gel | Pain perception during local anesthetic injection (needle insertion) At needle insertion · Pediatric dental treatment · Split-mouth studies, Wong-Baker Faces Pain Rating Scale (WBFPRS) | MD -3.3 [-3.98, -2.62] GRADE not reported 2 studies · 55 participants |
| Children and adolescents receiving dental local anesthesia | Photobiomodulation (low-level laser) before injection | Placebo laser, topical anesthetic, pre-cooling or vibration | Pain perception At or after injection · Pediatric dental local anesthesia injection | The overall certainty of the evidence for the outcome pain perception was rated as low Low Downgraded: imprecision, inconsistency 10 studies |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| AmruthaVarshini 2021 Effectiveness of Pre-cooling the Injection Site, Laser Biostimulation, and Topical Local Anesthetic Gel in Reduction of Local Anesthesia… PMID:34326589 | 2021 | this review only | not stated | not extracted yet |
| Aykanat 2024 Effect of photobiomodulation on the efficacy of anesthesia in maxillary permanent molar teeth with molar incisor hypomineralization: A… DOI:10.1111/ipd.13118 | 2023 | this review only | not stated | not extracted yet |
| Dehgan 2022 Evaluation of the effects of photobiomodulation with different laser application doses on injection pain in children: a randomized… DOI:10.1007/s10103-022-03674-1 | 2022 | this review only | Pain perception during local anesthetic injection (needle insertion) | not extracted yet |
| Elbay 2023 Effects of photobiomodulation with different application parameters on injection pain in children: a randomized clinical trial DOI:10.22514/jocpd.2023.035 | 2023 | this review only | Pain perception during local anesthetic injection (needle insertion) | not extracted yet |
| Hamouda 2024 The use of laser photobiomodulation as pre-anesthetic tissue management technique in reducing injection pain in children DOI:10.1186/s12903-024-04430-3 | 2024 | this review only | not stated | not extracted yet |
| Khan 2023 Low-level Laser Therapy to Alleviate Pain of Local Anesthesia Injection in Children: A Randomized Control Trial. PMID:38268643 | 2023 | this review only | Pain perception during local anesthetic injection (needle insertion) | not extracted yet |
| Seraj 2023 Effect of Photobiomodulation Therapy With an 810-nm Diode Laser on Pain Perception Associated With Dental Injections in Children: A… PMID:37583496 | 2023 | this review only | not stated | not extracted yet |
| Shekarchi 2022 Evaluating the Preemptive Analgesic Effect of Photo‐biomodulation Therapy on Pain Perception During Local Anesthesia Injection in… DOI:10.1111/php.13605 | 2022 | this review only | Pain perception during local anesthetic injection (needle insertion) | not extracted yet |
| Shrutha 2024 Use of Three Pre-Injection Procedures to Reduce Pain Perception of Intraoral Injections in Eight- to 12-Year-Old Children: Randomized… PMID:39420491 | 2024 | this review only | not stated | not extracted yet |
| Ucar 2022 Effects of low level laser therapy on injection pain and anesthesia efficacy during local anesthesia in children: A randomized clinical… DOI:10.1111/ipd.12936 | 2022 | this review only | Pain perception during local anesthetic injection (needle insertion) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adolescents undergoing local anesthesia for dental treatment | Children aged 5-13 years (n=773) in India, Iran, Egypt, Turkey |
| Intervention | Photobiomodulation/low-level laser therapy before anesthetic procedure | Diode laser PBMT 660-980 nm, continuous (n=9) or pulsed (n=1) mode (n=10) |
| Comparison | No pre-treatment, placebo laser, topical anesthesia, or other comparative methods | Placebo laser (n=5); topical anesthetic gel (n=5); pre-cooling, vibration or Buzzy (n=3, within multi-arm trials) |
| Outcomes | Pain perception during administration of local anesthesia (reversibility of anesthesia removed by amendment) | Pain perception (WBFPRS, FLACC, VAS, MBPS, FPS, SEM); heart rate |
| Study designs | Controlled clinical trials in humans | 10 RCTs (2 split-mouth) |
| Timing | Not specified | At needle insertion (pooled) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Yes | no |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |