Page 45 - Demo

Analgesic effects of preinjection low-level laser/light therapy433Study participantsBetween March and June of 2015 a single-center double-blind randomized controlled trial (RCT) was conducted. Male and female patients who were referred for maxillary or mandibular third molar extractions at the Department of Oral and Maxillofacial Surgery of the Amstelland Hospital in Amstelveen, The Netherlands were eligible for participation. Patients were approached for enrollment during the preoperative consultation, 45 min before their scheduled wisdom tooth removal. Informed consent was obtained during this consultation by two dental students (IM and ZK). Inclusion criteria were as follows: referral to a maxillofacial surgeon for surgical removal of third molars, ASA≤2 (excluding pregnancy), and age of ≥18 years. The exclusion criteria were previous history of oral disease, refusal to give signed informed consent, and allergy to articaine/hydrochloride.Study procedureLocal anesthesia or mandibular block anesthesia was performed by an oral and maxillofacial surgeon (OMFS) following a standardized protocol. Two experienced surgeons performed the third molar extractions in this study. All included patients received local anesthesia with articaine/hydrochloride 40 mg with epinephrine 0.01 mg (1.7-mL syringe Ultracain D-S forte, Sanofi-Aventis Netherlands BV, Gouda, The Netherlands), using a 27-G needle (Terumo® 27×13/8, Somerset, NJ, USA). Anxiety and pain measurement instrumentsEach patient was asked to complete a questionnaire to measure their expected pain and pre-injection anxiety. This questionnaire comprised three different parts. The first two parts included questions about the patient’s expectations and previous experience with dental injections of local anesthesia, and were completed before the injection. The third part was completed immediately after local anesthetic injections, and focused on the patient’s experience after the injections. The first part (expectations) included two questions about expected pain and pre-injection anxiety, which were answered on an 11-point numerical rating scale (NRS), with 0 indicating no pain/anxiety and 10 severe pain/anxiety. The second part (previous experience with dental injections of local anesthesia) began with one question about the patient’s previous experience with local anesthesia injections (Have you previously had a dental