Pulsed Nd: YAG laser induces pulpal analgesia: a randomized clinical trial.

This double-blind, randomized, clinical trial investigated the effectiveness and underlying mechanism of neural inhibition of pulsed Nd:YAG laser induction of pulpal analgesia compared with 5% EMLA anesthetic cream. Forty-four paired premolars from 44 orthodontic patients requiring bilateral premolar extraction from either dental arch were randomly assigned to the 'Laser plus Sham-EMLA' or 'EMLA plus Sham-Laser' treatment group. Analgesia was tested by an Electric Pulp Tester (EPT) and the cutting of a standardized cavity, which was terminated when participants reported sensitivity, and Visual Analogue Scale (VAS) and numbness were recorded. Statistical analyses were done by paired t test, McNemar's test, and a chi-squared test (p < 0.05). Sixty-eight percent of laser- and 59% of EMLA-treated teeth had completed cavities with statistically significant EPT increases above baseline. No significant within-patient differences were found for either group. No laser-treated participants reported numbness. The trial confirmed that the pulsed Nd:YAG laser effectively induced pulpal analgesia, by suppression of intradental nerve responses to electrical and mechanical stimuli. Such a laser provides an alternative for dental pain management (ANZ-Clinical Trial Registry: N12611001099910).