Evaluation of the Analgesic Effect of Laser Therapy at Acupuncture Points in Orthodontic Patients

Evaluation of the Analgesic Effect of Laser Therapy at Acupuncture Points in Orthodontic Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of the Analgesic Effect of Laser Therapy at Acupuncture Points in Orthodontic Patients Raquel Porto Queiroga, Aguinaldo Silva Garcez Segundo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5440005/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 17 Apr, 2025 Read the published version in Lasers in Medical Science → Version 1 posted 13 You are reading this latest preprint version Abstract Photobiomodulation and laser acupuncture are pain management treatments, offering safe, non-invasive options for patients seeking alternatives to conventional treatments. Therefore, the aim of this research is to evaluate the effects of low-level laser therapy at acupuncture points on pain mechanisms caused by orthodontic separators. For the study, 162 healthy adult volunteers over the age of 18 were selected. Orthodontic separators were installed to stimulate pain. The volunteers were divided into three groups: Group 1 received diode laser (808 nm, 100 mW) at acupuncture points for 40 seconds (4 J energy), Group 2 received diode laser (808 nm, 100 mW) on molars with orthodontic separators for 40 seconds (4 J energy), and Group 3 received a placebo at acupuncture points. The acupuncture points used were: LI4 (Hegu), EX2 (Yintang), LI6 (Pianli), LI11 (Quchi), and LU7 (Lieque). A modified Visual Analogue Scale (VAS) was used to assess pain levels. To evaluate differences in pain intensity between groups and over time, the Friedman and Kruskal-Wallis tests were used. Statistical analysis confirmed a significant difference in pain intensity between groups over time (p < 0.001). No significant difference in pain perception was observed between genders (p = 0.943). The difference between the groups that received laser therapy at acupuncture points and local points was not statistically significant (p = 0.272). It can be concluded that laser therapy at acupuncture points yields results similar to laser therapy for pain induced by the installation of orthodontic separators, with both being more effective than placebo treatment. Laser Therapy Acupuncture Orthodontics Figures Figure 1 INTRODUCTION Orthodontics is a dental specialty focused on the prevention and diagnosis of issues caused by malocclusion. Its purpose is to harmonize the relationship among teeth, bones, and soft tissues, providing patients with balanced masticatory function and appropriate aesthetics [ 1 ]. Orthodontic movement can cause painful symptoms, especially during the initial phases of treatment. Pain sensation is frequently associated with orthodontic treatment in up to 90% of patients and can be the main reason for treatment discontinuation or fear of undergoing this type of intervention [ 2 ]. When orthodontic treatment requires band placement, elastomeric separators can be a useful tool to separate teeth. However, their placement in the interdental space creates tension in supporting dental structures and pain induced by inflammatory molecules, such as prostaglandins, leukotrienes, bradykinins, and other cytokines [ 3 ]. Managing pain associated with dental treatment is a frequent concern for dental surgeons and demands significant attention in clinical practice. Low-intensity laser therapy is a non-pharmacological method suggested as an effective treatment to reduce this type of pain, with various advantages and no side effects [ 4 ]. Acupuncture can also be used to control and alleviate pain. This therapy stimulates the release of substances by the body itself, affecting the central pain inhibition mechanism, involving segmental blockade in the spinal cord. This triggers the release of neuromodulators, such as endorphins and serotonin, which alter pain sensitivity [ 5 ]. Another treatment option is laser therapy applied at acupuncture points, aiming to achieve an analgesic effect through the release of chemical mediators [ 6 ]. Therefore, this study aims to evaluate the effects of low-level laser therapy at acupuncture points on pain mechanisms caused by the installation of orthodontic separators. MATERIALS AND METHODS This project was submitted to the Ethics and Research Committee of the São Leopoldo Mandic Center for Dental Research, receiving approval under opinion number 5.638.978. All participants signed an [informed consent form (ICF)] that explained the research objectives, treatment indication, and the associated risks and benefits. The sample size consisted of 162 individuals randomly distributed into three groups, providing a test power of 0.95 to detect effect size, with a significance level of 0.05 (α = 0.05). The sample size calculation was performed using the Gpower program. Inclusion criteria were: volunteers of both genders, over 18 years old; indicated for orthodontic treatment; possessing first and second premolars and first and second lower molars; having good periodontal health; agreeing to participate in the study by signing the ICF. Exclusion criteria included: individuals using controlled medication, analgesics, or anti-inflammatory drugs within three months prior to the study; those with periodontal and/or endodontic issues; pregnant or breastfeeding women; presence of diastema in the lower premolar and molar region; individuals who had undergone oral surgical procedures or were under prescription anti-inflammatory medication within six months prior to the experiment. Orthodontic separators (Morelli, Sorocaba, SP, BR) approximately 1 mm thick were installed on the right and left sides, mesial and distal surfaces of the first lower permanent molars. Separators remained in place for 72 hours to evaluate the pain peak and its decline. The [Visual Analogue Scale (VAS)] was used for pain assessment. All patients were instructed to fill out the scale at night (Day 1, Day 2, Day 3), always at the same time, and on the last day after separator removal. To use the VAS, the volunteer recorded their pain level, with 0 (zero) indicating no pain and 10 (ten) representing the maximum pain level tolerable by the patient. The volunteers were divided into three groups: Group 1 received laser acupuncture, Group 2 received photobiomodulation on molars with orthodontic separators, and Group 3 received a placebo at acupuncture points. For the placebo, the laser tip was covered with reflective material (aluminum foil) at the beam exit, preventing irradiation, although volunteers could hear the equipment's sound during irradiations, thus avoiding them knowing they were in the control group. The device used in this study was a Gallium Aluminum Arsenide (GaAlAs) semiconductor diode laser (Therapy XT, DMC, São Carlos, SP). Volunteers were irradiated immediately after separator placement and on the 1st, 2nd, and 3rd days between 12:00 and 14:00 at five acupuncture points. The irradiation protocol used was: wavelength of 810 nm, power of 100 mW, energy of 4 J, and exposure time of 40 s. The selection of acupuncture points was based on their individual therapeutic indications according to the literature [ 7 – 10 ]. These were: - IG4 – Hegu: located on the back of the hand, analgesia point for painful conditions in the face and teeth. It has significant analgesic importance as the meridian internally relates to the oral cavity. - EX2 – Yintang: located between the eyebrows, used for anxiety. - LI6 – Pianli: situated on the posterolateral margin of the forearm, indicated for facial paralysis. - IG11 – Quchi: on the radial side of the elbow, indicated for acute head inflammations. - P7 – Lieque: located laterally to the radial artery, indicated for facial paralysis. The data obtained from VAS responses were tabulated in a Microsoft Excel platform and analyzed using descriptive and inferential statistics in the IBM SPSS software (version 26.0, IBM Corporation, Armonk, New York, USA). Initially, continuous variable data were assessed for normality distribution using the Shapiro-Wilk test (p < 0.001) – non-normal distribution. Subsequently, comparison tests between groups were selected based on the verified normality distribution. To evaluate differences in pain intensity between groups and over time, the Friedman and Kruskal-Wallis tests were used. Statistical data analysis was performed using Jamovi and Python software. For all comparisons, a 5% significance level was adopted. RESULTS Of the 162 study participants, 101 were women, and 61 were men. All participants were randomly distributed into three groups: control (placebo), laser therapy at acupuncture points, and laser therapy at local points. Pain intensity was assessed using VAS at four different times: T0 (immediately after therapy application), T1 (24 hours after application), T2 (48 hours after application), and T3 (72 hours after application). These assessments are presented in Tables 1 and 2 . Table 1 VAS. Período Type of Intervention Average Median Percentis 25th 75th T0 Placebo 2.84 3 2.00 4.00 Ponto acupuntura 1.85 2 1.00 2.00 Ponto local 2.14 2 1.00 3.00 T1 Placebo 3.01 3 2.00 4.00 Ponto acupuntura 2.14 2 1.00 3.00 Ponto local 2.42 2 2.00 3.00 T2 Placebo 4.12 4 3.00 5.00 Ponto acupuntura 2.63 2 1.00 3.00 Ponto local 2.66 2 2.00 3.00 T3 Placebo 3.33 3 2.00 4.00 Ponto acupuntura 1.79 2 1.00 3.00 Ponto local 2.02 2 1.00 3.00 Period Type of Intervention Average Median Percentiles 25th 75th T0 Placebo 2.84 3 2.00 4.00 Acupuncture Point 1.85 2 1.00 2.00 Local Point 2.14 2 1.00 3.00 T1 Placebo 3.01 3 2.00 4.00 Acupuncture Point 2.14 2 1.00 3.00 Local Point 2.42 2 2.00 3.00 T2 Placebo 4.12 4 3.00 5.00 Acupuncture Point 2.63 2 1.00 3.00 Local Point 2.66 2 2.00 3.00 T3 Placebo 3.33 3 2.00 4.00 Acupuncture Point 1.79 2 1.00 3.00 Local Point 2.02 2 1.00 3.00 Note Average, median, and percentiles of pain intensity (VAS) at different periods and types of intervention (n = 162). Source Own authorship (2024). Table 2 Comparison Between Gender and Type of Intervention (n = 162).’ Variable df p Gender 1 0.943 Type of Intervention 2 < .001* Statistically significant difference. Source: Research data (2024). The results indicate that both laser acupuncture and photobiomodulation were significantly more effective in reducing pain compared to the placebo. Statistical analysis confirmed a significant difference in pain intensity among the groups over time (p < 0.001). No significant difference was observed in pain perception between genders (p = 0.943). The detailed analysis is available in Table 3 . Table 3 Comparison Between Types of Interventions Used (n = 162). Type of Intervention SE df t p-value Acupuncture Point - Placebo 0.134 480 9.13 < .001* Local Point - Placebo 0.134 480 7.59 < .001* | Acupuncture Point - Local Point 0.134 480 -1.54 0.272 *Statistically significant difference. Source: Research data (2024). The results indicate a statistically significant difference in pain intensity between the group that received laser therapy at acupuncture points and the placebo group (p < 0.001), as well as between the group that received laser therapy at local points and the placebo group (p < 0.001). However, the difference between the groups that received laser therapy at acupuncture points and local points was not statistically significant (p = 0.272). The detailed analysis is available in Table 3 . DISCUSSION Pain management associated with orthodontic movement requires attention, especially at the start of treatment [ 2 , 4 , 11 ], as observed in the results where all groups showed increased pain sensation after separator placement. Laser therapy for pain management in dentistry is well-established, with several studies demonstrating positive effects, confirming the results obtained [ 12 – 19 ], in which the laser acupuncture group showed significantly lower pain levels than the placebo group. The growing use of acupuncture in various dental applications has been accompanied by scientific exploration of its mechanisms, aiming to investigate its effects [ 20 – 24 ]. Scientific studies have led to new therapy modalities and revealed new knowledge about neurotransmitters and their release through different forms and frequencies of stimuli, such as laser acupuncture [ 6 , 25 , 26 ]. Studies involving traditional acupuncture provided the methodological basis for developing clinical trials with laser acupuncture [ 26 , 27 ], like this research. Studies on laser acupuncture in dentistry address different criteria for point selection, session frequency, intensity, type of evaluation, and assessment methods. Laser acupuncture in the facial region uses the same dosimetry parameters as laser therapy but only at specific acupuncture points [ 6 , 25 ]. The acupuncture points used in this study were chosen based on their therapeutic indications related to the oral cavity. Laser acupuncture, with fewer irradiation points (only extra-oral points), reduces clinical therapy time, making the session less tiring for both the dentist and the patient. Laser acupuncture can be an alternative treatment modality for TMD and is well-documented in scientific literature [ 6 , 25 , 28 , 29 ]. In Orthodontics, however, research on laser acupuncture is scarce, justifying this study. In this study, regarding pain intensity assessed using the VAS scale, a statistical difference in pain intensity was observed among groups over time (p < 0.001). This result aligns with Ferreira et al. (2013), who evaluated TMD patients and obtained positive results regarding pain over time [ 30 ]. It also aligns with the findings of Huang et al. (2014), who observed significant pain reduction in TMD patients subjected to laser acupuncture through a clinical trial [ 29 ]. Ferreira et al. (2013) used points ST6, SI19, GB20, GB43, LI4, LR3, NT3, and EX-HN3 for TMD treatment, resulting in lower pain intensity [ 30 ]. Huang et al. (2014) and Madani et al. (2020) used points ST6, ST7, and LI4 for TMD treatment and concluded that laser acupuncture can result in partial or total pain relief [ 6 , 29 ]. Castro and Isoldi (2022) used points Taiyang, ID19, E6, IG4, F3, PC6, and GB34 and observed reduced TMD pain levels after laser acupuncture treatment [ 28 ]. This study used points LI4, EX2, LI6, LI11, and LU7 and observed reduced pain induced by orthodontic separator placement. The variety of acupuncture points and lack of standardization in studies can be explained by the large number of points distributed along meridians related to the orofacial region. According to Valente et al. (2015), the radiation used in acupuncture by laser devices ranges from visible light wavelengths (400–700 nm) to infrared radiation (760 nm to 1 mm) [ 26 ]. Sampaio Filho et al. (2016) suggest that the low-power laser chosen should have a deeper wavelength, as acupuncture needles are 15 to 70 mm long; thus, in this case, 810 nm is more appropriate [ 31 ]. This study used parameters distinct from other studies, opting for a wavelength of 810 nm with a power of 100 mW and an energy dose of 4 J over 40 seconds. Ferreira et al. (2013) performed laser acupuncture with 780 nm, 50 mW power for 90 seconds, and 4.5 J energy [ 30 ]. Madani et al. (2020) used a wavelength of 810 nm, 200 mW power for 30 seconds per point. All studies demonstrated positive effects of laser acupuncture [ 6 ]. CONCLUSION It can be concluded that laser therapy at acupuncture points yields similar results to laser therapy for pain induced by the installation of orthodontic separators, with both being more effective than placebo treatment. Declarations Ethical Approval This project was submitted to the Ethics and Research Committee and was approved under opinion. Data and Material Availability All data generated or analyzed during this study are included in this article. Competing Interests The authors declare no potential conflicts of interest. Funding The resources required for this research were funded by the authors. Author Contribution Raquel Porto Queiroga: study methodology, data collection, data tabulation, data analysis, creation of tables and graphs, text writing, and standardization of norms according to the journal. Aguinaldo Silva Garcez Segundo: study methodology, text review and addition of significant parts, final approval of the version to be published. Acknowledgement We would like to thank São Leopoldo Mandic School of Dentistry for providing the necessary resources for conducting this research. We also extend our gratitude to the volunteers for their commitment to this study, as well as to my family and colleagues, who shared with me the challenges and joys of this work. 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Cite Share Download PDF Status: Published Journal Publication published 17 Apr, 2025 Read the published version in Lasers in Medical Science → Version 1 posted Editorial decision: Revision requested 16 Jan, 2025 Reviews received at journal 16 Jan, 2025 Reviewers agreed at journal 08 Jan, 2025 Reviewers agreed at journal 05 Jan, 2025 Reviewers agreed at journal 04 Jan, 2025 Reviews received at journal 04 Jan, 2025 Reviewers agreed at journal 04 Jan, 2025 Reviewers agreed at journal 23 Nov, 2024 Reviewers agreed at journal 22 Nov, 2024 Reviewers invited by journal 21 Nov, 2024 Editor assigned by journal 21 Nov, 2024 Submission checks completed at journal 13 Nov, 2024 First submitted to journal 12 Nov, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5440005","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":381824974,"identity":"30ecf78c-36fa-4bbf-b519-9121b8da4d52","order_by":0,"name":"Raquel Porto Queiroga","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/klEQVRIiWNgGAWjYNCCAhiDzSYBTCcU4FIKAwYg1WAtaQlgRoIB8VoOQ7Qw4NFi3n54m8QHgzty5vObDzD8KDufxy/fnfjhgQGDPL/YAaxaZM6klUnOMHhmLHOMLYGx59ztYsk23s0SQIcZzpydgFWLBEOOmTSPweHEGWw8BsyMbbcTNxzj3QDSkmBwG4cW/jdm0n8QWs6BtGz+gVeLBNAWBoSWAyAt2/DbIvGs2LIH6BcJYPge7DmXnDizLXebRYKBBG6/8CdvvPGj4o6cBPPhgw9+lNkl9jOf3XzzR4WNPL80di0MkCg4AGYdQAkXPAChZRSMglEwCkYBVgAA7PtZ1Y9VliIAAAAASUVORK5CYII=","orcid":"","institution":"Faculdade São Leopoldo Mandic","correspondingAuthor":true,"prefix":"","firstName":"Raquel","middleName":"Porto","lastName":"Queiroga","suffix":""},{"id":381824975,"identity":"a9d2a4da-a90d-455b-b687-a1ed9e95638c","order_by":1,"name":"Aguinaldo Silva Garcez Segundo","email":"","orcid":"","institution":"Faculdade São Leopoldo Mandic","correspondingAuthor":false,"prefix":"","firstName":"Aguinaldo","middleName":"Silva Garcez","lastName":"Segundo","suffix":""}],"badges":[],"createdAt":"2024-11-12 13:38:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5440005/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5440005/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s10103-025-04435-6","type":"published","date":"2025-04-17T15:56:58+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":71633331,"identity":"98595fd0-d91b-47de-9fd2-1a7fd6fba191","added_by":"auto","created_at":"2024-12-17 09:51:47","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":57562,"visible":true,"origin":"","legend":"\u003cp\u003eVariation in Pain Scale (VAS) Across Different Periods and Types of Intervention (n=162).\u003c/p\u003e\n\u003cp\u003eSource: Research data (2024).\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5440005/v1/405da4b717f23e2bc89880bf.png"},{"id":81050738,"identity":"33d365af-52aa-498f-a4b6-96ff99d7d2db","added_by":"auto","created_at":"2025-04-21 16:02:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":587313,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5440005/v1/c9a47914-41fa-4fb3-8747-728cc9ffe7f9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Evaluation of the Analgesic Effect of Laser Therapy at Acupuncture Points in Orthodontic Patients","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eOrthodontics is a dental specialty focused on the prevention and diagnosis of issues caused by malocclusion. Its purpose is to harmonize the relationship among teeth, bones, and soft tissues, providing patients with balanced masticatory function and appropriate aesthetics [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOrthodontic movement can cause painful symptoms, especially during the initial phases of treatment. Pain sensation is frequently associated with orthodontic treatment in up to 90% of patients and can be the main reason for treatment discontinuation or fear of undergoing this type of intervention [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhen orthodontic treatment requires band placement, elastomeric separators can be a useful tool to separate teeth. However, their placement in the interdental space creates tension in supporting dental structures and pain induced by inflammatory molecules, such as prostaglandins, leukotrienes, bradykinins, and other cytokines [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eManaging pain associated with dental treatment is a frequent concern for dental surgeons and demands significant attention in clinical practice. Low-intensity laser therapy is a non-pharmacological method suggested as an effective treatment to reduce this type of pain, with various advantages and no side effects [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAcupuncture can also be used to control and alleviate pain. This therapy stimulates the release of substances by the body itself, affecting the central pain inhibition mechanism, involving segmental blockade in the spinal cord. This triggers the release of neuromodulators, such as endorphins and serotonin, which alter pain sensitivity [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother treatment option is laser therapy applied at acupuncture points, aiming to achieve an analgesic effect through the release of chemical mediators [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTherefore, this study aims to evaluate the effects of low-level laser therapy at acupuncture points on pain mechanisms caused by the installation of orthodontic separators.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003e This project was submitted to the Ethics and Research Committee of the S\u0026atilde;o Leopoldo Mandic Center for Dental Research, receiving approval under opinion number 5.638.978. All participants signed an [informed consent form (ICF)] that explained the research objectives, treatment indication, and the associated risks and benefits.\u003c/p\u003e \u003cp\u003eThe sample size consisted of 162 individuals randomly distributed into three groups, providing a test power of 0.95 to detect effect size, with a significance level of 0.05 (α\u0026thinsp;=\u0026thinsp;0.05). The sample size calculation was performed using the Gpower program.\u003c/p\u003e \u003cp\u003eInclusion criteria were: volunteers of both genders, over 18 years old; indicated for orthodontic treatment; possessing first and second premolars and first and second lower molars; having good periodontal health; agreeing to participate in the study by signing the ICF.\u003c/p\u003e \u003cp\u003eExclusion criteria included: individuals using controlled medication, analgesics, or anti-inflammatory drugs within three months prior to the study; those with periodontal and/or endodontic issues; pregnant or breastfeeding women; presence of diastema in the lower premolar and molar region; individuals who had undergone oral surgical procedures or were under prescription anti-inflammatory medication within six months prior to the experiment.\u003c/p\u003e \u003cp\u003eOrthodontic separators (Morelli, Sorocaba, SP, BR) approximately 1 mm thick were installed on the right and left sides, mesial and distal surfaces of the first lower permanent molars. Separators remained in place for 72 hours to evaluate the pain peak and its decline.\u003c/p\u003e \u003cp\u003eThe [Visual Analogue Scale (VAS)] was used for pain assessment. All patients were instructed to fill out the scale at night (Day 1, Day 2, Day 3), always at the same time, and on the last day after separator removal. To use the VAS, the volunteer recorded their pain level, with 0 (zero) indicating no pain and 10 (ten) representing the maximum pain level tolerable by the patient.\u003c/p\u003e \u003cp\u003eThe volunteers were divided into three groups: Group 1 received laser acupuncture, Group 2 received photobiomodulation on molars with orthodontic separators, and Group 3 received a placebo at acupuncture points. For the placebo, the laser tip was covered with reflective material (aluminum foil) at the beam exit, preventing irradiation, although volunteers could hear the equipment's sound during irradiations, thus avoiding them knowing they were in the control group.\u003c/p\u003e \u003cp\u003eThe device used in this study was a Gallium Aluminum Arsenide (GaAlAs) semiconductor diode laser (Therapy XT, DMC, S\u0026atilde;o Carlos, SP). Volunteers were irradiated immediately after separator placement and on the 1st, 2nd, and 3rd days between 12:00 and 14:00 at five acupuncture points. The irradiation protocol used was: wavelength of 810 nm, power of 100 mW, energy of 4 J, and exposure time of 40 s.\u003c/p\u003e \u003cp\u003eThe selection of acupuncture points was based on their individual therapeutic indications according to the literature [\u003cspan additionalcitationids=\"CR8 CR9\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. These were:\u003c/p\u003e \u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e- IG4 \u0026ndash; Hegu: located on the back of the hand, analgesia point for painful conditions in the face and teeth. It has significant analgesic importance as the meridian internally relates to the oral cavity.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e- EX2 \u0026ndash; Yintang: located between the eyebrows, used for anxiety.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e- LI6 \u0026ndash; Pianli: situated on the posterolateral margin of the forearm, indicated for facial paralysis.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e- IG11 \u0026ndash; Quchi: on the radial side of the elbow, indicated for acute head inflammations.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e- P7 \u0026ndash; Lieque: located laterally to the radial artery, indicated for facial paralysis.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e \u003cp\u003eThe data obtained from VAS responses were tabulated in a Microsoft Excel platform and analyzed using descriptive and inferential statistics in the IBM SPSS software (version 26.0, IBM Corporation, Armonk, New York, USA). Initially, continuous variable data were assessed for normality distribution using the Shapiro-Wilk test (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) \u0026ndash; non-normal distribution. Subsequently, comparison tests between groups were selected based on the verified normality distribution. To evaluate differences in pain intensity between groups and over time, the Friedman and Kruskal-Wallis tests were used. Statistical data analysis was performed using Jamovi and Python software. For all comparisons, a 5% significance level was adopted.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eOf the 162 study participants, 101 were women, and 61 were men. All participants were randomly distributed into three groups: control (placebo), laser therapy at acupuncture points, and laser therapy at local points. Pain intensity was assessed using VAS at four different times: T0 (immediately after therapy application), T1 (24 hours after application), T2 (48 hours after application), and T3 (72 hours after application). These assessments are presented in Tables \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e and\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eVAS.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"2\"\u003e\n \u003cp\u003ePer\u0026iacute;odo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eType of Intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eAverage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\" style=\"width: 16.6986%;\"\u003e\n \u003cp\u003ePercentis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e25th\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e75th\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eT0\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePlacebo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePonto acupuntura\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePonto local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePlacebo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePonto acupuntura\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePonto local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePlacebo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e4.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePonto acupuntura\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePonto local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eT3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePlacebo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePonto acupuntura\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePonto local\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 7.4653%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\" style=\"width: 2.4305%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003ePeriod\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eAverage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"4\" style=\"width: 16.6986%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentiles\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e25th\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e75th\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eT0\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePlacebo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eAcupuncture Point\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eLocal Point\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePlacebo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eAcupuncture Point\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eLocal Point\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePlacebo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e4.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e5.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eAcupuncture Point\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eLocal Point\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eT3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003ePlacebo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eAcupuncture Point\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eLocal Point\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\" style=\"width: 6.7178%;\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eNote\u0026nbsp;\u003c/strong\u003eAverage, median, and percentiles of pain intensity (VAS) at different periods and types of intervention (n\u0026thinsp;=\u0026thinsp;162).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSource\u0026nbsp;\u003c/strong\u003eOwn authorship (2024).\u003c/p\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparison Between Gender and Type of Intervention (n\u0026thinsp;=\u0026thinsp;162).\u0026rsquo;\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003edf\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.943\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of Intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eStatistically significant difference.\u003c/p\u003e\n\u003cp\u003eSource: Research data (2024).\u003c/p\u003e\n\u003cp\u003eThe results indicate that both laser acupuncture and photobiomodulation were significantly more effective in reducing pain compared to the placebo. Statistical analysis confirmed a significant difference in pain intensity among the groups over time (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). No significant difference was observed in pain perception between genders (p\u0026thinsp;=\u0026thinsp;0.943). The detailed analysis is available in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparison Between Types of Interventions Used (n\u0026thinsp;=\u0026thinsp;162).\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eType of Intervention\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003edf\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003et\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAcupuncture Point - Placebo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocal Point - Placebo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e| Acupuncture Point - Local Point\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.272\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Statistically significant difference.\u003c/p\u003e\n\u003cp\u003eSource: Research data (2024).\u003c/p\u003e\n\u003cp\u003eThe results indicate a statistically significant difference in pain intensity between the group that received laser therapy at acupuncture points and the placebo group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), as well as between the group that received laser therapy at local points and the placebo group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, the difference between the groups that received laser therapy at acupuncture points and local points was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.272). The detailed analysis is available in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003ePain management associated with orthodontic movement requires attention, especially at the start of treatment [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], as observed in the results where all groups showed increased pain sensation after separator placement. Laser therapy for pain management in dentistry is well-established, with several studies demonstrating positive effects, confirming the results obtained [\u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17 CR18\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], in which the laser acupuncture group showed significantly lower pain levels than the placebo group.\u003c/p\u003e \u003cp\u003eThe growing use of acupuncture in various dental applications has been accompanied by scientific exploration of its mechanisms, aiming to investigate its effects [\u003cspan additionalcitationids=\"CR21 CR22 CR23\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Scientific studies have led to new therapy modalities and revealed new knowledge about neurotransmitters and their release through different forms and frequencies of stimuli, such as laser acupuncture [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Studies involving traditional acupuncture provided the methodological basis for developing clinical trials with laser acupuncture [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], like this research.\u003c/p\u003e \u003cp\u003eStudies on laser acupuncture in dentistry address different criteria for point selection, session frequency, intensity, type of evaluation, and assessment methods. Laser acupuncture in the facial region uses the same dosimetry parameters as laser therapy but only at specific acupuncture points [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The acupuncture points used in this study were chosen based on their therapeutic indications related to the oral cavity.\u003c/p\u003e \u003cp\u003eLaser acupuncture, with fewer irradiation points (only extra-oral points), reduces clinical therapy time, making the session less tiring for both the dentist and the patient. Laser acupuncture can be an alternative treatment modality for TMD and is well-documented in scientific literature [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. In Orthodontics, however, research on laser acupuncture is scarce, justifying this study.\u003c/p\u003e \u003cp\u003eIn this study, regarding pain intensity assessed using the VAS scale, a statistical difference in pain intensity was observed among groups over time (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). This result aligns with Ferreira et al. (2013), who evaluated TMD patients and obtained positive results regarding pain over time [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. It also aligns with the findings of Huang et al. (2014), who observed significant pain reduction in TMD patients subjected to laser acupuncture through a clinical trial [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFerreira et al. (2013) used points ST6, SI19, GB20, GB43, LI4, LR3, NT3, and EX-HN3 for TMD treatment, resulting in lower pain intensity [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Huang et al. (2014) and Madani et al. (2020) used points ST6, ST7, and LI4 for TMD treatment and concluded that laser acupuncture can result in partial or total pain relief [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Castro and Isoldi (2022) used points Taiyang, ID19, E6, IG4, F3, PC6, and GB34 and observed reduced TMD pain levels after laser acupuncture treatment [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. This study used points LI4, EX2, LI6, LI11, and LU7 and observed reduced pain induced by orthodontic separator placement. The variety of acupuncture points and lack of standardization in studies can be explained by the large number of points distributed along meridians related to the orofacial region.\u003c/p\u003e \u003cp\u003eAccording to Valente et al. (2015), the radiation used in acupuncture by laser devices ranges from visible light wavelengths (400\u0026ndash;700 nm) to infrared radiation (760 nm to 1 mm) [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Sampaio Filho et al. (2016) suggest that the low-power laser chosen should have a deeper wavelength, as acupuncture needles are 15 to 70 mm long; thus, in this case, 810 nm is more appropriate [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. This study used parameters distinct from other studies, opting for a wavelength of 810 nm with a power of 100 mW and an energy dose of 4 J over 40 seconds. Ferreira et al. (2013) performed laser acupuncture with 780 nm, 50 mW power for 90 seconds, and 4.5 J energy [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Madani et al. (2020) used a wavelength of 810 nm, 200 mW power for 30 seconds per point. All studies demonstrated positive effects of laser acupuncture [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIt can be concluded that laser therapy at acupuncture points yields similar results to laser therapy for pain induced by the installation of orthodontic separators, with both being more effective than placebo treatment.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthical Approval\u003c/h2\u003e\n\u003cp\u003eThis project was submitted to the Ethics and Research Committee and was approved under opinion.\u003c/p\u003e\n\u003ch2\u003eData and Material Availability\u003c/h2\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this article.\u003c/p\u003e\n\u003ch2\u003eCompeting Interests\u003c/h2\u003e\n\u003cp\u003eThe authors declare no potential conflicts of interest.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThe resources required for this research were funded by the authors.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eRaquel Porto Queiroga: study methodology, data collection, data tabulation, data analysis, creation of tables and graphs, text writing, and standardization of norms according to the journal. Aguinaldo Silva Garcez Segundo: study methodology, text review and addition of significant parts, final approval of the version to be published.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eWe would like to thank S\u0026atilde;o Leopoldo Mandic School of Dentistry for providing the necessary resources for conducting this research. We also extend our gratitude to the volunteers for their commitment to this study, as well as to my family and colleagues, who shared with me the challenges and joys of this work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCarvalho BN, Carvalho RNM, Dantas JBL (2021) Aplicabilidade da laserterapia de baixa pot\u0026ecirc;ncia na movimenta\u0026ccedil;\u0026atilde;o ortod\u0026ocirc;ntica e redu\u0026ccedil;\u0026atilde;o da dor: revis\u0026atilde;o narrativa. 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Bio Med Cent 17:2\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://trialsjournal.biomedcentral.com/articles/\u003c/span\u003e\u003cspan address=\"https://trialsjournal.biomedcentral.com/articles/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s13063-016-1540-9\u003c/span\u003e\u003cspan address=\"10.1186/s13063-016-1540-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"lasers-in-medical-science","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"lims","sideBox":"Learn more about [Lasers in Medical Science](https://link.springer.com/journal/10103)","snPcode":"10103","submissionUrl":"https://submission.springernature.com/new-submission/10103/3","title":"Lasers in Medical Science","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Laser Therapy, Acupuncture, Orthodontics","lastPublishedDoi":"10.21203/rs.3.rs-5440005/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5440005/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePhotobiomodulation and laser acupuncture are pain management treatments, offering safe, non-invasive options for patients seeking alternatives to conventional treatments. Therefore, the aim of this research is to evaluate the effects of low-level laser therapy at acupuncture points on pain mechanisms caused by orthodontic separators. For the study, 162 healthy adult volunteers over the age of 18 were selected. Orthodontic separators were installed to stimulate pain. The volunteers were divided into three groups: Group 1 received diode laser (808 nm, 100 mW) at acupuncture points for 40 seconds (4 J energy), Group 2 received diode laser (808 nm, 100 mW) on molars with orthodontic separators for 40 seconds (4 J energy), and Group 3 received a placebo at acupuncture points. The acupuncture points used were: LI4 (Hegu), EX2 (Yintang), LI6 (Pianli), LI11 (Quchi), and LU7 (Lieque). A modified Visual Analogue Scale (VAS) was used to assess pain levels. To evaluate differences in pain intensity between groups and over time, the Friedman and Kruskal-Wallis tests were used. Statistical analysis confirmed a significant difference in pain intensity between groups over time (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). No significant difference in pain perception was observed between genders (p\u0026thinsp;=\u0026thinsp;0.943). The difference between the groups that received laser therapy at acupuncture points and local points was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.272). It can be concluded that laser therapy at acupuncture points yields results similar to laser therapy for pain induced by the installation of orthodontic separators, with both being more effective than placebo treatment.\u003c/p\u003e","manuscriptTitle":"Evaluation of the Analgesic Effect of Laser Therapy at Acupuncture Points in Orthodontic Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-17 09:51:43","doi":"10.21203/rs.3.rs-5440005/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-01-16T18:42:15+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-01-16T08:23:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"183277979209494341192094940191421266394","date":"2025-01-09T04:45:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"71697330973789183933442936587966218530","date":"2025-01-05T19:29:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"259768967658324890175284642872715901077","date":"2025-01-04T13:38:56+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-01-04T10:27:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"101775111542439237405019425323757804218","date":"2025-01-04T09:35:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"147606202628480259773852166070231503897","date":"2024-11-24T02:25:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"38685799767689625575146839892649388460","date":"2024-11-22T15:24:10+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-11-21T20:55:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-11-21T20:54:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-11-13T06:49:13+00:00","index":"","fulltext":""},{"type":"submitted","content":"Lasers in Medical Science","date":"2024-11-12T13:32:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"lasers-in-medical-science","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"lims","sideBox":"Learn more about [Lasers in Medical Science](https://link.springer.com/journal/10103)","snPcode":"10103","submissionUrl":"https://submission.springernature.com/new-submission/10103/3","title":"Lasers in Medical Science","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"55751999-1d73-4147-9ae7-52e3482102d2","owner":[],"postedDate":"December 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-04-21T15:58:31+00:00","versionOfRecord":{"articleIdentity":"rs-5440005","link":"https://doi.org/10.1007/s10103-025-04435-6","journal":{"identity":"lasers-in-medical-science","isVorOnly":false,"title":"Lasers in Medical Science"},"publishedOn":"2025-04-17 15:56:58","publishedOnDateReadable":"April 17th, 2025"},"versionCreatedAt":"2024-12-17 09:51:43","video":"","vorDoi":"10.1007/s10103-025-04435-6","vorDoiUrl":"https://doi.org/10.1007/s10103-025-04435-6","workflowStages":[]},"version":"v1","identity":"rs-5440005","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5440005","identity":"rs-5440005","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}