Clinical evaluation of single and repeated sessions of photobiomodulation with two different therapeutic wavelengths for reducing postoperative sequelae after impacted mandibular third molar surgery: a randomized, double-blind clinical study

Abstract

The effects of the number of photobiomodulation (PBM) sessions on the postoperative inflammatory process remain controversial. The current literature comparing single and repeated PBM sessions is limited. Objective This study aimed to compare the effects of single and repeated PBM sessions, applied at two different therapeutic wavelengths within the infrared spectrum, on postoperative inflammatory response after impacted third molar tooth extraction. Methodology This randomized, double-blind clinical study included 40 patients with bilateral impacted mandibular third molars (80 teeth). The patients were divided into two groups each including 20 subjects (40 teeth) to receive either single-session laser at 810 nm (20 teeth) and 940 nm (20 teeth) immediately after the surgery or repeated laser sessions at 810 nm (20 teeth) and 940 nm (20 teeth) (immediately after the surgery and on postoperative Day 1). Lasers at 940 nm (power density 0.5 Watt/cm2, energy density 4 J/cm2 for a time until the cumulative energy on the device screen reaches 50 J from 0 J, in continuous mode, spot size 2.8 cm2) and at 810 nm (power density 0.14 Watt/cm2, energy density 4 J/cm2, for 30 seconds, in continuous mode, spot size 2.1 cm2) were applied intra- and extra-orally. Pain, swelling, and trismus were evaluated postoperatively. Results No significant differences were determined between the groups on the evaluated parameters (p>0.05). Conclusion Within the study limitations, in PBM, the effects of 810 nm and 940 nm and those of single and repeated applications were similar regarding pain, swelling and trismus. Immediate postoperative PBM could be preferred to repeated applications performed by point application within a 24-hour period.

Impact of Single-Session Intraoral and Extraoral Photobiomodulation on Pain Control after Extraction of Impacted Mandibular Third Molar: A Pilot Study

“…In a recent randomized clinical trial, the single-session and repeated-session protocols were compared. It was found that there was no difference between the two protocols, and the single-session protocol was recommended [40].…”

Assessment of the pre-emptive effect of photobiomodulation in the postoperative period of impacted lower third molar extractions: A randomized, controlled, double-blind study protocol

“…Postoperative trismus assessment — Spasms in the masticatory muscles (trismus) can limit or even prevent mouth opening after the surgical removal of impacted third molars [ 21 , 23 , 29 ]. This outcome is typically evaluated by measuring the distance between the incisal edges of the upper and lower central incisors using calipers [ 27 , 29 ]. In this study, previously calibrated evaluators will measure mouth opening in each patient before surgery as well as two and seven days after surgery.…”

“…Postoperative trismus assessment-Spasms in the masticatory muscles (trismus) can limit or even prevent mouth opening after the surgical removal of impacted third molars [21,23,29]. This outcome is typically evaluated by measuring the distance between the incisal edges of the upper and lower central incisors using calipers [27,29].…”

Effect of photo-biomodulation therapy in decreasing postoperative pain after surgical removal of third molars compared to other treatment therapies: a systematic review

“…[25][26][27][28][29] Four studies were excluded due to various reasons (Table 1). [30][31][32][33] The study selection procedure was done by two independent reviewers (SG and AD) and any disagreements between the reviewers were solved by discussion. The study selection procedure is shown in (Figure 1).…”