Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction. A preliminary study

Abstract

Pain, swelling, and trismus are the most common complications after surgical removal of impacted lower third molars. The aim of this study was to evaluate the analgesic and anti-inflammatory effects of a low-level laser therapy (Laser Smile™, Biolase®, San Clemente, USA) applied to the wound appeared after the surgical removal of impacted lower third molars. A prospective, randomized, and double-blind study was undertaken in 20 healthy patients with two symmetrically impacted lower third molars. The application of a low-level laser was made randomly on one of the two sides after surgery. The experimental side received 5 J/cm(2) of energy density, a wavelength of 810 nm, and an output power of 0.5 W. On the control side, a handpiece was applied intraorally, but the laser was not activated. Evaluations of postoperative pain, trismus, and swelling were made. The sample consisted of 11 women and nine men, and mean age was 23.35 years (18-37). The pain level in the first hours after surgery was lower in the experimental side than in the placebo side, although without statistically significant differences (p = 0.258). Swelling and trismus at the 2nd and 7th postoperative days were slightly higher in the control side, although not statistically significant differences were detected (p > 0.05). The application of a low-level laser with the parameters used in this study did not show beneficial affects in reducing pain, swelling, and trismus after removal of impacted lower third molars.

Assessment of Low-Level Laser Therapy Effects After Extraction of Impacted Lower Third Molar Surgery

“…14 In a clinical trial, the assessment of analgesia and anti-inflammatory effects of low-level laser has revealed that it has no effect on swelling and pain reduction and improvement of trismus after impacted third molar surgery. 15 In another study, laser therapy could slightly, but not significantly, reduce pain, swelling and trismus. 16 Some studies have shown that LLLT has useful impact on the management of pain and swelling.…”

Low-intensity laser efficacy in postoperative extraction of third molars

“…However, the number of patients who were evaluated did not represent great expressiveness, in comparison to the number of people who go through this type of procedure every year. From the results, it was suggested that the laser therapy used in these studies was not efficient to reduce the pain state and the swelling, but it was benefic to minimize the trismus 23 .…”

“…The study included 10 trials published in the period from 1990 to 2011, with 581 patients evaluated with the goal to answer whether the adjuvant use of laser was efficient or not for such complications 23 . There were no restrictions regarding the patients characteristics, type or administration regime of LLLT and of the measuring methods of the results.…”

“…Such meta-analysis 23 stood out for being the first broad review on the subject. However, the number of patients who were evaluated did not represent great expressiveness, in comparison to the number of people who go through this type of procedure every year.…”

“…The evaluations were performed on the second and seventh day after the procedure, through the visual analog scale (VAS) and numerical rating scale of 101 points (NRS-101) 24 . These scales were greatly used in studies to measure pain, being VAS more commonly used in the postoperative phase of SETMs 15,18,[22][23][24] . Considering the intragroup analysis of the studied mentioned above, all of those who received the irradiation presented significantly reduction between the second and the seventh day after the surgery, except for the extraoral red laser group (660 nm).…”