Use of low-level laser therapy to reduce postoperative pain, edema, and trismus following third molar surgery: A systematic review and meta-analysis

Oliveira, Francisca Jennifer Duarte de; Brasil, Giuliana Moura Luz Cordeiro; Soares, Gabriella Peixoto Araújo; Paiva, Daniel Felipe Fernandes; Júnior, Francisco de Assis de Souza

doi:10.1016/j.jcms.2021.06.006

Cited by 23 publications

(22 citation statements)

References 52 publications

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“…In a systematic review and meta-analysis, Domah et al [44] and Duarte de Oliveira at al. [45] found that LLLT has a positive outcome in the reduction of postoperative swelling after mandibular third molar surgery. In contrast to the findings of our study, López-Ramírez et al [46] and Pedreira et al [47] have failed to show a beneficial effect of laser on swelling.…”

Section: Discussionmentioning

confidence: 94%

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Effect Of Low-Level Laser Therapy On Inflammatory Sequеlae Of Impacted Mandibular Third Molar Surgery: A Single-Blind, Placebo-Controlled, Randomized Clinical Trial

Hamad

2022

Russ Open Med J

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Objective — Postoperative pain, facial swelling, and limitation of mouth opening are common sequеlae of lower third molar surgery. The objective of the study was to evaluate the effect of Low- level laser irradiation in controlling these sequеlae. Material and Methods — This randomized, single-blinded, split-mouth pilot study was carried out at the department of oral and maxillofacial surgery, university affiliated hospital, Erbil, Iraq. The study was conducted on 20 patients (13 males and 7 females), with a mean age of 26.3±7.4 years, who needed surgical removal of symmetrical bilateral impacted lower third molars. In each patient, one side was treated by low level laser and the other side was control. Laser irradiation was performed by postoperative single intraoral application of 940 nm laser beam at four points. Pain, trismus, and facial swelling were evaluated at the first, third, and seventh postoperative days. The data were analyzed using Mann–Whitney U test and unpaired t -test. Results — As compared to the control sides, low- level laser irradiated sides showed a significant reduction in visual analogue pain scales (VAS) during the first three postoperative days (P<0.05). The VAS scores of the laser treated sides were 4.46, 4.00, and 3.35 as compared to 6.58, 5.82, and 5.17 for the control sides. The swelling, and trismus were significantly reduced on the first and third postoperative days in the laser treated sides, as compared to the control sides (P<0.05). The facial measurements during the first and third postoperative days were 108.72 mm and 114.77 mm in the laser sides and 113.57 mm and 118.43 mm in the control sides. The degree of mouth opening during the first and third postoperative days were 33.48 mm and 30.37 mm in the laser sides and 27.93 mm and 25.58 mm in the control sides Conclusions — Single intraoral application of low- level laser is effective in reducing pain, swelling and trismus after mandibular third molar surgery. Therefore, it can be used as an adjuvant in controlling postoperative complications after lower third molar surgery.

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Section: Discussionmentioning

confidence: 94%

“…In contrast to our results, Singh et al [41] found no significant effects of laser on trismus. In addition, in their systematic review and meta-analysis, Domah et al [44] Duarte de Oliveira et al [45], didn't found any significant effects of laser on the maximum mouth opening after third molar surgery.…”

Section: Discussionmentioning

confidence: 95%

Effect Of Low-Level Laser Therapy On Inflammatory Sequеlae Of Impacted Mandibular Third Molar Surgery: A Single-Blind, Placebo-Controlled, Randomized Clinical Trial

Hamad

2022

Russ Open Med J

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“…Six studies [ 7 , 12 , 13 , 27 , 30 , 32 ] had a high risk of bias regarding the study selection process (due to lack of specified databases' searched strategy or potential risk of selection of RCTs by only one reviewer instead of 2≤ independent reviewers). Seven studies [ 10 ]; [ 27 , 29 , 32 , 35 , 36 , 39 ] had a high risk of bias regarding the data collection step (according to unclear efforts made to minimize errors in data collection and quality assessment). In terms of synthesis, 9 studies [ 10 ]; [ 8 , 11 , 27 ]; [ 13 , 30 , 35 – 37 ] showed a high risk of bias (due to lack of appropriate interpretation and justification of the observed high heterogeneity or due to lack of sensitivity analysis where possible) ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Due to the lower overlap of Brignardello-Petersen et al's study [ 33 ] with other meta-analyses and outdated search strategies compared to Dawdy et al‘s, Dawdy et al's study [ 34 ] was selected for the main analysis. Domah et al's [ 35 ] and de Oliveira et al's [ 36 ] studies were excluded from the analyses due to their high risk of bias. Among two remaining meta-analyses [ 6 , 37 ] with moderate risk of bias and high overlap, the study conducted by de Barros et al [ 13 ] was included in the sensitivity analysis due to the inclusion of more recent RCTs compared with Dawdy et al's study (Figures 5 and 6 ).…”

Section: Resultsmentioning

confidence: 99%

Nonpharmacological Complementary Interventions for the Management of Pain after Third Molar Surgery: An Umbrella Review of Current Meta-Analyses

Firoozi

Falci

Kim

et al. 2022

Pain Research and Management

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Objectives. To provide a nonbiased, complete assessment of what the evidence from meta-analyses informs us about complementary and nonpharmacological treatment options for the management of pain after third molar surgery, as well as highlight any discordancy, gaps, or lack of evidence among meta-analyses. Methods. The quality of the included systematic reviews was assessed using the ROBIS tool. Corrected covered area (CCA) was calculated for pairs of similar meta-analyses to identify the amount of overlap. Reviews that were the most recent, comprehensive, and had adequate quality were considered for analyses when reviews showed a high overlap. In cases with a low amount of overlap among meta-analyses, all eligible studies were included. Also, citation matrices were constructed to address overlap. A network meta-analytical approach was adopted to rank different interventions. Results. Ten meta-analyses were included for quantitative synthesis. The quantitative analysis revealed that platelet-rich fibrin and its derivatives as well as ozone therapy reduce early and late pain better than the other complementary interventions compared to control (no complementary intervention). Conclusions. Despite the shortcomings of included meta-analyses, consolidated evidence suggests that platelet-rich-fibrin and its derivatives as well as ozone therapy outperform the other nonpharmacological complementary interventions in reducing early and late postsurgical pain following third molar extraction. However, the results should be interpreted with caution due to an unclear risk of bias and lack of firm evidence in the included meta-analyses. Moreover, there is a need for a standard protocol for the application of nonpharmacological complementary interventions.

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“…LLLT acts like an anaesthetic agent that temporally disrupts the cytoskeleton. The exact mechanism for this effect is unknown, but it has been shown that LLLT promote vasodilatation, enhance blood flow, lymph drainage and fibroblast and neutrophil activation, which results in changes in the pain threshold [14]. The modulation of neurotransmitters is another possible mechanism of pain relief, as serotonin and endorphin levels have been shown to increase following laser treatment of myofascial pain in patients [15].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and therapeutic efficacy of a two-week low-level laser acupuncture therapy for shoulder and neck pain in office workers: Protocol for a pilot, single-blind, double-armed, randomised controlled trial

et al. 2022

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Background Shoulder and neck pain (SNP) is common in office workers and represents a serious public health problem given its detrimental impact on quality of life, physical functioning, personal finances, employers, and the health care system. Management with painkillers has adverse implications such as tolerance, addiction, and opioid abuse. Safe, sustainable, cost-effective, and evidence-based solutions are urgently needed. The non-invasive, painless, non-infectious, and safe modality of low-level laser acupuncture (LLLA) has shown promise for SNP management. Objective The overarching aim of this study is to provide evidence of the feasibility and therapeutic efficacy of LLLA for office workers with SNP. Methods This is a pilot, single-blind, double-armed, randomised controlled trial on the feasibility and therapeutic efficacy of a two-week LLLA therapy for office workers with SNP, aged 18 to 65 years. Each of the two study groups will contain 35 participants: the intervention group will receive LLLA from a licensed acupuncturist at the researchers’ university clinic (10–20 min/session, 3 sessions/week) for two weeks; the control group will receive usual care without painkillers. Outcomes will be measured at baseline, throughout the two-week intervention, and at trial end. Surveys including open-ended questions will be completed. The primary outcome of this study is to evaluate the feasibility of a two-week LLLA therapy for office workers with SNP, as measured by recruitment and completion rates, patient safety, and treatment adherence and compliance. Participants’ attitudes, motivation, and challenges to participation, intervention non-compliance, and experience of participating in the trial will be investigated via qualitative data. The secondary outcome is to evaluate the therapeutic efficacy of LLLA on SNP using the visual analogue scale (VAS) and the Short-Form McGill Pain Questionnaire (SF-MPQ); the work productivity and activity assessment (WPAI:SHP); 12-Item Short Form Survey (SF-12) for quality of life assessment; and the past 3-month out-of-pocket (OOP) cost for prescription and non-prescription SNP therapy, which is an indicative of the economic burden of SNP on patients and health care systems. This study was approved by Edith Cowan University’s Human Research Ethics Committee (No. 2021-02225-WANG). Results Data collection will commence in December 2021 with anticipated completion by December 2022. Conclusions Safe, sustainable, cost-effective, evidence-based interventions are needed to minimise the negative implications of SNP in office workers. LLLA is a promising modality in managing SNP. However, more consolidated evidence is required to provide insight regarding the effectiveness of LLLA. This study is expected to contribute to the challenging work of reducing the burden of SNP in office workers. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000426886p; https://www.anzctr.org.au/ACTRN12621000426886p.aspx

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Use of low-level laser therapy to reduce postoperative pain, edema, and trismus following third molar surgery: A systematic review and meta-analysis

Cited by 23 publications

References 52 publications

Effect Of Low-Level Laser Therapy On Inflammatory Sequеlae Of Impacted Mandibular Third Molar Surgery: A Single-Blind, Placebo-Controlled, Randomized Clinical Trial

Effect Of Low-Level Laser Therapy On Inflammatory Sequеlae Of Impacted Mandibular Third Molar Surgery: A Single-Blind, Placebo-Controlled, Randomized Clinical Trial

Nonpharmacological Complementary Interventions for the Management of Pain after Third Molar Surgery: An Umbrella Review of Current Meta-Analyses

Feasibility and therapeutic efficacy of a two-week low-level laser acupuncture therapy for shoulder and neck pain in office workers: Protocol for a pilot, single-blind, double-armed, randomised controlled trial

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