Research Article
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Does Laser-LED Photobiomodulation Therapy Alleviate Swlling, Pain, and Trismus Following Impacted Third Molar Extraction?

Year 2025, Volume: 28 Issue: 1, 115 - 121, 28.03.2025

Esengül Şen , Yunus Balel

https://doi.org/10.7126/cumudj.1615267

Abstract

Objectives: The aim of this study is to examine the effectiveness of a single-session application of laser-LED based photobiomodulation therapy (PBMT) (using a 904 nm GaAlAs infrared laser and a 650 nm InGaAIP LED) on pain, edema, trismus, and the quality of life of patients following impacted mandibular third molar extraction.
Materials and Methods: The study included patients whose impacted mandibular third molars were to be extracted for prophylactic purposes. The patients were divided into two groups as the PBMT group and the placebo control group. Pain, swelling, maximum mouth opening, and quality of life parameters of the patients were evaluated.
Results: The study included a total of 36 patients, with 15 in the placebo control group and 21 in the laser group. Pain, maximum mouth opening, and edema measurements changed statistically after surgery (P<.05), but there was no statistically significant difference between the groups (P>.05). While no statistically significant difference was found between the groups in terms of isolation, eating-drinking, sleep, and physical appearance, the placebo control group was significantly less affected in terms of speech changes compared to the laser group (P = .019).
Conclusions: Further randomized controlled clinical trials are required to determine the optimal wavelength and dose for PBMT in reducing morbidity after impacted wisdom tooth surgery.

Keywords

Photobiomodulation Impacted third molar Extraction Pain Edema

Ethical Statement

This study was approved by Tokat Gaziosmanpaşa University Clinical Research Ethics Committee with the number 21-KAEK-078.

Supporting Institution

Tokat Gaziosmanpaşa University Scientific Research Projects Commission

Project Number

2021/20

References

  • 1. Balel Y. Bibliometric analysis of international publication trends in impacted third molar surgery research (2000–2020). Br J Oral Maxillofac Surg 2021;59:1220-1226.
  • 2. Steed MB. The indications for third-molar extractions. J Am Dent Assoc 2014;145:570-573.
  • 3. Vranckx M, Fieuws S, Jacobs R, Politis C. Prophylactic vs. Symptomatic Third Molar Removal: Effects on Patient Postoperative Morbidity. J Evid Based Dent Pract 2021;21:101582.
  • 4. Peñarrocha-Diago M, Camps-Font O, Sánchez-Torres A, Figueiredo R, Sánchez-Garcés M-A, Gay-Escoda C. Indications of the extraction of symptomatic impacted third molars. A systematic review. J Clin Exp Dent 2021;13:e278-286.
  • 5. Anders JJ, Lanzafame RJ, Arany PR. Low-level light/laser therapy versus photobiomodulation therapy. Photomed Laser Surg 2015;33:183.
  • 6. Dompe C, Moncrieff L, Matys J, Grzech-Leśniak K, Kocherova I, Bryja A, et al. Photobiomodulation-Underlying Mechanism and Clinical Applications. J Clin Med 2020;9:1724.
  • 7. Ferraresi C, Kaippert B, Avci P, Huang Y-Y, de Sousa MVP, Bagnato VS, et al. Low-level laser (light) therapy increases mitochondrial membrane potential and ATP synthesis in C2C12 myotubes with a peak response at 3-6 h. Photochem Photobiol 2015;91:411-416.
  • 8. Cotler HB, Chow RT, Hamblin MR, Carroll J. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol 2015;2:68-69.
  • 9. İşler S, Uraz A, Şengül J, Çakiroğlu M, Bakirarar B, Çetiner F. Evalution of the Patiens Oral Health Related Quality of Life After Harvesting Free Gingival Graft. Cumhur Dent J 2019;22:11-21.
  • 10. Farivar S, Malekshahabi T, Shiari R. Biological effects of low level laser therapy. J Lasers Med Sci 2014;5:58-62.
  • 11. Bearne LM, Hurley M V. Chapter 8 - Physical therapies: Treatment options in rheumatology. In: Dziedzic K, Hammond ABT-R, editors., Edinburgh: Churchill Livingstone; 2010, p. 111–122.
  • 12. Domah F, Shah R, Nurmatov UB, Tagiyeva N. The Use of Low-Level Laser Therapy to Reduce Postoperative Morbidity After Third Molar Surgery: A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 2021;79:313-319.
  • 13. Majid OW, Al-Mashhadani BA. Perioperative bromelain reduces pain and swelling and improves quality of life measures after mandibular third molar surgery: A randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 2014;72:1043-1048.
  • 14. Sales PH da H, Barros AWP, Silva PG de B, Vescovi P, Leão JC. Is the Er: YAG Laser Effective in Reducing Pain, Edema, and Trismus After Removal of Impacted Mandibular Third Molars? A Meta-Analysis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 2022;80:501-516.
  • 15. do Nascimento-Júnior EM, Dos Santos GMS, Tavares Mendes ML, Cenci M, Correa MB, Pereira-Cenci T, et al. Cryotherapy in reducing pain, trismus, and facial swelling after third-molar surgery: Systematic review and meta-analysis of randomized clinical trials. J Am Dent Assoc 2019;150:269-277.
  • 16. Duarte de Oliveira FJ, Brasil GMLC, Araújo Soares GP, Fernandes Paiva DF, de Assis de Souza Júnior F. Use of low-level laser therapy to reduce postoperative pain, edema, and trismus following third molar surgery: A systematic review and meta-analysis. J Cranio-Maxillo-Facial Surg Off Publ Eur Assoc Cranio-Maxillo-Facial Surg 2021;49:1088-1096.
  • 17. Hagiwara S, Iwasaka H, Okuda K, Noguchi T. GaAlAs (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Lasers Surg Med 2007;39:797-802.
  • 18. de Lima FM, Villaverde AB, Albertini R, Corrêa JC, Carvalho RLP, Munin E, et al. Dual Effect of low-level laser therapy (LLLT) on the acute lung inflammation induced by intestinal ischemia and reperfusion: Action on anti- and pro-inflammatory cytokines. Lasers Surg Med 2011;43:410-420.
  • 19. Heu F, Forster C, Namer B, Dragu A, Lang W. Effect of low-level laser therapy on blood flow and oxygen- hemoglobin saturation of the foot skin in healthy subjects: a pilot study. Laser Ther 2013;22:21–30.
  • 20. Lang-Illievich K, Winter R, Rumpold-Seitlinger G, Schicho K, Dorn C, Klivinyi C, et al. The Effect of Low-Level Light Therapy on Capsaicin-Induced Peripheral and Central Sensitization in Healthy Volunteers: A Double-Blinded, Randomized, Sham-Controlled Trial. Pain Ther 2020;9:717-726.
  • 21. Asutay F, Ozcan-Kucuk A, Alan H, Koparal M. Three-Dimensional Evaluation of the Effect of Low-Level Laser Therapy on Facial Swelling after Lower Third Molar Surgery: A Randomized, Placebo-Controlled Study. Niger J Clin Pract 2018;21.
  • 22. Hamid MA. Low-level Laser Therapy on Postoperative Pain after Mandibular Third Molar Surgery. Ann Maxillofac Surg 2017;7:207-216.
  • 23. Eshghpour M, Ahrari F, Takallu M. Is Low-Level Laser Therapy Effective in the Management of Pain and Swelling After Mandibular Third Molar Surgery? J Oral Maxillofac Surg 2016;74:1322-1328.
  • 24. Saber K, Chiniforush N, Shahabi S. The effect of low level laser therapy on pain reduction after third molar surgery. Minerva Stomatol 2012;61:319-322.
  • 25. Sierra SO, Deana AM, Bussadori SK, Mota ACC da, Motta LJ, Ferrari RAM, et al. Effect of low-intensity laser treatment on pain after extraction of impacted mandibular third molars: a randomised, controlled, clinical trial. Br J Oral Maxillofac Surg 2015;53:996–1000.
  • 26. Sampaio-Filho H, Bussadori SK, Gonçalves MLL, Silva D de FT da, Borsatto MC, Tortamano IP, et al. Low-level laser treatment applied at auriculotherapy points to reduce postoperative pain in third molar surgery: A randomized, controlled, single-blinded study. PLoS One 2018;13:e0197989.
  • 27. Fikackova H, Navratilova B, Dylevsky I, Navratil L, Jirman R. Assessment of the effect of non-invasive laser on the process of healing of an extraction wound by infrared thermography: preliminary study. J Appl Biomed 2003;1:175-180.
  • 28. Messer EJ, Keller JJ. The use of intraoral dexamethasone after extraction of mandibular third molars. Oral Surg Oral Med Oral Pathol 1975;40:594-598.
  • 29. Beirne OR, Hollander B. The effect of methylprednisolone on pain, trismus, and swelling after removal of third molars. Oral Surg Oral Med Oral Pathol 1986;61:134-138.
  • 30. Sortino F, Cicciù M. Strategies used to inhibit postoperative swelling following removal of impacted lower third molar. Dent Res J (Isfahan) 2011;8:162–71.
  • 31. Aras MH, Güngörmüş M. The Effect of Low-Level Laser Therapy on Trismus and Facial Swelling Following Surgical Extraction of a Lower Third Molar. Photomed Laser Surg 2009;27:21–24.
  • 32. López-Ramírez M, Vílchez-Pérez MÁ, Gargallo-Albiol J, Arnabat-Domínguez J, Gay-Escoda C. 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. Lasers Med Sci 2012;27:559–566.
  • 33. Eroglu CN, Keskin Tunc S. Effectiveness of Single Session of Low-Level Laser Therapy with a 940 nm Wavelength Diode Laser on Pain, Swelling, and Trismus After Impacted Third Molar Surgery. Photomed Laser Surg 2016;34:406–410.
  • 34. Jaroń A, Preuss O, Konkol B, Trybek G. Quality of Life of Patients after Kinesio Tape Applications Following Impacted Mandibular Third Molar Surgeries. J Clin Med 2021;10.
  • 35. Duarte-Rodrigues L, Miranda EFP, Souza TO, de Paiva HN, Falci SGM, Galvão EL. Third molar removal and its impact on quality of life: systematic review and meta-analysis. Qual Life Res an Int J Qual Life Asp Treat Care Rehabil 2018;27:2477–2489.
  • 36. Ibikunle AA, Adeyemo WL. Oral health-related quality of life following third molar surgery with or without application of ice pack therapy. Oral Maxillofac Surg 2016;20:239–247.

Lazer-LED Fotobiyomodülasyon Terapisi, Gömülü Üçüncü Molar Dişi Çekimi Sonrasında Şişlik, Ağrı ve Trismusu Hafifletir mi?

Year 2025, Volume: 28 Issue: 1, 115 - 121, 28.03.2025

Esengül Şen , Yunus Balel

https://doi.org/10.7126/cumudj.1615267

Abstract

Amaç: Bu çalışmanın amacı, gömülü mandibular üçüncü molar çekimi sonrası lazer-LED tabanlı fotobiyomodülasyon tedavisinin (PBMT) (904 nm GaAlAs kızılötesi lazer ve 650 nm InGaAIP LED kullanılarak) tek seanslık uygulamasının ağrı, ödem, trismus ve hastaların yaşam kalitesi üzerindeki etkinliğini incelemektir.
Gereç ve Yöntemler: Çalışmaya, profilaktik amaçlarla gömülü mandibular üçüncü molar dişleri çekilecek hastalar dahil edilmiştir. Hastalar, PBMT grubu ve plasebo kontrol grubu olarak ikiye ayrılmıştır. Hastaların ağrı, şişlik, maksimum ağız açıklığı ve yaşam kalitesi parametreleri değerlendirilmiştir.
Bulgular: Çalışmaya toplamda 36 hasta dahil edilmiştir; bunların 15’i plasebo kontrol grubunda, 21’i ise lazer grubunda yer almıştır. Ameliyat sonrası ağrı, maksimum ağız açıklığı ve ödem ölçümleri istatistiksel olarak anlamlı değişiklik göstermiştir (P<.05), ancak gruplar arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (P>.05). İzolasyon, yeme-içme, uyku ve fiziksel görünüm açısından gruplar arasında anlamlı bir fark bulunmazken, konuşma değişiklikleri açısından plasebo kontrol grubunun lazer grubuna göre anlamlı derecede daha az etkilendiği tespit edilmiştir (P = .019).
Sonuçlar: Gömülü yirmi yaş dişi çekimi sonrası morbiditeyi azaltmada PBMT için optimal dalga boyu ve dozun belirlenmesi amacıyla daha fazla randomize kontrollü klinik çalışmaya ihtiyaç vardır.

Keywords

Fotobiyomodülasyon Gömülü Üçüncü Molar Çekim Ağrı Ödem

Project Number

2021/20

References

  • 1. Balel Y. Bibliometric analysis of international publication trends in impacted third molar surgery research (2000–2020). Br J Oral Maxillofac Surg 2021;59:1220-1226.
  • 2. Steed MB. The indications for third-molar extractions. J Am Dent Assoc 2014;145:570-573.
  • 3. Vranckx M, Fieuws S, Jacobs R, Politis C. Prophylactic vs. Symptomatic Third Molar Removal: Effects on Patient Postoperative Morbidity. J Evid Based Dent Pract 2021;21:101582.
  • 4. Peñarrocha-Diago M, Camps-Font O, Sánchez-Torres A, Figueiredo R, Sánchez-Garcés M-A, Gay-Escoda C. Indications of the extraction of symptomatic impacted third molars. A systematic review. J Clin Exp Dent 2021;13:e278-286.
  • 5. Anders JJ, Lanzafame RJ, Arany PR. Low-level light/laser therapy versus photobiomodulation therapy. Photomed Laser Surg 2015;33:183.
  • 6. Dompe C, Moncrieff L, Matys J, Grzech-Leśniak K, Kocherova I, Bryja A, et al. Photobiomodulation-Underlying Mechanism and Clinical Applications. J Clin Med 2020;9:1724.
  • 7. Ferraresi C, Kaippert B, Avci P, Huang Y-Y, de Sousa MVP, Bagnato VS, et al. Low-level laser (light) therapy increases mitochondrial membrane potential and ATP synthesis in C2C12 myotubes with a peak response at 3-6 h. Photochem Photobiol 2015;91:411-416.
  • 8. Cotler HB, Chow RT, Hamblin MR, Carroll J. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol 2015;2:68-69.
  • 9. İşler S, Uraz A, Şengül J, Çakiroğlu M, Bakirarar B, Çetiner F. Evalution of the Patiens Oral Health Related Quality of Life After Harvesting Free Gingival Graft. Cumhur Dent J 2019;22:11-21.
  • 10. Farivar S, Malekshahabi T, Shiari R. Biological effects of low level laser therapy. J Lasers Med Sci 2014;5:58-62.
  • 11. Bearne LM, Hurley M V. Chapter 8 - Physical therapies: Treatment options in rheumatology. In: Dziedzic K, Hammond ABT-R, editors., Edinburgh: Churchill Livingstone; 2010, p. 111–122.
  • 12. Domah F, Shah R, Nurmatov UB, Tagiyeva N. The Use of Low-Level Laser Therapy to Reduce Postoperative Morbidity After Third Molar Surgery: A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 2021;79:313-319.
  • 13. Majid OW, Al-Mashhadani BA. Perioperative bromelain reduces pain and swelling and improves quality of life measures after mandibular third molar surgery: A randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 2014;72:1043-1048.
  • 14. Sales PH da H, Barros AWP, Silva PG de B, Vescovi P, Leão JC. Is the Er: YAG Laser Effective in Reducing Pain, Edema, and Trismus After Removal of Impacted Mandibular Third Molars? A Meta-Analysis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 2022;80:501-516.
  • 15. do Nascimento-Júnior EM, Dos Santos GMS, Tavares Mendes ML, Cenci M, Correa MB, Pereira-Cenci T, et al. Cryotherapy in reducing pain, trismus, and facial swelling after third-molar surgery: Systematic review and meta-analysis of randomized clinical trials. J Am Dent Assoc 2019;150:269-277.
  • 16. Duarte de Oliveira FJ, Brasil GMLC, Araújo Soares GP, Fernandes Paiva DF, de Assis de Souza Júnior F. Use of low-level laser therapy to reduce postoperative pain, edema, and trismus following third molar surgery: A systematic review and meta-analysis. J Cranio-Maxillo-Facial Surg Off Publ Eur Assoc Cranio-Maxillo-Facial Surg 2021;49:1088-1096.
  • 17. Hagiwara S, Iwasaka H, Okuda K, Noguchi T. GaAlAs (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Lasers Surg Med 2007;39:797-802.
  • 18. de Lima FM, Villaverde AB, Albertini R, Corrêa JC, Carvalho RLP, Munin E, et al. Dual Effect of low-level laser therapy (LLLT) on the acute lung inflammation induced by intestinal ischemia and reperfusion: Action on anti- and pro-inflammatory cytokines. Lasers Surg Med 2011;43:410-420.
  • 19. Heu F, Forster C, Namer B, Dragu A, Lang W. Effect of low-level laser therapy on blood flow and oxygen- hemoglobin saturation of the foot skin in healthy subjects: a pilot study. Laser Ther 2013;22:21–30.
  • 20. Lang-Illievich K, Winter R, Rumpold-Seitlinger G, Schicho K, Dorn C, Klivinyi C, et al. The Effect of Low-Level Light Therapy on Capsaicin-Induced Peripheral and Central Sensitization in Healthy Volunteers: A Double-Blinded, Randomized, Sham-Controlled Trial. Pain Ther 2020;9:717-726.
  • 21. Asutay F, Ozcan-Kucuk A, Alan H, Koparal M. Three-Dimensional Evaluation of the Effect of Low-Level Laser Therapy on Facial Swelling after Lower Third Molar Surgery: A Randomized, Placebo-Controlled Study. Niger J Clin Pract 2018;21.
  • 22. Hamid MA. Low-level Laser Therapy on Postoperative Pain after Mandibular Third Molar Surgery. Ann Maxillofac Surg 2017;7:207-216.
  • 23. Eshghpour M, Ahrari F, Takallu M. Is Low-Level Laser Therapy Effective in the Management of Pain and Swelling After Mandibular Third Molar Surgery? J Oral Maxillofac Surg 2016;74:1322-1328.
  • 24. Saber K, Chiniforush N, Shahabi S. The effect of low level laser therapy on pain reduction after third molar surgery. Minerva Stomatol 2012;61:319-322.
  • 25. Sierra SO, Deana AM, Bussadori SK, Mota ACC da, Motta LJ, Ferrari RAM, et al. Effect of low-intensity laser treatment on pain after extraction of impacted mandibular third molars: a randomised, controlled, clinical trial. Br J Oral Maxillofac Surg 2015;53:996–1000.
  • 26. Sampaio-Filho H, Bussadori SK, Gonçalves MLL, Silva D de FT da, Borsatto MC, Tortamano IP, et al. Low-level laser treatment applied at auriculotherapy points to reduce postoperative pain in third molar surgery: A randomized, controlled, single-blinded study. PLoS One 2018;13:e0197989.
  • 27. Fikackova H, Navratilova B, Dylevsky I, Navratil L, Jirman R. Assessment of the effect of non-invasive laser on the process of healing of an extraction wound by infrared thermography: preliminary study. J Appl Biomed 2003;1:175-180.
  • 28. Messer EJ, Keller JJ. The use of intraoral dexamethasone after extraction of mandibular third molars. Oral Surg Oral Med Oral Pathol 1975;40:594-598.
  • 29. Beirne OR, Hollander B. The effect of methylprednisolone on pain, trismus, and swelling after removal of third molars. Oral Surg Oral Med Oral Pathol 1986;61:134-138.
  • 30. Sortino F, Cicciù M. Strategies used to inhibit postoperative swelling following removal of impacted lower third molar. Dent Res J (Isfahan) 2011;8:162–71.
  • 31. Aras MH, Güngörmüş M. The Effect of Low-Level Laser Therapy on Trismus and Facial Swelling Following Surgical Extraction of a Lower Third Molar. Photomed Laser Surg 2009;27:21–24.
  • 32. López-Ramírez M, Vílchez-Pérez MÁ, Gargallo-Albiol J, Arnabat-Domínguez J, Gay-Escoda C. 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. Lasers Med Sci 2012;27:559–566.
  • 33. Eroglu CN, Keskin Tunc S. Effectiveness of Single Session of Low-Level Laser Therapy with a 940 nm Wavelength Diode Laser on Pain, Swelling, and Trismus After Impacted Third Molar Surgery. Photomed Laser Surg 2016;34:406–410.
  • 34. Jaroń A, Preuss O, Konkol B, Trybek G. Quality of Life of Patients after Kinesio Tape Applications Following Impacted Mandibular Third Molar Surgeries. J Clin Med 2021;10.
  • 35. Duarte-Rodrigues L, Miranda EFP, Souza TO, de Paiva HN, Falci SGM, Galvão EL. Third molar removal and its impact on quality of life: systematic review and meta-analysis. Qual Life Res an Int J Qual Life Asp Treat Care Rehabil 2018;27:2477–2489.
  • 36. Ibikunle AA, Adeyemo WL. Oral health-related quality of life following third molar surgery with or without application of ice pack therapy. Oral Maxillofac Surg 2016;20:239–247.
There are 36 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Surgery
Journal Section Original Research Articles
Authors

Esengül Şen 0000-0001-9273-0235

Yunus Balel 0000-0003-0496-8564

Project Number 2021/20
Publication Date March 28, 2025
Submission Date January 7, 2025
Acceptance Date February 5, 2025
Published in Issue Year 2025Volume: 28 Issue: 1

Cite

EndNote Şen E, Balel Y (March 1, 2025) Does Laser-LED Photobiomodulation Therapy Alleviate Swlling, Pain, and Trismus Following Impacted Third Molar Extraction?. Cumhuriyet Dental Journal 28 1 115–121.
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