Pain, Oedema and Trismus Responses Following Photobiomodulation Therapy Immediately After Lower Third Molar Extraction: Results of a Randomized, Doble-Blind and Split Mouth Clinical Trial

This is the authors' abstract. We don't add key points for this paper.

• -The study confirmed the effectiveness of photobiomodulation therapy in reducing adverse effects post-extraction of lower third molars. • A total of 83 subjects participate in this randomised, split-mouth, double-centre clinical trial. • We compared the outcomes between the side treated with activated laser and the side treated with a simulated laser. • We provided an application protocol based on previous studies which, like ours, had successful results. To assess the impact of photobiomodulation therapy in pain, facial oedema, and trismus mitigation in the postoperative period after lower third molar extractions. We conducted a comparison between active photobiomodulation and simulated photobiomodulation after both lower third molars extraction in the same patients, within a double-centre clinical trial. The role of photobiomodulation was evaluated based on pain, measured using the VAS scale. Oedema and trismus, assessed through millimetric measurements. Additionally, analgesic consumption was monitored during the 7-day postoperative period. The study adhered to the CONSORT checklist and was registered on the ClinicalTrials (NCT05255731). The Levene test was used to assess precision (α=0.05), and statistical analysis was performed using Jamovi software. Paired t-tests or the Wilcoxon test were employed to analyse the primary and secondary outcomes. The study included 83 patients and 166 randomisation units. The study group showed a significant reduction in pain at all evaluation times (p < 0.01), as well as reductions in facial oedema and trismus on postoperative days 2 and 7 (p < 0.01). A significant difference in analgesic use was observed on all days, except on the 7th postoperative day. The photobiomodulation protocol, using an 808 nm, 100 mW Ga-Al-As diode laser, applied both intraorally and extraorally in a single 30 seconds (3 Joules/per point) postoperative session, significantly reduced pain, oedema, and trismus following mandibular third molar extraction, particularly on postoperative days 2 and 7. Photobiomodulation can be an effective complementary therapy for reducing pain, facial oedema, and trismus in patients after lower third molar extraction.