Photobiomodulation for Managing "Dry Socket": A Randomised Controlled Trial

Abstract

Objective: There are no studies that have evaluated the effect of Alveogyl with and without adjunct photobiomodulation therapy (PBMT) in reducing self-rated post-operative pain (SPP) in patients with alveolar osteitis (AO; dry socket). The aim of the present randomised controlled trial was to assess the effectiveness of Alveogyl with and without PBMT for the management of SPP in patients with AO.

Methods: Adult nonsmokers with diagnosed AO were included. Patients were randomly divided into 4 groups. In Group 1, patients underwent mechanical curettage (MC) with copious normal saline irrigation. In Group 2, patients underwent MC + Alveogyl dressings in extraction sites which were changed every 48 hours until cessation of pain. In Group 3, patients underwent MC + Alveogyl followed by PBMT using a 660-nm indium-gallium-aluminum-phosphide diode laser. In Group 4, patients were treated solely with PBMT. The visual analogue scale was used up to 3 postoperative days to assess SPP up to 3 days at 6- (T0) and 12-hour (T1) intervals. Statistical analyses were performed using the analysis of variance and Bonferroni post hoc adjustment tests. Correlation between SPP scores and age, sex, and eruption status of teeth was assessed using logistic regression models. P values <.01 were nominated as being statistically significant.

Results: In all, 14, 13, 14, and 14 individuals with AO were included in groups 1, 2, 3 and 4, respectively. All patients had undergone extraction of mandibular third molars. At baseline and on day 1, there was no difference in SPP in all groups. On days 2 and 3, mean visual analogue scale (VAS) scores at T1 (P < .01) and T2 (P < .01) intervals were significantly high in Group 2 compared with Group 3. On days 2 and 3, mean VAS scores at T1 (P < .01) and T2 (P < .01) intervals were significantly high in Group 4 compared with Group 3. There was no difference in SPP in groups 3 and 4 on day 3 at T0 and T1 intervals.

Conclusions: PBMT following MC and Alveogyl dressing is more efficient in reducing SPP compared with MC with or without Alveogyl dressing in patients with AO.

Keywords: Alveogyl; Alveolar osteitis; Pain; Photobiomodulation; Visual analogue scale.

Fig. 1

Mean self-rated postoperative pain scores at T1 and T2 intervals in groups 1 (blue bars) and 2 (red bars). *Compared with T1 in Group 2 (P < .01). ^†Compared with T2 in Group 2 (P < .01). ^‡Compared with T1 in Group 2 (P < .01). ^§Compared with T2 in Group 2 (P < .01).

Fig. 2

Mean self-rated postoperative pain scores at T1 and T2 intervals in groups 1 (blue bars) and 3 (red bars). *Compared with T1 in Group 3 (P < .01). ^†Compared with T2 in Group 3 (P < .01). ^‡Compared with T1 in Group 3 (P < .01). ^§Compared with T2 in Group 3 (P < .01).

Fig. 3

Mean self-rated postoperative pain scores at T1 and T2 intervals in groups 1 (blue bars) and 4 (red bars). *Compared with T1 in Group 4 (P < .01). ^†Compared with T2 in Group 4 (P < .01).

Fig. 4

Mean self-rated postoperative pain scores at T1 and T2 intervals in groups 2 (blue bars) and 3 (red bars). *Compared with T1 in Group 3 (P < .01). ^†Compared with T2 in Group 3 (P < .01). ^‡Compared with T1 in Group 3 (P < .01). ^§Compared with T2 in Group 3 (P < .01).

Fig. 5

Mean self-rated postoperative pain scores at T1 and T2 intervals in groups 2 (blue bars) and 4 (red bars).

Fig. 6

Mean self-rated post-operative pain scores at T1 and T2 intervals in groups 3 (blue bars) and 4 (red bars). *Compared with T1 in Group 4 (P < .01). ^†Compared with T2 in Group 4 (P < .01).