Effect of Photobiomodulation on the Control of Edema and Pain After Third Molar Surgery: Double-Blinded Randomized Clinical Trial

Abstract

Background: Side effects of third molar surgery include edema and pain. Photobiomodulation (PBM) therapy is a noninvasive technology that minimizes these symptoms.

Purpose: To evaluate the effects of PBM on the control of postoperative edema and pain in patients undergoing surgical removal of third molars.

Study design, setting, and sample: A split-mouth, double-blinded, placebo-controlled, randomized clinical trial was conducted at the Faculty of Dentistry, José Antonio Páez University. The study enrolled patients who required bilateral surgical extraction of the impacted and retained third molars in comparable anatomical positions. Patients with soft or hard tissue pathology or systemic inflammatory conditions that could compromise healing were excluded from the study.

Predictor variable: The exposure to PBM was a predictor variable. One side of the jaw was randomly assigned as the treatment side and the opposite side as the untreated or control side. The treatment side received PBM using a 980 nm diode laser immediately after surgery and at 24, 48, and 72 hours postoperatively.

Outcome variables: The primary outcome variables were edema and pain. Edema was measured using a visual analog scale (VAS) and facial measurements (using a measuring tape in maximum intercuspation). Pain was measured using only the VAS.

Covariates: The covariates included age, sex, skin phototype, and analgesic use.

Analyses: Two-way analysis of variance and repeated measures analysis of variance were used for comparative analysis. A P value <.05 was considered statistically significant.

Results: A total of 37 patients, including 12 males (32.4%) and 25 females (67.6%), with a mean age of 22.8 ± 3.6 years, completed the study. Perceived edema, measured using a 10-cm VAS, was significantly lower in the PBM group at 24 hours (6 ± 2 vs 8 ± 2; P < .001), 48 hours (5 ± 2 cm vs 7 ± 2; P < .001), and 72 hours (3 ± 2 vs 6 ± 2; P < .001). Pain scores were also significantly reduced in the PBM group at 24 hours (4 ± 3 vs 6 ± 3; P = .002), 48 hours (4 ± 3 vs 5 ± 2; P = .003), and 72 hours (2 ± 2 vs 4 ± 2; P = .004).

Conclusion: The use of PBM significantly reduced edema and pain after the third molar surgery compared with the control group.