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Falci SGM, Fernandes IA, Guimarães MTBÁ, Galvão EL, de Souza GM, Al-Moraissi EA. Complementary and alternative therapies for managing postoperative pain after lower third molar surgery: a systematic review and network meta-analysis. Clin Oral Investig 2024; 28:231. [PMID: 38538810 DOI: 10.1007/s00784-024-05625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE The objective of this study was to evaluate the impact of complementary and alternative treatments on postoperative pain following lower third molar surgeries. METHODS A comprehensive search of Electronic databases (Embase, MEDLINE via PubMed, and Cochrane Library) and grey literature was conducted up until May 2022. Randomized clinical trials investigating the effect of acupuncture, ozone therapy, laser (LLLT), drainage tube, kinesio-taping, ice therapy, and compressions on pain after LTM surgeries were included. The estimated mean differences (MD) for alternative therapies were pooled using the frequentist approach to random-model network meta-analysis NMA. RESULTS Eighty-two papers were included in the qualitative analysis; 33 of them were included in the quantitative analyzes. NMA revealed that drainage tube and kinesio-taping were superior in controlling pain 24-hours postoperatively than no-treatment. At 48-hours follow-up, kinesio-taping and LLLT more effective than placebo and drainage tube; and kinesio-taping and LLLT were superior to no treatment. At 72 h postoperatively, ozone therapy was superior to placebo; and drainage tube, kinesio-taping, and LLLT were better than no treatment. At 7-days follow-up, ozone and LLLT were superior to placebo; and LLLT and kinesio-taping were superior to no treatment. The SUCRA-ranking placed drainage tube as top-ranking intervention at 48-hours (98.2%) and 72-hours (96%) follow-ups, and ozone (83.5%) at 7-days follow-up. CONCLUSION The study findings suggest that these alternative and complementary therapies may be useful in reducing postoperative pain after LTM surgeries, and may offer advantages when combined to traditional pain management methods. CLINICAL RELEVANCE Non-pharmacological therapies are gaining popularity among healthcare professionals and patients. This study found that some of these therapies, specifically kinesio-taping and drainage tube were effective in controlling postoperative pain after third molar surgeries. These findings have important implications for clinical practice, as they highlight the potential benefits of incorporating these therapies into postoperative pain management plans.
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Affiliation(s)
- Saulo Gabriel Moreira Falci
- Department of Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | - Ighor Andrade Fernandes
- Department of Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | | | - Endi Lanza Galvão
- Department of Physiotherapy, Federal University of Vales do Jequitinhonha e Murcuri, Diamantina, Minas Gerais, Brazil
| | - Glaciele Maria de Souza
- Department of Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Dhamar, Yemen
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Bonatto MDS, Feltran GDS, Barbosa TP, Pereira DA, Santos SDS, Mendes PGJ, E Pessoa RS, Bezerra FJB, Zambuzzi WF, de Oliveira GJPL. Green tea and hyaluronic acid gel enhance fibroblast activation and improves the gingival healing post-third molar extraction. Sci Rep 2024; 14:7124. [PMID: 38531928 DOI: 10.1038/s41598-024-57821-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/21/2024] [Indexed: 03/28/2024] Open
Abstract
This study evaluates the effects of a green tea (Camellia sinensis) and hyaluronic acid gel on fibroblast activity and alveolar bone repair following third molar extractions. By examining the gene expression related to cell survival, proliferation, and angiogenesis, the study bridges in vitro findings with clinical outcomes in a split-mouth randomized trial. Human fibroblasts were exposed to the treatment gel, analysing gene expression through RT-qPCR. Twenty participants undergoing bilateral third molar extractions received the test gel on one side and a placebo on the other. Assessments included patient-reported outcomes, professional evaluations, and radiographic analyses at multiple postoperative intervals. The test gel significantly enhanced AKT, CDKs, and VEGF gene expressions, indicating a positive effect on angiogenesis and cell proliferation. Clinically, it resulted in reduced exudate, swelling, and secondary interventions, with radiographs showing improved alveolar bone density after 90 days. The green tea and hyaluronic acid gel significantly improves soft tissue and bone healing post-extraction, offering a promising adjunctive therapy for enhancing postoperative recovery. This gel represents a novel adjuvant treatment option for facilitating improved healing outcomes after third molar extractions, highlighting its potential utility in clinical dental practice.
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Affiliation(s)
- Mariana da Silva Bonatto
- School of Dentistry - Universidade Federal de Uberlândia (UFU), Pará, Av., 1760-1844, Uberlândia, MG, 38405-320, Brazil
| | - Geórgia da Silva Feltran
- UNESP - Campus de Botucatu - Instituto de Biociências, São Paulo State University, Rua Prof a. Dr a. Irina Delanova Gemtchujnicov, s/nº, Botucatu, SP, 18618-693, Brazil
| | - Thamires Prazeres Barbosa
- UNESP - Campus de Botucatu - Instituto de Biociências, São Paulo State University, Rua Prof a. Dr a. Irina Delanova Gemtchujnicov, s/nº, Botucatu, SP, 18618-693, Brazil
| | - Davisson Alves Pereira
- School of Dentistry - Universidade Federal de Uberlândia (UFU), Pará, Av., 1760-1844, Uberlândia, MG, 38405-320, Brazil
| | - Samara de Souza Santos
- School of Dentistry - Universidade Federal de Uberlândia (UFU), Pará, Av., 1760-1844, Uberlândia, MG, 38405-320, Brazil
| | - Pedro Gomes Junqueira Mendes
- School of Dentistry - Universidade Federal de Uberlândia (UFU), Pará, Av., 1760-1844, Uberlândia, MG, 38405-320, Brazil
| | | | - Fábio José Barbosa Bezerra
- UNESP - Campus de Botucatu - Instituto de Biociências, São Paulo State University, Rua Prof a. Dr a. Irina Delanova Gemtchujnicov, s/nº, Botucatu, SP, 18618-693, Brazil
| | - Willian Fernando Zambuzzi
- UNESP - Campus de Botucatu - Instituto de Biociências, São Paulo State University, Rua Prof a. Dr a. Irina Delanova Gemtchujnicov, s/nº, Botucatu, SP, 18618-693, Brazil.
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de Paula LM, de Andrade Fernandes AC, Evangelista BC, do Couto Lima-Moreira F, Andrade G, de Andrade Fernandes JV, de Castro FLA, Roriz VM. Clinical and thermographic evaluation after lower third molar extractions and the application of different photobiomodulation protocols: double-blind randomised clinical trial. Clin Oral Investig 2024; 28:203. [PMID: 38453808 DOI: 10.1007/s00784-024-05594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES to compare the parameters of pain, oedema, temperature, and soft tissue closure in dental sockets that received two different photobiomodulation (PBM) protocols following extractions. MATERIALS AND METHODS Thirty-one participants had their teeth 38 and 48 extracted. Subsequently, one of the dental sockets received PBM at a wavelength (WL) of 808 nanometers (808 group- nm) and the other dental socket received the PBM at WLs of 808 nm and 660 nm, simultaneously (808 + 660 group). The PBM was applied immediately after the surgical procedure and on the 3rd and 7th days. RESULTS The mean of Visual Analogue Scale (VAS) values for pain were 1.45 for the 3rd day and 0.52 for the 7th day in the 808 + 660 and 808 group, respectively. The mean the pogonion-tragus measurement, used to assess facial oedema on the 3rd day, was 15.38 cm (range 13.5-17.5) in the 808 + 660 group and 15.48 cm (range 14.0-17.5) in the 808 group. The mean facial temperatures in the 808 + 660 group were 34.9 degrees Celsius (ºC) (range 33.5-36.4) on the 3rd day and 35 ºC (range 33.4-36.4) on the 7th day. In the 808 group, the mean temperatures were 34.9 ºC (range 33.9-36.2) on the 3rd day and 34.9 ºC (33.7-36.2) on the 7th day. Regarding the dimensions of the dental socket, the mean were similar for both groups. Significant differences between the groups were only observed in the pain parameter and only on the 7th day, being greater for the 808 + 660 group (p = 0.031). CONCLUSIONS The association of the 660 nm with 808 nm, and the increase in energy did not showed more benefits in pain reduction oedema, or acceleration of the closure of the soft tissues of the dental sockets of lower third molars, in the protocols used here. CLINICAL RELEVANCE There is no need to combine lasers at wavelengths of 660 and 808 nm to reduce oedema, pain and repair of soft tissues after extraction of lower third molars. CLINICAL TRIAL REGISTRATION This trial was registered in the Brazilian Registry of Clinical Trials (ReBEC) with the following code: RBR-66pyrh8, on 29th December, 2022.
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Affiliation(s)
- Laiz Moreira de Paula
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | - Alessah Carolyna de Andrade Fernandes
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | - Beatriz Castro Evangelista
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | | | - Geovana Andrade
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | - João Victor de Andrade Fernandes
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | | | - Virgílio Moreira Roriz
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil.
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Lacerda-Santos JT, Granja GL, Firmino RT, Dias RDF, de Melo DP, Granville-Garcia AF, Martins CC. Use of Photobiomodulation to Reduce Postoperative Pain, Edema, and Trismus After Third Molar Surgery: A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg 2023; 81:1135-1145. [PMID: 37290483 DOI: 10.1016/j.joms.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Third molar extraction can cause surgical trauma, which is associated with pain, edema, trismus, and functional limitations. The aim of the present systematic review was to investigate the effects of photobiomodulation (PBM) following the extraction of impacted mandibular third molars. METHODS An electronic search was conducted in 10 databases from inception up to October 2021 and the grey literature, with no restrictions regarding language or year of publication. Randomized controlled clinical trials (RCT) were included. Studies that were not RCTs were excluded. Reviewers independently analyzed titles and abstracts, followed by full-text analysis. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The exposure variable was the use of PBM and the outcomes were pain, edema, and trismus. Meta-analysis was performed using a random-effects model. The estimate was calculated considering standardized mean differences (SMD) and respective 95% confidence intervals (CI) obtained for each outcome on the first, second, third and seventh postoperative days. The level of evidence was assessed using the GRADE approach. RESULTS The search resulted in the 3,324 records. Thirty-three RCTs were included in the systematic review and 23 of these were included in the meta-analyses. The studies involved a total of 1,347 participants (56.6% female and 43.4% male) between 16 and 44 years of age. A greater reduction in pain was found in the PBM group compared to the control group on the third postoperative day (SMD: -1.09; 95% CI: -1.63; -0.55; P < .001; low certainty). Edema was discretely lower in the PBM group on the second postoperative day (SMD: -0.61; 95% CI: -1.09; -0.13; P < .001; low certainty) and trismus was discretely lower in the PBM group on the seventh postoperative day (SMD: 0.48; 95% CI: 0.00; 0.96; P < .001; very low certainty). CONCLUSION The evidence of the effect of PBM regarding the control of pain, edema, and trismus following third molar extractions is low or very low.
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Affiliation(s)
- Jhonatan Thiago Lacerda-Santos
- PhD Student, Postgraduate Program in Dentistry, State University of Paraiba (UEPB), Campina Grande, Brazil; Professor, Department of Dentistry, FIP Campina Grande, Campina Grande, Brazil
| | - Gélica Lima Granja
- PhD Student, Postgraduate Program in Dentistry, State University of Paraiba (UEPB), Campina Grande, Brazil; Professor, Department of Dentistry, FIP Campina Grande, Campina Grande, Brazil
| | - Ramon Targino Firmino
- Professor, School of Medical Sciences of Campina Grande, UNIFACISA University Center (UNIFACISA), Campina Grande, Brazil; Postgraduate Program in Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | | | | | - Carolina Castro Martins
- Associate Professor, Dental School, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Pereira DA, Mendes PGJ, Prisinoto NR, de Rezende Barbosa GL, Soares PBF, de Oliveira GJPL. Advanced platelet-rich-fibrin (A-PRF +) has no additional effect on the healing of post-extraction sockets of upper third molars. A split mouth randomized clinical trial. Oral Maxillofac Surg 2023; 27:411-419. [PMID: 35614276 DOI: 10.1007/s10006-022-01075-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study evaluated the effects of advanced platelet-rich fibrin (A-PRF +) on the healing of upper third molar post-extraction sockets. METHODS Sixteen patients who underwent extractions of the upper third molars (18 and 28) were included in this randomized split-mouth study. The alveoli on the test side were filled with A-PRF + , while the control side was maintained with blood clot. The side that received treatment was randomly defined. Alveolar bone regeneration was evaluated by CBCT scans to assess healing stage, bone density, and fractal analysis 1 week and 90 days post-extraction. Additionally, pain, edema, bleeding, and soft tissue alveolar repair were evaluated by clinical analyses 3, 7, 14, 30, and 90 days after the surgical procedure using a visual analog scale. RESULTS There were no clinical differences regarding treatments in any experimental period. In the tomographic evaluation, at 7 days, the alveoli treated with A-PRF + presented a suggestive sign of higher bone density than the control alveoli, which was not confirmed 90 days after the surgical procedure. CONCLUSION Thus, the use of A-PRF + does not demonstrate a clinical advantage in the repair of post-extraction sockets of upper third molars.
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Affiliation(s)
- Davisson Alves Pereira
- Department of Periodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlândia, MG, Brazil
| | - Pedro Gomes Junqueira Mendes
- Department of Periodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlândia, MG, Brazil
| | - Nuryê Rezende Prisinoto
- Department of Periodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlândia, MG, Brazil
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Nunes CEN, Andrade KDS, Martins CA, Chaves FN, de Oliveira DHIP, Sampieri MBDS. Effectiveness of low power laser in reducing postoperative signs and symptoms after third molar surgery: a triple-blind clinical trial. Braz Dent J 2023; 34:158-168. [PMID: 37909639 PMCID: PMC10642278 DOI: 10.1590/0103-6440202305413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/24/2023] [Indexed: 11/03/2023] Open
Abstract
The objective of this research was to evaluate the effectiveness of using LPL (Low power laser) to reduce pain, edema, and trismus after impacted lower third molar extraction. A split-mouth randomized triple-blind clinical trial was conducted at the Federal University of Ceará. For inclusion criteria, it was necessary that the patient presented a clear indication for removal of both lower third molars, in addition to both molars being in similar positions. The third molars (38 and 48) were randomly allocated to the test group that received the LPL application protocol, and to the placebo group that received a simulation of the protocol, making a total sample of 44 surgeries. Patients in the test group used an average of 50% of the amount of analgesics that was used by the placebo group, however, there was a statistically significant difference only on days four and five. Regarding trismus, the test group presented wide mouth openings, both at 48 hours and at 7 days after surgery compared to the placebo group, but without a statistically significant difference. For edema, we noted an equilibrium between the test group and the placebo group, but no measurement obtained a statistically significant difference. The use of LPL presented better pain and trismus indicators after complex extractions. The use of LPL is thus indicated as a complementary therapy to reduce postoperative discomfort caused by complex tooth extractions.
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Affiliation(s)
| | | | - Carlos Aragão Martins
- Department of Stomatology- School of Odontology, UFC, Federal of University Ceará, Sobral, Ceará, Brazil
| | - Filipe Nobre Chaves
- Department of Stomatology- School of Odontology, UFC, Federal of University Ceará, Sobral, Ceará, Brazil
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Maleki D, Sigaroodi A, Motevasseli S, Maleki D, Fard R. Low-level laser and management of common complications after the mandibular third molar surgery: A double-blind randomized clinical trial. Dent Res J (Isfahan) 2023. [DOI: 10.4103/1735-3327.367913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Cetira Filho EL, Silva PGB, Wong DVT, Choquenaira-Quispe C, Cesário FRAS, de Sousa Nogueira G, de Sousa AVC, de Aguiar ASW, da Cruz Fonseca SG, Costa FWG. Effect of preemptive photobiomodulation associated with nimesulide on the postsurgical outcomes, oxidative stress, and quality of life after third molar surgery: a randomized, split-mouth, controlled clinical trial. Clin Oral Investig 2022; 26:6941-6960. [PMID: 35948699 PMCID: PMC9365445 DOI: 10.1007/s00784-022-04649-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/16/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this study is to compare the effect of photobiomodulation with low-level laser therapy (LLLT) and nimesulide on inflammatory parameters, biomarkers of oxidative stress and inflammation, and quality of life after lower third molar (L3M) surgery. MATERIAL AND METHODS A randomized, two-factor, triple-blind, controlled, split-mouth clinical trial was performed with 40 volunteers who required bilateral L3M removal. Patients were allocated depending on the use or not of 100 mg nimesulide 1 hbefore surgery, as well as the use or not of LLLT in the preoperative period. RESULTS Pain peaks occurred after 6 h (nimesulide-placebo [N-P] group) and 8 h (nimesulide group). In the N-P group, LLLT resulted in significantly lower mean pain scores than the subgroup without LLLT after 4 h (p = 0.009) and 6 h (p = 0.048). As for edema, a shorter distance between the mandibular angle and the outer canthus of the eyes after 7 days (p = 0.037) and a smaller cumulative effect (p = 0.036) were observed in the N-P group associated with LLLT. A direct effect between LLLT (p = 0.047) and a reduction in the mean scores of overall dissatisfaction with quality of life was detected. CONCLUSIONS Preemptive use of nimesulide only delayed peak pain. LLLT reduced edema, trismus, and contributed to a better perception of quality of life. Nimesulide inhibits peroxidation by increasing GSH and stopping neutrophil migration. The benefit of the association of both strategies was not superior to the use of LLLT alone. CLINICAL RELEVANCE Translational study with impact on clinical-surgical protocols involving L3M surgery related to pharmacological and non-pharmacological methods.
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Affiliation(s)
- Edson Luiz Cetira Filho
- Division of Oral and Maxillofacial Surgery, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.,UNICHRISTUS, Fortaleza, Ceará, Brazil
| | | | - Deysi Viviana Tenazoa Wong
- Department of Physiology and Pharmacology - FAMED, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Celia Choquenaira-Quispe
- Laboratory of Pharmacology of Inflammation and Cancer (LAFICA), Postgraduate Program in Pharmaceutical Sciences, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Francisco Rafael Alves Santana Cesário
- Laboratory of Pharmacology of Inflammation and Cancer (LAFICA), Postgraduate Program in Pharmacology, Federal University of Ceará, Fortaleza, Ceará, Brazil.,Federal University of Ceará, Fortaleza, Ceará, Brazil
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Efficacy of Low-Level Laser Therapy in Reducing Pain in the Initial Stages of Orthodontic Treatment. Int J Dent 2022; 2022:3934900. [PMID: 35747204 PMCID: PMC9213123 DOI: 10.1155/2022/3934900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/28/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose There is no consensus about the mechanism and efficacy in alleviating pain of the lower-level laser therapy (LLLT) during orthodontic treatment. This study aimed to evaluate the LLLT effectiveness clinically in reducing pain caused by orthodontic movement that occurs in the early stages of treatment. Methods The sample consisted of 54 patients in need of orthodontic treatment divided into two groups. A 28 experimental patients group (initial mean age: 26.84 years old) was undergone gallium-aluminum-arsenide infrared laser application on 12 points for each tooth immediately after the installation of the first alignment archwire, and a 26 patients control group (initial mean age: 29.13 years old) was undergone to no pain control intervention at all. Pain intensity was measured by using a visual analog scale, which was marked pain level (mm) reported in 06, 24, 48, and 72 hours. The perception of pain (beginning, peak, decline, and absence) was evaluated by filling up a questionnaire. To compare the intensity and perception of pain between groups, a nonparametric Mann-Whitney has been performed. Results The experimental group showed levels (mm) at 6 (p < 0.001), 24 (p=0.004), and 48 hours (p=0.007) and perception of pain (hours) in the peak (p=0.026), decline (p=0.025), and absence (p=0.008) significantly lower compared to the group control. Conclusion Low-level laser therapy is effective in reducing pain severity caused by orthodontic forces activation, and it promotes the analgesic action lasting effect during the most painful feeling time.
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da Silveira RB, Ferreira I, Botelho AL, Dos Reis AC. Effect of photobiomodulation treatment on pain control in patients with temporomandibular dysfunction disorder: systematic review. Cranio 2022:1-11. [PMID: 35703499 DOI: 10.1080/08869634.2022.2086599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To critically evaluate the literature and answer the question, "How effective is photobiomodulation treatment on pain control in patients with TMJ disorder?". METHODS PRISMA, PubMed, Web of Science, Scopus, and Embase databases were used for the personalized search strategy. For risk of bias, Rob 2.0 for randomized clinical trials and ROBINS-I for non-randomized clinical trials were used. RESULTS Eighty-four articles were found and, after removing duplicates, seventy one studies were included for titles and abstracts. For a full reading, 30 articles were selected and, according to the eligibility criteria, 24 remained for qualitative analysis. The studies showed a low risk of bias. Due to the heterogeneity of the studies, it was not possible to perform a meta-analysis. CONCLUSION Photobiomodulation is an effective adjunct for the treatment of temporomandibular disorders, being a less invasive approach, safe, low-cost, and without side effects.
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Affiliation(s)
- Roberta Bertolli da Silveira
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Izabela Ferreira
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - André Luis Botelho
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, Brazil
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Low-level laser therapy is effective in controlling postoperative pain in lower third molar extractions: a systematic review and meta-analysis. Lasers Med Sci 2022; 37:2363-2377. [PMID: 35013845 DOI: 10.1007/s10103-021-03470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
This systematic review aimed to evaluate the effectiveness of low-level laser therapy in controlling postoperative pain in lower third molar extractions. A search was carried out in MEDLINE/PubMed, Web of Science and Cochrane Library (CENTRAL) databases, using the "low-level laser therapy", "photobiomodulation therapy", "impacted mandibular third molar", "mandibular third molar", "third molar extraction" descriptors and 2625 studies were found, including only randomized clinical trials published until July 2020, with no restrictions on language and country of study. Selected studies were submitted to initial screening based on the reading of titles, abstracts and full article, and duplicate studies were excluded. Overall, 2562 articles were found, of which only 15 randomized clinical trials were included in this review. A total of 648 patients (16-44 years) who received low-level laser therapy as an intervention and placebo in their control group were evaluated. The pain evaluation criterion was the Visual Analog Scale (VAS) on the second and seventh days after surgery. Photobiomodulation with low-level laser showed statistically significant reduction in postoperative pain in lower third molar extractions, both on the second (MD: - 0.59; CI: - 0.92, - 0.27) and seventh day after surgery (MD: - 0.76; CI: - 1.21, - 0.32).
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Reza B, Soheil N, Ehsan B, Kourosh S, Reza F. Efficacy of photo bio-modulation therapy for pain relief and soft tissue wound healing after dental implant surgery: A double-blind randomized clinical trial. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2021. [DOI: 10.1016/j.jpap.2021.100062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Yüksek MN, Eroğlu CN. Clinical evaluation of single and repeated sessions of photobiomodulation with two different therapeutic wavelengths for reducing postoperative sequelae after impacted mandibular third molar surgery: a randomized, double-blind clinical study. J Appl Oral Sci 2021; 29:e20210383. [PMID: 34787280 PMCID: PMC8673830 DOI: 10.1590/1678-7757-2021-0383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/15/2021] [Indexed: 12/04/2022] Open
Abstract
The effects of the number of photobiomodulation (PBM) sessions on the postoperative inflammatory process remain controversial. The current literature comparing single and repeated PBM sessions is limited.
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Affiliation(s)
- Mehmet Nuri Yüksek
- Yuzuncu Yil University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Van, Turkey
| | - Cennet Neslihan Eroğlu
- Yuzuncu Yil University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Van, Turkey
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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 Craniomaxillofac Surg 2021; 49:1088-1096. [PMID: 34217567 DOI: 10.1016/j.jcms.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/16/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022] Open
Abstract
This Systematic Review and Meta-analysis was conducted with the following PICOS question: patients undergoing third molar surgery (P) can benefit from low-intensity laser therapy (I) as compared to other postoperative management (C) to reduce pain, edema, and trismus (O), evaluated in previous randomized clinical trials (S). Databases used were PubMed, SCOPUS, Web of Science, and Biblioteca Virtual em Saúde, screening for studies published between 2015 and 2020. The meta-analysis was based on the standardized mean difference (SMD), under a 95% confidence interval (CI). 246 studies were initially included, and after the screening of data, 10 studies were selected for the final sample. The qualitative analysis resulted in favorable results for pain and edema management in most studies, whereas trismus remained controversial. Meta-analysis resulted in (SMD, -0.53; 95% CI, -0.82,-0.24), (SMD, -0.60; 95% CI, -0.81,-0.39), and (SMD, -0.62; 95% CI, -2.63, 1.39) for pain, edema, and trismus, respectively, indicating statistical success on pain and edema reduction, but not for trismus. LLLT can act on reducing postoperative pain and edema following third molar surgery, whereas, trismus remains not significantly changed.
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Isolan C, Kinalski MD, Leão OA, Post LK, Isolan TM, Dos Santos MB. Photobiomodulation therapy reduces postoperative pain after third molar extractions: A randomized clinical trial. Med Oral Patol Oral Cir Bucal 2021; 26:e341-e348. [PMID: 33340081 PMCID: PMC8141316 DOI: 10.4317/medoral.24228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/11/2020] [Indexed: 12/31/2022] Open
Abstract
Background To assess the efficacy of PBMT on reducing postoperative pain scores in patients submitted to third molar extractions.
Material and Methods A randomized controlled trial (ReBEC:RBR-94BCKZ) was designed according to the SPIRIT and followed the CONSORT. Patients were randomly allocated according to control or PBMT groups. PBMT consisted of the application of GaAlAs laser (808nm;50mW) applied in six points (1.23 min;11 J/cm2) after extraction. Pain scores were assessed using the Visual Analogue Scale (VAS) in millimeters evaluated after 6 (T6), 24 (T24), and 48 (T48) hours. The Wilcoxon Mann–Whitney test was used to check for possible associations between VAS scores and treatment groups.
Results A total of 101 third molar extractions were performed in 44 patients. The mean age was 28 years old(SD±11.54). Comparing control and intervention, PBMT group showed a significant effect on the reduction of postoperative pain at T6(mean VAS=0.9; C.I:0.63–1.16) compared to control (mean VAS=2.5;C.I:2.1–2.88)(p<0.001). The same statistically significant effect on the reduction of postoperative pain was observed at T24 (PBMT mean VAS=0.72;C.I:0.51–0.93; control mean VAS=2.86;C.I:2.40–3.31;p<0.001) and T48 (PBMT mean VAS=0.64;C.I:0.36–0.92; control mean VAS=2.86;C.I:2.37–3.34;p<0.001).
Conclusions PBMT significantly reduce the postoperative pain scores when assessed 6, 24, and 48 hours after third molar extractions. Key words:Controlled clinical trial, gallium aluminium arsenide lasers, third molar.
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Affiliation(s)
- C Isolan
- School of Dentistry, Federal University of Pelotas 457 Gonçalves Chaves street, room 502 96015-560, Pelotas, RS, Brazil
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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 2020; 79:313.e1-313.e19. [PMID: 33058775 DOI: 10.1016/j.joms.2020.09.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE Surgical removal of third molars carries morbidity and significantly affects patients' quality-of-life. This study aims to investigate whether administration of low-level laser therapy (LLLT) is effective in reducing postoperative morbidity in patients undergoing surgical removal of mandibular third molars compared with placebo. MATERIAL AND METHODS A systematic review and meta-analysis involving a comprehensive search strategy implemented across 5 electronic databases. This was supplemented by hand searching and contacting international experts and grey literature. Titles, abstracts, and full articles were scrutinized for studies meeting the inclusion criteria. All randomized controlled trials comparing treatment group of LLLT with a placebo control group were eligible for inclusion. The outcomes variables were postoperative pain, swelling, and trismus. Risk of bias and methodological quality assessment was carried out. We pooled data statistically, and meta-analyses were carried out using a random-effects model. RESULTS Seventeen randomized controlled trials were included in this systematic review, all of which were considered to have a low risk of bias. Participants, aged 13 to 70 years, and 35% women, totaled 1064. Meta-analyses found significant reductions in standardized mean differences (SMDs) in swelling at day 2 and day 7 postoperatively (SMD, -0.611; 95% confidence interval, -0.968, -0.234 and SMD, -0.532; 95% confidence interval, -0.795, -0.269). There were nonsignificant reductions in SMD in pain and trismus at day 2 and day 7 postoperatively. CONCLUSIONS LLLT significantly reduces swelling after extraction of mandibular third molars compared with placebo. LLLT has not shown to reduce postoperative pain and trismus. LLLT does not cause adverse effects. There is currently insufficient evidence available, to promote the investment in LLLT vs the net clinical benefit. Randomized controlled trials with larger sample size and standardized study design and outcome measures are required, to make definitive recommendations to clinicians on its use on patients.
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Affiliation(s)
- Farya Domah
- Oral Surgery Specialist Registrar, Department of Oral Surgery, University of Birmingham, Birmingham, United Kingdom
| | - Raunaq Shah
- Private Dental Surgeon, Department of Implantology, College of Medicine & Dentistry, Birmingham, United Kingdom.
| | - Ulugbek B Nurmatov
- Research Fellow, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Nara Tagiyeva
- Director, MSc International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Ahrari F, Eshghpour M, Zare R, Ebrahimi S, Fallahrastegar A, Khaki H. Effectiveness of Low-Level Laser Irradiation in Reducing Pain and Accelerating Socket Healing After Undisturbed Tooth Extraction. J Lasers Med Sci 2020; 11:274-279. [PMID: 32802287 DOI: 10.34172/jlms.2020.46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: This study aimed to determine the effect of low-level laser therapy (LLLT) on reducing complications following tooth extraction. Methods: This randomized clinical trial consisted of 40 subjects who underwent lower molar extraction. The patients were randomly assigned to 4 groups. Group 1 was irradiated with a 660 nm laser (200 mW, 30 seconds radiation to lingual, buccal and occlusal surfaces of the socket, 6 J/area). In group 2, an 810 nm laser was applied similar to group 1. In group 3, a combination of 660 and 810 nm lasers was used. The patients in group 4 served as a placebo group. LLLT was performed after 0.5-1 hour of extraction and 2 days later. The participants were asked to record pain degree using a visual analogue scale (VAS) over 7 days. The amount of wound healing was evaluated on the third and seventh days. Results: There was no significant difference in pain scores among the groups at any of the assessment intervals (P >0.05). The between-group differences in wound healing scores were small and insignificant (P >0.05). Conclusion: LLLT with 660 nm or 810 nm lasers or their combination had no greater effect than the placebo laser for reducing the complications of tooth extraction.
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Affiliation(s)
- Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Eshghpour
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Zare
- Oral & Maxillofacial Diseases Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samaneh Ebrahimi
- Department of Operative Dentistry, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan/Branch), Isfahan, Iran
| | - Amir Fallahrastegar
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Hosseinpour S, Tunér J, Fekrazad R. Photobiomodulation in Oral Surgery: A Review. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:814-825. [DOI: 10.1089/photob.2019.4712] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Sepanta Hosseinpour
- School of Dentistry, Oral Health Centre, The University of Queensland, Brisbane, Australia
| | - Jan Tunér
- Private Practice, Swedish Laser Medical Society (SLMS), Stockholm, Sweden
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Al-Delayme RMA. Randomized clinical study comparing Piezoelectric Surgery with conventional rotatory osteotomy in mandibular third molars surgeries. Saudi Dent J 2019; 33:11-21. [PMID: 33473237 PMCID: PMC7801233 DOI: 10.1016/j.sdentj.2019.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 11/17/2019] [Accepted: 11/21/2019] [Indexed: 01/06/2023] Open
Abstract
Purpose The aim of this study was to evaluate the performance and to assess the postoperative sequel and quality of life after removal of impacted mandibular third molars using piezoelectric surgery compared with conventional rotatory osteotomy. Patients and methods A single blinded, randomized, control clinical study was performed. Sixty-three patients (44 males, 19 females) who presented with bilaterally asymptomatic impacted mandibular third molars were included in this analysis. Each patient was treated, at two separate sessions approximately 4 weeks apart, with a conventional rotatory hand piece on one side of the mandible and a piezoelectric device on the contralateral side. Patients were followed up on postoperative days 1, 3, 5, 7, and 15 to rate the pain, swelling and trismus. Inferior alveolar nerve paresthesia was evaluated up to 12 months postoperatively. Results The severity of the pain, trismus and swelling using the piezosurgery were significantly different from the rotary group. In both groups, pain was most intense and peaked during the first post-operative day, while swelling and trismus reached peak levels on the third postoperative day. The piezoelectric procedure resulted in a significantly longer procedural duration compared to the rotatory surgery (P < 0.001). Conclusion Piezoelectric surgery is considered a viable alternative technique compared to the conventional rotary systems and can improve a patient’s quality of life. Thus, piezoelectric surgery might be a preferred modality for patients undergoing complicated surgical extraction of impacted lower third molars.
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Feslihan E, Eroğlu CN. Can Photobiomodulation Therapy Be an Alternative to Methylprednisolone in Reducing Pain, Swelling, and Trismus After Removal of Impacted Third Molars? PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:700-705. [PMID: 31589558 DOI: 10.1089/photob.2019.4696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background and objective: Studies investigating an alternative to corticosteroids in terms of potential side effects after surgical removal of impacted third molars are still ongoing. Accordingly, the present randomized single-blind study aimed to compare the efficacy of photobiomodulation therapy (PBMT) and methylprednisolone on pain, edema, and trismus after surgical removal of impacted third molars. Methods: The study included 30 healthy patients with bilaterally impacted lower third molars. The side (right or left molar) that would be extracted at first and the treatment (PBMT or corticosteroid) that would be applied to this side were decided by tossing a coin. The time interval between two surgical operations was at least 3 weeks. In the laser group, immediately after the surgical procedure, PBMT was applied extraorally to the insertion point of the masseter muscle for 60 sec with an output power of 0.3 W and an energy density of 6 J/cm2 and then repeated on postoperative days 1 and 2. In the corticosteroid group, 40 mg/2 mL methylprednisolone sodium succinate was injected postoperatively into the masseter muscle with the intrabuccal approach. On postoperative day 1, methylprednisolone injection (20 mg/1 mL) was repeated. Pain was evaluated using the visual analog scale on postoperative days 1, 2, and 7. Edema (in mm) and trismus (in mm) were evaluated preoperatively and on postoperative days 2 and 7. Results: There were no significant differences between the PBMT and methylprednisolone administration in terms of postoperative pain, edema, and trismus. Conclusions: Within the limits of the present study, PBMT was considered an alternative and a useful method for controlling inflammatory complications following impacted wisdom tooth surgery as it exhibited similar clinical efficacy to that of methylprednisolone.
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Affiliation(s)
- Erkan Feslihan
- Tekirdag Oral and Dental Health Hospital, Tekirdag, Turkey
| | - Cennet Neslihan Eroğlu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Ross G. Photobiomodulation Therapy: A Possible Answer to the Opioid Crisis. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:667-668. [PMID: 31502922 DOI: 10.1089/photob.2019.4711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Gerald Ross
- Private practice, Tottenham, Ontario, Canada
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22
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Effect of Low-level Laser Therapy on Postoperative Pain in Molars with Symptomatic Apical Periodontitis: A Randomized Placebo-controlled Clinical Trial. J Endod 2018; 44:1610-1615. [DOI: 10.1016/j.joen.2018.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/27/2018] [Accepted: 07/02/2018] [Indexed: 11/17/2022]
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Bernal Rodriguez CG, Kraul LF, Cardoso TW, Eduardo CDP, Aranha ACC, de Freitas PM. Photobiomodulation in the Postoperative of Bichectomy Surgeries: Case Series. Photomed Laser Surg 2018; 36:391-394. [PMID: 29920150 DOI: 10.1089/pho.2017.4407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Several photobiomodulation (PBM) protocols with low-power lasers have been reported for pain control and tissue repair in the postoperative period of oral surgeries. However, there are still no reports of a protocol for bichectomy surgeries' postoperative period. OBJECTIVE This article presents six reports of clinical cases in which bichectomy surgery was performed. METHODS In the postoperative period, three patients were submitted to PBM with low-power lasers, while three patients did not receive it. Facial edema was evaluated using a millimeter tape. Pain was determined using the visual analog scale. RESULTS Data of each clinical case were evaluated in a descriptive way and compared. CONCLUSIONS The efficacy of the PBM protocol on the postoperative period of bichectomy surgeries was evidenced by the decrease of edema and pain.
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Affiliation(s)
- Christian Giancarlo Bernal Rodriguez
- 1 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo , São Paulo, Brazil
| | - Luciane Franco Kraul
- 1 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo , São Paulo, Brazil
| | | | - Carlos de Paula Eduardo
- 1 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo , São Paulo, Brazil
| | - Ana Cecília Corrêa Aranha
- 1 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo , São Paulo, Brazil
| | - Patrícia Moreira de Freitas
- 1 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo , São Paulo, Brazil
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Dawdy J, Halladay J, Carrasco-Labra A, Araya I, Yanine N, Brignardello-Petersen R. Efficacy of adjuvant laser therapy in reducing postsurgical complications after the removal of impacted mandibular third molars. J Am Dent Assoc 2017; 148:887-902.e4. [DOI: 10.1016/j.adaj.2017.06.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 06/22/2017] [Indexed: 12/14/2022]
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