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Camolesi GCV, Silva FFVE, Aulestia-Viera PV, Marichalar-Mendía X, Gándara-Vila P, Pérez-Sayáns M. IS THE PHOTOBIOMODULATION THERAPY EFFECTIVE IN CONTROLLING POST-SURGICAL SIDE EFFECTS AFTER THE EXTRACTION OF MANDIBULAR THIRD MOLARS? A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2024; 24:101983. [PMID: 38821660 DOI: 10.1016/j.jebdp.2024.101983] [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: 09/15/2023] [Revised: 01/09/2024] [Accepted: 02/20/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES The extraction of third molars is one of the most performed surgical procedures in oral and maxillofacial surgery. Pain, oedema, and trismus are the most frequently complications related in the surgical postoperative period. The literature has indicated PBM as a potential adjuvant method to reduce these complications. The aim of this review and meta-analysis is evaluate the PBM, as an optimal method to improve patient experience and minimize postoperative morbidity. Additionally, we seek to determine which wavelength, site, and frequency of application are most effective. METHODS This review was registered in PROSPERO (CRD42023429966) and followed PRISMA guidelines. The search was carried out in the main databases, PubMed/MEDLINE, Cochrane Library, Embase, Scopus, and Lilacs, including reviews in the most important journals in the area of oral surgery and laser applied to oral surgery. In addition, all article references and also gray literature were reviewed. After the studies selection, the relevant data was collected. All the studies were randomized controlled trials and the patients were allocated into two groups: active PBM and inactive PBM. The statistical analysis was carried out using Stata v.16, and the methodological quality and risk of bias were assessed by the Jadad scale and RoB 2.0, respectively. RESULTS Where included 22 studies and 989 subjects, to all with a minimum follow-up of 7 days. Pain and oedema showed statistically significant results in favor to the active PBM group. Especially when laser applied in infrared mode, for pain and oedema at 48 h, MD = -1.80 (CI95% -2.88, -0.72) I² = 92.13% and MD = -1.45 (CI95% -2.42, -0.48) I² = 65.01%, respectively. The same is not true for trismus at 48 h, MD = 0.07 (CI95% -0.06, 0.21) I² = 3.26%. The meta-analysis also presented results in respect of laser site of application and number of PBM sessions. CONCLUSIONS PBM with infrared laser, in a combination intraoral and extraoral application, in one session in the immediate postoperative period, has been shown to be effective to achieve the objectives of reducing pain and oedema after third molar extraction.
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Affiliation(s)
- Gisela Cristina Vianna Camolesi
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
| | - Fábio França Vieira E Silva
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
| | | | - Xabier Marichalar-Mendía
- Biobizkaia Health Research Institute, Barakaldo, Bizkaia, Spain; Research Group: GIU21/042, Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Pilar Gándara-Vila
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain.
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery, and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain; ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Materials Institute of Santiago de Compostela (iMATUS), Santiago de Compostela, Spain
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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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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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Parreira LFS, Pinheiro SL, Fontana CE. Photobiomodulation in the Treatment of Dysgeusia in Patients with Long COVID: A Single-Blind, Randomized Controlled Trial. Photobiomodul Photomed Laser Surg 2024; 42:215-224. [PMID: 38416635 DOI: 10.1089/photob.2023.0148] [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] [Indexed: 03/01/2024] Open
Abstract
Objective: The aim of this study is to evaluate local and systemic photobiomodulation (PBM) in patients with COVID-19-related dysgeusia, with the expectation of improving taste dysfunction. Background: PBM has garnered attention as a potential therapy in long COVID, a condition characterized by many persistent symptoms following the acute phase of COVID-19. Among these symptoms, dysgeusia, or altered taste perception, can significantly affect patients' quality of life. Emerging research suggests that PBM may hold promise in ameliorating dysgeusia by modulating cellular processes and reducing inflammation. Further clinical studies and randomized controlled trials are essential to establish the efficacy and safety of PBM for the treatment of dysgeusia in long COVID, but initial evidence suggests that this noninvasive modality may offer a novel avenue for symptom management. Methods: Seventy patients experiencing dysgeusia were randomly assigned to receive active local and systemic PBM (n = 34) or simulated PBM (n = 36). Low-power laser (red wavelength) was used at 18 spots on the lateral borders of the tongue (3 J per spot), salivary glands (parotid, sublingual, and submandibular glands-3 J per spot), and over the carotid artery for 10 min (60 J). Alongside laser therapy, all patients in both groups received weekly olfactory therapy for up to 8 weeks. Results: Dysgeusia improved in both groups. At weeks 7 and 8, improvement scores were significantly higher in the PBM group than in the sham group (p = 0.048). Conclusions: Combined local and systemic PBM, as applied in this study, proved effective and could serve as a viable treatment option for alleviating dysgeusia in long-COVID patients. Clinical Trial Registration: RBR-2mfbkkk.
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Affiliation(s)
- Letícia Fernandes Sobreira Parreira
- Postgraduate Program in Health Sciences, Center for Life Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
| | - Sérgio Luiz Pinheiro
- Postgraduate Program in Health Sciences, Center for Life Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
| | - Carlos Eduardo Fontana
- Postgraduate Program in Health Sciences, Center for Life Sciences, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, Brazil
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Meng T, He L, Chen Y, Zhang Z. Efficacy of a single Nd:YAG laser dose in reducing pain after mandibular third molar extraction: a prospective randomized controlled clinical trial. Lasers Med Sci 2024; 39:63. [PMID: 38361090 DOI: 10.1007/s10103-024-04010-5] [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: 06/21/2023] [Accepted: 02/02/2024] [Indexed: 02/17/2024]
Abstract
The purpose is to explore the analgesic effect of a single Nd:YAG laser dose after mandibular third molar extraction. This was a prospective randomized controlled clinical trial. Subjects were enrolled according to the inclusion and exclusion criteria and randomly divided into the experimental and control groups. In the experimental group, the wound was irradiated with the Nd:YAG laser (wavelength, 1064 nm; output power, 1.5 W; energy density, 45 J/cm2; and power density, 1.5/cm2, pulsed mode) immediately after mandibular third molar extraction for 120 s (30 s at each site). In the control group, the laser working tip was placed near the extraction site but not activated. The primary outcome was the visual analog scale (VAS) pain scores in both groups at 2, 4, 12, 24, 48, and 72 h and 7 days after surgery. Secondary outcomes included wound healing scores and adverse reactions. The VAS score was significantly lower in the experimental group than in the control group at 2 and 4 h after surgery, while there was no significant difference in the VAS score between the two groups at 12, 24, or 48 h or 7 days after surgery. There were no significant differences in the wound healing scores between the two groups on postoperative day 7. No adverse reactions were observed in any of the laser-irradiated areas. A single Nd:YAG laser dose was effective in reducing pain at 2 and 4 h after mandibular third molar extraction. China Clinical Trial Registry: ChiCTR2000033870 (Registration Date: 2020-6-15).
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Affiliation(s)
- Tian Meng
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China.
| | - Linhai He
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Yuhuan Chen
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Zhiyong Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
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Falci SGM, Guimarães MTBÁ, Canarim NM, Falci SE, Martins OBL, de Souza GM, Galvão EL. Comparison of suture and sutureless techniques on postoperative complications after third molar surgery: a systematic review. Clin Oral Investig 2024; 28:115. [PMID: 38267703 DOI: 10.1007/s00784-024-05518-4] [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: 08/14/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To compare, among patients undergoing third molar surgeries, whether the use or omission of sutures improves postoperative clinical parameters. METHOD A systematic literature review was conducted to identify randomized clinical trials in humans. The steps of this review were conducted following the PRISMA protocol. The risk of bias assessment was performed using the revised Cochrane tool (RoB 2). The RevMan software was employed for meta-analyses, and the quality of evidence was evaluated using GRADE. RESULT A total of seven articles were included in the systematic review; however, only one article quantitatively measured bleeding, rendering meta-analysis for this outcome unfeasible. The group of patients in whom sutures were not used presented lower pain and edema on the first day (respectively: MD - 1.08; 95% CI - 1.35 to - 0.81; MD - 1.23; 95% CI - 2.34 to - 0.11) and second day (respectively: MD - 0.50; 95% CI - 0.83 to - 0.17; MD - 10.66; 95% CI - 1.16 to - 0.16) postoperatively, compared to the group where sutures were employed. The group of patients who received sutures exhibited increased trismus on the first day postoperatively (MD 1.04; 95% CI 0.67 to 1.41). CONCLUSION The omission of postoperative sutures in third molar surgeries appears to favor pain and edema outcomes within the first 24 h after the procedure, as well as trismus within the same timeframe. CLINICAL RELEVANCE Despite the suture being the standard conduct in tooth extractions. The omission of sutures in third molar extractions may favor inflammatory outcomes of pain, edema, and trismus in the immediate postoperative period.
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Affiliation(s)
- Saulo Gabriel Moreira Falci
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Marco Túllio Becheleni Ávila Guimarães
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Nathalia Moore Canarim
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Salomão Emanuel Falci
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Olga Beatriz Lopes Martins
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil
| | - Glaciele Maria de Souza
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Rua da Glória, 187, Diamantina, MG, 39100-000, Brazil.
| | - Endi Lanza Galvão
- Department of Physical Therapy, School of Biological and Health Sciences, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, MG, 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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Sourvanos D, Lander B, Sarmiento H, Carroll J, Hall RD, Zhu TC, Fiorellini JP. Photobiomodulation in dental extraction therapy: Postsurgical pain reduction and wound healing. J Am Dent Assoc 2023; 154:567-579. [PMID: 37204376 PMCID: PMC10877507 DOI: 10.1016/j.adaj.2023.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND This scoping review and analysis were designed to assess the amount of time spent delivering photobiomodulation (PBM) light therapy after dental extraction to improve postoperative pain and wound healing. TYPES OF STUDIES REVIEWED The scoping review was performed according to the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Publications were specific for human randomized controlled clinical trials, PBM after dental extraction therapy, and related clinical outcomes. Online databases searched included PubMed, Embase, Scopus, and Web of Science. Analyses were conducted to analyze the prescribed intervals of time (seconds) per application of PBM. RESULTS Of the 632 studies initially identified, 22 studies fulfilled the inclusion criteria. Postoperative pain and PBM were reported in 20 articles for 24 treatment groups, with treatment times ranging from 17 through 900 seconds and wavelengths from 550 through 1,064 nm. Clinical wound healing outcomes were reported in 6 articles for 7 groups with treatment times ranging from 30 through 120 seconds and wavelengths from 660 through 808 nm. PBM therapy was not associated with adverse events. CONCLUSIONS AND PRACTICAL IMPLICATIONS There is future potential to integrate PBM after dental extraction therapy to improve postoperative pain and clinical wound healing. The amount of time spent delivering PBM will vary by wavelength and the type of device. Further investigation is needed to translate PBM therapy into human clinical care.
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de Moraes FB, Pinheiro SL. Photobiomodulation for Pain Relief After Third Molar Extraction: A Randomized Double-Blind Split-Mouth Clinical Trial. Photobiomodul Photomed Laser Surg 2023. [PMID: 37367209 DOI: 10.1089/photob.2022.0159] [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: 06/28/2023] Open
Abstract
Objective: To evaluate the local and systemic application of photobiomodulation (PBM) to reduce pain after third molar extraction. Background: PBM has been applied locally to reduce pain after third molar extraction, but there are no published studies evaluating its systemic application for this purpose. Methods: Thirty patients with two erupted third molars indicated for extraction were included in this split-mouth clinical trial. Extractions were performed 3 weeks apart in each patient, with one extraction socket being randomly assigned to local and systemic PBM (PBM group) and the other to no PBM (control group). Postoperative analgesia consisted of oral acetaminophen for 3 days. Outcomes included pain (visual analog scale), swelling, and quality of life (14-item Oral Health Impact Profile) assessed before and immediately, 24 h, 48 h, and 7 days after extraction. Results were analyzed by Kruskal-Wallis test, followed by Student-Newman-Keuls test. Results: In the control group, pain increased significantly at 24 and 48 h after extraction (p = 0.0000), decreasing after 7 days (before: 0.36; immediately after: 1.06; 24 h: 4.26; 48 h: 2.53; 7 days: 0.36). In the PBM group, patients reported no pain at all time points, indicating effectiveness of local and systemic PBM in relieving pain after third molar extraction (p = 0.2151) (before: 0.30; immediately after: 0.36; 24 h: 0.86; 48 h: 0.30; 7 days: 0.03). PBM also had a modulatory effect on the inflammatory process and improved comfort after extraction. Conclusions: Combined local and systemic PBM can be useful for pain relief, swelling control, and quality-of-life improvement in patients undergoing third molar extraction.
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Bahari Bandari A, Hajmohammady S, Mafi S. Therapeutic Effect of a Low-Level Laser on Acute Pain and Post-operative Mouth Opening After Closed Reduction of Mandibular-Condylar Fracture. J Lasers Med Sci 2022; 13:e30. [PMID: 36743149 PMCID: PMC9841373 DOI: 10.34172/jlms.2022.30] [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: 08/15/2021] [Accepted: 06/07/2022] [Indexed: 11/22/2022]
Abstract
Introduction: The purpose of this study was to determine the therapeutic effect of low-level laser therapy (LLLT) on acute pain and the range of mouth opening after condylar closed reduction surgery. The use of low-level lasers, especially to reduce inflammation and pain, has received more attention in recent years. The results of many studies performed in this field are contradictory, and the effectiveness of low-level lasers in the treatment of patients is still uncertain. Methods: This study was performed as a randomized, double-blinded clinical trial on 40 patients with condylar closed reduction surgery. Patients were randomly assigned to two groups of 20 patients, including the placebo and intervention groups. In the intervention group, the patients received LLLT (100 mw, 2 J/cm2, 20 S/point, 14 extraoral points, 7 days). The range of jaw movements after opening the intermaxillary-fixation was measured. Patients' pain was assessed using the visual analog scale (VAS). Data were analyzed using SPSS software version 21, the chi-square test, and repeated measures ANOVA. Results: There was no significant difference between the study groups in terms of the range of jaw motions. The mean VAS score was 56.85 (SD=3.817) in the intervention group and 60.95 (SD=4.861) in the placebo group, showing a statistically significant difference between the two groups at the end of the study (P=0.007) Conclusion: The results of this study indicated the effectiveness of low-level lasers in reducing acute pain in patients undergoing closed condylar surgery. Iranian Registry of Clinical Trials (IRCT20200520047519N1).
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Affiliation(s)
- Arash Bahari Bandari
- Department of Oral and Maxillofacial Surgery, Dental School of Kermanshah, Kermanshah, Iran
| | | | - Sahar Mafi
- Assistant Professor, Department of Oral Medicine, Dental School of Kermanshah, Kermanshah, Iran,Correspondence to Sahar Mafi, Tel: 09123592738, E-mail:
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Hamad SA. Effect Of Low-Level Laser Therapy On Inflammatory Sequеlae Of Impacted Mandibular Third Molar Surgery: A Single-Blind, Placebo-Controlled, Randomized Clinical Trial. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective — Postoperative pain, facial swelling, and limitation of mouth opening are common sequеlae of lower third molar surgery. The objective of the study was to evaluate the effect of Low- level laser irradiation in controlling these sequеlae. Material and Methods — This randomized, single-blinded, split-mouth pilot study was carried out at the department of oral and maxillofacial surgery, university affiliated hospital, Erbil, Iraq. The study was conducted on 20 patients (13 males and 7 females), with a mean age of 26.3±7.4 years, who needed surgical removal of symmetrical bilateral impacted lower third molars. In each patient, one side was treated by low level laser and the other side was control. Laser irradiation was performed by postoperative single intraoral application of 940 nm laser beam at four points. Pain, trismus, and facial swelling were evaluated at the first, third, and seventh postoperative days. The data were analyzed using Mann–Whitney U test and unpaired t -test. Results — As compared to the control sides, low- level laser irradiated sides showed a significant reduction in visual analogue pain scales (VAS) during the first three postoperative days (P<0.05). The VAS scores of the laser treated sides were 4.46, 4.00, and 3.35 as compared to 6.58, 5.82, and 5.17 for the control sides. The swelling, and trismus were significantly reduced on the first and third postoperative days in the laser treated sides, as compared to the control sides (P<0.05). The facial measurements during the first and third postoperative days were 108.72 mm and 114.77 mm in the laser sides and 113.57 mm and 118.43 mm in the control sides. The degree of mouth opening during the first and third postoperative days were 33.48 mm and 30.37 mm in the laser sides and 27.93 mm and 25.58 mm in the control sides Conclusions — Single intraoral application of low- level laser is effective in reducing pain, swelling and trismus after mandibular third molar surgery. Therefore, it can be used as an adjuvant in controlling postoperative complications after lower third molar surgery.
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Vidya KC, Das A, Srikar MV, Pathi J, Jaiswal A. Effectiveness of low-level laser therapy after surgical removal of impacted mandibular third molars: A randomized clinical trial. Natl J Maxillofac Surg 2022; 13:60-66. [PMID: 35911809 PMCID: PMC9326211 DOI: 10.4103/njms.njms_297_21] [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: 01/13/2021] [Revised: 07/04/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction: The low-level laser therapy has been accepted globally as cell bio-modulator, used to reach ideal therapeutic effects, acting in the reduction of the pain response, with anti-inflammatory effects, stimulating local micro-circulation and wounds repair, promoting a rapid recovery, which brings a better quality of life to the patient. In this study, we aim to to determine the effectiveness of low-level laser therapy on reducing the pain and swelling after removal of impacted third molars. Materials and Methods: In this present prospective randomized clinical study, third molar surgeries were performed in thirty patients who were divided into two equal groups (placebo group and study group) a placebo group with routine treatment and a study group with low-level laser therapy which was applied both intraorally and extraorally after the surgical extraction of mandibular third molar. Results: The parameters such as postoperative pain, edema, and trismus were assessed on 1st and 7th day. All these parameters showed statistically significant results in patients with low-level laser therapy. Conclusions: Low-level laser therapy was effective in reducing the postoperative pain, edema, and trismus in the third molar surgeries.
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