Is Low-Level Laser Treatment Effective in Reducing Pain, Swelling, and Trismus After Removing Impacted Maxillary and Mandibular Third Molars?

Abstract

Background: The most common side effects of wisdom teeth removal are postoperative pain, swelling, and trismus. The efficacy of low-level laser treatment (LLLT) in reducing these side effects remains controversial.

Purpose: The purpose of this study was to evaluate the effectiveness of LLLT on pain, swelling and trismus after surgical removal of upper and lower wisdom teeth. The investigators hypothesize that the use of LLL will reduce pain, swelling and trismus compared to the mouth side treated with placebo laser (PL).

Study design: This double-blind, randomized, split-mouth study involved 20 (100%) healthy patients aged 18 to 24 years with asymptomatic impacted maxillary and mandibular third molars. Exclusion criteria included pregnant or lactating women, smokers, noncompliant patients, those with infectious diseases, anticoagulated patients, or those with intraoperative oral-antrum connection or previous pericoronitis. The study was conducted at the Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Switzerland.

Predictor variable: The predictor variable is the therapeutic intervention, LLL versus PL. Treatments were randomly assigned to LLL (ORCOS Medical AG, LASOTRONIC, Küsnacht, Switzerland) or PL.

Outcome variable: The primary outcome was pain 3 days postoperatively and the secondary outcomes were swelling and trismus 3 and 7 days postoperatively after wisdom teeth removal. Pain was measured using a visual analog scale, swelling was measured with an extraoral 3-dimensional scanner, and mouth opening with a ruler. The measurements were taken preoperatively and 3 and 7 days postoperatively. Age and sex were similar between the groups.

Covariates: The covariates were age and sex.

Analyses: A 2-sided Wilcoxon signed-rank test with a significance level α = 0.05 was used.

Results: The sample included 20 (100%) subjects with a mean age of 20.4 years (±1.9), 11 (55%) of whom were female. On day 3, the median pain score was 2.5 (interquartile range [IQR]: 3) in the LLLT group and 2.0 (IQR = 2.3) in the PL group (P = .5). The median swelling was 10,697 mm³ (IQR = 11,234 mm³) in LLLT versus 13,407 mm³ (IQR = 11,308 mm³) in PL group on day 3 (P = .1) and 2,379 mm³ (IQR = 4,322 mm³) in LLLT versus 1,553 mm³ (IQR = 3,079 mm³) in PL group on day 7 (P = .6). The median trismus was 35 mm (IQR = 9.8 mm) in LLLT versus 35.5 mm (IQR 9.5 mm) in PL group on day 3 (P = .7), and 43.5 mm (IQR = 11.3 mm) in LLLT versus 48 mm (IQR = 13 mm) in PL group on day 7 (P = .9).

Conclusion: Postoperative LLLT showed no statistically significant benefits in reducing pain, swelling, and trismus after wisdom teeth removal.