Comparison of the Effectiveness of Red and Infrared Low-Level Laser Therapy for post-operative pain control, Swelling, Trismus in Patients with Impacted Mandibular Third Molar

Abstract

Introduction: Extraction of impacted wisdom teeth is the most commonly performed oral surgery. This surgery is performed under local anesthesia and its degree of difficulty varies depending on its position. Extraction of the impacted wisdom teeth is followed by pain, swelling and trismus. In order to reduce post-operative symptoms, different methods have been investigated and studied such as the use of corticosteroids, NSAIDS and laser therapy. The aim of the present study is to investigate the effect of pre-emptive low-power laser application on postoperative pain management after impacted mandibular third molar surgery. Materials and Methods: Thirty patients with impacted third mandibular molars were randomly assigned into three independent groups after entering the study CRITERIA and obtaining written consent. The first group was irradiated by a red laser (680 nm 6 J/cm2 for 5 minutes), the second group was irradiated by an infrared laser (890 nm, 6 J/cm2 for 10 minutes), and the third group was exposed to off laser. Patients were irridiated half an hour before surgery and then the second day after surgery. The assessment of swelling and trismus was performed once before surgery and then on the second and seventh day after surgery. Pain evaluation was also performed on the second and seventh day after surgery. After each operation, amoxicillin antibiotics, chlorhexidine mouthwash and anti-inflammatory drug Ibuprofen 400 mg were prescribed for pain control and the patients were asked to write down the number of consumed pain relief tablets everyday for 7 days. Finally, all data were collected and the final dose of analgesics, pain intensity, trismus and swelling rate were calculated for each group. Results: On day 2 after surgery, the highest pain intensity was in the OFF group and 4.19 ± 0.46 units, and in the 7th postoperative day in the OFF group and equal to 1.15 ± 0.80 units. The lowest pain level occurred on the 2nd day after the operation in the IR group and 3.00 ± 0.38 and in the 7th day after the operation, the RED group was 0.25 ± 0.54. Significant differences were observed between the study groups (p=0.001). The IR group consumed pain relief tablets for three days, the RED group consumed for four days, and the OFF group consumed for five days . Significant differences were observed between the study groups (p=0.001). There was no significant difference between the two groups in terms of maximal oral openness and swelling (p> 0.05). Conclusion: It can be concluded that extra-oral use of infrared laser with a wavelength of 890 nm and red laser with a wavelength of 660 nm can reduce the amount of pain but has no effect on reducing the amount of swelling and trismus after third molar surgery.