Evaluation of a low-level laser protocol for the control of postoperative pain, trismus, and edema in retained third molar surgeries
Avaliação de um protocolo de laser de baixa potência no controle da dor, trismo e edema pós-operatórios nas cirurgias de terceiros molares retidos
Resumo
This split mouth double-blind randomized trial was aimed to evaluate the effect of low‑level laser therapy (LLLT) on pain, trismus, and swelling used in the postoperative period of surgery of third molars retained. Fifteen patients with symmetrically impacted mandibular third molars were randomized in two groups: LLLT group received only single‑dose intraoral and extraoral immediately after surgery; another group, received LLLT placebo on the other side. They were evaluated on the second and seventh days after surgery, the pain was evaluated in the first day too. There was no statistical difference in trismus, edema and pain between groups when examining data in the postoperative period of one, two or seven days. The pain level was significantly lower from the first day to seventh day in both groups. The laser group presented a delay or decreasing use of analgesics in the first postoperative day. Despite the statistically insignificant difference results, clinically it has been observed improvement of symptoms of discomfort related by patients. The results suggest that further studies are necessary for protocols consolidation and suggest explore combinations of photodynamic therapies.
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Referências
Abdel-Alim, H.M., Abdel-Dayem, H., Mustafa, Z. A., Bayoumi, A., Jan, A. & Jadu, F. A. (2015). Comparative Study of the Effectiveness of Immediate Versus Delayed Photobiomodulation Therapy in Reducing the Severity of Postoperative Inflammatory Complications. Photomedicine and Laser Surgery, 33(9), 447–451. doi: 10.1089/pho.2015.3923
Ahrari, F., Eshghpour, M., Zare, R., Ebrahimi, S., Fallahrastegar, A. & Khaki, H. (2020). Effectiveness of low-level laser irradiation in reducing pain and accelerating socket healing after undisturbed tooth extraction. J Lasers Med Sci, 11(3):274-279. doi: 10.34172/jlms.2020.46
Alan, H., Yolcu, Ü., Koparal, M., Özgür, C., Öztürk, S. A., & Malkoç, S. (2016). Evaluation of the effects of the low-level laser therapy on swelling, pain, and trismus after removal of impacted lower third molar. Head & Face Medicine, 12(1). doi: 10.1186/s13005-016-0121-1
Amarrillas- Escobar, E.D., Toranzo-Fernandez, J.M., Martinez-Rider, R., Noyola-Frias, M.A., Hidalgo-Hurtado, J.A., Serna, V.M.,…Pozos-Guillén, A.J. (2010). Use of therapeutic laser after surgical removal of impacted lower third molars. J Oral Maxillofac Surg, 68:319–324. doi: 10.1016/j.joms.2009.07.037
Aras, M.H. & Güngörmüs M (2009). The effect of low-level laser therapy on trismus and facial swelling following surgical extraction of a lower third molar. Photomed Laser Surg, 27:1, 21–24. doi: 10.1089/pho.2008.2258
Aras, M.H. & Güngörmüs, M. (2010). Placebo-controlled randomized clinical trial of the effect two different low-level laser therapies (LLLT) -intraoral and extraoral- on trismus and facial swelling following surgical extraction of the lower third molar. Lasers Med Sci, 25: 641-645. doi: 10.1007/s10103-009-0684-1
Asutay, F., Ozcan-Kucuk, A., Alan, H. & Koparal, M. (2018). Three-dimensional evaluation of the effect of low-level laser therapy on facial swelling after lower third molar surgery: A randomized, placebo-controlled study. Niger J Clin Pract, 21:1107. doi: 10.4103/njcp.njcp_38_18
Barros, D.D., Catão, J.S.S.B., Ferreira, A.C.D., Almeida, R.A.C., Simões, T.M.S. & Catão, M.H.C.V. (2022, June 22) Low‑level laser therapy is effective in controlling postoperative pain in lower third molar extractions: a systematic review and meta‑analysis. Lasers Med Sci, 37(5):2363-2377. doi: 10.1007/s10103-021-03470-3
Batinjan, G., Filipovic Zore, I., Rupic, I., Bago Juric, I., Zore, Z. & Panduric, D.G. (2013). Assessing health-related quality of life with antimicrobial photodynamic therapy (APDT) and low level laser therapy (LLLT) after third molar removal. J Lasers Med Sci, 4: (3): 120–6. PMCID: PMC4295359 PMID: 25606319
Brignardello-Petersen, R., Carrasco-Labra, A., Araya, I., Yanine, N., Beyene, J., & Shah, P.S. (2012). A terapia a laser adjuvante é eficaz na prevenção da dor, edema e trismo após a remoção cirúrgica de terceiros molarses inferiores impactados? Uma Revisão Sistemática e Meta-Análise. Jornal de Cirurgia Oral e Maxilofacial, 70(8), 1789–1801. doi:10.1016/j.joms.2012.01.008
Dawdy, J., Halladay, J., Carrasco-Labra, A., Araya, I., Yanine, N., & Brignardello-Petersen, R. (2017). Efficacy of adjuvant laser therapy in reducing postsurgical complications after the removal of impacted mandibular third molars A systematic review update and meta-analysis.The Journal of the American Dental Association, 148(12), 887–902.e4. doi: 10.1016/j.adaj.2017.06.043
Domah, F., Shah, R., Nurmatov, U.B. & Tagiyeva, N. (2020). The Use of Laser Therapy to Reduce Postoperative Morbidity After Third Molar Surgery: A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg, 1:1.e1-1.e19. doi.org/10.1016/j.joms.2020.09.01 8.
Erǒglu, C.N. & Keskin Tunc, S. (2016). Effectiveness of Single Session of Low-Level Laser Therapy with a 940 nm Wavelength Diode Laser on Pain, Swelling, and Trismus After Impacted Third Molar Surgery. Photomedicine and Laser Surgery, 34 (9). doi: 10.1089/pho.2016.4101
Ezzati, K., Fekrazad, R. & Raoufi, Z. (2019, primavera). The Effects of Photobiomodulation Therapy on Post-Surgical Pain. J Lasers Med Sci, 10(2):79-85. doi: 10.15171/jlms.2019.13
Farhadi F., Eslami, H., Majidi, A., Fakhrzadeh, V., Ghanizadeh, M., & Khadem Neghad, S. (2017). Evaluation of adjunctive effect of low-level laser Therapy on pain, swelling and trismus after surgical removal of impacted lower third molar: A double blind randomized clinical trial. Laser Therapy, 26(3), 181–187. doi: 10.5978/islsm.17-OR-13
Ferrante, M., Petrini, M., Trentini, P., Perfetti, G., & Spoto, G. (2012). Effect of low-level laser therapy after extraction of impacted lower third molars. Lasers in Medical Science, 28(3), 845–849. doi: 10.1007/s10103-012-1174-4
Ferreira, G.M., Prado, L.F., Santos, K.V., Rodrigues, L.G., Valladares-Neto, J., Torres, E.M. & Silva, M.A. (2022, April 30);Efficacy of two low-level laser therapy protocols following lower third molar surgery - a randomized, double-blind, controlled clinical trial. Acta Odontol Latinoam. 35(1):31-38. doi: 10.54589/aol.35/1/31
Feslihan, E. & Erǒglu, C.N. (2019, November). Can Photobiomodulation Therapy be na Alternative to Methylprednisolone in Reducing Pain, Swelling and Trismus After Removal of Impacted Third Molars? Fotobiomodul Photomed Laser Surg, 37 (11):700-705. doi: 10.1089/photob.2019.4696
Fraga, R.S., Antunes, L.A.A., Soares Fialho, W.L., Valente, M.I., Gomes, C.C., Fontes, K.B.F.C. & Antunes, L.S. (2020). Do Antimicrobial Photodynamic Therapy and Low-Level Laser Therapy Minimize Postoperative Pain and Edema After Molar Extraction? Journal of Oral and Maxillofacial Surgery,1.e1-1.e10.doi: 10.24859/SaberDigital. 2023v16n1.1390
Garcez, A.S., Ribeiro, M.S. & Nuñez, S.C. (2012). Laser de baixa potência: princípios básicos e aplicações clínicas na Odontologia. Rio de Janeiro: Elsevier.
Hadad, H. (2020). Protocolo de laser de baixa potência na prevenção de dor, edema e trismo decorrente de extrações de terceiros molares inferiores retidos. Estudo clínico, comparativo, randomizado e duplo cego. (dissertação). Universidade Estadual Paulista “Júlio de Mesquita Filho”, Área de concentração em Cirurgia e Traumatologia Buco Maxilo Facial, Araçatuba.
Hamblin, M.R. (2018). Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation. Photochemistry and Photobiology, 9; 4(2), 199–212. doi: 10.1111/php.12864
Hamid, M.A. (2017). Low-level laser therapy on postoperative pain after mandibular third molar surgery. Ann Maxillofac Surg, 7:207-16. doi: 10.4103/ams.ams_5_17
He, W.L., Yu, F.Y., Li, C.J., Pan, J., Zhuang, R. & Duan, P.J. (2014). A systematic review and meta-analysis on the efficacy of low level laser therapy in the management of complication after mandibular third molar surgery. Lasers Med Sci, 30:1779–1788. doi: 10.1007 / s10103-014-1634-0
Huang, Y.-Y., Sharma, S.K., Carroll, J., & Hamblin, M.R. (2011, September 2). Resposta bifásica à dose na terapia de luz de baixa intensidade - uma atualização. Dose-Resposta. 9(4). doi: 10.2203/dose-response.11-009.Hamblin
Kahraman, S.A., Cetiner, S. & Strauss, R.A. (2017). The Effects of Transcutaneous and Intraoral Low-Level Laser Therapy After Extraction of Lower Third Molars: A Randomized Single Blind, Placebo Controlled Dual-Center Study. Photomedicine and Laser Surgery, 35(8): 401-407. doi: 10.1089/pho.2016.4252
Karu, T.I., Pyatibrat, L.V., Kolyakov, S.F. & Afanasyeva, N.I. (2005, november). Absorption measurements of a cell monolayer relevant to phototherapy: Reduction of cytochrome c oxidase under near IR radiation. Journal of Photochemistry and Photobiology B:Biology, [s.l.],81,n.2, p.98106. doi: 10.1016/ j.jphotobiol.2005.07.002.
Koparal, M., Ozcan-Kucuk, A., Alan, H., Asutay, F., Avci, M. (2018). Effects of low-level laser therapy following surgical extraction of the lower third molar with objective measurement of swelling using a three-dimensional system. Experimental and Therapeutic Medicine, 15: 3820-3826. 10.3892/etm.2018.5921
Kreisler, M.B., Al Haj, H., Noroozi, N., Willershausen, B. & d’Hoedt, B. (2004). Efficacy of low level laser therapy in reducing postoperative pain after endodontic surgery—A randomized double blind clinical study. Int J Oral Maxillofac Surg, 33: 38–41. doi:10.1054/ijom.2002.0449
Landucci, A.C., Wosny, L. C., Uetanabaro, Moro, A. & Araujo, M. R. (2015). Efficacy of a single dose of low-level laser therapy in reducing pain, swelling, and trismus following third molar extraction surgery, Int J Oral Maxillofac Surg, 1-7. dx.doi.org/10.1016/j.ijom.2015.10.023.
Lopez-Ramirez, M., Vilchez-Perez, M.A., Gargallo-Albiol, J., Arnabat-Domínguez, J. e Gay-Escoda, C. (2012). Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction. A preliminary study. Lasers Med Sci . 27:559–566. doi 10.1007/s10103-011-0936-8
Markovic, A, Todorovic, Lj. (2007). Effectiveness of dexamethasone and low-power laser in minimizing edema after third molar surgery: a clinical trial. Int J Oral Maxillofac Surg, 36: 226–229. doi:10.1016/j.ijom.2006.10.006
Merigo, E., Vescovi, P., Margalit, M., Ricotti, E., Stea, S., Meleti, M. ...Fornaini, C. (2015). Efficacy of LLLT in swelling and pain control after the extraction of lower impacted third molars. Laser Therapy, 24(1), 39–46. doi:10.5978/islsm.15-OR-05
Mohajerani, H., Tabeie, F., Alirezaei, A., Keyvani, G. & Bemanali, M. (2020). Does Combined Low-Level Laser and Light-Emitting Diode Light Irradiation Reduce Pain, Swelling, and Trismus After Surgical Extraction of Mandibular Third Molars? A Randomized Double-Blinded Crossover Study. J Oral Maxillofac Surg, 1-8. doi.org/10.1016/j.joms.2020.07.017
Momeni, E., Barati, H., Arbabi, M.R., Jalali, B., & Moosavi, M.S. (2021, February 18). Low‐level laser therapy using laser diode 940 nm in the mandibular impacted third molar surgery: double-blind randomized clinical trial. BMC Oral Health, 21(1):77. doi.org/10.1186/s12903-021-01434-1
Palmeira, C.C.A., Ashmawi, H.A., Posso I.P. (2011). Rev Bras Anestesiol. 61: 6: 814-828. doi:10.1590/S0034-70942011000600014
Pandeshwar, P., Roa, M.D., Das, R., Shastry, S.P., Kaul, R., & Srinivasreddy, M.B. (2016). Photobiomodulation in oral medicine: a review. Journal of Investigative and Clinical Dentistry, 7(2), 114–126. doi: 10.1111/jicd.12148
Pol, R., Ruggiero, T., Gallesio, G., Riso, M., Bergamasco, L., Mortellaro, C., & Mozzati, M. (2016). Efficacy of Anti-Inflammatory and Analgesic of Superpulsed Low Level Laser Therapy After Impacted Mandibular Third Molars Extractions. Journal of Craniofacial Surgery, 27(3): 685-690. doi: 10.1097/SCS.0000000000002523
Sierra, S.O., Deana, A.M., Bussadori, S.K., da Mota, A.C.C., Ferrari, R.A.M., do Vale, K.L. & Fernandes, K.P. (2016 July). Choosing between intraoral or extraoral, red or infrared laser irradiation after impacted third molar extraction. Lasers in Surgery and Medicine, 48(5), 511–8. doi:10.1002/lsm.22488
Silveira, K.G. da; Veríssimo, M.H.G.; Inaoka, S.D.; Costa, D.F.N.; Laureano Filho, J.R. & Vasconcellos, R.J.de H. (2021). Estudo da eficácia do laser de baixa intensidade em cirurgia bucomaxilofacial: Uma revisão narrativa da literatura. Research, Society and Development, [S. l.], v10, n 9, p.e12410917761. doi: 10.33448/rsd-v10i9.17761
Tenis, C.A., Martins, M.D., Gonçalves, M.L.L., Silva, D.F.T.D., Cunha Filho, J.J.D., Martins MAT, …Fernandes, K. P. S. (2018, September). Efficacy of diode-emitting diode (LED) photobiomodulation in pain management, facial edema, trismus, and quality of life after extraction of retained lower third molars: A randomized, double-blind, placebo-controlled clinical trial. Medicine (Baltimore), 97(37):e12264. doi: 10.1097/MD. 0000000000012264