Photobiomodulation With Infrared and Dual-Wavelength Laser Induces Similar Repair and Control of Inflammation After Third Molar Extraction: A Double-Blinded Split-Mouth Randomized Controlled Trial.

Abstract

Background: Photobiomodulation therapy (PBMT) has been showed to have beneficial effects on the healing and control of inflammation associated with oral surgical wounds. However, different PBMT protocols have been proposed and it is not clear if different protocols impact the hard and soft tissues healing equally.

Purpose: To compare the tissue repair of postextraction alveoli of third molars between treated with dual-wavelength PBMT (red and infrared) or PBMT with infrared laser (IRL) alone.

Study design, setting, sample: This split mouth randomized controlled trial enrolled 20 patients, who were submitted to the extraction of the 4 partially erupted or fully impacted third molars between August 2023 and December 2023 at the clinic of the INPES postgraduate school (Institute for Clinical Health Research), and at the Federal University of Uberlândia. Adult with all the 4 molars were included in this study, while patients with systemic diseases/conditions, with less than 4 third molars were excluded of this study.

Exposure variable: The exposure variable is PBMT treatment. Treatment side was randomly allocated to according to the PBMT protocol applied on the postextraction sockets: IRL-PBMT: irradiation with PBMT with an IRL (808 nm) and IRL-RL-PBMT: irradiation with dual-wavelength PBMT (660 and 808 nm).

Main outcome variable(s): The primary outcome variable was the bone tissue healing that was measured using the fractal analysis and bone tissue density assessed using the radiographic images. The secondary outcome variable was soft tissue healing measured assessing the facial dimensions variations and a healing index that assessed the tissue consistence, color, exudation, bleeding, and edema. Additionally, the analyses centered on the patients' perceptions was assessed by the application of a visual analogic scale to assess pain, bleeding, edema, difficulty in chewing, and mouth opening conditions. Subjects were clinically evaluated at 3, 7, 14, 30, and 90 days after the surgical procedure.

Covariates: The covariates are the tooth position, and the demographic data (age and sex).

Analyses: The evaluation of the effects of the independent variables (Treatment and period of evaluation) on the primary and secondary outcomes was performed through the application of the repeated measures ANOVA (P < .05).

Results: The sample was composed of 20 subjects with a mean age of 28.58 ± 8.94 years, and 12 (60%) were females. There were no statistically significant differences between the 2 treatments for any outcome variables (P > .10).

Conclusion and relevance: It can be concluded that PBMT with dual wavelengths (red and infrared) and an IRL alone induced similar postoperative clinical results after third molar extraction surgeries.