Journal of Craniomaxillofacial Research 2017. 4(1):284-288.

Efficacy of low level laser for prevention of pain and trismus after impacted mandibular third molar surgery
Mehrnoush Momeni Roochi, Hossein Heidar, Sheida Kordi, Naghmeh Bahrami


Objectives: This study sought to assess the effect of low-level laser (LLL) on pain and trismus after impacted mandibular third molar surgery.
Materials and Methods: This double blind controlled clinical trial was conducted on 40 healthy patients with no underlying disease and impacted mesioangular mandibular third molars
with the same level of difficulty. The patients were divided into two groups of intervention and control using block randomization. In the intervention group, LLL was intraoral irradiated to
the surgical site 10 minutes after suturing from 1cm distance. Sham laser was used in the control group. The patients were provided with postoperative instructions and were scheduled for visits at two and seven days postoperatively to fill out a questionnaire and for suture removal. Level of pain
was determined using a pictorial visual analog scale (VAS) and degree of trismus was measured in millimeters. The data were analyzed using SPSS.
Results: Mouth opening in the laser group was greater than that in the control groupat two days postoperatively, which indicates the efficacy of laser for prevention of trismus. The changes in
mouth opening were significant at baseline and at two and seven days postoperatively in the two groups (P=0.000); however, the trend of change was equal in both groups. No significant differences were noted in any variable between patients over and under 24 years of age in the two groups except for the amount of drug intake at two days post-surgery.
Conclusion: The results showed that laser irradiation efficiently decreased trismus and improved mouth opening during the first seven days post surgery. Thus, laser irradiation can shorten
the course of recovery after impacted mandibular third molar surgery.
Key words: Gene therapy, Dentistry, Viral vector, Stem cell.


Gene therapy; Dentistry; Viral vector; Stem cell.

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Costa MG, Pazzini CA, Pantuzo MC, Jorge ML,Marques LS. Is there justification for prophylactic extraction of third molars? A systematic review.Braz Oral Res 2013; 27:183-8.

Coulthard P, Bailey E, Esposito M, Furness S,Worthington HV. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev 2014; CD004345.

Li C, Men Y, Li L. Discrepancies on dexamethasone for trismus after third molar extraction. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:253.

Sotto-Maior BS, Senna PM, de Souza Picorelli Assis NM. Corticosteroids or cyclooxygenase 2-selective inhibitor medication for the management of pain and swelling after third-molar surgery. J Craniofac Surg 2011; 22:758-62.

Akbulut N, Üstüner E, Atakan C, Çölok G. Comparison of the effect of naproxen, etodolac and diclofenac on postoperative sequels following third molar surgery: a randomised, double-blind, crossover study. Med Oral Patol Oral Cir Bucal 2014; 19:e149-56.

R. Brignardello-Petersen, A. Carrasco-Labra, I.Araya, N. Yanine, J. Beyene, P.S. Shah .Is adjuvant laser therapy effective for preventing pain, swelling,and trismus after surgical removal of impacted mandibular third molars? A systematic review and meta-analysis. J Oral Maxillofac Surg, 70 (2012), pp. 1789–1801.

J.M. Bjordal, M.I. Johnson, V. Iversen, F. Aimbire,R.A. Lopes-Martins.Low level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg,24 (2006), pp. 158–168.

L. Lago-Méndez, M. Diniz-Freitas, C. Senra-Rivera,F. Gude-Sampedro, J.M. Gándara Rey, A.García-García. Relationships between surgical difficulty and postoperative pain in lower third molar extractions. J Oral Maxillofac Surg, 65 (2007),pp. 979–983.

M.H. Aras, M. Güngörmüş. The effect of low-level laser therapy on trismus and facial swelling following surgical extraction of a lower third molar.Photomed Laser Surg, 27 (2009), pp. 21–24.

E. Visintini, D. Angerame, F. Costantinide s, M.Maglione. Peripheral neurological damage following lower third molar removal. A preliminary clinical study. Minerva Stomatol, 56 (2007), pp.319–326.

H.O. Kazancioglu, S. Ezirganli, N. Demirtas.Comparison of the influence of ozone and laser therapies on pain, swelling, and trismus following impacted third-molar surgery. Lasers Med Sci, 29 (2013), pp. 1313–1319.

M. Montesinos.Experimental effects of low power laser in encephalon and endorphin synthesis. J Eur Med Laser Assoc, 1 (1988), pp. 2–7.

A.B. Marković, L. Todorovic.Postoperative analgesia after lower third molar surgery: Contribution of the use of long-acting local anesthetics,low-power laser, and diclofenac. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 102 (2006),pp. 4–8.

M.H. Aras, M. Güngörmüs.The effect of low-level laser therapy on trismus and facial swelling following surgical extraction of a lower third molar.Photomed Laser Surg, 27 (2009), pp. 21–24

S. Fernando, C.M. Hill, R. Walker.A randomized double blind comparative study of low-level laser therapy following surgical extraction of lower third molar teeth.Br J Oral Maxillofac Surg, 31 (1993), pp. 170–172.

R. Brignardello-Petersen, A. Carrasco-Labra, I.Araya, et al.Is Adjuvant laser therapy is effective for preventing pain, swelling, and trismus after surgical removal of impacted mandibular third molars? A systematic review and meta-analysis.J Oral Maxillofac Surg, 70 (2012), pp. 1789–1801.

M. Ferrante, M. Petrini, P. Trentini, et al.Effect of low-level laser therapy after extraction of impacted lower third molars.Lasers Med Sci, 28 (2013),pp. 845–849.

G. Sun, J. Tunér.Low-level laser therapy in dentistry.Dent Clin North Am, 48 (2004), pp. 1061–1076.

Aras MH, Güngörmüş M (2010) Placebo-controlledrandomized 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 thirdmolar. Lasers Med Sci 25(5):641–518.

López-Ramírez M, Vílchez-Pérez MA, Gargallo-Albiol J, Arnabat-Domínguez J, 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 Sci27(3):559–566.

G. Kesava Reddy. Journal of Clinical Laser Medicine & Surgery. July 2004, 22(2): 141-150.

Silveira PC, Silva LA, Freitas TP, Latini A, Pinho RA (2010) Effects of low-power laser irradiation (LPLI) at different wavelengths and doses on oxidative stress and fibrogenesis parameters in an animal model of wound healing. Lasers Med Sci26(1):125–131.

Kreisler, Matthias; Al Haj, Haitham; d’Hoedt, Bernd.Temperature Changes at the Implant-Bone InterfaceDuring Simulated Surface Decontamination with an Er:YAG Laser. International Journal of Prosthodontics . Nov/Dec2002, Vol. 15 Issue 6,p582-587.

Pallotta RC, Bjordal JM, Frigo L, Leal Junior EC, Teixeira S, Marcos RL, Ramos L, Messias Fde M, Lopes-Martins RA (2011) Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation. Lasers Med Sci 27(1):71–78

Amarillas-Escobar ED, Toranzo-Fernández JM,Martínez-Rider R (2010) Use of therapeutic laser after surgical removal of impacted lower thirdmolars. J Oral Maxillofac Surg 68(2):319–324.


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