Abstract
Introduction:
Low-level laser therapy (LLLT) has been of interest in the clinical application in dentistry. Hence, we evaluated the LLLT on the wound healing in the mandibular surgical extraction.
Materials and Methods:
We conducted a prospective clinical study with 50 male subjects, equally distributed as controls and cases. Routine surgical extraction was done for control group, and in case group, LLLT was applied after the extraction. Evaluation was done for various parameters and after comparison the P value was less than 0.05 which was considered as significant.
Results:
Significant difference was seen between the groups for the socket depth on 7th day, swelling on 1st, 3rd, and 5th days, and pain on all the days.
Conclusion:
LLLT can be successfully used for the surgical extractions.
KEYWORDS: Low-level laser therapy, surgical extractions, wound healing
INTRODUCTION
Low-level laser therapy (LLLT) has been of interest in the clinical application in dentistry. The main factor that affects the LLLT is the power output and the frequencies. The normal used frequency is 50 mW.[1,2,3,4,5] LLLT brings about the effect on the erythrocytes and hence the microvasculature. This may bring about the desired effect for the wound healing, which in turn is a factor of the microvasculature. The heat generated by this laser is very low; hence, no deleterious effects are usually seen.[4,5,6] The penetration of the LLLT is also lower than the conventional lasers.[7] Therefore, we evaluated the LLLT on the wound healing in the mandibular surgical extraction.
MATERIALS AND METHODS
We conducted a prospective clinical study with 50 male subjects, equally distributed as controls and cases. They all were match for the health status as well as age and were to undergo the surgical extraction for the impacted molar in the mandible. After the institutional ethical clearance was obtained, the patient consent was also taken.
In the cases the subjects received LLLT of 70 mW frequency, energy output is 4 J/cm2 and power output for 4 min. We observed for the pain, swelling, and the socket depth in the groups from the day of surgery through 3rd, 5th, and 7th days. The readings were compared keeping P < 0.05 as significant.
RESULTS
We observed that no significant difference was seen for the socket depth on 1st, 3rd, and 5th days and swelling on 7th day. However, there was statistically significant difference for the socket depth on 7th day, swelling on 1st, 3rd, and 5th days, and pain on all the days [Table 1].
Table 1.
Comparison of the various readings between groups
| Variable | Groups | n | Mean | SD | P |
|---|---|---|---|---|---|
| Socket depth - 1st, 3rd, 5th days | LLLT | 25 | 7.606 | 0.22673 | 0.931 |
| Control | 25 | 7.620 | 0.26476 | ||
| Socket depth - 7th day | LLLT | 25 | 5.961 | 0.22735 | <0.0001 |
| Control | 25 | 6.401 | 0.27026 | ||
| Swelling - 1st, 3rd, 5th days | LLLT | 25 | 7.606 | 0.22673 | <0.0001 |
| Control | 25 | 7.620 | 0.26476 | ||
| Swelling - 7th day | LLLT | 25 | 5.961 | 0.22735 | 0.02 |
| Control | 25 | 6.401 | 0.27026 | ||
| Pain - 1st, 3rd, 5th days | LLLT | 25 | 7.606 | 0.22673 | <0.0001 |
| Control | 25 | 7.620 | 0.26476 | ||
| Pain - 7th day | LLLT | 25 | 7.606 | 0.22673 | <0.0001 |
| Control | 25 | 7.620 | 0.26476 |
LLLT: Low-level laser therapy, SD: Standard deviation
DISCUSSION
One of the most common procedures in the surgical dentistry is the surgical extraction of the molars that are impacted and the most common are the mandibular teeth. Our observations suggested that subjects in whom LLLT was applied has better healing capacity when compares to those in whom it was not applied. In our study, there was statistically significant difference for the socket depth on 7th day, swelling on 1st, 3rd, and 5th days, and pain on all the days. This is in accordance with the study of Hamid, where they also observed a reduction in pain on the after the surgical extractions.[8] They also noted that it may increase after 4th day; however, it was not seen in our study. Contrary to our findings in the study of Ahrari et al., they noted that there was no significant difference in those who received the LLLT than those without after the surgical extractions for the wound healing.[9] In the study of Oliveira Sierra et al.[10], they also found significant reduction of swelling and trismus after the application of the LLLT. However, they compared for the various frequencies of the LLLT and compared them. There were few limitations in our study that the long-term follow-up was not done and only we observed in the men the effect of the LLLT. The same study may show different results with both genders considered. Further studies in this direction are advised.
CONCLUSION
We can conclude that LLLT may successfully control the trismus, swelling, and pain and may affect the bone quality. Hence, they can be considered after the surgical extractions as well as other surgical procedures.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
- 1.An E. Biostimulation and photodynamic therapy. In: Miserendino L, Pick R, editors. Lasers in Dentistry. Chicago-Berlin, London-Tokyo, Sao Paolo-Moscow-Warsaw: Quintessence Publishing Co; 1995. pp. 247–57. [Google Scholar]
- 2.Walsh LJ. The current status of low level laser therapy in dentistry. Part 1. Soft tissue applications. Aust Dent J. 1997;42:247–54. doi: 10.1111/j.1834-7819.1997.tb00129.x. [DOI] [PubMed] [Google Scholar]
- 3.Karu T. Photobiology of low-power laser effects. Health Phys. 1989;56:691–704. doi: 10.1097/00004032-198905000-00015. [DOI] [PubMed] [Google Scholar]
- 4.Laakso L, Richardson C, Cramond T. Factors affecting low level laser therapy. Aust J Physiother. 1993;39:95–9. doi: 10.1016/S0004-9514(14)60473-6. [DOI] [PubMed] [Google Scholar]
- 5.Walsh LJ. The current status of laser applications in dentistry. Aust Dent J. 2003;48:146–55. doi: 10.1111/j.1834-7819.2003.tb00025.x. [DOI] [PubMed] [Google Scholar]
- 6.Sandford MA, Walsh LJ. Thermal effects during desensitisation of teeth with gallium-aluminium arsenide lasers. Periodontol. 1994;15:25–30. [Google Scholar]
- 7.Ohshiro T, Calderhead RG. Chichester: John Wiley and Sons; 1988. Low Level Laser Therapy: A Practical Introduction; pp. 11–8. [Google Scholar]
- 8.Hamid MA. Low-level laser therapy on postoperative pain after mandibular third molar surgery. Ann Maxillofac Surg. 2017;7:207–16. doi: 10.4103/ams.ams_5_17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Ahrari F, Eshghpour M, Zare R, Ebrahimi S, Fallahrastegar A, Khaki H. Effectiveness of low-level laser irradiation in reducing pain and accelerating socket healing after undisturbed tooth extraction. J Lasers Med Sci. 2020;11:274–9. doi: 10.34172/jlms.2020.46. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Oliveira Sierra S, Melo Deana A, Mesquita Ferrari RA, Maia Albarello P, Bussadori SK, Santos Fernandes KP. Effect of low-level laser therapy on the post-surgical inflammatory process after third molar removal: Study protocol for a double-blind randomized controlled trial. Trials. 2013;14:373. doi: 10.1186/1745-6215-14-373. [DOI] [PMC free article] [PubMed] [Google Scholar]
