Effect of photo-biomodulation therapy in decreasing postoperative pain after surgical removal of third molars compared to other treatment therapies: a systematic review
DOI:
https://doi.org/10.18203/2320-6012.ijrms20240538Keywords:
Photobiomodulation, Third molar, Post-operative painAbstract
Post-operative pain, discomfort, and trismus are common postoperative complications after surgical extraction of third molars. Various therapeutic approaches like prescribing analgesic drugs, corticosteroids, and Non-steroidal anti-inflammatory drugs are followed to reduce these complications. Photo-biomodulation therapy (PBMT) utilizes a monochromatic light source that shows effects in all phases of inflammation by reducing edema, redness, heat, and pain. In vivo studies were searched to evaluate postoperative pain levels in patients who underwent photo-biomodulation therapy following extraction of impacted third molars. A comprehensive search was done from January 2023 to July 2023 in PubMed electronic databases. In addition, a manual search of the references mentioned in the studies and gray literature was done. The literature search yielded a total of 157 studies through a search in the electronic database PubMed. Among all the studies, 51 duplicate records were removed. Ninety-seven studies were removed after screening of titles and abstracts. A total of 9 studies were included for full-text reading. Five studies were included (one randomized single-blind study, two randomized double-blind split-mouth studies, and two randomized clinical trials) in the review. Four out of five studies that were included in this review demonstrated a positive impact of PBMT on reducing pain, especially during the post-operative period compared to other non-surgical treatment protocols. Photo-biomodulation therapy demonstrated an overall positive impact on reducing postoperative complications like edema and trismus.
References
Qi W, Wang Y, Huang YY, Jiang Y, Yuan L, Lyu P, et al. Photobiomodulation therapy for management of inferior alveolar nerve injury post-extraction of impacted lower third molars. Lasers Dent Sci. 2020;4(1):25-32.
ALHarthi SS, Ali D, Alamry NZ, Alshehri MK, Divakar DD, Bin Shabaib MS. Photobiomodulation for Managing "Dry Socket": A Randomised Controlled Trial. Int Dent J. 2023;73(2):267-73.
Hounsome J, Pilkington G, Mahon J, Boland A, Beale S, Kotas E, et al. Prophylactic removal of impacted mandibular third molars: a systematic review and economic evaluation. Health Technol Assess. 2020;24(30):1-116.
Sreesha S, Ummar M, Sooraj S, Aslam S, Roshni A, Jabir K. Postoperative pain, edema and trismus following third molar surgery - A comparitive study between submucosal and intravenous dexamethasone. J Family Med Prim Care. 2020;9(5):2454-9.
Sifuentes-Cervantes JS, Carrillo-Morales F, Castro-Núñez J, Cunningham LL, Van Sickels JE. Third molar surgery: Past, present, and the future. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;132(5):523-31.
Kiencało A, Jamka-Kasprzyk M, Panaś M, Wyszyńska-Pawelec G. Analysis of complications after the removal of 339 third molars. Dent Med Probl. 2021;58(1):75-80.
Gay-Escoda C, Hanna M, Montero A, Dietrich T, Milleri S, Giergiel E, et al. Tramadol/dexketoprofen (TRAM/DKP) compared with tramadol/paracetamol in moderate to severe acute pain: results of a randomised, double-blind, placebo and active-controlled, parallel group trial in the impacted third molar extraction pain model (DAVID study). BMJ Open. 2019;9(2):e023715.
Nadhreen AA, Alamoudi NM, Elkhodary HM. Low-level laser therapy in dentistry: Extra-oral applications. Niger J Clin Pract. 2019;22(10):1313-8.
Arjmand B, Khodadost M, Jahani Sherafat S, Rezaei Tavirani M, Ahmadi N, Hamzeloo Moghadam M, et al. Low-Level Laser Therapy: Potential and Complications. J Lasers Med Sci. 2021;12:e42.
Kocherova I, Bryja A, Bruska M, Dominiak M, Mozdziak P, Skiba THI, et al. Photobiomodulation-Underlying Mechanism and Clinical Applications. J Clin Med. 2020;9(6):1724.
Mussttaf RA, Jenkins DFL, Jha AN. Assessing the impact of low level laser therapy (LLLT) on biological systems: a review. Int J Radiat Biol. 2019;95(2):120-43.
Nunez JH, Strong AL, Comish P, Hespe GE, Harvey J, Sorkin M, et al. A Review of Laser Therapies for the Treatment of Scarring and Vascular Anomalies. Adv Wound Care (New Rochelle). 2023;12(2):68-84.
Glass GE. Photobiomodulation: The Clinical Applications of Low-Level Light Therapy. Aesthet Surg J. 2021;41(6):723-38.
Hamblin MR. Mechanisms and applications of the anti-inflammatory effects of photobiomodulation. AIMS Biophys. 2017;4:337-61.
Tsai SR, Hamblin MR: Biological effects and medical applications of infrared radiation. J Photochem Photobiol B. 2017;170:197-207.
Wang Y, Huang YY, Wang Y, Lyu P, Hamblin MR. Photobiomodulation (blue and green light) encourages osteoblastic-differentiation of human adipose-derived stem cells: role of intracellular calcium and light-gated ion channels. Sci Rep. 2016;6:33719.
Brignardello-Petersen R, Carrasco-Labra A, Araya I, Yanine N, Beyene J, Shah PS. 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. 2012;70:1789-801.
Asnaashari M, Safavi N. Application of low level lasers in dentistry (Endodontic). J Lasers Med Sci. 2013;4:57-66.
Boschi ES, Leite CE, Saciura VC, Caberlon E, Lunardelli A, Bitencourt S, et al. Anti-Inflammatory effects of low-level laser therapy (660 nm) in the early phase in carrageenan-induced pleurisy in rat. Lasers Surg Med. 2008;40(7):500-8.
Albertini R, Villaverde AB, Aimbire F, Salgado MA, Bjordal JM, Alves LP, et al. Anti-inflammatory effects of low-level laser therapy (LLLT) with two different red wavelengths (660 nm and 684 nm) in carrageenan-induced rat paw edema. J Photochem Photobiol B. 2007;89(1):50-5.
Ferrante M, Petrini M, Trentini P, Perfetti G, Spoto G. Effect of low-level laser therapy after extraction of impacted lower third molars. Lasers Med Sci. 2013;28:845-9.
Farivar S, Malekshahabi T, Shiari R. Biological effects of low level laser therapy. J Lasers Med Sci. 2014;5:58-62.
Ezzati K, Fekrazad R, Raoufi Z. The Effects of Photobiomodulation Therapy on Post-Surgical Pain. J Lasers Med Sci. 2019;10:79-85.
Higgins JPT, Altman GD, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
Feslihan E, Eroğlu CN. Can Photobiomodulation Therapy Be an Alternative to Methylprednisolone in Reducing Pain, Swelling, and Trismus After Removal of Impacted Third Molars? Photobiomodul Photomed Laser Surg. 2019;37(11):700-5.
Singh V, Garg A, Bhagol A, Savarna S, Agarwal SK. Photobiomodulation Alleviates Postoperative Discomfort After Mandibular Third Molar Surgery. J Oral Maxillofac Surg. 2019;77(12):2412-21.
Hadad H, Santos AFP, de Jesus LK, Poli PP, Mariano RC, Theodoro LH, et al. Photobiomodulation Therapy Improves Postoperative Pain and Edema in Third Molar Surgeries: A Randomized, Comparative, Double-Blind, and Prospective Clinical Trial. J Oral Maxillofac Surg. 2022;80(1):37.
Isolan C, Kinalski MD, Leão OA, Post LK, Isolan TM, Dos Santos MB. Photobiomodulation therapy reduces postoperative pain after third molar extractions: A randomized clinical trial. Med Oral Patol Oral Cir Bucal. 2021;26(3):e341-8.
Nejat AH, Eshghpour M, Danaeifar N, Abrishami M, Vahdatinia F, Fekrazad R. Effect of Photobiomodulation on the Incidence of Alveolar Osteitis and Postoperative Pain following Mandibular Third Molar Surgery: A Double-Blind Randomized Clinical Trial. Photochem Photobiol. 2021;97(5):1129-35.
Abdel-Alim HM, Abdel-Dayem H, Mustafa ZA, Bayoumi A, Jan A, Jadu F. A Comparative Study of the Effectiveness of Immediate Versus Delayed Photobiomodulation Therapy in Reducing the Severity of Postoperative Inflammatory Complications. Photomed Laser Surg. 2015;33(9):447-51.
Tenis CA, Martins MD, Gonçalves MLL, Silva DFTD, Cunha Filho JJD, Martins MAT, et al. 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). 2018;97(37):e12264.
Yüksek MN, Eroğlu CN. Clinical evaluation of single and repeated sessions of photobiomodulation with two different therapeutic wavelengths for reducing postoperative sequelae after impacted mandibular third molar surgery: a randomized, double-blind clinical study. J Appl Oral Sci. 2021;29:e20210383.
Cetira Filho EL, Silva PGB, Wong DVT, Choquenaira-Quispe C, Cesário FRAS, de Sousa Nogueira G, et al. Effect of preemptive photobiomodulation associated with nimesulide on the postsurgical outcomes, oxidative stress, and quality of life after third molar surgery: a randomized, split-mouth, controlled clinical trial. Clin Oral Investig. 2022;26(12):6941-60.
Australian Government, NHMRC. How to use the evidence: assessment and application of scientific evidence. Available at: https://www.nhmrc.gov.au /sites/default/files/documents/reports/clinical%20guidelines/how-to-useevidence-cp69.pdf. Accessed on 07 July 2023.
Lopez-Ramirez M, Vilchez-Perez MA, Gargallo-Albiol J, Arnabat-Dominguez J, Gay-Escoda C. 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. 2012;27(3):559-66.
Markovic A, Todorovic LJ. Effectiveness of dexamethasone and low power laser in minimizing oedema after third molar surgery: a clinical trial. Int J Oral Maxillofac Surg. 2007;36(3):226-9.
Amarillas-Escobar ED, Toranzo-Fernández JM, Martínez-Rider R, Noyola-Frías MA, Hidalgo-Hurtado JA, Serna VM, et al. Use of therapeutic laser after surgical removal of impacted lower third molars. J Oral Maxillofac Surg. 2010;68(2):319-24.
He WL, Yu FY, Li CJ, Pan J, Zhuang R, Duan PJ. 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. 2015;30(6):1779-88.
Aras MH, Güngörmüş M. Placebo-controlled randomized clinical trial of the effect two different low-level laser therapies (LLLT)--intraoral an extraoral on trismus and facial swelling following surgical extraction of the lower third molar. Lasers Med Sci. 2010;25(5):641-5.
