ASSESSMENT OF PHOTOBIOMODULATION THERAPY IN ENHANCING POSTOPERATIVE HEALING AFTER MANDIBULAR THIRD MOLAR SURGERY

Surgical extraction of impacted mandibular third molars is usually followed by pain, swelling of the face, and trismus,
all of which impair patient comfort. In the wake of the Impaction, a painful experience is rendered more so by the
renowned triad of being post-operatively inflicted with pain, swelling, and facial hypoesthesia. Photobiomodulation
therapy (PBMT) has gained popularity in recent times as a non-invasive adjunct promoting healing and minimizing
postoperative morbidities. The aim of this prospective, randomized, double-blind controlled clinical trial was to assess
the effect exerted by standardized PBMT (808 nm wavelength, 100 mW power, 4 J/cm² per point output irradiance,
applied intra- and extra-orally immediately after suturing and at 48 hours) on the improvement of postoperative
outcomes after mandibular third molar surgical procedure. Sixty healthy patients, aged 18–35 years, requiring bilateral extraction of impacted mandibular third molars, were divided into either a PBMT group or a sham-laser control group.
The primary outcome was the measurement of pain intensity postoperatively using the Visual Analog Scale (VAS) at
24 hours, 48 hours, 7 days, and 14 days. Secondary outcomes included facial swelling measured by simple facial
distances, maximal interincisal mouth opening, analgesic consumption, and time to return to a normal diet. Data
analysis was done by repeated measures ANOVA, independent t-tests, and Mann–Whitney U tests. The results revealed the patients who had in PBMT demonstrated significantly less pain according to VAS score at all time intervals, less facial swelling at 48 hours and 7 days, faster recovery of maximal mouth opening, fewer analgesics ingested during the 7-day period, and a faster return to a normal diet relative to the controls (p < 0.05 in all cases). These results establish that PBMT exerts a significant effect on postoperative recovery after mandibular third molar extraction by reducing pain, swelling, and trismus; therefore, it can be considered an adjunctive therapy in oral surgery practice that is safe to use and useful for enhancing patient-centered outcome.