Photobiomodulation after Surgical Extraction of the Lower Third Molars: A Narrative Review

Daniele Pergolini,Gaspare Palaia,Gianluca Tenore,Federica Rocchetti,Umberto Romeo,Riccardo De Angelis,Raffaele Cefalà,Alessandro Del Vecchio

doi:10.3390/oral2010004

Abstract

The surgical extraction of the lower third molar is widely practiced in oral surgery. Inflammatory complications such as pain, swelling, and trismus can cause discomfort to the patients after third molar extraction. Several methods have been used to reduce these postoperative sequelae, including the use of corticosteroids, nonsteroidal anti-inflammatory drugs, analgesics, antibiotics, less traumatic surgical methods, and the use of photobiomodulation. This narrative review summarizes the current evidence on the effect of photobiomodulation on pain, facial swelling and trismus after third molar surgery. A literature search using MEDLINE (NCBI PubMed and PMC), EMBASE, Scopus, Cochrane library, Web of Science, and Google Scholar was undertaken up to October 2021. Forty-one articles met the inclusion criteria. Photobiomodulation can be considered an alternative and useful method for controlling pain following impacted wisdom tooth surgery. The effectiveness of PBM in reducing swelling and trismus is still controversial. This review highlights the lack of consensus in the literature on protocols used in PBM therapy.

Highlights

The surgical extraction of the third mandibular molar is the most frequent procedure in oral and maxillo-facial surgery [1].An impacted third molar can cause different consequences such as pericoronitis, distal caries and periodontal pocket of the second molar, odontogenic abscesses, and the development of follicular cysts [2].The healing period following the surgical extraction of an impacted third mandibular molar is associated with an intense inflammatory response
This process is responsible for postoperative pain, facial swelling, and trismus, which negatively affect the quality of life of the patients during 7–10 days after the surgery [3]
The present narrative review evaluates the role of PBM in the management of pain, facial swelling, and trismus that accompany the postoperative period after the extraction of the third molars

Summary

Introduction

The healing period following the surgical extraction of an impacted third mandibular molar is associated with an intense inflammatory response. This process is responsible for postoperative pain, facial swelling, and trismus, which negatively affect the quality of life of the patients during 7–10 days after the surgery [3]. These signs and symptoms are a consequence of the surgical wound and the duration of the surgery itself [4], as the result of a direct trauma on the blood and lymphatic vessels [5]. Swelling reaches peak intensity in to 48 h, influencing facial esthetics and social interactions It usually resolves between the fifth and seventh days. It may lead to difficulty in eating and functioning if it persists for more than a few days

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Results

Discussion

Conclusion