PurposeImpacted third molars occur commonly and often require surgery for tooth extraction. As consequence, postoperative complications of varying degrees of severity are commonly seen. Thus, searching for less traumatic surgeries protocols is of importance. The aim of this study was to evaluate the outcome of impacted lower third molar teeth extraction using traditional protocol (scapples and surgical burs) or photonics protocol [Er,CR:YSGG associated with photobiomodulation therapy (PBMT)].MethodsThirty-five patients with bilateral impacted mandibular third molars were included in this split-mouth, controlled, and randomized clinical study. Seventy impacted third molars were divided into control group: extraction using traditional surgical scapples for soft tissue and burs for bone cutting or photonics group: extraction using Er,CR:YSGG laser (2780 nm) for soft tissue and bone cutting followed by PBMT (940-nm diode laser). The maximum mouth aperture (MMA) before and after extraction was used for comparing the surgeries’ outcomes.ResultsImmediately after surgery, the MMA for the control group remained unchanged and decreased significantly at 7 days after surgery. In the photonics group, the MMA remained unchanged during whole experimental time.ConclusionThe presented photonics protocol (Er,CR:YSGG laser plus PBMT) for third molar extraction prevents impairment of the maximum mouth aperture.