Choosing between intraoral or extraoral, red or infrared laser irradiation after impacted third molar extraction.

BACKGROUND AND OBJECTIVE: Swelling and trismus are complications experienced by nearly all subjects after undergoing oral surgery for the removal of impacted teeth. The main purpose of this paper was to compare the effects of photobiomodulation therapy (PBMT) at two different wavelengths applied intra-orally and extra-orally on facial swelling and trismus in the postoperative period following the extraction of impacted mandibular third molars.

STUDY DESIGN/MATERIALS AND METHODS: Sixty subjects were randomly divided into five groups, taking into account the type of laser therapy applied after surgery (intraoral or extraoral irradiation with 660 nm laser; intraoral or extraoral irradiation with 808 nm; and sham irradiation). Two and seven days after the surgery, two blinded evaluators measured the subjects' faces (swelling), and mouth opening (trismus).

RESULTS: There was a statistically significant interaction between the irradiation site and wavelength (swelling and trismus were smaller if the red laser was applied intra-orally or if infrared laser was applied extra-orally). The intra-group analyses showed that 808 nm laser applied extra-orally favored reductions in postoperative facial swelling and trismus, although the inter-group comparisons revealed no statistically significant differences.

CONCLUSION: Besides energy parameters, the combination of irradiation site and wavelength drive the results of phototherapy after the removal of impacted teeth. Lasers Surg. Med. 48:511-518, 2016. © 2016 Wiley Periodicals, Inc.