Photobiomodulation as an adjuvant for pain relief and healing pre-orthodontic mandibular third molar surgery: double-blinded randomized clinical trial

This study aimed to evaluate the effects of photobiomodulation therapy (PBM) on post-operative pain and wound healing following the extraction of mandibular third molars. A split-mouth, double-blind, placebo-controlled, randomized clinical trial was conducted at the Faculty of Dentistry, José Antonio Páez University. Patients requiring bilateral surgical extraction of impacted and retained mandibular third molars in comparable anatomical positions were enrolled. Individuals with soft or hard tissue pathologies or systemic inflammatory conditions that could interfere with healing were excluded. One side of the jaw was randomly assigned as the treatment side, whereas the contralateral side served as the control. The treatment side received photobiomodulation (PBM) via a 980 nm diode laser (SOLASE PRO LASER, LAZON®) immediately after surgery and at 24, 48, and 72 h postoperatively. The primary outcome variables were wound healing and pain intensity. Pain was assessed via a visual analog scale (VAS) at 24, 48, 72, and 168 h. Wound healing was clinically evaluated on postoperative days 3, 7, and 14. Comparative analysis was performed via two-way ANOVA and repeated-measures ANOVA. A p value < 0.05 was considered statistically significant. Thirty-seven patients (32.4% male and 67.6% female) aged 22.8 ± 3.6 years participated in this study. VAS results revealed that PBM controlled pain at 24 h (4 ± 3) in comparison with the control group (6 ± 3) (p = 0.002), at 48 h (4 ± 3 and 5 ± 2, respectively) (p = 0.003), and at 72 h (2 ± 2 and 4 ± 2, respectively) (p = 0.004). Wound healing was significantly better on the PBM-treated side on day 3 (2,1 ± 0,2) than on the control side (3,2 ± 0,6) (p = 0.00), at 7 days (1,5 ± 0,5 and 2,5 ± 0,8, respectively) (p = 0.00), and at 14 days (1 ± 0 and 1,8 ± 0,8), respectively (p = 0.00). No adverse effects were reported. PBM with a 980 nm diode laser significantly reduced postoperative pain and enhanced wound healing compared to the contralateral control side, supporting its use as a safe and effective adjunct in third molar surgery.