Does Combined Low-Level Laser and Light-Emitting Diode Light Irradiation Reduce Pain, Swelling, and Trismus After Surgical Extraction of Mandibular Third Molars? A Randomized Double-Blinded Crossover Study.

PURPOSE: Complications after extraction of mandibular third molars, including pain, swelling, and trismus, are common problematic phenomena for both patients and surgeons. The main objective of the present study was to evaluate the therapeutic effect of combined low-level laser (LLL) and light-emitting diode (LED) irradiation on the recovery rate of such complications. PATIENTS AND METHODS: The authors implemented a prospective randomized, double-blind crossover design. Forty participants (80 teeth) were enrolled, each with bilateral and symmetrical impacted lower third molars. Participants had lower third molars extracted at 2 separate visits. Participants were randomized to receive LLL plus LED or placebo at the initial surgical procedure. Participants acted as their control during the second surgical procedure. The primary predictor variable was LLL plus LED. The primary outcome variable was pain measured at postoperative days 3 and 7. Secondary outcome variables were swelling and trismus. The Mann-Whitney U, Wilcoxon, and Friedman tests were used for statistical analysis with a P < .05 considered significant. RESULTS: The sample size of each group was 40 (male to female ratio of 1:1, mean age 24.8 ± 3.9). Preoperative scores of all scales were lower for both groups compared with days 3 and 7 (P < .0001). Postoperative pain levels on days 3 and 7 were significantly less in the intervention group (P = .03 and P = .01, respectively). Compared with the control group, the postoperative trismus level of the intervention group was significantly less on day 3 (P = .006). However, the difference on day 7 was not significant. Postoperative swelling levels on days 3 and 7 were significantly less in the intervention group (P < .0001). CONCLUSIONS: Combined LLL plus LED irradiation could be an effective therapy to decrease postoperative pain and swelling after impacted third molar extractions.

Effect of Low-Level Laser and Light-Emitting Diode on Inferior Alveolar Nerve Recovery After Sagittal Split Osteotomy of the Mandible: A Randomized Clinical Trial Study.

PURPOSE: The major concern of sagittal split osteotomy (SSO) is the neurosensory disturbance. The authors investigated the effect of low-level laser therapy and light-emitting diode on the inferior alveolar nerve recovery after SSO. METHODS: In this double-blinded randomized clinical trial, 20 subjects with inferior alveolar nerve injury after SSO of the mandible were studied. Neurosensory recovery was assessed by 6 tests: visual analog scale (VAS), brush stroke, 2-point discrimination, contact detect detection, pinprick nociception, and thermal discrimination, and each one was performed before and after the surgery on days 1, 3, 7, 14, 60, and 180. RESULTS: After 1 week, the VAS score in the laser group significantly improved in comparison with the control group. Visual analog scale score improvement was 25% (P = 0.015) at 2 weeks, 21% (P = 0.001) at 2 months, and 24% (P = 0.001) at 6 months. After 2 weeks, the brush stroke score improvement was significant in the laser group. The improvement values were 21.5% (P = 0.002) at 2 months and 15.1% (P = 0.004) at 6 months. CONCLUSION: Low-level laser therapy and light-emitting diode may improve VAS scores, 2-point discrimination, and brush stroke test results without any effect on the pinprick or contact detection test results.

Evaluation of Sensorimotor Nerve Damage in Patients with Maxillofacial Trauma; a Single Center Experience.

OBJECTIVE: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, Iran. METHODS: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with maxillofacial trauma referring to our center during the study period. The demographic information, type of fracture, location of fracture and nerve injuries were assessed and recorded in each patients. The frequency of sensorimotor injuries in these patients was recorded. Data are presented as frequencies and proportions as appropriate. RESULTS: Overall we included 495 patients with maxillofacial trauma with mean age of 31.5±13.8 years. There were 430 (86.9% men and in 65 (13.1%) women among the patients. The frequency of nerve injuries was 67.7% (336 patients). The mean age of the patients with nerve injuries was 33.4 ± 3.7 years. Marginal mandibular branch of facial nerve was the most common involved nerve being involved in 5 patients (1%). Regarding trigeminal nerve, the inferior alveolar branch (194 patients 39.1%) was the most common involved branch followed by infraorbital branch (135 patients 27.2%). Mandibular fracture was the most common injured bone being reported in 376 patient (75.9%) patients followed by zygomatic bone in 100 patient (20%). CONCLUSION: The most frequent fracture occurred in mandible followed by zygoma and the most injured nerve was inferior alveolar nerve followed by infraorbital branch of trigeminal nerve. In facial nerve the marginal branch was the most involved nerve. The frequency of nerve injury and the male to female ratio was higher in the current study compared to the literature.