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Nd:YAG laser therapy on postoperative pain, swelling, and trismus after mandibular third molar surgery: a randomized double-blinded clinical study

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Abstract

This study aims to evaluate the effect of Nd:YAG laser therapy (NdLT) on postoperative pain, swelling, and trismus after mandibular third molar (M3) surgery. Three hundred patients were randomly divided into the Nd group (n = 100), medication group (n = 100), and Nd+medication (Nd+m) group (n = 100). The WHARFE classification system was used to assess surgical difficulty. After surgery, the Nd group was irradiated by the Nd:YAG laser in very long-pulsed mode (VLP, pulse duration 1 ms, 20 Hz, 4 W, R21-C3) in 6 regions of the extraction socket with a total energy of 300 J. For the medication group, dexamethasone 0.75 mg and loxoprofen 60 mg were prescribed immediately and every 12 h thereafter for 3 days. The Nd+m group received both treatments mentioned above. Pain assessment was performed at 6, 24, 48, and 72 h postoperatively using the visual analog scale (VAS). Swelling was evaluated by changes in the distance from (1) the tragus to the labial commissure, (2) the tragus to the pogonion, and (3) the mandibular angle to the lateral canthus preoperatively and 72 h postoperatively. Trismus was assessed by the change in maximum mouth opening. Groups Nd and Nd+m had lower VAS scores at 6 h, 24 h, and 48 h (F = 13.80, p = 0.00), but the difference between the two groups was not significant (F = 1.34, p = 0.11). However, no significant difference was observed at 72 h (p = 0.10). There was no significant difference in swelling or trismus among the three groups (p > 0.05). NdLT is an effective approach to improve complications after M3 surgery.

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Data Availability

Data used or analysed in this study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Xu Haotian, PhD (PBC School of Finance, Tsinghua University) for reviewing the methodology of this study as a statistician.

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Authors and Affiliations

  1. Department of Stomatology, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhongguancun, Changping District, Beijing, China

    Han Yang, Zhu Jie, Hu Suning, Li Cong & Xiqian Zhang

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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Yang Han. The first draft of the manuscript was written by Yang Han, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Han Yang.

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This study was approved by the Bioethics Committee of Peking University International Hospital (No:2020-031).

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Han, Y., Zhu, J., Hu, S. et al. Nd:YAG laser therapy on postoperative pain, swelling, and trismus after mandibular third molar surgery: a randomized double-blinded clinical study. Lasers Med Sci 38, 176 (2023). https://doi.org/10.1007/s10103-023-03836-9

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