Low-level laser therapy in acute pain management after complex tooth extraction

Objective. To evaluate the efficiency of low-level laser therapy (LLLT) in reducing early acute postoperative pain (APP) in patients after complex tooth extraction.
Material and methods. All the patients (18–44 years old) after complex tooth extraction were divided into 4 groups. The first group included 28 patients who did not receive LLLT. In the 2nd group (32 patients), the LO-904-25 laser emitting head and the ZM-50 magnetic mirror nozzle were used. The pulsed radiation power in this group was 10 W, and the radiation frequency was 80 Hz. In the 3rd group (30 patients), dental attachments from the S-1 set were used together with the LO-904-25 laser emitting head in the area of the socket formed after tooth extraction. The pulsed radiation power in this group was 7 W, and the radiation frequency was 80 Hz. In the 4th group (29 patients), a laser head with a wavelength of 0.63 μm (KLO 635-15 laser head) emitting a continuous red spectrum was used. The radiation power was 10 mW, the radiation frequency was 635 nm. The exposure time of the nozzles and heads in the projection of the extracted tooth was 3 minutes in all groups. All patients received laser therapy 1 hour, 24 hours, and 48 hours after surgery, and acute pain intensity was assessed in these time points using a visual analogue scale (VAS) in mm.
Results. According to Wilcoxon test, in the first group of patients without photobiomodulation therapy (PBMT), the intensity of APP according to VAS one hour after tooth extraction was significantly lower than that after 3 hours (p<0.04) and increased significantly at 24 hours compared with the previous time point (p<0.029). In group 2, acute pain increased significantly after 3 hours (p<0.049), then decreased significantly after 24 hours (p<0.042) and was practically absent 48 hours after surgery (p<0.0002). In group 3, acute pain peaked at 3 hours (p<0.018), decreased significantly after 24 hours (p<0.03) and 48 hours (p<0.047) and was practically absent after two days. In group 4, maximum pain intensity was observed after 3 hours (p<0.007). After 24 hours, the APP intensity significantly decreased compared with 3 hours after surgery (p<0.023) and continued to decrease after 48 hours (p<0.041). The mean VAS pain severity score corresponded to very mild pain. According to Mann-Whitney test, 3 hours after surgery, pain intensity in group 1 was significantly higher than in groups 2-4 (p<0.022, p<0.034, and p<0.048, respectively). In group 2, acute pain was significantly milder than in group 3 (p<0.045) and in group 4 (p<0.037). After 24 hours, pain decreased in all groups but remained highest in group 1 compared with groups 2 (p<0.014), 3 (p<0.032), and 4 (p<0.05). In group 2, APP was significantly less pronounced than in the other groups with laser therapy (p<0.049 and p<0.011 for groups 3 and 4, respectively). According to Student’s t-test, 48 hours after the operation, patients in group 2 experienced virtually no pain, and pain intensity in this group was significantly lower than in groups 3 and 4 (p<0.0012 and p<0.001, respectively).
Conclusion. The use of laser therapy in the first hours and days after complex tooth extraction leads to a decrease in acute pain.
Keywords: laser radiation, tooth extraction, pain syndrome, visual analogue scale.
Conflicts of interest. The authors have no conflicts of interest to declare.
Financing. The study received no funding.