Low Power Laser in Mandibular Third Molar Surgery
Condition: Laser Therapy, Low-Level
Study type: Interventional

Summary: 
      The low-power laser provides the body with an improvement in the inflammatory response. Thus,
      the objective of this study is to evaluate two laser application protocols in 60 patients
      requiring surgical treatment for extraction of third molars included, without distinction of
      race or gender, aged between 16 and 40 years, coming from the Faculty of Dentistry Of São
      José dos Campos (UNESP). These patients will be divided randomly into 3 groups: group 1 -
      intraoral irradiation with 660 nm laser at a dose of 10 J (30 mW, 10 J / cm 2) , group 2 -
      intraoral irradiation with 660 nm laser at a dose of 30 J (30 mW, 30 J / cm 2) and group 3-
      control group, with application of placebo laser. At 3 and 7 days after surgery, the patients
      will be evaluated by two evaluators who will measure edema, trismus and pain. The tissue
      repair will also be evaluated after 1, 3 and 6 months of surgery, through radiographic
      analysis and periodontal conditions in the distal of the lower second molar. The results will
      be submitted to descriptive statistics and compared using the statistical analysis of
      variance (ANOVA) and Tukey test with significance level of 5%.
    

Detailed description: 
      Knowing the ability of the low-power laser to provide the body with an improvement in
      inflammatory response, with consequent reduction of edema, minimizing painful symptoms and
      leading to biostimulation, laser therapy is presented as an alternative for processes that
      present an inflammatory reaction, Pain and need for tissue regeneration. The literature shows
      the efficacy of laser in the postoperative surgery for extraction of third molars. However,
      to date, there is no consensus on the best protocol to be used in these cases. Thus, the
      objective of this study will be to evaluate two laser application protocols. To this end, 60
      patients will be selected who require surgical treatment for the extraction of third molars,
      regardless of race or gender, between the ages of 16 and 40, from the School of Dentistry of
      São José dos Campos (UNESP). These patients will be divided randomly into 3 groups: group 1 -
      intraoral irradiation with 660 nm laser at a dose of 10 J (30 mW, 10 J / cm 2), group 2 -
      intraoral irradiation with 660 nm laser at a dose of 10 J (30 mW, 10 J / cm 2) and group 3 -
      control group, with application of placebo laser. At 3 and 7 days after surgery, patients
      will be evaluated by two evaluators who will measure edema, mouth opening (assessment of
      muscle spasm) and pain. To compare the data, we will use the analog pain scale (VAS), the
      method of Ustün et al. (2003), and the millimeter rule. The patient will also be questioned
      about possible postoperative problems, as well as the surgeon, who will classify the
      postoperative repair process according to Batinjan et al. (2013). The tissue repair will also
      be evaluated after 1, 3 and 6 months of surgery, through radiographic analysis and
      periodontal conditions in the distal of the lower second molar. The results will be submitted
      to descriptive statistics and compared using the statistical analysis of variance (ANOVA) and
      Tukey test with significance level of 5%.
    

Intervention name(s): Grupo I- Lower laser fluency; Grupo II- Greater laser fluency; Grupo III- Laser sham
Intervention type(s): Radiation; Radiation; Radiation
Intervention description(s): The region determined for the application of the laser will be 4 points of the gingival mucosa: 1 - center of the alveolus; 2- center of the cervical third of the lingual face; 3 - lingual face; And 4 - apical third of the lingual face. The application time of the laser will be divided equally between the four points of application.; The region determined for the application of the laser will be 4 points of the gingival mucosa: 1 - center of the alveolus; 2- center of the cervical third of the lingual face; 3 - lingual face; And 4 - apical third of the lingual face. The application time of the laser will be divided equally between the four points of application.; The region determined for the application of the laser will be 4 points of the gingival mucosa: 1 - center of the alveolus; 2- center of the cervical third of the lingual face; 3 - lingual face; And 4 - apical third of the lingual face. The application time of the laser will be divided equally between the four points of application.
Other intervention name(s): Red laser diode of 660 nm/ power 30 mW/ creep of 10 J / cm2; Red laser diode of 660 nm/ power 30 mW/ creep of 30 J / cm2.; Control group, application of laser sham
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The sample of this study will be composed of 60 patients between 16 and 40 years old, who need to undergo the extraction of third molars included and / or impacted. The patients will be those who voluntarily seek the Discipline of Buccomaxillofacial Surgery and Traumatology, at the State University of São Paulo "Júlio de Mesquita Filho" - Unesp, to perform the procedure.
This study will be a randomized, double-blind, prospective clinical trial with the following groups:
Group I (with 20 patients) - laser therapy used in the immediate postoperative period will be intraoral irradiation with 660 nm red diode laser, 30 mW power and 10 J / cm2 fluency.
Group II (with 20 patients) - laser therapy used in the immediate postoperative period will be intraoral irradiation with 660 nm red diode laser, 30 mW power and 30 J / cm2 fluency.
Group III (with 20 patients) - Control Group - Application of laser sham.
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Third molar;; Third molar surgery;; Laser;; Tissue Repair.