## 4 Discussion  
The surgical-orthodontic canine disimpaction protocol used in this study differs from the conventional approach that involves immediate positioning of the bracket or button to exert the orthodontic force. This procedure can be difficult due to possible bleeding or to the reduced area of surgical exposure [23]. Moreover, in the conventional approach, the mechanical eruption of palatally impacted canines may lead to prolonged treatment, with an increased propensity for root resorptions and poor patient compliance [24; 25]. Additionally, root resorption of teeth neighboring the impacted tooth is thought to be accelerated if mechanical eruption is undertaken [25; 26]. The surgical approach with the laser showed, compared to the traditional surgery, advantages already underlined in the literature: precision during the tissue incision, the need for a lower dose of local anesthesia, and the elimination of sutures with consequent reduction in infections and inflammatory processes. Furthermore, an antibacterial effect of the laser has been demonstrated [27], a property that improves post-operative admission and reduces the intake of antibiotics. No risks were found during laser application. The literature reports numerous applications of lasers in oral surgery (HILT), for example, for operoclectomy in the surgical removal of soft tissue that overlies an impacted tooth [28]. However, the biostimulating action of HILT during the surgical exposure has not yet been demonstrated. With this study, we wanted to investigate it. The application of PBM (LLLT) during orthodontic tooth movement has been widely investigated by different authors. Lasers acting in the \"therapeutic window\" (from about 600-1100 nm) with an output energy of less than 500 mW are proven to have a biostimulating effect on the tissues without increasing the temperature of the treated region above normal body temperature. Therefore, they have the potential to accelerate tooth movement by means of influencing the remodeling of alveolar bone without unwanted impacts on the tooth and periodontium. Histologic investigations revealed that PBM during orthodontic tooth movement can profoundly affect cell-mediated alveolar bone remodeling [28]. [PERSON] et al. used 635 nm diode laser irradiations at two different energy densities (1 and 3 J/cm\({}^{2}\)) to investigate the biostimulating effects on the healing of cutaneous skin  
Figure 8: Values of eruption of the 13 canines at 16 weeks after laser surgery. wounds, in vivo, by means of bioimpedance measurements and histological examinations. Laser irradiations of both energy densities stimulated the wound healing process. In particular, laser irradiation of lower energy density had more evidence, especially for the first days of the healing process [29]. The purpose of our study was to propose a canine disinclusion protocol that would exploit the indisputable surgical qualities of the diode laser, which make it a very useful tool for these applications, and the biostimulating effect of a wavelength of 980 nm, fully inserted in the therapeutic window. If, at the surgical level, we can say with certainty that the diode laser can represent a very useful tool because it offers countless surgical and post-operative advantages, the discussion relating to biomodulation deserves a separate mention and must be validated with an RCT and a control group. As for the spontaneous eruption of the amines without traction, it is true that some studies tell us that most canines could erupt with traditional methods, which, however, would lead to inconvenience for the patient during and after the operation (bleeding, discomfort due to the sutures [30]). Our data suggest that the response of the dental element to the biostimulant action of the laser, applied to expose the crown, may be considered effective. The results obtained led us to hypothesize the effectiveness in photobiomodulation (PBM) on the dental use of a diode laser in the described surgical procedure, although it was performed on a small sample of patients.