Effect of LLLT and Ozone to Reduce Complications After Extraction of Impacted Lower Molar

Study Overview
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Brief Summary
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Many factors cause third molars to stay impacted in the jaws, hence the extraction of impacted wisdom teeth occurs often in dental clinics. Pain, trismus, and edema are typical postoperative complications following third molar surgery. Various strategies have been developed to prevent or reduce these postoperative complications, Among these is the use of Low-Level Laser Therapy (LLLT), which demonstrates numerous benefits in lowering pain, trismus, and edema by managing inflammation. The precise biological mechanism of action remains unknown. There seems to be evidence that it may have neuro-pharmacological impacts on the production, metabolism, and release of a number of biological compounds, the other option is use of ozone which has antimicrobial effectiveness (viricidal, bactericidal, and fungicidal). Additional well-known advantages include immunological modulatory and stimulating actions, including anti-inflammatory, biosynthetic, anti-hypoxic, and bioenergetic characteristics. Ozone can interact with blood components in the right amounts to positively impact oxygen metabolism and cell energy while also triggering antioxidant defense mechanisms

Official Title
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Efficiency of Low Level Laser Therapy and Ozone on Sequelae After Extraction of Impacted Mandibular Third Molar

Conditions
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Complications of Extraction of Impacted Teeth

Intervention / Treatment
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* Radiation: low level laser therapy
* Drug: ozone gel


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who had mandibular third molar, totally or partially impacted in the bone (Class II-III and position B, Pell and Gregory's classification), in need of surgical extraction, which were evaluated clinically and by radiological examination. Patients who were in age range between 18-40 years old. Patients who were willing to compliance with study and were available for follow up. Patients should be with good oral hygiene and without any acute illness Exclusion Criteria: Patients with medical condition that prevent any surgical intervention such as patient with recent myocardial infarction, bleeding disorders, psychiatric problem and patients with pacemaker, uncontrolled systemic disease, immunocompromised patient and patients taking corticosteroid and anti-inflammatory drugs. Patients with history of head and neck radiotherapy. Pregnant or lactation women Active advanced uncontrolled periodontal disease and bad oral hygiene, or patients with local acute infection in relation to third molar especially pericoronitis. Patients who suffer from photodermatoses and photosensitized patients (photoallergies). Hyperthyroidism

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 38 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LLLT and ozone group<br>administered of low level laser therapy and ozone gel after extraction of impacted mandibular third molar | Radiation: low level laser therapy<br>* LLLT induces cellular biostimulation, speeds up tissue regeneration, enhances wound healing, and reduces pain and swelling through an anti-inflammatory effect. This is because the LLLT increases phagocytic activity, and the number and diameter of lymphatic vessels, decreases the permeability of blood vessels and restores microcapillary function<br>Drug: ozone gel<br>* ozone is effective antimicrobial (viricidal, bactericidal, and fungicidal). Other well-known benefits include immunological modulatory and stimulating effects and anti-inflammatory, biosynthetic, anti-hypoxic, and bioenergeticseffects<br>|
| Experimental: LLLT group<br>administered of low level laser therapy after extraction of impacted mandibular third molar | Radiation: low level laser therapy<br>* LLLT induces cellular biostimulation, speeds up tissue regeneration, enhances wound healing, and reduces pain and swelling through an anti-inflammatory effect. This is because the LLLT increases phagocytic activity, and the number and diameter of lymphatic vessels, decreases the permeability of blood vessels and restores microcapillary function<br>|
| Experimental: ozone group<br>administered of low ozone gel after extraction of impacted mandibular third molar | Drug: ozone gel<br>* ozone is effective antimicrobial (viricidal, bactericidal, and fungicidal). Other well-known benefits include immunological modulatory and stimulating effects and anti-inflammatory, biosynthetic, anti-hypoxic, and bioenergeticseffects<br>|
| No Intervention: control group<br>routinely extraction of impacted mandibular third molar | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain | measurement of pain by NRS, between 0 and 10, zero meaning no pain and 10 meaning worst imaginable pain | baseline to seventh day | 
| swelling | measurement of swelling by using tape, using 3 lines | baseline to seventh day | 
| trismus | measurement of maximum mouth opening by using digital Vernia | baseline to seventh day |