Low Laser Light Therapy After Impacted Third Molar Removal

NCT ID: NCT02602431

Last Updated: 2016-05-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-31

Study Completion Date

2016-07-31

Brief Summary

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Third molars extraction is a surgery frequently performed in dentistry. It is generally associated to a great postoperative distress rendered by pain, swelling and trismus, caused by surgical trauma inflammation. Several methods have been proposed to prevent these complications and to increase tissue repair quality. The use of low level laser therapy (LLLT) has been reported in dentistry since 1970. A large number of studies have reported the benefits of LLLT without collateral damage, positive effect as an anti-inflammatory agent and benefits in accelerating wound repair. However, some clinical applications strategies have been contradictories in everyday practice with results not always equivalent.

Objective: To verify if a single LLLT intra or extra oral application, singly, are analogous in their effects in controlling postoperative edema, trismus, pain and wound repair in third molar surgery.

Detailed Description

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30 healthy participants of both genders, with 18 to 35 years-of-age, with the necessity of inferior bilateral third molar removal will be selected. Inclusion criteria will consider the presence of upper central incisive and same surgical difficulty for third molar extraction. Participants that present chronic TMJ pain, neurological or psychiatric disorders, pericoronitis, anti-inflammatory or analgesic use for the last 15 days, bisphosphonates usage history at any time, tabagism, pregnancy or a family history of photosensitivity and hypersensibility to analgesics, anti-inflammatory or antibiotics will not be included. The surgical procedures will be randomized for the group to be assigned respecting the interval of one month between the surgeries.

Intra-oral group (IO) will be that in whose participant will receive the LLLT (Photon Lase III DMC equipment) with 660 nm wavelength, 100 mW of power, 107J / cm2 of power density, during 30 seconds, positioning the tip of the laser device in straight contact with each of the four points in the surgical area:

1. corresponding to the occlusal surface of the tooth surgically extracted,
2. in the middle third of the lingual surface, point
3. the middle third of the buccal surface and point
4. retro molar triangle region. Each point will receive energy 3J (Et= 12J).

The extra-oral group (EO) will receive phototherapy with the 808nm of wavelength following the same above protocol although positioning the laser point over the skin in straight contact with four points on the masseter muscle:

1. next jaw insert,
2. lower middle region,
3. upper middle region
4. near the insertion of the zygomatic arch.

In the IO group the extra-oral region will not be irradiated (the laser tip will be put in place without energy) in the EO group it will be done the opposite, so as the same patient will be the control because the participant will not be capable to identify which group he belongs to. The same investigator will perform surgical procedures and laser therapy. All participants will receive the same postoperative medication. Three distances will evaluate the range of edema: from tragus to the corner of the mouth, from gonial angle to the corner of the mouth and from gonial angle to the corner of the eye using a malleable millimeter rule. Trismus will be evaluated by the maximum range of mouth opening considering the inter-incisal distance between the edges of upper and lower right central incisors by a caliper in three moments: before surgery, 24 hours and 8 days after surgery. Participants will be asked to fill in a diary to assess the severity of postoperative pain on a visual analogue pain scale after the end of anesthetic effect: 4, 6, 8, 24, 48 hours postoperatively. The amount and time of medication will be also recorded. The quality of wound repair will be evaluated by two blinded calibrated observers, 24 hours and 8 days postoperatively in score from 0 to 3. The data will be submitted to appropriate statistical analysis for non-parametric samples.

Conditions

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Trismus Edema Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Extra-oral laser irradiation

infra-red wave laser, 660nm, 100mW, and 107J/cm2

Group Type ACTIVE_COMPARATOR

Extra-oral laser irradiation

Intervention Type DEVICE

Irradiation will be employed extra oral by infra-red wave laser, 660nm, 100mW, and 107J/cm2 in four points of Masseter muscle for 30 seconds in each

Extra-oral placebo

Laser point will be placed in region without irradiation on.

Group Type PLACEBO_COMPARATOR

Extra-oral placebo

Intervention Type DEVICE

Laser point will be placed over the same extra-oral points for 30 seconds in each point without irradiation on

Intra-oral laser irradiation

red wave laser, 660nm, 100mW, and 107J/cm2

Group Type ACTIVE_COMPARATOR

Intra-oral laser irradiation

Intervention Type DEVICE

Irradiation will be employed intra oral by red wave laser, 660nm, 100mW, and 107J/cm2 in four points for 30 seconds in each : 1. Superficial face of dental socket, 2. Lingual face; 3. buccal face and 4. Retromolar region

intra-oral placebo

Laser point will be placed in region without irradiation on.

Group Type PLACEBO_COMPARATOR

Intra-oral Placebo

Intervention Type DEVICE

Laser point will be placed over the same intra-oral points for 30 seconds in each point without irradiation on

Interventions

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Extra-oral laser irradiation

Irradiation will be employed extra oral by infra-red wave laser, 660nm, 100mW, and 107J/cm2 in four points of Masseter muscle for 30 seconds in each

Intervention Type DEVICE

Intra-oral laser irradiation

Irradiation will be employed intra oral by red wave laser, 660nm, 100mW, and 107J/cm2 in four points for 30 seconds in each : 1. Superficial face of dental socket, 2. Lingual face; 3. buccal face and 4. Retromolar region

Intervention Type DEVICE

Extra-oral placebo

Laser point will be placed over the same extra-oral points for 30 seconds in each point without irradiation on

Intervention Type DEVICE

Intra-oral Placebo

Laser point will be placed over the same intra-oral points for 30 seconds in each point without irradiation on

Intervention Type DEVICE

Other Intervention Names

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DMC Photon Laser III DMC Photn Laser III DMC Photn Laser III DMC Photn Laser III

Eligibility Criteria

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Inclusion Criteria

* necessity of bilateral impacted third molar removal with similar dental arch positioning and similar surgical difficulty.

Exclusion Criteria

* Compromised Systemic Health status, Neurologic and/or mental disorders, local infection history, anti-inflammatory or analgesic use for the last 15 days, tabagism, ethylism, pregnancy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Maria Cristina Zindel Deboni

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Maria Cristina Deboni, PhD

Role: PRINCIPAL_INVESTIGATOR

Associate Professor

Locations

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Maria Cristina Zindel Deboni

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Maria Cristina Deboni, PhD

Role: CONTACT

11.55 28488185

Vinicius PA Santos, Undergraduate

Role: CONTACT

11. 55. 28488185

Facility Contacts

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Maria Cristina Deboni, PhD

Role: primary

+5511984269925

References

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Brignardello-Petersen R, Carrasco-Labra A, Araya I, Yanine N, Beyene J, Shah PS. Is adjuvant laser therapy effective for preventing pain, swelling, and trismus after surgical removal of impacted mandibular third molars? A systematic review and meta-analysis. J Oral Maxillofac Surg. 2012 Aug;70(8):1789-801. doi: 10.1016/j.joms.2012.01.008. Epub 2012 Mar 6.

Reference Type BACKGROUND
PMID: 22398186 (View on PubMed)

He WL, Yu FY, Li CJ, Pan J, Zhuang R, Duan PJ. A systematic review and meta-analysis on the efficacy of low-level laser therapy in the management of complication after mandibular third molar surgery. Lasers Med Sci. 2015 Aug;30(6):1779-88. doi: 10.1007/s10103-014-1634-0. Epub 2014 Aug 7.

Reference Type BACKGROUND
PMID: 25098769 (View on PubMed)

Larrazabal C, Garcia B, Penarrocha M, Penarrocha M. Influence of oral hygiene and smoking on pain and swelling after surgical extraction of impacted mandibular third molars. J Oral Maxillofac Surg. 2010 Jan;68(1):43-6. doi: 10.1016/j.joms.2009.07.061.

Reference Type BACKGROUND
PMID: 20006153 (View on PubMed)

Mehrabi M, Allen JM, Roser SM. Therapeutic agents in perioperative third molar surgical procedures. Oral Maxillofac Surg Clin North Am. 2007 Feb;19(1):69-84, vi. doi: 10.1016/j.coms.2006.11.010.

Reference Type BACKGROUND
PMID: 18088865 (View on PubMed)

Markovic A, Todorovic Lj. Effectiveness of dexamethasone and low-power laser in minimizing oedema after third molar surgery: a clinical trial. Int J Oral Maxillofac Surg. 2007 Mar;36(3):226-9. doi: 10.1016/j.ijom.2006.10.006. Epub 2006 Dec 8.

Reference Type BACKGROUND
PMID: 17157479 (View on PubMed)

Aras MH, Gungormus M. Placebo-controlled randomized clinical trial of the effect two different low-level laser therapies (LLLT)--intraoral and extraoral--on trismus and facial swelling following surgical extraction of the lower third molar. Lasers Med Sci. 2010 Sep;25(5):641-5. doi: 10.1007/s10103-009-0684-1. Epub 2009 May 31.

Reference Type BACKGROUND
PMID: 19484402 (View on PubMed)

Kazancioglu HO, Ezirganli S, Demirtas N. Comparison of the influence of ozone and laser therapies on pain, swelling, and trismus following impacted third-molar surgery. Lasers Med Sci. 2014 Jul;29(4):1313-9. doi: 10.1007/s10103-013-1300-y. Epub 2013 Mar 14.

Reference Type BACKGROUND
PMID: 23494104 (View on PubMed)

Lopez-Ramirez M, Vilchez-Perez MA, Gargallo-Albiol J, Arnabat-Dominguez J, Gay-Escoda C. Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction. A preliminary study. Lasers Med Sci. 2012 May;27(3):559-66. doi: 10.1007/s10103-011-0936-8. Epub 2011 May 27.

Reference Type BACKGROUND
PMID: 21617973 (View on PubMed)

Ferrante M, Petrini M, Trentini P, Perfetti G, Spoto G. Effect of low-level laser therapy after extraction of impacted lower third molars. Lasers Med Sci. 2013 May;28(3):845-9. doi: 10.1007/s10103-012-1174-4. Epub 2012 Jul 28.

Reference Type BACKGROUND
PMID: 22843310 (View on PubMed)

Pallotta RC, Bjordal JM, Frigo L, Leal Junior EC, Teixeira S, Marcos RL, Ramos L, Messias Fde M, Lopes-Martins RA. Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation. Lasers Med Sci. 2012 Jan;27(1):71-8. doi: 10.1007/s10103-011-0906-1. Epub 2011 Apr 12.

Reference Type BACKGROUND
PMID: 21484455 (View on PubMed)

Other Identifiers

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31861414.4.0000.0075

Identifier Type: -

Identifier Source: org_study_id

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