Avaliação clínica e termográfica após exodontias de terceiros molares inferiores e diferentes terapias de fotobiomodulação: um ensaio clínico randomizado duplo-cego

Abstract

The aim of this study was to compare the parameters of pain, edema, temperature and soft tissue closure, after extractions of lower third molars, in dental sockets that received two different photobiomodulation therapy (PBMT) protocols. This is a double-blind, split-mouth randomized clinical study, in which 31 participants had their teeth 38 and 48 extracted. After extractions, one of the dental socket received PBMT at a wavelength of 808 nanometers (nm) (infrared – group 808) and the other dental socket received irradiation at wavelengths of 808 nm and 660 nm associated simultaneously (infrared + red – group 808+660), both in 3 points in the region of the dental socket, after the surgical procedure and on the 3rd and 7th days. Patients were evaluated for pain perception using the Visual Analogue Scale (VAS) and measurements were taken of facial edema, in centimeters (cm), temperature using Infrared Thermography, in degrees Celsius (ºC) and the distance between the edges of surgical wounds, in millimeters (mm), in the immediate postoperative period and on the 3rd, 7th and 28th days. For both 808+660 and the 808 groups, the mean VAS values for pain were 1.45 for the 3rd day and 0.52 for the 7th day. Regarding the assessment of facial edema, the averages for the pogonion-tragus measurement, on the 3rd day, were 15.38 cm for the 808+660 group and 15.48 cm for the 808 group and the averages for the labial commissure measurement-tragus, on the 3rd day, was 11.97 cm for the 808+660 group and 12 cm for the 808 group. The average temperatures for the 808+660 group were 34.9 ºC for the 3rd day and 35 ºC for the 7th day and for group 808, it was 34.9 ºC for the 3rd and 7th days. Regarding the size of the dental socket, measured on the 28th day, the averages for the 808+660 group were 5.25 mm (length) and 2.38 mm (width) and for the 808 group they were 5.12 mm (length) and 2.45 mm (width). All patients benefited from the effects of both PBMT protocols and no complications or adverse effects were encountered. After statistical analyses, adopting the value of p<0.05, no significant differences were found for the parameters of edema, temperature and socket healing, when comparing the two protocols. For the pain parameter, significant differences were found only for the 7th day, being greater for the 808+660 group (p=0.031). It can be concluded that the addition of the red laser (660nm) and the increase in energy did not intensify the benefits in reducing pain, edema or closing the soft tissues of the alveoli of lower third molars, in the protocols used here