HIỆU QUẢ LÀNH THƯƠNG MÔ MỀM CỦA LASER CÔNG SUẤT THẤP SAU PHẪU THUẬT RĂNG KHÔN HÀM DƯỚI LỆCH NGẦM

Abstract

Background: The surgical extraction of impacted mandibular third molars is a relatively invasive procedure that can cause injury to both soft tissue and bone at the extraction site. Wound healing of the extraction socket following surgical removal of impacted mandibular third molars occurs in three main phases: inflammatory, proliferative, and remodeling. Low-level laser therapy (LLLT) has been considered a promising adjunctive approach to promote wound healing. Objective: This study aimed to evaluate the effect of LLLT on wound healing following surgical extraction of impacted mandibular third molars. Patients and methods: A randomized controlled, double-blind, split-mouth clinical trial was conducted on 22 patients presenting with symmetrically impacted mandibular third molars of similar difficulty levels on panoramic radiographs. All extractions were performed by the same surgeon following a standardized protocol, with an interval of at least 28 days between the two procedures. The experimental sites received low-level laser irradiation (InGaAsP diode laser, wavelength of 940 nm, energy density of 5 J/cm²) immediately after surgery and on postoperative days 1, 3, 7, 14, 21, and 28, while the contralateral sites served as controls – the laser hanpiece was also positioned at the surgical site, but the laser beam was not activated. Wound healing was assessed on postoperative days 3, 7, and 30 using a modified healing assessment scale based on the Inflammatory–Proliferative–Remodeling (IPR) index proposed by Hamzani et al. (2018). Results: Mean soft tissue healing scores for the control and laser groups, respectively, were: inflammatory phase (day 3) = 5.32 ± 0.99 vs 6.55 ± 0.67 /8; proliferative phase (day 7) = 2.95 ± 0.84 vs 3.73 ± 0.70 /5; and remodeling phase = 2.45 ± 0.51 vs 2.50 ± 0.51 /3. The total cumulative score across all phases was 10.72 ± 1.72 for the control group and 12.77 ± 1.07 for the laser group (out of 16). The laser group consistently had higher healing scores, with statistically significant differences in the inflammatory and proliferative phases (p < 0.001). This shows that LLLT speeds up healing. Conclusions: Low-level laser therapy significantly accelerates postoperative soft tissue healing, particularly during the inflammatory and proliferative phases, following surgical extraction of impacted mandibular third molars.