Fotobiomodulação em duplo comprimento de onda como manejo pós-operatório de exodontias de terceiros molares

Abstract

The objective of this study was to evaluate the effects of different photobiomodulation protocols (PBMT) in mono or dual-wavelength (red and infrared), and the antibiotic therapy in the postoperative management of third molar extractions. This PhD thesis was divided into 5 chapters carried out as follows according to the specific objectives of this study. In the study 1, a paralled randomized trial assessed the evolution of the alveolar repair process after third molar extraction compared the patients treated with dual-wavelength PBMT or antibiotic therapy. In study 2, 3 and 4, the different PBMT protocols (dual-wavelength with intraoral - or association of intra and extraoral application, isolated application of red laser or infrared laser) in the post-operative management after extraction of third molars through of split-mouth randomized trial. In study 5, the repair of post-extraction alveoli of third molars treated with dual-wavelength PBMT applied only intraorally was prospectively evaluated. PBMT was applied immediately at 3 and 7 days after oral surgery. Clinical analyzes, involving the (edema, variation in mouth opening and soft tissue healing); and the patient-centered analyzes (application of visual analog scale (VAS) to assess pain, inflammation, bleeding, difficulty opening the mouth and chewing) were performed at 3, 7, 14, 30 and 90 days after the oral surgical procedure. Radiographic analyzes were performed to evaluate bone repair by measuring the radiodensity and fractal dimension at periods of 7 and 90 days after tooth extraction. Dual wavelength PBMT reduced the edema and generated greater postoperative comfort due to reduced pain and less loss of mouth opening range than the application of ATB. PBMT with infrared light and different dual-wavelength PBMT application protocols were equally effective in improving the postoperative course of third molar extractions. It can be concluded that PBMT reduces the inflammatory process after third molar extractions and ATB has no beneficial effect on the postoperative control of these surgeries.