The Use of Low-Level Laser Therapy to Reduce Postoperative Morbidity After Third Molar Surgery: A Systematic Review and Meta-Analysis

Purpose Surgical removal of third molars carries morbidity and significantly affects patients' quality-of-life. This study aims to investigate whether administration of low-level laser therapy (LLLT) is effective in reducing postoperative morbidity in patients undergoing surgical removal of mandibular third molars compared with placebo. Material and Methods A systematic review and meta-analysis involving a comprehensive search strategy implemented across 5 electronic databases. This was supplemented by hand searching and contacting international experts and grey literature. Titles, abstracts, and full articles were scrutinized for studies meeting the inclusion criteria. All randomized controlled trials comparing treatment group of LLLT with a placebo control group were eligible for inclusion. The outcomes variables were postoperative pain, swelling, and trismus. Risk of bias and methodological quality assessment was carried out. We pooled data statistically, and meta-analyses were carried out using a random-effects model. Results Seventeen randomized controlled trials were included in this systematic review, all of which were considered to have a low risk of bias. Participants, aged 13 to 70 years, and 35% women, totaled 1064. Meta-analyses found significant reductions in standardized mean differences (SMDs) in swelling at day 2 and day 7 postoperatively (SMD, −0.611; 95% confidence interval, −0.968, −0.234 and SMD, −0.532; 95% confidence interval, −0.795, −0.269). There were nonsignificant reductions in SMD in pain and trismus at day 2 and day 7 postoperatively. Conclusions LLLT significantly reduces swelling after extraction of mandibular third molars compared with placebo. LLLT has not shown to reduce postoperative pain and trismus. LLLT does not cause adverse effects. There is currently insufficient evidence available, to promote the investment in LLLT vs the net clinical benefit. Randomized controlled trials with larger sample size and standardized study design and outcome measures are required, to make definitive recommendations to clinicians on its use on patients

Can Infrared Thermography be a Diagnostic Tool for Arthralgia of the Temporormandibular Joint?

This paper presents a review of the use of infrared thermography in diagnosis of temporomandibular joint (TMJ) arthralgia. The question examined was whether the infrared thermography could be reliably used as a tool to diagnose arthralgia by objectively assessing the site of origin and the degree of irritation. Controlled studies were performed by using advanced thermographic devices to show both diagnostic va-lidity and reliability of infrared thermography as a screening test for selecting healthy subjects from patients with unilateral TMJ arthralgia. The study revealed that thermography fails to meet the criteria of high level of evidence. Further studies are required to confirm these results in order to specify analysis of facial thermal patterns and to better un-derstand the relationship between TMJ arthralgia and regional tem-perature changes. Until then infrared thermography cannot be recom-mended for routine use as a diagnostic technique to identify TMJ dis-orders