Giovannacci I, Romeo U, Spadari F, Biasotto M, Pentenero M, Pedrazzi G, Venuti AA, Meleti M, Tenore G, Pergolini D, Porrini M, Bosotti M, Ottaviani G, Rupel K, Val M, Vescovi P. An italian multicenter triple-blind randomized controlled trial on photobiomodulation after third molar extraction (BIOSTOTT). A study of italian society for laser in dentistry (SILO). Med Oral Patol Oral Cir Bucal. 2026 Mar 1;31 (2):e344-55.

doi:10.4317/medoral.27834

https://dx.doi.org/doi:10.4317/medoral.27834

1. Chiapasco M, De Cicco L, Marrone G. Side effects and complications associated with third molar surgery. Oral Surg Oral Med Oral Pathol. 1993;76:412-417. https://doi.org/10.1016/0030-4220(93)90005-O PMid:8233418

2. Grossi GB, et al. Assessing postoperative discomfort after third molar surgery: A prospective study. J Oral Maxillofac Surg. 2007;65:901-914. https://doi.org/10.1016/j.joms.2005.12.046 https://doi.org/10.1016/j.joms.2006.11.036 PMid:17448840

3. Brickley M, Shepherd J, Mancini G. Comparison of clinical treatment decisions with US National Institutes of Health consensus indications for lower third molar removal. Br Dent J. 1993;175:102-106. https://doi.org/10.1038/sj.bdj.4808228 PMid:8357657

4. Tulloch JF, Antczak AA, Wilkes JW. The application of decision analysis to evaluate the need for extraction of asymptomatic third molars. J Oral Maxillofac Surg. 1987;45:855-861. https://doi.org/10.1016/0278-2391(87)90236-9 PMid:3309225

5. Goldberg MH, Nemarich AN, Marco WP. Complications after mandibular third molar surgery: A statistical analysis of 500 consecutive procedures in private practice. J Am Dent Assoc. 1985;111:277-279. https://doi.org/10.14219/jada.archive.1985.0098 PMid:3862695

6. Osborn TP, Frederickson G, Small IA, Torgerson TS. A prospective study of complications related to mandibular third molar surgery. J Oral Maxillofac Surg. 1985;43:767-769. https://doi.org/10.1016/0278-2391(85)90331-3 PMid:2995624

7. Sato FRL, Asprino L, De Araújo DES, De Moraes M. Short-term outcome of postoperative patient recovery perception after surgical removal of third molars. J Oral Maxillofac Surg. 2009;67:1083-1090. https://doi.org/10.1016/j.joms.2008.09.032 PMid:19375022

8. Aras MH, Güngörmüş M. Placebo-controlled randomized clinical trial of the effect of 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;25:641-648. https://doi.org/10.1007/s10103-009-0684-1 PMid:19484402

9. Brignardello-Petersen R, et al. 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;70:1789-1796. https://doi.org/10.1016/j.joms.2012.01.008 PMid:22398186

10. Camolesi GCV, et al. Is photobiomodulation therapy effective in controlling post-surgical side effects after the extraction of mandibular third molars? A systematic review and meta-analysis. J Evid Based Dent Pract. 2024;24. https://doi.org/10.1016/j.jebdp.2024.101983 PMid:38821660

11. AlGhamdi KM, Kumar A, Moussa NA. Low-level laser therapy: A useful technique for enhancing the proliferation of various cultured cells. Lasers Med Sci. 2012;27:237-249. https://doi.org/10.1007/s10103-011-0885-2 PMid:21274733

12. Hagiwara S, Iwasaka H, Okuda K, Noguchi T. GaAlAs (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Lasers Surg Med. 2007;39:797-803. https://doi.org/10.1002/lsm.20583 PMid:18081143

13. Chow RT, David MA, Armati PJ. 830 nm laser irradiation induces varicosity formation, reduces mitochondrial membrane potential and blocks fast axonal flow in small and medium diameter rat dorsal root ganglion neurons: Implications for the analgesic effects of 830 nm laser. J Peripher Nerv Syst. 2007;12:28-39. https://doi.org/10.1111/j.1529-8027.2007.00114.x PMid:17374099

14. Boschi ES, et al. Anti-inflammatory effects of low-level laser therapy (660 nm) in the early phase in carrageenan-induced pleurisy in rat. Lasers Surg Med. 2008;40:500-508. https://doi.org/10.1002/lsm.20658 PMid:18727002

15. Albertini R, et al. Anti-inflammatory effects of low-level laser therapy (LLLT) with two different red wavelengths (660 nm and 684 nm) in carrageenan-induced rat paw edema. J Photochem Photobiol B. 2007;89:50-55. https://doi.org/10.1016/j.jphotobiol.2007.08.005 PMid:17920925

16. Herranz-Aparicio J, Vázquez-Delgado E, Arnabat-Domínguez J, España-Tost A, Gay-Escoda C. The use of low level laser therapy in the treatment of temporomandibular joint disorders: Review of the literature. Med Oral Patol Oral Cir Bucal. 2013;18:603-609. https://doi.org/10.4317/medoral.18794 PMid:23722130 PMCid:PMC3731088

17. Romanos GE, et al. Laser wavelengths and oral implantology. Lasers Med Sci. 2009;24:961-965. https://doi.org/10.1007/s10103-009-0676-1 PMid:19430724

18. Qadri T, Miranda L, Tunér J, Gustafsson A. The short-term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol. 2005;32:714-720. https://doi.org/10.1111/j.1600-051X.2005.00749.x PMid:15966876

19. Ishikawa I, et al. Application of lasers in periodontics: True innovation or myth? Periodontol 2000. 2009;50:90-126. https://doi.org/10.1111/j.1600-0757.2008.00283.x PMid:19388956

20. Cruz AR, et al. Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: Systematic review and meta-analysis. Support Care Cancer. 2023;31:1-12. https://doi.org/10.1007/s00520-023-08105-7 https://doi.org/10.21203/rs.3.rs-3078698/v1 PMid:37853254

21. Nammour S, et al. Photobiomodulation therapy vs corticosteroid for the management of erosive/ulcerative and painful oral lichen planus: Assessment of success rate during one-year follow-up: A retrospective study. Healthcare (Basel). 2021;9:xxx-xxx. https://doi.org/10.3390/healthcare9091137 PMid:34574912 PMCid:PMC8466159

22. A DV, et al. Effects of laser photobiomodulation in the management of oral lichen planus: A literature review. Clin Ter. 2021;172:xxx-xxx. https://doi.org/10.7417/CT.2021.2360 PMid:34625781

23. AlHerafi E, Hamadah O, Parker S. Photobiomodulation in recurrent aphthous stomatitis management using three different laser wavelengths: A randomized clinical trial. Lasers Med Sci. 2024;39:1-10. https://doi.org/10.1007/s10103-024-04236-3 PMid:39557704

24. Kadam AS, et al. Effect of laser photobiomodulation on postoperative pain in endodontics: A systematic review. Photobiomodul Photomed Laser Surg. 2024;42:11-22. https://doi.org/10.1089/photob.2023.0129 PMid:38252493

25. Mobadder ME, et al. Dentinal hypersensitivity treatment using diode laser 980 nm: In vivo study. Dent J (Basel). 2019;7:xxx-xxx. https://doi.org/10.3390/dj7010005 PMid:30634421 PMCid:PMC6473910

26. Winter G. Principles of exodontias as applied to the impacted third molars: A complete treatise on the operative technic with clinical diagnoses and radiographic interpretations. American Medical Books. 1926;835.

27. Pell GJ, Gregory GT. Impacted third molars: Classification and modified technique for removal. Dent Digest. 1933;39:338-346.

28. Majid OW. Submucosal dexamethasone injection improves quality of life measures after third molar surgery: A comparative study. J Oral Maxillofac Surg. 2011;69:2289-2295. https://doi.org/10.1016/j.joms.2011.01.037 PMid:21514710

29. Amarillas-Escobar ED, et al. Use of therapeutic laser after surgical removal of impacted lower third molars. J Oral Maxillofac Surg. 2010;68:319-324. https://doi.org/10.1016/j.joms.2009.07.037 PMid:20116702

30. He WL, et al. A systematic review and meta-analysis on the efficacy of low-level laser therapy in the management of complications after mandibular third molar surgery. Lasers Med Sci. 2015;30:1779-1788. https://doi.org/10.1007/s10103-014-1634-0 PMid:25098769

31. Campos TM, et al. Cost-effectiveness analysis of photobiomodulation after third molar extraction for pain control. Int J Environ Res Public Health. 2025;22:159. https://doi.org/10.3390/ijerph22020159 PMid:40003385 PMCid:PMC11855853

32. Kuffler DP. Photobiomodulation in promoting wound healing: A review. Regen Med. 2016;11:107-122. https://doi.org/10.2217/rme.15.82 PMid:26681143

33. Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B. 1999;49:1-17. https://doi.org/10.1016/S1011-1344(98)00219-X PMid:10365442

34. Dompe C, et al. Photobiomodulation - underlying mechanism and clinical applications. J Clin Med. 2020;9:1-24. https://doi.org/10.3390/jcm9061724 PMid:32503238 PMCid:PMC7356229

35. Petrova MB. The morphofunctional characteristics of the healing of a skin wound in rats by exposure to low-intensity laser radiation. Morfologiia. 1992;102:112-118. PMid:1343249

36. Merigo E, et al. Efficacy of LLLT in swelling and pain control after the extraction of lower impacted third molars. Laser Ther. 2015;24:39-46. https://doi.org/10.5978/islsm.15-OR-05 PMid:25941424 PMCid:PMC4416144

37. Mergoni G, et al. The effect of laser therapy on the expression of osteocalcin and osteopontin after tooth extraction in rats treated with zoledronate and dexamethasone. Support Care Cancer. 2016;24:807-815. https://doi.org/10.1007/s00520-015-2847-x PMid:26190360

38. Kingsley JD, Demchak T, Mathis R. Low-level laser therapy as a treatment for chronic pain. Front Physiol. 2014;5:xxx-xxx. https://doi.org/10.3389/fphys.2014.00306 PMid:25191273 PMCid:PMC4137223

39. Martu MA, et al. The effectiveness of laser applications and photodynamic therapy on relevant periodontal pathogens (Aggregatibacter actinomycetemcomitans) associated with immunomodulating anti-rheumatic drugs. Bioengineering. 2023;10:61. https://doi.org/10.3390/bioengineering10010061 PMid:36671633 PMCid:PMC9855085

40. Chung H, et al. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng. 2012;40:516-533. https://doi.org/10.1007/s10439-011-0454-7 PMid:22045511 PMCid:PMC3288797

41. Do Nascimento PM, Pinheiro ALB, Salgado MÂC, Ramalho LMP. A preliminary report on the effect of laser therapy on the healing of cutaneous surgical wounds as a consequence of an inversely proportional relationship between wavelength and intensity: Histological study in rats. Photomed Laser Surg. 2004;22:513-518. https://doi.org/10.1089/pho.2004.22.513 PMid:15684753

42. Hamblin MR, Huang YY, Sharma SK, Carroll J. Biphasic dose response in low level light therapy - an update. Dose-Response. 2011;9:602-618. https://doi.org/10.2203/dose-response.11-009.Hamblin PMid:22461763 PMCid:PMC3315174

43. Domah F, Shah R, Nurmatov UB, Tagiyeva N. The use of low-level laser therapy to reduce postoperative morbidity after third molar surgery: A systematic review and meta-analysis. J Oral Maxillofac Surg. 2021;79:313.e1-313.e12. https://doi.org/10.1016/j.joms.2020.09.018 PMid:33058775

44. Oliveira Sierra S, et al. Effect of low-level laser therapy on the post-surgical inflammatory process after third molar removal: Study protocol for a double-blind randomized controlled trial. Trials. 2013;14:1-8. https://doi.org/10.1186/1745-6215-14-373 PMid:24195796 PMCid:PMC3832037

45. Eshghpour M, Ahrari F, Takallu M. Is low-level laser therapy effective in the management of pain and swelling after mandibular third molar surgery? J Oral Maxillofac Surg. 2016;74:1322.e1-1322.e6. https://doi.org/10.1016/j.joms.2016.02.030 PMid:27055228

46. Camolesi GCV, et al. Pain, oedema and trismus responses following photobiomodulation therapy immediately after lower third molar extraction: Results of a randomized, double-blind and split-mouth clinical trial. J Evid Based Dent Pract. 2025;25:xxx-xxx. https://doi.org/10.1016/j.jebdp.2024.102080 PMid:39947773

47. Ferreira González F, et al. Effectiveness of low-level diode laser in the management of complications after third-molar surgical extraction: Systematic review and meta-analysis. J Am Dent Assoc. 2025;156:xxx-xxx. https://doi.org/10.1016/j.adaj.2024.12.008 PMid:39903156

48. Eroglu CN, Keskin Tunc S. Effectiveness of single session of low-level laser therapy with a 940 nm wavelength diode laser on pain, swelling, and trismus after impacted third molar surgery. Photobiomodul Photomed Laser Surg. 2016;34:406-412. https://doi.org/10.1089/pho.2016.4101 PMid:27420732

49. Uzeda MJ, et al. Evaluating the effectiveness of low-level laser therapy in patients undergoing lower third molar extraction: A double-blinded randomized controlled trial. Med Oral Patol Oral Cir Bucal. 2024;30:e129-e136. https://doi.org/10.4317/medoral.26894 PMid:39582408 PMCid:PMC11801674

50. Karşıcı S, Balaban E. The effect of preoperative low-level laser therapy on pain, swelling, and trismus associated with mandibular third molar extraction. BMC Oral Health. 2025;25. https://doi.org/10.1186/s12903-025-05589-z PMid:40011868 PMCid:PMC11866568