O efeito da associação entre a laserterapia e a fibrina rica em plaquetas e leucócitos (l-prf) na cicatrização alveolar, modulação da dor e qualidade de vida pós-operatória em exodontias de terceiros molares: um ensaio clínico controlado randomizado triplo-cego.

Abstract

Introduction: Third molar extractions are associated with pain and slow healing. Low-level laser therapy (LLLT) demonstrates potential for pain modulation, while Leukocyte- and Platelet-Rich Fibrin (L-PRF) aids in tissue regeneration and inflammation control. However, the combination of these techniques in third molar surgeries lacks clinical evidence. Objective: To evaluate alveolar healing, pain modulation, and quality of life following third molar extractions using LLLT combined with L-PRF. Methods: This randomized triple-blind split-mouth study, approved by the Ethics Committee (approval number 77530023.4.0000.5537), included 20 healthy patients with bilaterally classified third molars. The test group received L-PRF (obtained by collecting blood into two 9mL tubes and centrifuging for 12 minutes at 2700 rpm) combined with Gallium-Aluminum-Arsenide (AlGaAs) laser therapy at 808 nm, 220 mW, and 36 J per session. The control group received only L-PRF. The laser was applied at the following intervals: immediately, 24h, 48h, and 7 days. Pain was assessed using the Visual Analogue Scale (VAS) at 6, 12, 24, and 48 hours. Healing was evaluated using the Landry Scale (1985), considering granulation tissue, tissue coloration, pain on palpation, and epithelial incision margin on days 1, 2, and 7 post-surgery. Quality of life was assessed with the OHIP-14 questionnaire pre- and post-operatively. Results: The comparison between the test and control groups showed no significant differences in VAS, OHIP-14, or Landry Scale scores. However, in the intra-group analysis, the test group exhibited a significant reduction in pain within the first 12 hours (p=0.004), an effect not observed in the control group (p=0.136). Healing progressed faster in the irradiated group, with significant improvement at 48 hours (p=0.038) and 7 days (p<0.001). Quality of life showed no statistically significant difference (p=0.659). Conclusion: The combination of L-PRF and LLLT did not demonstrate additional benefits for postoperative pain, healing, or quality of life.