Comparison of the effect of low-level laser biostimulation on postoperative pain, edema and mouth opening in orthognathic surgery patients

Orthognathic surgery is a procedure that provides treatment of dentofacial deformities and malocclusions by restoring the maxilla and mandible to a functionally and aesthetically appropriate position. Edema, pain and trismus may occur due to tissue trauma at the surgical site. Postoperative edema, pain and restriction of mouth opening affect patient comfort. Antibiotics, corticosteroids and non-steroidal anti-inflammatory drugs are given to patients to manage this process. Non-invasive alternative treatment methods are available to avoid the existing side effects of medications. Examples of these therapies include low-level laser biostimulation. Low-level laser therapy stimulates cells in the target tissue, activating the immune system and reducing the inflammatory response. Thus, it accelerates wound healing and stimulates tissue growth. As a result of the mechanisms of action, low-level laser therapy has been found to be an effective method used to reduce postoperative edema, pain and trismus. In our study, the data of 30 patients who underwent orthognathic surgery were analyzed. The patients were divided into 2 groups of 15 patients each as laser treated group and control group. Low level laser therapy was performed immediately after surgery, at 24th hour, 48th hour, 72nd hour and 7th day. The laser therapy was applied extraorally to the area between the tragus and labial commissure with a deep tissue handpiece with 4 W output power for 120 seconds on each side, and to the intraoral incision sites, 8 points on the maxilla and 4 points on each side of the mandible with 0.1 W output power for 30 seconds on each point. Edema evaluations were measured on the 3rd day, 7th day, 15th day and 6th month postoperatively with the measured between cephalometric points and stereophotogrammetry method. Pain assessment was performed with the VAS scale at 24 hours, 48 hours, 3 days, 7 days and 7 days postoperatively. Mouth opening measurements were evaluated by measuring the distance between the incisal teeth with a flexible ruler on the 2nd day, 7th day, 15th day, 30th day and 6th month after surgery. The results of our study, the edema values of the patients in the laser group were lower in both measurement methods, but no statistically significant difference was found between the groups. A significant difference was found between the groups only in the gonion-lateral canthus value on the 3rd day in the measured between cephalometric points method. High correlation was also found between the two different methods used for edema assessment. Pain values were lower in the laser group at all times, but no significant difference was found between the groups. Score of 0 was observed on day 15 in the laser group, a score of 0 was not reached on day 15 in the control group. There was a significant difference between the groups in the mouth opening values at 30 days and 6 months, while the values of the patients in the laser group were higher, although there was no significant difference between the groups at other times. Low-level laser therapy improves patient comfort by improving the findings in the period after orthognathic surgery. Keywords: Low level laser therapy, edema, pain, mouth opening, stereophotogrammetry