Impacted Mandibular Third Molar
Conditions
Keywords
Third Molar Surgery, Er:YAG Laser, Laser-Assisted Surgery, Oral Surgery
Brief summary
This randomized controlled clinical trial aims to evaluate the efficacy of the Er:YAG laser in the removal of impacted mandibular third molars compared to the conventional surgical technique. The study assesses surgical efficiency, postoperative pain, swelling, trismus, and overall patient recovery. The goal is to determine whether the Er:YAG laser provides a safer and less traumatic alternative to traditional bone-cutting methods during third molar surgery.
Detailed description
Impacted mandibular third molars are among the most commonly extracted teeth, and conventional surgical removal often involves bone cutting using rotary instruments, which may increase postoperative morbidity. Laser-assisted surgery, particularly using the Er:YAG laser, has been proposed as a minimally invasive alternative with potential benefits such as reduced thermal damage, improved healing, and less postoperative discomfort. This study compares Er:YAG laser-assisted bone removal with the conventional bur technique in terms of operative time, intraoperative ease, and postoperative outcomes including pain, edema, and trismus. Patients meeting the eligibility criteria are randomly allocated into two groups: a laser-assisted surgery group and a conventional surgery group. Standardized measurements and follow-up assessments are conducted to evaluate clinical outcomes and determine the effectiveness and safety of the Er:YAG laser in third molar surgery.
Interventions
DEVICEEr:YAG laser
Er:YAG laser (2940 nm) used for bone cutting during impacted mandibular third molar surgery.
PROCEDUREConventional Rotary Instruments Surgery
Conventional rotary instruments used for bone removal during surgical extraction of impacted mandibular third molars.
Sponsors
Alexandria University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
No masking was performed because both the surgeon and the participants were aware of the intervention type.
Intervention model description
Participants are randomly assigned into two parallel groups: Er:YAG laser-assisted surgery and conventional rotary instrument surgery.
Eligibility
Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
No
Inclusion criteria
* • Adults aged 20-30 years requiring surgical extraction of a mesioangular impacted mandibular third molar. * Healthy individuals with no systemic diseases that may influence bone metabolism or wound healing. * Good oral hygiene and absence of local infection at the surgical site. * No contraindications to local anesthesia, surgical extraction, or use of the Er:YAG laser. * Radiographic evidence confirming normal bone structure without cysts or pathological lesions. * Willingness to participate and ability to provide informed consent.
Exclusion criteria
* • Systemic medical conditions affecting bone healing or postoperative response (e.g., uncontrolled diabetes, immunodeficiency, metabolic bone disorders). * Current or recent use of medications influencing bone remodeling (e.g., bisphosphonates, corticosteroids, immunosuppressants). * Heavy smoking (\>10 cigarettes/day). * Pregnant or breastfeeding females. * Poor oral hygiene, active infection, or pericoronitis at the surgical site. * Previous surgery, trauma, or pathology in the mandibular third molar region. * Known allergies or contraindications to any material or procedure used in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Score | Immediate postoperative, 24 hours, 3 days, and 7 days | Postoperative pain will be assessed using a Visual Analog Scale (VAS) ranging from 0 (no pain) to 10 (worst pain) at postoperative intervals. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Swelling | Immediate postoperative, 24 hours, 3 days, and 7 days | Facial swelling will be measured using linear facial measurements (tragus-pogonion and gonion-pogonion distances) preoperatively and at postoperative intervals. |
| Postoperative Trismus | Immediate postoperative, 24 hours, 3 days, and 7 days | Maximum interincisal mouth opening will be measured in millimeters preoperatively and at postoperative intervals to assess trismus. |
| Bone Density | Immediate postoperative, 1 month, and 3 months | Bone density at the extraction site will be assessed using standardized digital radiographs. Gray-scale values will be measured at predetermined reference points to compare bone healing between groups. |
Countries
Egypt
Outcome results
None listed