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Oral Health
Published on
September 11, 2026

Mauriello L et al. - Photobiomodulation and Pain Following Extraction of an Impacted Mandibular Third Molar: A Systematic Review with Meta-Analysis

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In this systematic review with meta-analysis, intraoral photobiomodulation is associated with less postoperative pain during the first 72 hours following the extraction of an impacted mandibular third molar. The authors note, however, that the evidence remains limited, as only 2 of the 8 studies provided data suitable for the meta-analysis.

What this study measured

Pain following the extraction of an impacted mandibular third molar is a common complication that impairs patients’ quality of life. The authors sought to determine whether intraoral photobiomodulation—proposed as a complementary, non-pharmacological approach—reduces this pain compared with a placebo, sham treatment, or standard postoperative care.

This is a systematic review conducted in accordance with the PRISMA 2020 guidelines. The PubMed and Embase databases were searched through January 2025 for randomized controlled trials. Only studies reporting postoperative pain on a visual analog scale (VAS) were included. Risk of bias was assessed using the Cochrane RoB 2 tool, and the certainty of the evidence was assessed using the GRADE approach.

Key Findings

Eight randomized trials were included in the qualitative synthesis. Only two of them provided data suitable for quantitative analysis. Random-effects meta-analyses were conducted at 24, 48, and 72 hours after the intervention, using standardized mean differences (SMD). A negative SMD indicates less pain in the photobiomodulation group.

  • À 24 h : DMS = -0,64 (IC à 95 % : -0,90 à -0,38), p < 0,001.
  • At 48 hours: DMS = -0.82 (95% CI: -1.64 to -0.01), p = 0.047.
  • À 72 h : DMS = -1,11 (IC à 95 % : -1,38 à -0,84), p < 0,001.

The 48-hour confidence interval is wide, and its upper bound is close to zero: this result, which is on the borderline of statistical significance, should be interpreted with caution.

How photobiomodulation works for this indication

Photobiomodulation involves applying red or near-infrared light to tissues. In this review, it was evaluated for intraoral application—that is, directly at the surgical site—as a complementary, non-pharmacological approach. The abstract does not detail a specific biological mechanism: the authors limit themselves to describing it as an adjuvant approach proposed to reduce postoperative pain.

The protocols used in the trials are not uniform, and this lack of uniformity is one of the authors' concerns.

Limits You Should Know

The authors conclude that intraoral photobiomodulation “appears” to reduce postoperative pain during the first 72 hours, but they outline several significant limitations.

  • Only 2 of the 8 trials provided data suitable for the meta-analysis, which limits the robustness of the estimates.
  • Photobiomodulation protocols vary from one study to another.
  • The reporting of outcome measures is inconsistent across trials.
  • The result at 48 hours is on the borderline of statistical significance (p = 0.047).

The abstract does not specify the GRADE certainty level or provide details on the risk of bias; therefore, this information cannot be summarized here. The authors call for new, well-designed trials.

What This Means in Practice

These results suggest that intraoral photobiomodulation may be considered as a complementary approach to reducing pain following the extraction of an impacted mandibular third molar. However, they do not support the conclusion that it can replace the instructions or treatments prescribed by the dentist.

Any decision is made in consultation with the healthcare professional overseeing the procedure.

Frequently Asked Questions

Does photobiomodulation reduce pain after a wisdom tooth extraction?

In this meta-analysis, pain as measured on the visual analog scale was lower in the photobiomodulation group at 24, 48, and 72 hours. The authors note an apparent reduction and emphasize the limited number of studies analyzed.

How many studies were analyzed?

Eight randomized trials were included in the review, but only two provided data that could be extracted for quantitative analysis. The numerical results are therefore based on a small number of trials.

Does this approach replace standard postoperative care?

No. It is presented as a complementary, non-pharmacological approach. The dental team’s instructions and prescriptions remain the standard of care, and photobiomodulation does not replace them.

Reference

Mauriello L, Pezzella V, Blasi A, Trapanese G, Ramaglia E, Iorio-Siciliano V, Ramaglia L. The Effect of Photobiomodulation Therapy in the Treatment of Postoperative Pain Following Extraction of an Impacted Lower Third Molar: A Systematic Review with Meta-Analysis. Dent J (Basel), 2026;14(9). PMID 42782975. https://pubmed.ncbi.nlm.nih.gov/42782975/

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.