Efficacy of Er:YAG laser in removal of impacted mandibular third molars (a randomized controlled clinical trial)

Title (English)

Efficacy of Er:YAG laser in removal of impacted mandibular third molars (a randomized controlled clinical trial)

Thong tin bai bao / Article info

• Tac gia / Authors: Karim A. Elhaw, Ahmed A. Abdelhakim, Arnabat. Dominguez J, Riham M. Eldibany, España. Tost A
• Tap chi / Journal: BMC Oral Health
• Ngay xuat ban / Published: 2026-06-05
• DOI: 10.1186/s12903-026-08790-w
• Nguon / Source: OpenAlex

Abstract (English)

Abstract Background Removal of impacted mandibular third molars is associated with postoperative discomfort and delayed bone healing. Er:YAG laser osteotomy has been proposed as a minimally invasive alternative to conventional rotary instrumentation. Aim To compare Er:YAG laser osteotomy and conventional rotary osteotomy regarding postoperative radiographic bone density and clinical healing outcomes following impacted mandibular third molar removal (pain, edema, and trismus). Methods Twenty-four patients ( n = 24) were randomized equally (laser n = 12; rotary n = 12). CBCT scans were obtained preoperatively and at 3 months for voxel-based grayscale bone density assessment. Standardized 3D ellipsoid VOIs were used. A single trained examiner performed all CBCT measurements twice, two weeks apart (ICC > 0.90). Postoperative pain, edema, and trismus were clinically assessed. Results Immediate postoperative bone density showed no significant difference between groups ( p = 0.319). At 3 months, bone density was significantly higher in the laser group compared with the rotary group (median: 310.7 vs. 270.0; p = 0.017), with a moderate effect size ( r = 0.477). Bone density significantly increased over time in both groups ( p = 0.002), with a significantly greater increase observed in the laser group ( p = 0.017). Pain scores on day 2 were significantly lower in the laser group ( p = 0.020). Edema and trismus showed significant improvement over time within both groups, with no statistically significant differences between groups. Operation time was significantly longer in the laser group. Conclusion Er:YAG laser osteotomy was associated with lower postoperative pain and higher radiographic grayscale values at 3 months compared with rotary osteotomy. Edema and trismus improved over time in both groups, with no significant differences between the two techniques. Clinical relevance Er:YAG laser may improve patient comfort by reducing postoperative pain and may be associated with improved radiographic bone healing. However, further studies are needed to confirm its long-term effects on bone density. Trial registration ClinicalTrials.gov (Identifier: NCT07297043). Registered 09 December 2025 (retrospective).

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