title: Evaluation of low-level laser at auriculotherapy points to reduce postoperative pain in inferior third molar surgery: study protocol for a randomized controlled trial.
abstract: A comfortable postoperative return to daily activities has increased the need to control inflammation after third molar surgery. Anti-inflammatory drugs and analgesics are not exempt from adverse effects such as allergies and chronic gastritis, and they are not without cost. The association between low-level laser and auricular acupuncture can be an alternative when conventional drugs are contraindicated. Among its advantages, we can mention the low risk of side effects, low cost and simplicity of application. The objective of this study is to evaluate the efficiency of low-level laser at auriculotherapy points in reducing postoperative pain in lower third molar surgery.
  
  
  
  Ninety bilateral, symmetrical lower third molar surgeries will be performed in 45 healthy patients. Each patient will be their own control, through a split-mouth crossover study. One side of the mouth will be randomly chosen and, immediately after surgery, will be treated with low-level laser. After 21 days, the contralateral side will be operated on with low-level laser simulation used postoperatively. This regimen (laser application or not) will be repeated at 24 and 48 h after surgery. All patients will be requested to take analgesics (acetaminophen) if they have pain, i.e. in case of pain. Neither the surgeon nor the patients will know the assigned treatment. The primary variable will be postoperative pain assessed using a Visual Analog Scale, and the secondary variables will be trismus, edema, local temperature, dysphagia, presence of infection and painkiller ingestion. These variables will be assessed at baseline, 24 h, 48 h and 7 days after surgery. Blood samples for systemic inflammatory cytokine (TNF-α, IL-1, IL-6 and IL-8) analysis will be assessed at baseline and 24 h after surgery.
  
  
  
  Some authors believe that using a wavelength of 633 to 670 nm is a good option for laser therapy in the field of acupuncture. This wavelength can penetrate biological tissue to a depth of about 3 mm. However, for auriculotherapy points, the stimulus (mustard seeds, needles 1 to 2.5 mm) does not penetrate so deeply. For this reason, we chose a laser wavelength of 660 nm (red wavelength).
  
  
  
  ClinicalTrials.gov Identifier: NCT02657174 , registered on 11 January 2016.
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
authors: Hélio
authors: H
authors: Sampaio-Filho
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
authors: Juliane
authors: J
authors: Sotto-Ramos
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
authors: Erika Horácio
authors: EH
authors: Pinto
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
authors: Marcia Regina
authors: MR
authors: Cabral
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
authors: Priscila Larcher
authors: PL
authors: Longo
authors: Integrated Clinic, Department of Estomatology, São Paulo University, São Paulo, Brazil.
authors: Isabel Peixoto
authors: IP
authors: Tortamano
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
authors: Rodrigo Labat
authors: RL
authors: Marcos
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
authors: Daniela Fátima Teixeira
authors: DF
authors: Silva
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
authors: Christine
authors: C
authors: Pavani
authors: Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil. annacrth@gmail.com.
authors: Anna Carolina Ratto Tempestini
authors: AC
authors: Horliana
mesh_terms: D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D055097:Auriculotherapy / Q000009:adverse effects / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D002985:Clinical Protocols; D018592:Cross-Over Studies; D016207:Cytokines / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D028022:Low-Level Light Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D012107:Research Design; D013997:Time Factors; D014081:Tooth Extraction / Q000009:adverse effects*; D014098:Toothache / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators
keywords: Auriculotherapy; Laser; Pain; Postoperative; Third molar surgery