Application of a 2940-nm erbium laser in the extraction of impacted third molars

Background: Minimally invasive surgery is a key objective in modern medicine, contributing to a more favorable postoperative course. This study aimed to evaluate the effectiveness of laser-assisted surgery, specifically using a 2940-nm erbium (Er:YAG) laser, in the extraction of impacted mandibular third molars compared with conventional scalpel and rotary instrumentation, based on clinical, radiographic, and immunologic parameters. Aim: To assess the clinical efficacy of 2940-nm Er:YAG laser irradiation in the surgical removal of impacted mandibular third molars. Methods: The study was conducted at the Department of Oral Surgery of Borovsky Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University). A total of 60 patients meeting inclusion and exclusion criteria were randomly assigned to either the laser group (Er:YAG laser) or the control group (scalpel and rotary instruments). Postoperative evaluation included clinical parameters (postoperative pain, collateral soft tissue edema, and maximal mouth opening), radiographic assessment (bone regeneration time), and immunologic markers [tumor necrosis factor-alpha (TNF-α) and human beta-defensin 2 (HBD2)]. Results: Clinical findings demonstrated a more favorable postoperative course in patients treated with the Er:YAG laser, as evidenced by significantly lower levels of postoperative pain, reduced collateral soft tissue edema, and improved maximal mouth opening compared to the control group treated with rotary instruments and a scalpel (p 0.001). Radiologic findings indicated accelerated bone regeneration following the use of Er:YAG laser compared to conventional surgical methods. The expression levels of TNF-α in the buccal epithelium and attached gingiva were lower in the intervention group than in the control group, whereas the expression of HBD2 was higher in the intervention group. Conclusion: Analysis of clinical, radiological, and immunological findings demonstrated that the use of an erbium laser with a 2940-nm wavelength for the extraction of impacted mandibular third molars was more effective than the use of conventional cutting and rotary instruments.