Comparative Evaluation of Efficacy of Scalpel Versus Diode Laser in Transalveolar Extraction of Impacted Mandibular Third Molar: A Prospective Split-Mouth Study

Background: Surgical removal of impacted mandibular third molars is associated with postoperative pain, swelling, restricted mouth opening, and delayed healing. Diode lasers provide cutting and coagulative effects and may improve perioperative outcomes compared with conventional scalpel incision. Aim: To compare conventional scalpel and 940-nm diode laser incisions during transalveolar extraction of impacted mandibular third molars. Materials and Methods: This prospective split-mouth study included 15 patients requiring bilateral surgical removal of impacted mandibular third molars. One side received a No. 15 scalpel incision and the contralateral side a 940-nm diode laser incision. Intraoperative bleeding and operative time were recorded. Postoperative pain, facial swelling, maximum mouth opening, and soft-tissue healing were assessed using a visual analogue scale, standardized facial measurements, interincisal distance, and Landry's healing index, respectively. Independent t-test and repeated-measures ANOVA were used, with p≤0.05 considered significant. Results: Participants included 9 males and 6 females, with a mean age of 24.33±3.74 years. Laser incision significantly reduced pain on day 3 (2.80±0.56 vs. 4.26±0.79; p<0.001) and day 7 (0.13±0.35 vs. 0.80±0.67; p=0.002). Mouth opening was greater on days 1 and 3 (p=0.012 and 0.016). Laser also reduced bleeding (1.13±0.35 vs. 3.20±0.41; p<0.001) and operative time (17.40±2.19 vs. 22.86±3.11 min; p<0.001), with better day-3 healing (p<0.001). Swelling showed no significant difference. Conclusion: Diode laser incision demonstrated favourable perioperative outcomes compared with scalpel incision. Larger randomized studies are warranted.