Clinical Effects of Photobiomodulation, Corticosteroids, and Nonsteroidal Anti-Inflammatory Drugs Following Third Molar Surgery: A Systematic Review of Randomized Clinical Trials.
6 affiliations
- 1University of Santa Maria Santa Maria Peru.
- 2Federal University of Pelotas Pelotas Rio Grande do Sul Brazil ufpel.edu.br.
- 3Federal University of Paraíba (UFPB) João Pessoa Paraíba Brazil ufpb.br.
- 4São Leopoldo Mandic College João Pessoa Paraíba Brazil slmandic.edu.br.
- 5Piracicaba Dental School University of Campinas Piracicaba São Paulo Brazil unicamp.br.
- 6Regional Hospital of Osasco Osasco São Paulo Brazil.
Abstract
Objective
To systematically synthesize the effects and safety of corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and photobiomodulation, as evaluated within the comparisons available in randomized clinical trials, for controlling postoperative sequelae after third molar surgery.Methods
This systematic review followed PRISMA 2020 and was prospectively registered in PROSPERO (CRD420251178943). PubMed/MEDLINE, Embase, Scopus, Web of Science, and Google Scholar were searched without language or publication-date restrictions. Randomized clinical trials evaluating at least one eligible intervention and reporting pain, edema, trismus, rescue medication, or adverse events were included. Risk of bias was assessed with Cochrane RoB 2, and a structured narrative synthesis was performed by intervention class, comparator type, outcome, and follow-up period.Results
Thirty-six randomized trials involving 1838 participants were included: 13 primarily evaluated corticosteroids, 11 NSAIDs, 7 photobiomodulation, and 5 direct or combined therapeutic comparisons. Twenty-seven trials were judged at low risk of bias, seven raised some concerns, and two were at high risk. Corticosteroids were frequently associated with reductions in edema and trismus within placebo-controlled and active-comparator trials; NSAIDs showed more consistent effects on pain than on edema or trismus; and photobiomodulation produced heterogeneous, protocol-dependent findings. Only a small number of trials directly compared different treatment classes. Substantial clinical and methodological heterogeneity precluded meta-analysis and a valid indirect ranking.Conclusion
The three approaches may improve different postoperative outcomes, but the available evidence does not support a definitive hierarchy among them. Direct head-to-head trials with standardized outcomes, treatment protocols, and follow-up periods are required.
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BibTeX
@article{zevallos2026clinical,
title = {{Clinical Effects of Photobiomodulation, Corticosteroids, and Nonsteroidal Anti-Inflammatory Drugs Following Third Molar Surgery: A Systematic Review of Randomized Clinical Trials.}},
author = {Érick Andres Alpaca Zevallos and Luciano Leocádio Teixeira Nogueira and Anderson Jara Ferreira and Camila Coelho Guimarães and Arthur Felipe de Brito Andrade and Ilan Hudson Gomes de Santana and Patrícia de Medeiros Loureiro Lopes and Elio Hitoshi Shinohara and Monique Danyelle Emiliano Batista Paiva},
journal = {International journal of dentistry},
year = {2026},
month = oct,
doi = {10.1155/ijod/5965550},
url = {https://europepmc.org/article/MED/42928805},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical Effects of Photobiomodulation, Corticosteroids, and Nonsteroidal Anti-Inflammatory Drugs Following Third Molar Surgery: A Systematic Review of Randomized Clinical Trials.
AU - Érick Andres Alpaca Zevallos
AU - Luciano Leocádio Teixeira Nogueira
AU - Anderson Jara Ferreira
AU - Camila Coelho Guimarães
AU - Arthur Felipe de Brito Andrade
AU - Ilan Hudson Gomes de Santana
AU - Patrícia de Medeiros Loureiro Lopes
AU - Elio Hitoshi Shinohara
AU - Monique Danyelle Emiliano Batista Paiva
PY - 2026
DA - 2026/10/25
JO - International journal of dentistry
DO - 10.1155/ijod/5965550
UR - https://europepmc.org/article/MED/42928805
AB - Objective To systematically synthesize the effects and safety of corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and photobiomodulation, as evaluated within the comparisons available in randomized clinical trials, for controlling postoperative sequelae after third molar surgery.Methods This systematic review followed PRISMA 2020 and was prospectively registered in PROSPERO (CRD420251178943). PubMed/MEDLINE, Embase, Scopus, Web of Science, and Google Scholar were searched without language or publication-date restrictions. Randomized clinical trials evaluating at least one eligible intervention and reporting pain, edema, trismus, rescue medication, or adverse events were included. Risk of bias was assessed with Cochrane RoB 2, and a structured narrative synthesis was performed by intervention class, comparator type, outcome, and follow-up period.Results Thirty-six randomized trials involving 1838 participants were included: 13 primarily evaluated corticosteroids, 11 NSAIDs, 7 photobiomodulation, and 5 direct or combined therapeutic comparisons. Twenty-seven trials were judged at low risk of bias, seven raised some concerns, and two were at high risk. Corticosteroids were frequently associated with reductions in edema and trismus within placebo-controlled and active-comparator trials; NSAIDs showed more consistent effects on pain than on edema or trismus; and photobiomodulation produced heterogeneous, protocol-dependent findings. Only a small number of trials directly compared different treatment classes. Substantial clinical and methodological heterogeneity precluded meta-analysis and a valid indirect ranking.Conclusion The three approaches may improve different postoperative outcomes, but the available evidence does not support a definitive hierarchy among them. Direct head-to-head trials with standardized outcomes, treatment protocols, and follow-up periods are required.
SN - 1687-8728
SN - 1687-8736
ER -