The use of four different lasers in a “surgery first” case, for orthodontic movement acceleration, paresthesia, aphthous ulcer, edema, and pain control

Photobiomodulation is an important resource during an orthodontic treatment. It is useful to control post archwire activation pain, reduce orthodontic treatment time, and achieve faster-wound healing. The aim of this report is to present an ortho-surgical case treated with four different laser wavelengths applied during all stages of the treatment to achieve different results in the benefit of the patient.

A severe class II 52-year-old female patient with muscular pain and temporomandibular disorders. The patient was treated with a surgery-first protocol and passive self-ligating brackets to achieve dental movement acceleration and pain control; the patient was irradiated using 808 nm wavelength, 100 mW, ED 80 J/cm², E 2.2 J, 22 s along the vestibular and palatal surface performing a scanning movement. After surgery, the patient has irradiated 6 sessions for edema and inflammation control, with a 940 nm, in continuous mode, 2.5 W, 120 s, 85.71 J/cm², over the right and left side. After 2 weeks, the patient reports paresthesia in her left lower lip. A paresthesia protocol was started with a 650 nm wavelength laser, using the following parameters: 100 mW, PD 0.2 W/cm², E 6 J, 60 s, one session every 2 days for 3 weeks. When the patient reported one aphthous ulcer in her left lower lip, the affected surface was irradiated with a wavelength of the 660 nm laser, 25 J/cm², 100 mW, for 14 s, applying laser by scanning the lesion 1 mm away. Only one laser application per aphthous lesion was made.

The patient finished all the ortho-surgical treatment in 4 and a half months.

Four successful wavelengths, but also two laser protocols were applied during the treatment, not only to accelerate orthodontic movement but also to reduce edema after orthognathic surgery, paresthesia, and aphthous ulcer as well.