Original Research Articles
4 April 2025
Vol. 32 No. 1 (2025)
https://doi.org/10.4081/ltj.2025.411

A comparative study of photobiomodulation enhancing hemostasis in older patients at risk of extraction socket bleeding

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Photocoagulation, photobiomodulation, bleeding, healthcare unit, gerontology
505
Views
142
Downloads

Authors

Suwat Tanya
https://orcid.org/0000-0001-7801-6123
Graduate School, Faculty of Dentistry, Khon Kaen University; Lasers in Dentistry Research Group, Khon Kaen University, Thailand.
Piyachat Patcharanuchat
Lasers in Dentistry Research Group, Khon Kaen University; Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Thailand.
Sajee Sattayut
sajee@kku.ac.th
https://orcid.org/0000-0001-7111-9381
Lasers in Dentistry Research Group, Khon Kaen University; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Khon Kaen University, Thailand.

Laser therapy effectively reduces the risk of excessive bleeding, a critical condition in rural healthcare units due to limited hemostatic tools and specialist availability. This research aimed to compare the clinical outcomes of utilizing lasers to enhance socket hemostasis in Thailand’s primary, secondary, and tertiary-level healthcare units. This prospective observational study involved a total of 27 patients, aged 50 and older, who were at risk of extraction socket bleeding due to medications or gingival inflammation. Each study unit provided routine dental treatments along with supplemental laser therapy, as chosen by the operators. A single researcher assessed the related clinical outcomes. Primary and secondary-level healthcare units utilized an 810 nm diode laser; in contrast, a tertiary-level healthcare unit employed a 653 nm and 980 nm diode laser. Soft-assisted tissue loosening was conducted using 810 nm or 980 nm diode lasers, with a power of 2.5 to 3 W delivered via a 320-micron optical fiber. To initiate blood clot formation, a 635 nm at 0.2 W, 5.08 J/cm2 via 8-mm diameter laser probe, or 810 nm at 0.8 W, 5.93 J/cm2 via 6-mm diameter biomodulation probe was applied for 10 s per session. Secondary and tertiary-level healthcare units often combined laser-assisted soft tissue loosening and photobiomodulation, whereas the primary-level healthcare unit generally opted for utilizing photobiomodulation alone (p<0.001). Laser therapies employed in this study achieved socket hemostasis in 72 out of 86 sockets, with 55 achieving hemostasis within 5 min. The operators confirmed the clinical efficacy in reducing hemostasis duration across all study units (p=0.702), without experiencing post-extraction bleeding or clinical complications. Our findings indicate that a combination of laser-assisted soft tissue loosening and photobiomodulation to induce blood clot formation is a safe and effective local measure for enhancing socket hemostasis.

Altmetrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
1. Nagraj SK, Prashanti E, Aggarwal H, et al. Interventions for treating post-extraction bleeding. Cochrane Database of Syst Rev 2018. DOI: https://doi.org/10.1002/14651858.CD011930.pub3
2. Krishnan B, Prasad GA, Madhan B, et al. Post-extraction bleeding complications in patients on uninterrupted dual antiplatelet therapy—a prospective study. Clin Oral Investig 2021;25:507-14. DOI: https://doi.org/10.1007/s00784-020-03410-5
3. Cheng Y, Al-Aroomi MA, Al-Worafi NA, et al. Influence of inflammation on bleeding and wound healing following surgical extraction of impacted lower third molars. BMC Oral Health 2023;23. DOI: https://doi.org/10.1186/s12903-023-02754-0
4. Shao X, Xu XM, Yang X, Ji AP. Analysis of Risk Factors for Post-Extraction Bleeding and Study on Emergency Intervention Strategies. Risk Manag Healthc Policy 2024;17:1279-86. DOI: https://doi.org/10.2147/RMHP.S458260
5. Ueda K, Inokoshi M, Kubota K, et al. Factors influencing postoperative bleeding after dental extraction in older adult patients receiving anticoagulation therapy. Clin Oral Investig 2024;28. DOI: https://doi.org/10.1007/s00784-023-05424-1
6. Rubboli A. Incidence, clinical impact and risk of bleeding during oral anticoagulation therapy. World J Cardiol 2011;3. DOI: https://doi.org/10.4330/wjc.v3.i11.351
7. Li L, Zhang W, Yang Y, et al. Dental management of patient with dual antiplatelet therapy: a meta-analysis. Clin Oral Investig 2019;23. DOI: https://doi.org/10.1007/s00784-018-2591-y
8. Sattayut S, Tanya S, Patcharanuchat P. Low-Intensity Laser Therapy Inducing Photobiomodulation for Oral Health Promotion of Older People in Primary Health Care Unit; Case Study. J Gerontol Geriatr Med [Internet] 2021;1:112-4. Available from: https://journalggm.org/article_pdf-PA21021.pdf/
9. Mahardawi B, Jiaranuchart S, Rochanavibhata S, et al. The role of hemostatic agents after tooth extractions: A systematic review and meta-analysis. J Am Dent Assoc 2023;154:742-52.e1. DOI: https://doi.org/10.1016/j.adaj.2023.05.003
10. Ji J, Barrett EJ. Suspected intraoperative anaphylaxis to gelatin absorbable hemostatic sponge. Anesth Prog 2015;62. DOI: https://doi.org/10.2344/0003-3006-62.1.22
11. Ishikawa I, Okamoto T, Morita S, et al. Blue-violet light emitting diode (LED) irradiation immediately controls socket bleeding following tooth extraction; clinical and electron microscopic observations. Photomed Laser Surg 2011;29. DOI: https://doi.org/10.1089/pho.2010.2856
12. Veleska-Stevkoska D, Koneski F. Haemostasis in oral surgery with blue-violet light. Open Access Maced J Med Sci 2018;6:687-91. DOI: https://doi.org/10.3889/oamjms.2018.181
13. Gaur S, Madhulaxmi M. Application of LED light of the Blue-Violet Spectrum to induce Haemostasis Post Therapeutic Extractions-A Prospective Study. J Res Med Dent Sci [Internet] 2021;9:202-5. Available from: https://www.jrmds.in/articles/application-of-led-light-of-the-blueviolet-spectrum-to-induce-haemostasis-post-therapeutic-extractionsa-prospective-stud.pdf
14. Okamoto T, Ishikawa I, Kumasaka A, et al. Blue-violet light-emitting diode irradiation in combination with hemostatic gelatin sponge (Spongel) application ameliorates immediate socket bleeding in patients taking warfarin. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;117. DOI: https://doi.org/10.1016/j.oooo.2013.09.009
15. Malakam C, Sattayut S. A variety of photocoagulation techniques haemostasis in oral soft tissue and extraction socket. Laser Magazine [Internet] 2016;16-20. Available from: https://www.researchgate.net/publication/306399209_Photocoagulation_for_hemostasis_in_soft_tissue_and_bone-socket_Case_reports
16. Hamzah BF, Ibraheem NS. The effect of low-level laser therapy after simple tooth extraction. J Int Oral Health 2019;11:181. DOI: https://doi.org/10.4103/jioh.jioh_288_18
17. Kelkar M, Kadanthode M, Mohanty S, Verma A. Effect of low-level laser therapy on post-extraction hemostasis in patients with hemophilia — A prospective cohort study. J of Craniomaxillofac Surg 2023;51. DOI: https://doi.org/10.1016/j.jcms.2023.05.003
18. Klangthong A, Sattayut S, Kantrong N, et al. Diode Laser-Mediated Photocoagulation in an Alveolar Socket after Tooth Extraction: A Preliminary Study. Khon Kaen Dent J [Internet] 2022;25:91-100. Available from: https://he01.tci-thaijo.org/index.php/KDJ/article/view/244713/175055
19. Larionova EV, Diachkova EY, Morozova EA, et al. Laser-assisted tooth extraction in patients with impaired hemostasis. BioMedicine (Taiwan) 2021;11. DOI: https://doi.org/10.37796/2211-8039.1072
20. Luo GY, Sun L, Wei EX, Tan X, Liu TC. The effects of low-intensity He-Ne laser irradiation on erythrocyte metabolism. Lasers Med Sci 2015;30:2313-8. DOI: https://doi.org/10.1007/s10103-015-1806-6
21. Al Musawi MS, Jaafar MS, Al-Gailani B, et al. Erythrocyte sedimentation rate of human blood exposed to low-level laser. Lasers Med Sci 2016;31. DOI: https://doi.org/10.1007/s10103-016-1972-1
22. Mi XQ, Chen JY, Liang ZJ, Zhou LW. In vitro effects of helium-neon laser irradiation on human blood: blood viscosity and deformability of erythrocytes. Photomed Laser Surg 2004;22:477-82. DOI: https://doi.org/10.1089/pho.2004.22.477
23. Hupp JR, Tucker MR, Ellis E. Contemporary oral and maxillofacial surgery. 7th ed. Philadelphia, Pa: Elsevier, 2019. DOI: https://doi.org/10.25241/stomaeduj.2019.6(4).bookreview.1
24. Morkmued S, Tanya S, Sattayut S. Immediate Laser-Induced Coagulation after Tooth Extraction to Prevent Complications in Compromised Bleeding Tendency Patients (abstract). In: 15th International Conference of the Asian Academy of Preventive Dentistry, 8-11 Nov 2023, Hong Kong. Hong Kong, 2023.
25. Dompe C, Moncrieff L, Matys J, et al. Photobiomodulation—underlying mechanism and clinical applications. J Clin Med 2020;9:1724. DOI: https://doi.org/10.3390/jcm9061724
26. Hamblin MR. Mechanisms and mitochondrial redox signaling in photobiomodulation. Photochem Photobiol 2018;94:199-212. DOI: https://doi.org/10.1111/php.12864
27. Wajih N, Alipour E, Rigal F, et al. Effects of nitrite and far-red light on coagulation. Nitric Oxide 2021;107:11-8. DOI: https://doi.org/10.1016/j.niox.2020.11.005
28. Walski T, Grzeszczuk-Kuć K, Gałecka K, et al. Near-infrared photobiomodulation of blood reversibly inhibits platelet reactivity and reduces hemolysis. Sci Rep 2022;12:1-12. DOI: https://doi.org/10.1038/s41598-022-08053-y
29. Vladimirov YA, Gorbatenkova EA, Paramonov NV, Azizova OA. Photoreactivation of superoxide dismutase by intensive red (laser) light. Free Radic Biol Med 1988;5:281-6. DOI: https://doi.org/10.1016/0891-5849(88)90098-6

Supporting Agencies

This study was supported by the Fundamental Fund (2024), which Khon Kaen University received from the National Science Research and Innovation Fund (NFRF) and the Lasers in Dentistry Research Group, Khon Kaen, Thailand

How to Cite



A comparative study of photobiomodulation enhancing hemostasis in older patients at risk of extraction socket bleeding. (2025). Laser Therapy, 32(1). https://doi.org/10.4081/ltj.2025.411
Copyright (c) 2025 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.