Effect of low-level laser therapy on postoperative swelling after surgical management of zygomaticomaxillary complex fracture.

Introduction: The face is highly vulnerable to traumatic injuries, with the zygomaticomaxillary complex (ZMC) frequently fractured due to its prominent position. Postoperative swelling after ZMC surgery can lead to discomfort, limited mouth opening, and aesthetic concerns. Reduction methods include medications such as corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), enzyme preparations, and non-pharmacological approaches such as manual lymph drainage, cryotherapy, and head elevation. Low-level laser therapy (LLLT), also known as cold laser therapy, has shown promise in reducing postoperative swelling. LLLT uses low-energy lasers (10-500 mW) in the red to near-infrared spectrum (660-905 nm) to penetrate tissues, promoting lymphatic drainage and tissue repair. It modulates inflammatory responses, increases ATP production, and enhances microcirculation. LLLT's non-invasive nature and its ability to reduce swelling and promote healing make it a valuable adjunctive therapy. In this study, LLLT was used for managing postoperative swelling after ZMC fractures. Objective: The objective of our study was to determine the effect of LLLT on postoperative swelling after surgical management of a ZMC fracture. Materials and Methods: The study was performed at Krishna Hospital and School of Dental Sciences and included 46 patients with ZMC fractures, diagnosed via 3D CT facial scans. Patients, aged 20-50 years, were randomly assigned to two groups: one received LLLT postoperatively, while the other did not. All patients underwent open reduction and internal fixation surgery under general anesthesia with standardized postoperative medications. Swelling was measured using tape measurements between specific facial landmarks. Group one received LLLT of 810 nm at 500 mW for 17 minutes twice daily for 4 days, with evaluations on days 1, 3, 5, 7, and after 1 month. LLLT was administered in an isolated room, with both patients and operators wearing protective eyewear. Measurements were taken by a different operator to minimize bias. Results: The study evaluated LLLT on postoperative swelling in patients with ZMC fractures. We observed significant reductions in ala-tragus and outer canthus to mandible measurements in the LLLT group compared to the control. The LLLT group showed a consistent and significant decrease in swelling over 30 days, especially notable in the ala-tragus measurements, indicating LLLT's effectiveness in reducing postoperative swelling. Conclusion: This study showed that LLLT significantly reduces immediate postoperative swelling in ZMC fractures compared to a control group. Although long-term swelling reduction was similar, LLLT proved effective in the early postoperative period, highlighting its potential for broader maxillofacial applications.