This randomized controlled clinical trial aims to evaluate the efficacy of the Er:YAG laser in the removal of impacted mandibular third molars compared to the conventional surgical technique. The study assesses surgical efficiency, postoperative pain, swelling, trismus, and overall patient recovery. The goal is to determine whether the Er:YAG laser provides a safer and less traumatic alternative to traditional bone-cutting methods during third molar surgery.

Impacted mandibular third molars are among the most commonly extracted teeth, and conventional surgical removal often involves bone cutting using rotary instruments, which may increase postoperative morbidity. Laser-assisted surgery, particularly using the Er:YAG laser, has been proposed as a minimally invasive alternative with potential benefits such as reduced thermal damage, improved healing, and less postoperative discomfort.

This study compares Er:YAG laser-assisted bone removal with the conventional bur technique in terms of operative time, intraoperative ease, and postoperative outcomes including pain, edema, and trismus. Patients meeting the eligibility criteria are randomly allocated into two groups: a laser-assisted surgery group and a conventional surgery group. Standardized measurements and follow-up assessments are conducted to evaluate clinical outcomes and determine the effectiveness and safety of the Er:YAG laser in third molar surgery.

Inclusion Criteria:

• • Adults aged 20-30 years requiring surgical extraction of a mesioangular impacted mandibular third molar.

  • Healthy individuals with no systemic diseases that may influence bone metabolism or wound healing.
  • Good oral hygiene and absence of local infection at the surgical site.
  • No contraindications to local anesthesia, surgical extraction, or use of the Er:YAG laser.
  • Radiographic evidence confirming normal bone structure without cysts or pathological lesions.
  • Willingness to participate and ability to provide informed consent.

Exclusion Criteria:

• • Systemic medical conditions affecting bone healing or postoperative response (e.g., uncontrolled diabetes, immunodeficiency, metabolic bone disorders).

  • Current or recent use of medications influencing bone remodeling (e.g., bisphosphonates, corticosteroids, immunosuppressants).
  • Heavy smoking (>10 cigarettes/day).
  • Pregnant or breastfeeding females.
  • Poor oral hygiene, active infection, or pericoronitis at the surgical site.
  • Previous surgery, trauma, or pathology in the mandibular third molar region.
  • Known allergies or contraindications to any material or procedure used in the study.

The plan for sharing individual participant data (IPD) has not yet been determined. Decisions regarding IPD sharing will depend on institutional policies, ethical approvals, and future publication requirements.

No masking was performed because both the surgeon and the participants were aware of the intervention type.