低水平激光治疗下颌第三磨牙拔除术后牙关紧闭、面部肿胀及疼痛的效果

Omid Soltaninia, L. Gholami, H. Hashemzehi, Javad Feradmal, Mehdi Parvan, Navid Rangzan, Amirhosein Najafi
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摘要

背景:受激辐射(激光)的光放大目前被用作减轻口腔手术后炎症的治疗方法。因此,本研究旨在评估使用二极管低功率激光照射(光生物调节)对潜在下颌第三磨牙手术(手术切除潜在下颌第三磨牙)引起的疼痛,肿胀和牙关的影响。方法:采用双盲随机临床试验方法,选取16例具有相同症状的下颌第三磨牙潜伏患者。将牙齿随机分为两组:激光照射干预组和未照射对照组。输出功率为200 mW,能量密度为12 J/cm2的940 nm二极管激光器在距离1 cm的三个口内点和一个口外点上照射60秒。术前及术后2、7 d分别测量上、下中牙切缘距离、唇与耳廓水平距离(LE)、眼外眦与下颌角垂直距离(EA)、疼痛视觉模拟量表。结果:干预前、干预后第2、7天两组患者EA、LE比较,差异均无统计学意义(P>0.05)。而对照组在干预前(3.31±0.7比2.38±0.8,P=0.001)和干预后第2天(6.5±1.32比4.5±0.97,P<0.001)疼痛评分明显高于对照组。第7天,干预组最大颌开口(MJO)高于对照组(40.68±5.76∶36.81±4.35,P=0.04)。结论:第三磨牙手术后辅助二极管激光光生物调节与疼痛和牙关的显著减少有关。
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Effect of Low-Level Laser Therapy on Trismus, Facial Swelling, and Pain Following Surgical Extraction of Impacted Lower Third Molars
Background: Light amplification by the stimulated emission of radiation (laser) is currently used as a therapy method for decreasing inflammation followed by oral surgeries. Therefore, the present study aimed at evaluating the effect of using diode low-power laser irradiation (photobiomodulation) on the amount of pain, swelling, and trismus due to latent mandibular third molar surgery (surgical removal of latent mandibular third molars). Methods: In this double-blind randomized clinical trial study, 16 individuals with latent mandibular third molars with an identical condition were selected. The teeth were randomly assigned to two groups of laser irradiated intervention group and a non-irradiated control group. A 940 nm diode laser with an output power of 200 mW and an energy density of 12 J/cm2 was applied for 60 seconds at a distance of 1 cm three intraoral points and an extraoral point. The distance between incisal edges of upper and lower central teeth, the horizontal distance between corners of lips and auricle (LE), the vertical distance between the outer canthus of the eye and the mandibular angle (EA), and pain visual analogue scale were measured before surgery and two and seven days after surgery. Results: There was no statistically significant difference between the two groups regarding EA and LE before intervention and on days 2 and 7 after intervention (P>0.05). However, the pain score was significantly higher before intervention (3.31±0.7 vs. 2.38±0.8, P=0.001) and on day 2 after intervention (6.5±1.32 vs. 4.5±0.97, P<0.001) in the control group. On day 7, a higher maximum jaw opening (MJO) was observed in the intervention group (40.68±5.76 vs. 36.81±4.35, P=0.04). Conclusions: Adjunctive diode laser photobiomodulation after third molar surgery was associated with a significant reduction in pain and trismus.
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