Youssef Mohamed, Ashkar Sharif, Hamade Eyad, Gutknecht Norbert, Lampert Friedrich, Mir Maziar
Dental School, Damascus University, Damascus, Syria.
Lasers Med Sci. 2008 Jan;23(1):27-33. doi: 10.1007/s10103-007-0449-7. Epub 2007 Mar 15.
It has been emphasized that one of the most valuable treatment objectives in dental practice is to afford the patient a pain-free treatment. By the evolution of the laser applications, the dental committee aimed to achieve this goal without analgesic drugs and painful methods. Orthodontic treatment is one of these concerns, that one of the major components of patient to reject this treatment is the pain accompanied during the different treatment phases. Another great concern of the patient is not to get through prolonged periods of treatment. The aim of this study is to evaluate the effect of the low-level (GaAlAs) diode laser (809 nm, 100 mW) on the canine retraction during an orthodontic movement and to assess pain level during this treatment. A group of 15 adult patients with age ranging from 14 to 23 years attended the orthodontic department at Dental School, Damascus University. The treatment plan for these patients included extraction of the upper and lower first premolars because there was not enough space for a complete alignment or presence of biprotrusion. For each patient, this diagnosis was based on a standard orthodontic documentation with photographs, model casts, cephalometric, panorama, and superior premolar periapical radiographies. The orthodontic treatment was initiated 14 days after the premolar extraction with a standard 18 slot edgewise brackets [Rocky Mountain Company (RMO)]. The canine retraction was accomplished by using prefabricated Ricketts springs (RMO), in both upper and lower jaws. The right side of the upper and lower jaw was chosen to be irradiated with the laser, whereas the left side was considered the control without laser irradiation. The laser was applied with 0-, 3-, 7-, and 14-day intervals. The retraction spring was reactivated on day 21 for all sides. The amount of canine retraction was measured at this stage with a digital electronic caliper (Myoto, Japan) and compared each side of the relative jaw (i.e., upper left canine with upper right canine and lower left canine with lower right canine). The pain level was prompted by a patient questionnaire. The velocity of canine movement was significantly greater in the lased group than in the control group. The pain intensity was also at lower level in the lased group than in the control group throughout the retraction period. Our findings suggest that low-level laser therapy can highly accelerate tooth movement during orthodontic treatment and can also effectively reduce pain level.
一直以来都强调,牙科实践中最有价值的治疗目标之一是为患者提供无痛治疗。随着激光应用的发展,牙科委员会旨在不使用镇痛药和痛苦方法来实现这一目标。正畸治疗就是其中一个关注点,患者拒绝这种治疗的主要原因之一是在不同治疗阶段伴随的疼痛。患者的另一个重大担忧是不想经历长时间的治疗。本研究的目的是评估低强度(GaAlAs)二极管激光(809纳米,100毫瓦)在正畸移动过程中对犬齿后移的影响,并评估该治疗过程中的疼痛程度。一组15名年龄在14至23岁之间的成年患者前往大马士革大学牙科学院正畸科就诊。这些患者的治疗方案包括拔除上下第一前磨牙,因为没有足够空间进行完全排齐或存在双前突。对于每位患者,该诊断基于带有照片、模型石膏、头影测量、全景和上前磨牙根尖片的标准正畸记录。在拔除前磨牙14天后,使用标准的18槽方丝弓托槽[落基山公司(RMO)]开始正畸治疗。通过使用预制的里克茨弹簧(RMO)实现上下颌犬齿的后移。选择上颌和下颌的右侧用激光照射,而左侧作为未接受激光照射的对照。激光分别在第0天、第3天、第7天和第14天进行照射。在第21天对所有部位的后移弹簧进行重新激活。在这个阶段,用数字电子卡尺(日本Myoto)测量犬齿后移的量,并比较相对颌骨的每一侧(即左上犬齿与右上犬齿以及左下犬齿与右下犬齿)。疼痛程度由患者问卷提示。激光照射组犬齿移动速度明显快于对照组。在整个后移期间,激光照射组的疼痛强度也低于对照组。我们的研究结果表明,低强度激光治疗可在正畸治疗期间显著加速牙齿移动,还能有效降低疼痛程度。