Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Gaziantep University, Gaziantep, Turkey.
Lasers Med Sci. 2010 Sep;25(5):641-5. doi: 10.1007/s10103-009-0684-1. Epub 2009 May 31.
The purpose of this study is to compare the effects of extraoral and intraoral low-level laser therapies (LLLT) on postoperative trismus and oedema following the removal of mandibular third molars. Forty-eight patients who were to undergo surgical removal of their lower third molars were studied. Patients were randomly allocated to one of three groups: extraoral LLLT, intraoral LLLT, or placebo. In the study, a Ga-Al-As diode laser device with a continuous wavelength of 808 nm was used, and the laser therapy was applied by using a 1 x 3-cm handpiece. The flat-top laser beam profile was used in this therapy. For both of the LLLT groups, laser energy was applied at 100 mW (0.1 W) for a total of 120 s (0.1 W x 120 s = 12 J). Patients in the extraoral-LLLT group (n = 16) received 12-J (4 J/cm(2)) low-level laser irradiation, and the laser was applied at the insertion point of the masseter muscle immediately after the operation. Patients in the intraoral-LLLT group (n = 16) received 12-J (4 J/cm(2)) low-level laser irradiation intraorally at the operation site 1 cm from the target tissue. In the placebo group (n = 16), the handpiece was inserted intraorally at the operation site and then was touched extraorally to the masseter muscle for 1 min at each site (120 s total), but the laser was not activated. The size of the interincisal opening and facial swelling were evaluated on the second and seventh postoperative days. At the second postoperative day, trismus (29.0 +/- 7.6 mm [p = 0.010]) and swelling (105.3 +/- 5.0 mm [p = 0.047]) in the extraoral-LLLT group were significantly less than in the placebo group (trismus: 21.1 +/- 7.6 mm, swelling: 109.1 +/- 4.4 mm). Trismus (39.6 +/- 9.0 mm [p = 0.002]) in the extraoral-LLLT group at the seventh postoperative day was also significantly less than in the placebo group (29.0 +/- 6.2 mm). However, at the seventh postoperative day in the intraoral-LLLT group, only trismus (35.6 +/- 8.5 [p = 0.002]) was significantly less than in the placebo group (29.0 +/- 6.2 mm). This study demonstrates that extraoral LLLT is more effective than intraoral LLLT for the reduction of postoperative trismus and swelling after extraction of the lower third molar.
本研究旨在比较口外和口内低水平激光疗法（LLLT）对下颌第三磨牙拔除术后牙关紧闭和肿胀的影响。研究纳入了 48 名拟行下颌第三磨牙手术切除的患者。患者被随机分配至三组：口外 LLLT 组、口内 LLLT 组或安慰剂组。研究中使用了连续波长为 808nm 的 Ga-Al-As 二极管激光设备，使用 1 x 3cm 的手柄进行激光治疗。该疗法采用平顶激光束模式。对于两个 LLLT 组，激光能量以 100mW（0.1W）的强度应用 120s（0.1W x 120s = 12J）。口外-LLLT 组（n=16）的患者接受 12J（4J/cm(2)）的低水平激光照射，在术后立即在咬肌插入点进行照射。口内-LLLT 组（n=16）的患者在手术部位口腔内 1cm 处接受 12J（4J/cm(2)）的低水平激光照射。在安慰剂组（n=16）中，手柄在手术部位插入口腔内，然后在每个部位在口腔外接触咬肌 1 分钟（总时长 120s），但不激活激光。在术后第 2 天和第 7 天评估切牙间开口大小和面部肿胀情况。术后第 2 天，口外-LLLT 组的牙关紧闭（29.0 +/- 7.6mm [p=0.010]）和肿胀（105.3 +/- 5.0mm [p=0.047]）明显小于安慰剂组（牙关紧闭：21.1 +/- 7.6mm，肿胀：109.1 +/- 4.4mm）。术后第 7 天，口外-LLLT 组的牙关紧闭（39.6 +/- 9.0mm [p=0.002]）也明显小于安慰剂组（29.0 +/- 6.2mm）。然而，在口内-LLLT 组，仅术后第 7 天的牙关紧闭（35.6 +/- 8.5mm [p=0.002]）明显小于安慰剂组（29.0 +/- 6.2mm）。本研究表明，与口内 LLLT 相比，口外 LLLT 更能有效减轻下颌第三磨牙拔除术后的牙关紧闭和肿胀。
