Brain & Mind Research Institute, Nerve Research Foundation, Level 7, Building F, Brain and Mind Research Institute, the University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
J Dent Res. 2012 Jul;91(7 Suppl):79S-84S. doi: 10.1177/0022034512447947.
This double-blind, randomized, clinical trial investigated the effectiveness and underlying mechanism of neural inhibition of pulsed Nd:YAG laser induction of pulpal analgesia compared with 5% EMLA anesthetic cream. Forty-four paired premolars from 44 orthodontic patients requiring bilateral premolar extraction from either dental arch were randomly assigned to the 'Laser plus Sham-EMLA' or 'EMLA plus Sham-Laser' treatment group. Analgesia was tested by an Electric Pulp Tester (EPT) and the cutting of a standardized cavity, which was terminated when participants reported sensitivity, and Visual Analogue Scale (VAS) and numbness were recorded. Statistical analyses were done by paired t test, McNemar's test, and a chi-squared test (p < 0.05). Sixty-eight percent of laser- and 59% of EMLA-treated teeth had completed cavities with statistically significant EPT increases above baseline. No significant within-patient differences were found for either group. No laser-treated participants reported numbness. The trial confirmed that the pulsed Nd:YAG laser effectively induced pulpal analgesia, by suppression of intradental nerve responses to electrical and mechanical stimuli. Such a laser provides an alternative for dental pain management (ANZ-Clinical Trial Registry: N12611001099910).
这项双盲、随机、临床试验研究了与 5%EMLA 麻醉乳膏相比，脉冲 Nd:YAG 激光诱导牙髓镇痛的神经抑制的有效性和潜在机制。从需要从任一牙弓双侧前磨牙拔牙的 44 名正畸患者中随机选择 44 对第一前磨牙，分为“激光加假 EMLA”或“EMLA 加假激光”治疗组。通过电牙髓测试仪（EPT）和切割标准化腔来测试镇痛，当参与者报告敏感度时，测试结束，并记录视觉模拟量表（VAS）和麻木程度。通过配对 t 检验、McNemar 检验和卡方检验（p<0.05）进行统计分析。68%的激光治疗牙和 59%的 EMLA 治疗牙的 EPT 比基线有显著增加，完成了牙腔。两组均未发现患者内的显著差异。没有激光治疗的参与者报告麻木。该试验证实，脉冲 Nd:YAG 激光通过抑制牙内神经对电和机械刺激的反应，有效地诱导了牙髓镇痛。这种激光为牙科疼痛管理提供了一种替代方法（ANZ-临床试验注册处：N12611001099910）。
