Domínguez Angela, Velásquez Sergio A
Department of Orthodontics, Universidad del Valle, Cali, Colombia.
Photomed Laser Surg. 2013 Jan;31(1):36-40. doi: 10.1089/pho.2012.3360. Epub 2012 Dec 16.
The purpose of this study was to evaluate the efficacy of GaAlAs laser light to reduce pain induced by post-adjustment orthodontic final archwire, compared with a placebo control group, and also to evaluate if there are differences in pain gradient when conventional brackets or self-ligating brackets are used for orthodontic treatment.
Previous reports indicate that laser therapy is a safe and efficient alternative to alleviate pain caused in the initial stages of treatment, but there are no studies about its efficacy during the last stages of orthodontic treatment.
The initial sample was 60 orthodontic patients from a private practice, treated by straight wire technique, 30 of them with mini brackets Equilibrium(®) (Dentaurum, Ispringen, Germany) and 30 with self-ligation In-Ovation C(®) (GAC/Dentsply, Tokyo, Japan) slot 0.022 inch brackets. The archwires used in the final stage of orthodontic treatment were stainless steel 0.019×0.025 inch, slot 0.022 inch in both groups. In a design of divided mouth, the dental arches were randomly assigned to receive one dental arch irradiation with 830 nm 100mW therapeutic laser (Photon Lase II), for 22 sec (2.2 J, 80 J/cm(2)) along the vestibular surface and 22 sec (2.2 J, 80 J/cm(2)) along the palatal surface of the root in the randomly selected arch. The opposite dental arch received placebo treatment, with the laser light off. Pain was evaluated using a visual analog scale (VAS) after 2, 6, and 24 h, and 2, 3, and 7 days of application.
The time course of pain showed the same tendency in both groups, reaching a peak 24 h after the archwire activation. The application of laser therapy reduced pain for any period of time up to 7 days (p<0.00001) and for any kind of bracket.
Low intensity laser application reduces pain induced by archwires used during the final stage of orthodontic treatment, without any interference regarding the kind of bracket, as reported by patients.
本研究旨在评估与安慰剂对照组相比，镓铝砷激光减轻正畸最终弓丝调整后引起的疼痛的疗效，并评估在正畸治疗中使用传统托槽或自锁托槽时疼痛梯度是否存在差异。
先前的报告表明，激光治疗是缓解治疗初期引起疼痛的一种安全有效的替代方法，但尚无关于其在正畸治疗最后阶段疗效的研究。
初始样本为来自一家私人诊所的60名正畸患者，采用直丝弓技术进行治疗，其中30名使用迷你平衡托槽（Equilibrium®，德国登特伦公司，伊斯普林根），30名使用自锁In-Ovation C托槽（GAC/登士柏公司，日本东京），槽沟为0.022英寸。正畸治疗最后阶段两组均使用0.019×0.025英寸不锈钢弓丝，槽沟为0.022英寸。采用分口设计，将牙弓随机分为两组，一组接受用830nm 100mW治疗激光（Photon Lase II）沿随机选择牙弓牙根前庭面照射22秒（2.2J，80J/cm²），腭面照射22秒（2.2J，80J/cm²）；另一组牙弓接受安慰剂治疗，激光关闭。在照射后2、6和24小时以及照射后2、3和7天，使用视觉模拟量表（VAS）评估疼痛程度。
两组疼痛的时间进程显示出相同趋势，在弓丝激活后24小时达到峰值。激光治疗在长达7天的任何时间段内均可减轻疼痛（p<0.00001），且对任何类型的托槽均有效。
如患者报告所示，低强度激光照射可减轻正畸治疗最后阶段弓丝引起的疼痛，且不受托槽类型的影响。
