Eslamian Ladan, Borzabadi-Farahani Ali, Hassanzadeh-Azhiri Aidin, Badiee Mohammad R, Fekrazad Reza
Dentofacial Deformities Research Center, Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Lasers Med Sci. 2014 Mar;29(2):559-64. doi: 10.1007/s10103-012-1258-1. Epub 2013 Jan 20.
The purpose of this study was to assess the effect of 810-nm (DMC Equipamentos, Sao Carlos, Brazil) continuous wave low-level laser therapy (LLLT) on the pain caused by orthodontic elastomeric separators. Thirty-seven orthodontic patients (12 male and 25 female, aged 11-32 years, mean age = 24.97 years) participated in the study, including 20 subjects aged 18 years or more, and 17 under 18 years of age. Four elastomeric separators (Dentarum, Springen, Germany) were placed for the first permanent molars (distal and mesial), either for maxillary (22 patients) or mandibular (15 patients) arches; one quadrant was randomly selected and used as a placebo group (received no laser irradiation). After separator placement for each quadrant, patients received 10 doses (2 J/cm(2), 100 mW, 20 s) of laser irradiation on the buccal side (at the cervical third of the roots), for distal and mesial of the second premolars and first permanent molars, as well as distal of second permanent molars (five doses). The same procedure was repeated for the lingual or palatal side (five doses). After 24 h, patients returned to the clinic and received another 10 doses of laser irradiation on the same quadrant. Postseparation pain level recorded on a 10-cm visual analog scale for both jaws immediately (hour 0), and after 6, 24, 30 h, as well as on days 3, 4, 5, 6, and 7. Significant differences in the pain perception (PP) were found between the laser and placebo groups at 6, 24, 30 h, and day 3 of the experiment (P < 0.05). Friedman's test of multiple comparisons revealed significant differences in the PP among various time intervals for laser (chi-square = 173.407, P = 0.000) and placebo (chi-square = 184.712, P = 0.000) groups. In both groups, pain was highest at 6 and 30 h after placing elastomeric separators. No gender differences were observed in both groups. More pain was recorded in the mandible (P < 0.05) at 24 (laser group) and 30 h (both groups) after starting the experiment. The PP was significantly higher (P < 0.05) for the group aged 18 years or more, only at days 3 [both groups] and 4 [laser group only] of the experiment. The 810-nm continuous wave LLLT significantly reduced the PP in the first 3 days after orthodontic separation. However, the mean postseparation PP in both groups was low and wide ranges of PP scores were observed.
本研究旨在评估810纳米(巴西圣卡洛斯的DMC Equipamentos公司生产)连续波低强度激光疗法(LLLT)对正畸弹性分离器所致疼痛的影响。37名正畸患者(12名男性和25名女性,年龄11 - 32岁,平均年龄24.97岁)参与了本研究,其中20名受试者年龄在18岁及以上,17名年龄在18岁以下。为上颌(22例患者)或下颌(15例患者)牙弓的第一恒磨牙(远中及近中)放置了四个弹性分离器(德国斯普林根的Dentarum公司生产);随机选择一个象限作为安慰剂组(未接受激光照射)。在每个象限放置分离器后,患者在颊侧(牙根颈三分之一处)接受10次剂量(2 J/cm²,100 mW,20秒)的激光照射,照射第二前磨牙和第一恒磨牙的远中及近中,以及第二恒磨牙的远中(5次剂量)。舌侧或腭侧重复相同操作(5次剂量)。24小时后,患者返回诊所,在同一象限再接受10次剂量的激光照射。在分离后立即(0小时)、6小时、24小时、30小时以及第3、4、5、6和7天,用10厘米视觉模拟量表记录上下颌的分离后疼痛程度。在实验的6小时、24小时、30小时和第3天,激光组和安慰剂组之间的疼痛感知(PP)存在显著差异(P < 0.05)。Friedman多重比较检验显示,激光组(卡方 = 173.407,P = 0.000)和安慰剂组(卡方 = 184.712,P = 0.000)在不同时间间隔的PP存在显著差异。在两组中,放置弹性分离器后6小时和30小时疼痛最为剧烈。两组均未观察到性别差异。在实验开始后的24小时(激光组)和30小时(两组),下颌记录到的疼痛更多(P < 0.05)。仅在实验的第3天(两组)和第4天(仅激光组),18岁及以上组的PP显著更高(P < 0.05)。810纳米连续波LLLT在正畸分离后的前3天显著降低了PP。然而,两组的平均分离后PP较低,且观察到PP评分范围较宽。