Arduino Paolo G, Cafaro Adriana, Garrone Marco, Gambino Alessio, Cabras Marco, Romagnoli Ercole, Broccoletti Roberto
Department of Surgical Sciences, Oral Medicine Section, University of Turin, Unito Lingotto Dental Institute c/o Lingotto, Via Nizza 230, 10126, Turin, Italy.
Department of Surgical Sciences and Integrated Diagnostics, Genoa University, Genoa, Italy.
Lasers Med Sci. 2016 May;31(4):811-6. doi: 10.1007/s10103-016-1897-8. Epub 2016 Feb 12.
Comparison between low-level laser therapy (LLLT) and clonazepam for treating burning mouth syndrome (BMS) patients has never been documented; the aim of this study was to assess the effects of LLLT photobiomodulation versus medical therapy with clonazepam on BMS. Thirty-three patients (25 female, 8 male, mean age = 67.12) were randomly allocated to two different groups: the first one (group A, 18 patients) underwent two laser irradiation sessions weekly for 5 weeks, whereas the second one (group B, 15 patients) received topical clonazepam therapy [half a tablet (2 mg) in the mouth without swallowing for 3 min, three times a day for 21 days]. LLLT was delivered with a continuous wave 980-nm aluminum gallium arsenide (AlGaAs) diode laser and the output of 300 mW, delivering a Fluence of 10 J/cm(2), using a "spot technique," with an average power density of about 1 W/cm(2). The laser probe was held perpendicularly at a distance of about 2 mm from the mucosa. Visual analogue scale (VAS), McGill Pain Questionnaire, present pain intensity (PPI), and Oral Health Impact Profile (OHIP-49) assessed sensation of pain. Hospital Anxiety and Depression Scale and Geriatric Depression Scale assessed levels of anxiety and depression. Twelve weeks after the end of treatment, patients treated with LLLT experienced a decrease in pain sensation reported for all the parameters analyzed: VAS (P = 0.004), McGill Pain Questionnaire (P = 0.002), PPI (P = 0.002), and OHIP-49 (P = 0.010). The group treated with clonazepam had less favorable results for VAS (P = 0.33), McGill Pain Questionnaire (P = 0.005), PPI (P = 0.013), and OHIP-49 (P = 0.25). Levels of anxiety and depression did not change statistically in any groups (P > 0.05). Comparing the two groups, LLLT appeared to be superior in improving pain perception, but statistically only at 8 weeks after the end of the protocol proposed (P = 0.026). Based on this preliminary trial, LLLT is capable of reducing the symptoms of patients with BMS with a constant and long-lasting effect, experienced since the end of the first applications.
低强度激光疗法（LLLT）与氯硝西泮治疗灼口综合征（BMS）患者的比较尚无文献记载；本研究的目的是评估LLLT光生物调节与氯硝西泮药物治疗对BMS的效果。33例患者（25例女性，8例男性，平均年龄67.12岁）被随机分为两组：第一组（A组，18例患者）每周接受两次激光照射，共5周，而第二组（B组，15例患者）接受局部氯硝西泮治疗[半片（2mg）含于口中不吞咽3分钟，每天3次，共21天]。LLLT采用连续波980nm砷化镓铝（AlGaAs）二极管激光，输出功率300mW，采用“光斑技术”，能量密度为10J/cm²，平均功率密度约为1W/cm²。激光探头垂直于距黏膜约2mm处放置。采用视觉模拟量表（VAS）、麦吉尔疼痛问卷、当前疼痛强度（PPI）和口腔健康影响量表（OHIP - 49）评估疼痛感觉。采用医院焦虑抑郁量表和老年抑郁量表评估焦虑和抑郁水平。治疗结束12周后，接受LLLT治疗的患者在所有分析参数中报告的疼痛感觉均有所减轻：VAS（P = 0.004）、麦吉尔疼痛问卷（P = 0.002）、PPI（P = 0.002）和OHIP - 49（P = 0.010）。氯硝西泮治疗组在VAS（P = 0.33）、麦吉尔疼痛问卷（P = 0.005）、PPI（P = 0.013）和OHIP - 49（P = 0.25）方面的效果较差。任何一组的焦虑和抑郁水平均无统计学变化（P > 0.05）。比较两组，LLLT在改善疼痛感知方面似乎更优，但仅在方案结束后8周有统计学意义（P = 0.026）。基于此初步试验，LLLT能够减轻BMS患者的症状，且自首次应用结束后就有持续且持久的效果。
