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低水平激光疗法对人颌面部骨缺损愈合的影响:系统评价。

Influence of low-level laser therapy on the healing of human bone maxillofacial defects: A systematic review.

机构信息

Dental School, Univ. Estadual Paulista - UNESP, Araçatuba, Brazil; Dental School, Univ. do Oeste Paulista - UNOESTE, Presidente Prudente, Brazil.

Dental School, Univ. Estadual Paulista - UNESP, Araçatuba, Brazil.

出版信息

J Photochem Photobiol B. 2017 Apr;169:83-89. doi: 10.1016/j.jphotobiol.2017.03.004. Epub 2017 Mar 7.

Abstract

PURPOSE

This systematic review evaluates the effectiveness of low-level laser therapy (LLLT) to enhance maxillofacial area bone repair.

METHODS

A comprehensive search of studies published up to February 2017 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

RESULTS

The 15 selected studies evaluated a total of 374 patients (mean age, 28.5years) who were treated with LLLT. Gallium-arsenide (GaAs) and gallium aluminium arsenide (GaAlAs) were the most commonly used devices, and LLLT parameters varied greatly. Wavelengths varied from 500 to 1000nm. Tooth extraction, distraction osteogenesis, maxillary expansion, periodontal defects, orthodontic movement and maxillary cystic defects were evaluated. From the 15 selected studies, six evaluated bone repair (primary outcomes). Of these, four studies showed improvement in bone formation after using LLLT, two demonstrated improved results for only one follow up period, and one showed no additional benefits. The other 9 studies evaluated secondary parameters related to healing (secondary outcomes) in the maxillofacial area after applying LLLT, including anti-inflammatory, analgesic, and healing accelerator effects, and quality of life related to oral health. There were no adverse or negative effects of LLLT reported.

CONCLUSION

Within the limitation of this review, a possible improvement in bone density can be found when LLLT is applied postoperatively in maxillofacial bony defects. LLLT also seems to promote anti-inflammatory and analgesic effects and accelerate healing, as well as enhance quality of life related to oral health. However, LLLT use protocols need to be standardized before more specific conclusions can be drawn about this subject.

摘要

目的

本系统评价评估低水平激光疗法(LLLT)增强面骨修复的效果。

方法

根据系统评价和荟萃分析的首选报告项目(PRISMA)声明,对截至 2017 年 2 月发表在 PubMed/MEDLINE、Scopus 和 Cochrane 图书馆数据库中的研究进行全面检索。

结果

15 项选定的研究共评估了 374 名(平均年龄 28.5 岁)接受 LLLT 治疗的患者。砷化镓(GaAs)和砷化镓铝(GaAlAs)是最常用的设备,LLLT 参数差异很大。波长范围从 500nm 到 1000nm。评估的内容包括拔牙、牵张成骨术、上颌扩张、牙周缺损、正畸移动和上颌囊性缺损。在这 15 项选定的研究中,有 6 项评估了骨修复(主要结局)。其中,4 项研究显示使用 LLLT 后骨形成得到改善,2 项研究仅在一个随访期显示改善,1 项研究显示无额外获益。另外 9 项研究评估了在应用 LLLT 后面部区域愈合的次要参数(次要结局),包括抗炎、镇痛和愈合加速作用,以及与口腔健康相关的生活质量。没有报告 LLLT 的不良反应或负面效应。

结论

在本综述的限制范围内,在面骨骨缺损术后应用 LLLT 时可能会发现骨密度的改善。LLLT 似乎还能促进抗炎和镇痛作用,加速愈合,并提高与口腔健康相关的生活质量。然而,在得出关于该主题的更具体结论之前,需要标准化 LLLT 使用方案。

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