Kahraman Sevil Altundag, Cetiner Sedat, Strauss Robert A
1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University , Ankara, Türkiye .
2 Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University Medical Center , Richmond, Virginia.
Photomed Laser Surg. 2017 Aug;35(8):401-407. doi: 10.1089/pho.2016.4252. Epub 2017 Mar 14.
The surgical removal of impacted third molars is one of the most common procedures performed by oral and maxillofacial surgeons. The purpose of this study is to determine whether either transcutaneous or intraoral low-level laser therapy (LLLT) reduces postoperative pain and assists in the healing of mandibular third molar extraction.
This randomized, placebo controlled, single-blind, split-mouth design study was conducted on 60 patients with full bony impacted similar position mandibular third molars bilaterally. The patients were divided into two groups of 30 each: transcutaneous LLLT and intraoral LLLT and the other side of each group treated with nonactive laser (60 teeth). The laser treatment consisted of administering laser energy immediately before and after the extraction procedure with gallium aluminum arsenide (GaAlAs) 830 nm diode lasers. Postoperative pain and healing of the sockets were compared in transcutaneous and intraoral group with placebo for 1 week following the extraction. Descriptive and bivariate statistics was computed, and the p-value was set at 0.05.
Intraoral LLLT application resulted in a statistically significant reduction of postoperative pain in comparison with transcutaneous laser group and placebo. The unhealed socket numbers were compared in two groups at seventh day and no differences were observed.
The results of this study suggest that single-session intraoral LLLT is more effective than extraoral application for reducing postoperative pain. It was postulated that the differences between skin and mucosa could have effect on the results. Although intraoral use would allow closer application to the surgical site, the size of some laser devices precludes their use intraorally.
拔除阻生第三磨牙是口腔颌面外科医生最常开展的手术之一。本研究旨在确定经皮或口内低强度激光治疗(LLLT)是否能减轻术后疼痛并促进下颌第三磨牙拔除后的愈合。
本研究采用随机、安慰剂对照、单盲、双侧口内对照设计,对60例双侧下颌第三磨牙完全骨阻生且位置相似的患者进行研究。患者被分为两组,每组30例:经皮LLLT组和口内LLLT组,每组的另一侧用非活性激光治疗(共60颗牙)。激光治疗包括在拔牙手术前后立即使用波长830 nm的砷化镓铝(GaAlAs)二极管激光给予激光能量。拔牙后1周,比较经皮组和口内组与安慰剂组的术后疼痛及牙槽窝愈合情况。计算描述性和双变量统计量,p值设定为0.05。
与经皮激光组和安慰剂组相比,口内应用LLLT术后疼痛有统计学显著减轻。比较两组术后第7天未愈合牙槽窝数量,未观察到差异。
本研究结果表明,单次口内LLLT在减轻术后疼痛方面比口外应用更有效。据推测,皮肤和黏膜的差异可能对结果产生影响。尽管口内使用可使激光更接近手术部位,但一些激光设备的尺寸使其无法在口内使用。