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低强度激光疗法对治疗矢状劈开下颌支截骨术引起的神经感觉缺损有效吗?

Is Low-Level Laser Therapy Effective for Treatment of Neurosensory Deficits Arising From Sagittal Split Ramus Osteotomy?

作者信息

Eshghpour Majid, Shaban Baratollah, Ahrari Farzaneh, Erfanian Mahdi, Shadkam Elaheh

机构信息

Associate Professor of Oral and Maxillofacial Surgery, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.

Professor of Oral and Maxillofacial Surgery, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

J Oral Maxillofac Surg. 2017 Oct;75(10):2085-2090. doi: 10.1016/j.joms.2017.04.004. Epub 2017 Apr 13.

Abstract

PURPOSE

This study investigated the effectiveness of low-level laser therapy (LLLT) for treating neurosensory impairment after bilateral sagittal split osteotomy (BSSO).

MATERIALS AND METHODS

This randomized, double-blinded, split-mouth trial included patients requiring BSSO. After surgery, 1 side of each patient was randomly assigned to laser therapy and the other side served as the control. At 24, 48, and 72 hours after surgery, LLLT was accomplished by intraoral application of a 660-nm laser around the surgical site (200 mW, 10 seconds, 2 J, 1.5 J/cm) followed by extraoral irradiation by an 810-nm laser (200 mW, 10 seconds, 2 J, 7 J/cm) along the distribution of the inferior alveolar nerve. Subsequently, extraoral irradiation was repeated 2 times per week for 3 weeks along the path of the inferior alveolar nerve, lower lip, and chin. On the control side, the treatment was similar to the laser side but with laser simulation. The main outcome was assessing nerve damage by a "2-point discrimination test" before and up to 60 days after surgery.

RESULTS

The sample consisted of 16 patients. No significant difference was found between the laser and control sides before and after surgery and on postoperative days 15 and 30 (P > .05). The 2-point discrimination distance was significantly shorter on the laser side than on the control side on postoperative days 45 and 60 (P < .05).

CONCLUSION

LLLT was effective in the treatment of neurosensory disturbances arising from BSSO. Therefore, LLLT can be recommended to accelerate the recovery of sensory aberrations in patients undergoing BSSO.

摘要

目的

本研究调查了低强度激光疗法(LLLT)治疗双侧矢状劈开截骨术(BSSO)后神经感觉障碍的有效性。

材料与方法

这项随机、双盲、自身对照试验纳入了需要进行BSSO的患者。术后,将每位患者的一侧随机分配至激光治疗组,另一侧作为对照组。术后24、48和72小时,通过在手术部位周围经口应用660nm激光(200mW,10秒,2J,1.5J/cm),随后沿下牙槽神经分布经皮应用810nm激光(200mW,10秒,2J,7J/cm)来完成低强度激光疗法。随后,沿下牙槽神经、下唇和下巴路径每周进行2次经皮照射,共3周。在对照组,治疗与激光治疗组相似,但为激光模拟。主要观察指标是在术前及术后60天内通过“两点辨别试验”评估神经损伤情况。

结果

样本包括16例患者。术前、术后以及术后第15天和第30天,激光治疗组与对照组之间均未发现显著差异(P > 0.05)。术后第45天和第60天,激光治疗组的两点辨别距离显著短于对照组(P < 0.05)。

结论

低强度激光疗法对治疗BSSO引起的神经感觉障碍有效。因此,推荐使用低强度激光疗法来加速接受BSSO患者感觉异常的恢复。

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