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光生物调节疗法对痉挛型脑瘫患儿咬肌厚度及口腔健康相关生活质量的疗效

Efficacy of photobiomodulation therapy on masseter thickness and oral health-related quality of life in children with spastic cerebral palsy.

作者信息

Santos Maria Teresa Botti Rodrigues, Nascimento Karla Santos, Carazzato Simone, Barros Alina Oliveira, Mendes Fausto Medeiros, Diniz Michele Baffi

机构信息

Graduate Program in Dentistry, Cruzeiro do Sul University , Rua Galvão Bueno 868, Liberdade, São Paulo, SP CEP 01506-000, Brazil.

Patients with Special Needs, Cruzeiro do Sul University, Rua Galvão Bueno 868, Liberdade, São Paulo-SP, 01506-000, Brazil.

出版信息

Lasers Med Sci. 2017 Aug;32(6):1279-1288. doi: 10.1007/s10103-017-2236-4. Epub 2017 May 23.

DOI:10.1007/s10103-017-2236-4
PMID:28536904
Abstract

The study aimed to evaluate the efficacy of photobiomodulation therapy (PBMT) on bilateral masseter muscle thickness and amplitude of mouth opening in children with spastic cerebral palsy (CP), and the impact on their oral health-related quality of life (OHRQOL). Three groups were included: experimental CP group (EG: n = 26 with oral complaints), positive control CP group (PCG: n = 26 without complaints), and negative control group (NCG: n = 26 without CP). In the EG, the masseter muscles on both sides were irradiated with an infrared low-level Ga-Al-As laser (λ = 808 ± 3 nm, 120 mW) using a 3 J/cm energy dose per site, with a 20 s exposure time per site (spot area: 4 mm; irradiance: 3 W/cm; energy delivery per point: 2.4 J) six times over six consecutive weeks. Masseter thickness, assessed through ultrasonography, and the amplitude of mouth opening were measured in the EG before and after six applications of PBMT and once in the PCG and NCG. The Parental-Caregiver Perception Questionnaire (P-CPQ) was used to evaluate OHRQOL. ANOVA, chi-square, t tests, and multilevel linear regression were used for statistical analysis. In the EG, the study results revealed average increments of 0.77 (0.08) millimeter in masseter thickness (P < 0.05) and 7.39 (0.58) millimeter for mouth opening (P < 0.05) and reduction in all P-CPQ domains (P < 0.001), except for social well-being. The six applications of PBMT increased masseter thickness and mouth opening amplitude and reduced the impact of spastic CP on OHRQOL.

摘要

本研究旨在评估光生物调节疗法(PBMT)对痉挛型脑瘫(CP)患儿双侧咬肌厚度及张口幅度的疗效,以及对其口腔健康相关生活质量(OHRQOL)的影响。研究纳入三组:实验性CP组(EG:n = 26,有口腔问题)、阳性对照CP组(PCG:n = 26,无口腔问题)和阴性对照组(NCG:n = 26,无CP)。在EG组中,使用红外低强度Ga-Al-As激光(λ = 808 ± 3 nm,120 mW)对双侧咬肌进行照射,每个部位的能量剂量为3 J/cm,每个部位的照射时间为20秒(光斑面积:4 mm;辐照度:3 W/cm;每个点的能量传递:2.4 J),连续六周照射六次。通过超声评估咬肌厚度,并在EG组进行六次PBMT治疗前后以及在PCG组和NCG组测量一次张口幅度。使用家长-照顾者感知问卷(P-CPQ)评估OHRQOL。采用方差分析、卡方检验、t检验和多水平线性回归进行统计分析。在EG组中,研究结果显示咬肌厚度平均增加0.77(0.08)毫米(P < 0.05),张口幅度增加7.39(0.58)毫米(P < 0.05),除社会幸福感外,所有P-CPQ领域均有所降低(P < 0.

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