Guarini Daniela, Gracia Benjamín, Ramírez-Lobos Valeria, Noguera-Pantoja Alfredo, Solé-Ventura Pedro
1 School of Dentistry, Universidad de Los Andes , Santiago, Chile .
2 School of Medicine and School of Dentistry, Universidad de Los Andes , Santiago, Chile .
Photomed Laser Surg. 2018 Jan;36(1):3-9. doi: 10.1089/pho.2017.4312. Epub 2017 Oct 12.
To evaluate the effect of the application of photobiomodulation in a 2-year follow-up period in patients who have been intervened with a sagittal ramus split osteotomy and present neurosensory disturbance of the inferior alveolar nerve.
Photobiomodulation is a common clinical tool in dentistry, for its beneficial effects have been shown in surgical and periodontal wound healing, reducing of swelling and pain, neurosensory recovery, and treatment of temporomandibular joint disorders.
This is a 2-year follow-up study with an experimental (Laser) group (n = 33) that received photobiomodulation, and a control (Sham) group (n = 9), placebo. All patients from the Laser group received laser applications (continuous wave of 0.353 W/cm, 27 J in 270 sec per session) on days 1, 2, 3, 5, 10, 14, 21, and 28 after surgery. Neurosensory disturbance was evaluated with five tests: Visual Analog Scale (VAS) for pain and sensitivity, sensitivity threshold test, two-point discrimination, and thermal discrimination. All tests were performed before (24 h before surgery) and after surgery (24 h, 28 days, 60 days, 6 months, 1 year, 2 years, more than 2 years). Participants and evaluator were blinded to intervention. Variables were described with absolute frequencies, percentages, and medians. Ordinal and dichotomous variables were compared with Mann-Whitney's and Fisher's tests, respectively.
Clinical improvement was observed during the follow-up period for the Laser group; general VAS for sensitivity was normal in 11 participants from the Laser group at 2 years postsurgery (40.74%), while no participants from the Sham group achieved this (p = 0.0341). Twenty-three participants recovered initial values for two-point discrimination (69.7%) after 2 years of follow-up (p = 0.0025) as well as sensitivity threshold test. General VAS for pain was normal in 31 patients from the Laser group after 2 years of follow-up (93.94%, p = 0.0254).
Photobiomodulation was effective for neurosensory recovery on sample studied.
评估在接受矢状劈开截骨术并出现下牙槽神经感觉功能障碍的患者中，光生物调节在2年随访期内的应用效果。
光生物调节是牙科领域常用的临床工具，因为其在手术和牙周伤口愈合、减轻肿胀和疼痛、神经感觉功能恢复以及颞下颌关节紊乱治疗方面均显示出有益效果。
这是一项为期2年的随访研究，设立了接受光生物调节的实验组（激光组，n = 33）和接受安慰剂的对照组（假手术组，n = 9）。激光组的所有患者在术后第1、2、3、5、10、14、21和28天接受激光照射（连续波，0.353 W/cm，每次照射270秒，能量27 J）。通过五项测试评估神经感觉功能障碍：疼痛和感觉的视觉模拟量表（VAS）、感觉阈值测试、两点辨别试验以及温度辨别试验。所有测试均在手术前（手术前24小时）和手术后（术后24小时、28天、60天、6个月、1年、2年、2年以上）进行。参与者和评估者对干预措施均不知情。变量采用绝对频数、百分比和中位数进行描述。有序变量和二分变量分别采用曼-惠特尼检验和费舍尔检验进行比较。
在随访期间观察到激光组有临床改善；术后2年，激光组有11名参与者（40.74%）的感觉总体VAS恢复正常，而假手术组无参与者达到这一水平（p = 0.0341）。经过2年随访，23名参与者（69.7%）的两点辨别试验以及感觉阈值测试恢复到初始值（p = 0.0025）。随访2年后，激光组有31名患者（93.94%）的疼痛总体VAS恢复正常（p = 0.0254）。
在本研究样本中，光生物调节对神经感觉功能恢复有效。
