Noba Claudio, Mello-Moura Anna Carolina Volpi, Gimenez Thais, Tedesco Tamara Kerber, Moura-Netto Cacio
Dentistry Post Graduation Program, Universidade Cruzeiro do Sul, São Paulo, Brazil.
Dentistry Post Graduation Program, Universidade Ibirapuera, Av. Interlagos, 1329 - Chácara Flora, São Paulo, SP, 04661-100, Brazil.
Lasers Med Sci. 2018 Apr;33(3):667-674. doi: 10.1007/s10103-017-2400-x. Epub 2017 Dec 1.
The purpose of this study is to perform a systematic review on the use of lasers in oral surgery for bone healing. Selection of articles was carried out by two evaluators in Pubmed and Web of Science databases for published articles and OpenGray for gray literature. Search strategy was developed based on the PICO Question "Does the use of lasers after oral surgery improve bone healing?". Eligibility criteria were: being on laser; evaluate bone healing; involve oral surgery; do not be about implant, periodontics, orthodontics, osteonecrosis or radiotherapy, nor revisions, clinical cases, etc. Data were collected from each article in a structured spreadsheet and a descriptive analysis was performed. Risk assessment of bias of the articles was carried out through the tool elaborated by the Cochrane collaboration. A total of 827 potentially relevant references were identified. No articles were found in OpenGray. Eleven articles met the eligibility criteria and were included in the systematic review. Most of studies were in vivo and in jaw, being conducted with low-power lasers which were applied immediately after the surgical procedure of extraction. Neoformation and bone density were the outcomes of choice and there was a tendency of increase in bone density, neoformation, regeneration, mineralization, or bone condensation when laser was applied. Regarding the bias risk assessment, studies were not clear in reporting most of the parameters. Low-power laser therapy seems to reduce time of bone healing in oral surgery, although there are no defined protocols and the level of evidence is still considered weak.
本研究的目的是对激光在口腔外科手术中促进骨愈合的应用进行系统评价。两名评估人员在PubMed和Web of Science数据库中筛选已发表文章,并在OpenGray中筛选灰色文献。搜索策略是基于“口腔外科手术后使用激光是否能改善骨愈合?”这一PICO问题制定的。纳入标准为:涉及激光治疗;评估骨愈合情况;涉及口腔外科手术;不涉及种植、牙周病、正畸、骨坏死或放疗,也不涉及修订、临床病例等。从每篇文章中收集的数据记录在结构化电子表格中,并进行描述性分析。通过Cochrane协作组织制定的工具对文章的偏倚风险进行评估。共识别出827篇潜在相关参考文献。在OpenGray中未发现相关文章。11篇文章符合纳入标准并被纳入系统评价。大多数研究是在体内颌骨进行的,使用低功率激光,在拔牙手术后立即应用。新骨形成和骨密度是主要观察指标,应用激光后骨密度、新骨形成、再生、矿化或骨致密化有增加趋势。关于偏倚风险评估,大多数参数在研究报告中并不明确。低功率激光治疗似乎能缩短口腔外科手术中骨愈合的时间,尽管目前尚无明确的方案,证据水平仍被认为较弱。