Sleem Sherif Shafik Mohamed El Bahnasy, Zayet Mohamed Khalifa, El-Ghareeb Tarek Ibrahim, Saleh Hoda Abd Kader
Faculty of Dentistry, British University in Egypt, Cairo, Egypt.
Faculty of Dentistry, Cairo University, Cairo, Egypt.
Open Access Maced J Med Sci. 2019 Mar 14;7(5):869-875. doi: 10.3889/oamjms.2019.183. eCollection 2019 Mar 15.
Restoring masticatory function and replacing missing teeth with minimal pain and discomfort are the most important issues for the patient and clinician. Nowadays dental implants became the most popular line of treatment to replace missing teeth; offering a comfortable long lasting prosthesis. Osseo-integration reflects the long term success of a dental implant. Many bio-modulators are used aiming to improve the osseointegration and healing around dental implants such as Low-Level Laser treatment (LLLT) and Platelet Rich Fibrin (PRF). PRF has been proven to improve bone repair process around the dental implant. LLLT is considered a noninvasive, safe technique that stimulates osteogenesis and alleviates post-operative pain.
Evaluation of the bio-stimulatory effect of LLLT on a dental implant with PRF compared to PRF alone clinically and radiographically.
A randomised clinical trial with the split-mouth design was conducted on nine patients with bilaterally missing lower posterior tooth. All patients received one dental implant on each side with PRF. LASER application was performed to one side twice weekly for one month starting on the day of insertion. Post-operative pain was assessed daily through the first week using numerical rating pain scale (NRS) as the primary outcome. Relative peri-implant bone density was measured using direct digital intraoral radiography immediately after insertion, one, four and nine months postoperatively. Implants stability were measured using radio frequency assessment immediately after insertion, four and nine months post-operative as secondary outcomes.
The NRS for pain was significantly decreased by the end of the first-week postoperatively in the intervention and control group with a mean of (2.22 ± 1.56) (2.11 ± 1.83) respectively. However, there was no statistically significant difference between the test groups at P-Value (0.892). The relative bone density values were decreased by the end of the ninth month of follow-up in the intervention and control group with a mean of (134.42 ± 16.13) (128.77 ± 33.54) respectively. No statistically significant difference was observed between the two test groups at P-value (0.863). The radiofrequency values for implant stability showed no statically significant difference after nine months of follow up when compared to the initial stability values at the day of insertion in the intervention and control group. The mean radiofrequency values were (67.24 ± 1.79) and (66.9 ± 2.57) respectively, and no statistically significant difference was observed between the two test groups at P-value (0.793).
There are no statistically significant differences in post-operative pain values, implant stability and bone density between the implant sites treated with PRF augmented by Diode laser compared to implant sites treated by PRF alone.
恢复咀嚼功能并以最小的疼痛和不适替代缺失牙齿是患者和临床医生面临的最重要问题。如今,牙种植体已成为替代缺失牙齿最受欢迎的治疗方法;它能提供舒适且持久的修复体。骨结合反映了牙种植体的长期成功。许多生物调节剂被用于改善牙种植体周围的骨结合和愈合,如低强度激光治疗(LLLT)和富血小板纤维蛋白(PRF)。PRF已被证明可改善牙种植体周围的骨修复过程。LLLT被认为是一种非侵入性、安全的技术,可刺激骨生成并减轻术后疼痛。
与单独使用PRF相比,从临床和影像学角度评估LLLT对联合PRF的牙种植体的生物刺激作用。
对9例双侧下颌后牙缺失的患者进行了采用分口设计的随机临床试验。所有患者每侧均接受一枚联合PRF的牙种植体。从植入当天开始,对一侧每周进行两次激光照射,持续一个月。在术后第一周每天使用数字评分疼痛量表(NRS)评估术后疼痛作为主要结局。在植入后、术后1个月、4个月和9个月,使用直接数字化口内放射摄影测量种植体周围相对骨密度作为次要结局。在植入后、术后4个月和9个月,使用射频评估测量种植体稳定性作为次要结局。
术后第一周结束时,干预组和对照组的疼痛NRS均显著降低,均值分别为(2.22±1.56)和(2.11±1.83)。然而,两组之间在P值为0.892时无统计学显著差异。随访9个月结束时,干预组和对照组的相对骨密度值均降低,均值分别为(134.42±16.13)和(128.77±33.54)。两组之间在P值为0.863时未观察到统计学显著差异。与植入当天的初始稳定性值相比,干预组和对照组在随访9个月后种植体稳定性的射频值无统计学显著差异。平均射频值分别为(67.24±1.79)和(66.9±2.57),两组之间在P值为0.793时未观察到统计学显著差异。
与单独使用PRF治疗的种植部位相比,用二极管激光增强PRF治疗的种植部位在术后疼痛值、种植体稳定性和骨密度方面无统计学显著差异。