Yamamoto-Silva Fernanda Paula, Silva Lorena Rosa, de Lima Kaique Leite, Silva Maria Alves, Estrela Carlos, de Freitas Silva Brunno Santos
Gen Dent. 2019 Jul-Aug;67(4):63-66.
A 39-year-old woman sought specialized treatment complaining of a large, painful oral ulcer in the right buccal vestibule after receiving emergency endodontic treatment 3 days earlier. The patient reported that the tooth, the mandibular right first premolar, was not isolated with a rubber dam and that she felt the extrusion of a liquid in the buccal tissues. Clinically, a necrotic area with raised erythematous borders was observed in the mandibular right side. The clinical diagnosis was a chemically induced ulcer caused by a sodium hypochlorite accident. Dexamethasone and amoxicillin were prescribed to control pain and prevent secondary infection. The large size of the lesion was an indication for application of low-level laser therapy (LLLT), which was delivered at a wavelength of 685 nm (output power, 30 mW; power density, 0.5 mW⁄cm2 ; energy density, 6 J⁄cm2 ) every 2 days for a total of 6 sessions. The LLLT was applied to the necrotic area with a punctual mode (2 points) for 12 seconds per point. The patient reported a substantial reduction in pain after the second application, and the wound was completely healed after 6 sessions. The results observed in this patient suggest that LLLT could aid patients in recovering from NaOCl-related lesions.
一名39岁女性在3天前接受急诊牙髓治疗后，因右侧颊前庭出现一个大的疼痛性口腔溃疡而寻求专科治疗。患者报告称，下颌右侧第一前磨牙在治疗时未使用橡皮障隔离，且她感觉颊部组织有液体挤出。临床检查发现，下颌右侧有一个边界呈红斑状隆起的坏死区域。临床诊断为次氯酸钠事故导致的化学性溃疡。给予地塞米松和阿莫西林以控制疼痛并预防继发感染。鉴于溃疡面积较大，遂采用低强度激光治疗（LLLT），波长为685 nm（输出功率30 mW；功率密度0.5 mW/cm²；能量密度6 J/cm²），每2天治疗1次，共治疗6次。LLLT采用点状模式（2个点）照射坏死区域，每个点照射12秒。患者称第二次治疗后疼痛明显减轻，6次治疗后伤口完全愈合。该患者的治疗结果表明，LLLT有助于患者从与次氯酸钠相关的损伤中恢复。
