Al-Jundi Azzam, Sakka Salah, Riba Hicham, Ward Thaer, Hanna Reem
Department of Preventive Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Kingdom of Saudi Arabia.
Department of Orthodontics, The University of Hama Dental College, Hama, Syria.
Laser Ther. 2018 Sep 30;27(3):193-202. doi: 10.5978/islsm.27_18-OR-15.
The long duration of orthodontic treatment is a major patients' concern. A noninvasive method of accelerating tooth movement in a physiological manner is needed. The aim of the study was to evaluate the effects of Er:YAG laser application during orthodontic treatment of deep bite and to evaluate its analgesic effect during that movement.
A prospective randomized controlled clinical trial (RCT) was performed on 30 patients with deep bite. Sample was divided into two groups: (A), 15 patients (orthodontic treatment-control group) and (B), 15 patients (orthodontic treatment and Er:YAG Laser - laser group). The tooth movement was evaluated as the primary outcome variable by measuring angular and linear changes on three progress lateral cephalometeric radiographs (T1, T2 and T3); Lateral cephalograms were taken before treatment (T1), immediately after finishing the stage of leveling and alignment (T2) and after completion of the intrusion stage (T3).Laser parameters were 400 mJ/10 Hz/4 W and 400 mJ/15 Hz/6 W, depending on the handpiece used. The levels of pain and discomfort were evaluated and ranked according to a visual analog scale. Paired t-tests or Wilcoxon matched-pairs signed-rank tests were used to detect significant differences.
The main findings of the treatment were (1) significant positive difference in the rates of tooth intrusion movement on the experimental group compared with the control group at the baseline to T2 and T3 interval and the tooth movement rate was approximately 3 times faster in the experimental group. (2) The pain score in the experimental group was significantly lower compared with the control group on day 3 as on day 7.
The application of Er:YAG laser is an effective mean to speed orthodontic tooth movement with a significant reduction in pain and discomfort after application.
正畸治疗疗程较长是患者主要关心的问题。需要一种以生理方式加速牙齿移动的非侵入性方法。本研究的目的是评估铒激光在深覆合正畸治疗期间的应用效果，并评估其在牙齿移动过程中的镇痛效果。
对30例深覆合患者进行前瞻性随机对照临床试验（RCT）。样本分为两组：（A）15例患者（正畸治疗对照组）和（B）15例患者（正畸治疗加铒激光治疗组）。通过测量三张头颅侧位定位X线片（T1、T2和T3）上的角度和线性变化，将牙齿移动作为主要观察变量进行评估；在治疗前（T1）、完成排齐整平阶段后即刻（T2）以及压低阶段完成后（T3）拍摄头颅侧位片。根据使用的手持器械不同，激光参数分别为400 mJ/10 Hz/4 W和400 mJ/15 Hz/6 W。根据视觉模拟量表对疼痛和不适程度进行评估和分级。采用配对t检验或Wilcoxon配对符号秩检验来检测显著差异。
治疗的主要发现为：（1）与对照组相比，实验组在基线至T2和T3时间段的牙齿压低移动速率有显著正差异，实验组的牙齿移动速率约快三倍；（2）实验组在第3天和第7天的疼痛评分均显著低于对照组。
铒激光的应用是加速正畸牙齿移动的有效手段，应用后疼痛和不适显著减轻。
