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头颈部放射治疗后行牙拔除术患者的黏膜修复的光生物调节:一项双盲随机试点研究。

Photobiomodulation for mucosal repair in patients submitted to dental extraction after head and neck radiation therapy: a double-blind randomized pilot study.

机构信息

Oral Medicine Unit, Hospital das Clínicas, Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, 1235, CDU, Recife, PE, 50670-901, Brazil.

Graduate Program in Dentistry, Universidade Federal de Pernambuco, Recife, Brazil.

出版信息

Support Care Cancer. 2021 Mar;29(3):1347-1354. doi: 10.1007/s00520-020-05608-5. Epub 2020 Jul 9.

Abstract

OBJECTIVE

The aim of this study was to evaluate the efficacy of photobiomodulation therapy (PBMT) on the mucosal healing of patients submitted to simple dental extractions after head and neck radiation therapy (HNRT).

METHODS

Forty surgical procedures were randomly assigned into two groups: G1: dental extraction + PBMT (n = 19) and G2: dental extraction + sham-PBMT (n = 21). All patients received antibiotic therapy and the surgical alveolotomy to promote primary closure of the surgical site. Group 1 was submitted to PMBT according to the following parameters: 808 nm, 40 mW, 100 J/cm, 70 s, 2.8 J/point, 14 J/session, and area of 0.028cm. The primary outcome was complete mucosal lining at 14 days, and the secondary outcomes were the presence of infection, postoperative pain, and analgesics intake at 7 days. The patients were evaluated every 7 days until 28 days.

RESULTS

Alveolar mucosal lining was faster in G1, and at 14 postoperative days, 94.7% patients evolved with complete alveolar mucosal lining compared to no patient from G2 (p < 0.001). Patients from G1 reported postoperative pain less frequently (G1 = 4, 21.1% × G2 = 14, 66.7%, p = 0.005), and also reported lower intake of analgesic pills at D7 (21.1% × 66.7%, p = 0.005%). PBMT had a significant positive impact on both postoperative pain (NNT = 2.192, CI95% = 1.372-5.445) and mucosal healing (NNT = 1.056, CI95% = 0.954-1.181).

CONCLUSIONS

This preliminary study strongly supports the use of PMBT to promote surgical alveolar mucosal lining in a shorter time and with less postoperative pain.

摘要

目的

本研究旨在评估光生物调节疗法(PBMT)对头颈部放射治疗(HNRT)后行单纯牙拔除术患者的黏膜愈合的疗效。

方法

40 例手术随机分为两组:G1:牙拔除术+PBMT(n=19)和 G2:牙拔除术+假 PBMT(n=21)。所有患者均接受抗生素治疗和牙槽切开术以促进手术部位的一期愈合。G1 组接受 PMBT,参数如下:808nm、40mW、100J/cm、70s、2.8J/点、14J/次、面积 0.028cm。主要结局为 14 天完全黏膜覆盖,次要结局为感染、术后疼痛和术后 7 天止痛药摄入情况。患者在 28 天内每 7 天评估一次。

结果

G1 组牙槽黏膜覆盖更快,术后 14 天,94.7%的患者牙槽黏膜完全覆盖,而 G2 组无一例患者(p<0.001)。G1 组患者术后疼痛发生频率较低(G1=4,21.1%×G2=14,66.7%,p=0.005),术后 7 天止痛药服用量也较低(G1=4,21.1%×G2=14,66.7%,p=0.005)。PBMT 对术后疼痛(NNH=2.192,95%CI=1.372-5.445)和黏膜愈合(NNH=1.056,95%CI=0.954-1.181)均有显著积极影响。

结论

这项初步研究强烈支持使用 PMBT 以更快的时间和更少的术后疼痛促进手术牙槽黏膜覆盖。

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