Mohajerani Hassan, Tabeie Faraj, Alirezaei Arash, Keyvani Ghazaleh, Bemanali Mehdi
Professor, Deputy of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Associate Professor, Department of Basic Sciences, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Oral Maxillofac Surg. 2021 Aug;79(8):1621-1628. doi: 10.1016/j.joms.2020.07.017. Epub 2020 Jul 18.
Complications after extraction of mandibular third molars, including pain, swelling, and trismus, are common problematic phenomena for both patients and surgeons. The main objective of the present study was to evaluate the therapeutic effect of combined low-level laser (LLL) and light-emitting diode (LED) irradiation on the recovery rate of such complications.
The authors implemented a prospective randomized, double-blind crossover design. Forty participants (80 teeth) were enrolled, each with bilateral and symmetrical impacted lower third molars. Participants had lower third molars extracted at 2 separate visits. Participants were randomized to receive LLL plus LED or placebo at the initial surgical procedure. Participants acted as their control during the second surgical procedure. The primary predictor variable was LLL plus LED. The primary outcome variable was pain measured at postoperative days 3 and 7. Secondary outcome variables were swelling and trismus. The Mann-Whitney U, Wilcoxon, and Friedman tests were used for statistical analysis with a P < .05 considered significant.
The sample size of each group was 40 (male to female ratio of 1:1, mean age 24.8 ± 3.9). Preoperative scores of all scales were lower for both groups compared with days 3 and 7 (P < .0001). Postoperative pain levels on days 3 and 7 were significantly less in the intervention group (P = .03 and P = .01, respectively). Compared with the control group, the postoperative trismus level of the intervention group was significantly less on day 3 (P = .006). However, the difference on day 7 was not significant. Postoperative swelling levels on days 3 and 7 were significantly less in the intervention group (P < .0001).
Combined LLL plus LED irradiation could be an effective therapy to decrease postoperative pain and swelling after impacted third molar extractions.
下颌第三磨牙拔除后的并发症，包括疼痛、肿胀和牙关紧闭，对于患者和外科医生来说都是常见的问题现象。本研究的主要目的是评估低强度激光（LLL）和发光二极管（LED）联合照射对此类并发症恢复率的治疗效果。
作者采用前瞻性随机双盲交叉设计。招募了40名参与者（80颗牙齿），每人双侧均有对称的低位阻生第三磨牙。参与者在2次分开的就诊中拔除下颌第三磨牙。在初次手术过程中，参与者被随机分配接受LLL加LED或安慰剂治疗。在第二次手术过程中，参与者作为自己的对照。主要预测变量是LLL加LED。主要结局变量是术后第3天和第7天测量的疼痛。次要结局变量是肿胀和牙关紧闭。采用曼-惠特尼U检验、威尔科克森检验和弗里德曼检验进行统计分析，P <.05被认为具有统计学意义。
每组样本量为40（男女比例为1:1，平均年龄24.8±3.9）。与第3天和第7天相比，两组所有量表的术前评分均较低（P <.0001）。干预组术后第3天和第7天的疼痛水平明显较低（分别为P =.03和P =.01）。与对照组相比，干预组术后第3天的牙关紧闭程度明显较轻（P =.006）。然而，第7天的差异不显著。干预组术后第3天和第7天的肿胀程度明显较轻（P <.0001）。
LLL加LED联合照射可能是一种有效的治疗方法，可减少阻生第三磨牙拔除术后的疼痛和肿胀。
