Department of Orthodontics, Dental School, University of Damascus, Syria.
Department of Oral Medicine, Dental School, University of Damascus, Syria.
Dent Med Probl. 2020 Jul-Sep;57(3):285-293. doi: 10.17219/dmp/120181.
Only a few studies in the literature have reported patient-centered outcomes associated with minimally invasive corticotomy, and thus, related scientific evidence is limited.
The objective of this study was to evaluate patient-centered outcomes associated with upper canine retraction assisted with piezocision or laser-assisted flapless corticotomy (LAFC).
Thirty-two patients (19 females, 13 males) at a mean age of 18.25 ±3.05 years were randomly divided into 2 equal groups: the LAFC group (LG; n = 16) and the piezocision group (PG; n = 16). In each group, the surgical procedure was randomly assigned to one side of the maxillary arch, and the other side served as the control. Standardized questionnaires using the numerical rating scale (NRS) were distributed to all patients during the 1st month after the surgical procedure at 4 time points: 24 h (T1); 3 days (T2); 7 days (T3); and 14 days (T4). The patients' responses were obtained, regarding their feelings of pain, discomfort, swelling, eating difficulty, jaw movement restriction, analgesic consumption, and satisfaction.
The levels of pain, discomfort, swelling, and difficulty in chewing were significantly greater at the experimental sides as compared to the control sides only at T1 in both groups (p < 0.05). The levels of pain and discomfort in LG were significantly lower than those in PG only at T1 (p = 0.013 and p = 0.009, respectively) whereas there were no significant differences between the groups regarding swelling, eating difficulty, jaw movement restriction, and analgesic consumption. The patients in both groups reported high levels of satisfaction, with no significant differences. The levels of pain, discomfort, swelling, eating difficulty, and jaw movement restriction were dramatically decreased 1 day after flapless corticotomy treatment in both groups (p < 0.05).
Both LAFC and piezocision were associated with high levels of pain, discomfort, swelling, and difficulty in chewing at T1. Laser-assisted flapless corticotomy caused less pain and discomfort than piezocision.
仅有少数文献报道了与微创骨切开术相关的以患者为中心的结果，因此相关科学证据有限。
本研究旨在评估在上颌尖牙牵引中使用超声骨刀或激光辅助无瓣骨切开术（LAFC）辅助治疗与以患者为中心的结果相关。
32 名患者（19 名女性，13 名男性），平均年龄 18.25±3.05 岁，随机分为两组：LAFC 组（LG；n=16）和超声骨刀组（PG；n=16）。在每组中，手术程序随机分配到上颌弓的一侧，另一侧作为对照。在手术后的第 1 个月，所有患者在 4 个时间点（T1：术后 24 小时；T2：术后 3 天；T3：术后 7 天；T4：术后 14 天）使用数字评分量表（NRS）发放标准化问卷。患者的反应包括疼痛、不适、肿胀、咀嚼困难、下颌运动受限、镇痛药使用和满意度。
在两组中，实验组在 T1 时的疼痛、不适、肿胀和咀嚼困难水平均显著高于对照组（p<0.05）。LG 的疼痛和不适水平明显低于 PG，仅在 T1 时（p=0.013 和 p=0.009），而两组之间在肿胀、咀嚼困难、下颌运动受限和镇痛药使用方面无显著差异。两组患者均报告了较高的满意度，无显著差异。两组患者在无瓣骨切开术后 1 天，疼痛、不适、肿胀、咀嚼困难和下颌运动受限水平均显著降低（p<0.05）。
LAFC 和超声骨刀在 T1 时均与高水平的疼痛、不适、肿胀和咀嚼困难相关。与超声骨刀相比，激光辅助无瓣骨切开术引起的疼痛和不适程度更低。
