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光生物调节疗法对口腔外科手术后下牙槽神经损伤患者神经感觉恢复的疗效:系统评价。

Efficacy of photobiomodulation therapy on neurosensory recovery in patients with inferior alveolar nerve injury following oral surgical procedures: a systematic review.

出版信息

Quintessence Int. 2021;52(2):140-153. doi: 10.3290/j.qi.a45430.

Abstract

OBJECTIVE

The present systematic review aimed to assess the efficacy of photobiomodulation (PBM) therapy on neurosensory recovery of patients with inferior alveolar nerve injury following third molar surgery or dental implant placement.

METHOD AND MATERIALS

An electronic search was carried out in Scopus, Embase, Medline, PubMed, Web of Science, Cochrane Library, and Google Scholar databases. Among 1,122 identified papers, seven articles (three RCTs, one observational study, and three case series) met the inclusion criteria.
Results: Time lapse from nerve injury to the onset of PBM therapy varied widely from 2 days to 4 years. The number of patients in each study ranged between 4 and 74. In the majority of the studies, PBM was done using a diode laser at wavelengths ?in the range of 808 to 830 nm with power of 5 to 500 mW and radiation dose of 3 to 244 J/cm2. Two out of three RCTs found significant neurosensory recovery in the patients who received PBM therapy compared to the controls. The observational study and all case series reported significant improvement in the neurosensory status following PBM therapy. The degree of neurosensory recovery was found to be greater in younger patients and those who received the treatment within 6 months following the injury.
Conclusions: Due to the limited number of well-designed RCTs and small number of patients in each study, it is not possible to make a clear conclusion about the efficacy of PBM therapy on neurosensory recovery in patients with inferior alveolar nerve injury following third molar or implant procedures. Considering the possibility of spontaneous inferior alveolar nerve recovery during this period, the conclusion based on the studies with no control group should be interpreted with caution. (Quintessence Int 2021;52:140-153; doi: 10.3290/j.qi.a45430).

摘要

目的

本系统评价旨在评估光生物调节(PBM)疗法在下颌神经损伤患者第三磨牙手术后或牙种植体放置后神经感觉恢复的疗效。

方法和材料

在 Scopus、Embase、Medline、PubMed、Web of Science、Cochrane 图书馆和 Google Scholar 数据库中进行了电子检索。在 1122 篇已确定的论文中,有 7 篇文章(3 项 RCT、1 项观察性研究和 3 项病例系列研究)符合纳入标准。
结果:从神经损伤到开始 PBM 治疗的时间间隔从 2 天到 4 年不等。每项研究的患者人数从 4 到 74 不等。在大多数研究中,使用二极管激光,波长在 808 到 830nm 之间,功率为 5 到 500mW,辐射剂量为 3 到 244J/cm2。3 项 RCT 中有 2 项发现接受 PBM 治疗的患者在神经感觉恢复方面明显优于对照组。观察性研究和所有病例系列报告了 PBM 治疗后神经感觉状态的显著改善。年轻患者和受伤后 6 个月内接受治疗的患者神经感觉恢复程度更大。
结论:由于设计良好的 RCT 数量有限,且每项研究的患者数量较少,因此无法对 PBM 疗法在下颌神经损伤患者第三磨牙或种植体手术后神经感觉恢复中的疗效得出明确结论。考虑到在此期间下颌神经自发恢复的可能性,没有对照组的研究的结论应谨慎解释。(《牙髓学杂志》2021 年;52:140-153;doi:10.3290/j.qi.a45430)。

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