评价激光辅助无瓣皮质切开术加速犬牙内收的疗效：一项分侧随机对照临床试验。
Evaluation of the efficacy of laser-assisted flapless corticotomy in accelerating canine retraction: a split-mouth randomized controlled clinical trial.
机构信息
Department of Orthodontics, University of Damascus Dental School, Damascus, Syria.
Department of Orthodontics, University of Hama Dental School, Hama, Syria.
出版信息
Oral Maxillofac Surg. 2022 Mar;26(1):81-89. doi: 10.1007/s10006-021-00963-x. Epub 2021 Apr 20.
OBJECTIVE
To evaluate the efficacy of laser-assisted flapless corticotomy in the acceleration of canine retraction compared with the conventional technique and to evaluate patients' pain and discomfort levels after corticotomy.
MATERIALS AND METHODS
A single-center randomized controlled trial was conducted on 18 class II division 1 patients (7 males, 11 females; age range: 16 to 24 years) who required the first-upper-premolar extraction followed by canine retraction. A split-mouth design was used in which the Er:YAG laser-assisted flapless corticotomy was randomly allocated to one side, whereas the other side served as the control side. The primary outcome measure was the canine retraction rate which was assessed immediately after laser application, 1, 2, 4, 8, and 12 weeks after laser application. Also, the levels of pain and discomfort during the first week following laser application were assessed. Paired t-tests or Wilcoxon matched-pairs signed-rank tests were used to detect significant differences.
RESULTS
All of the selected eighteen patients entered the statistical analysis stage. Significant differences were observed (P < 0.001) in canine retraction rates between the experimental and control sides at the baseline to 1st-week, 1st- to 2nd-week, 2nd- to 4th-week, and 4th- to 8th-week intervals. No significant difference was found between the two sides at the 8th- to 12th-week interval. A significant reduction was seen in the mean score of pain during eating at all assessment times when compared to the baseline data (P = 0.002 at day 2, P < 0.001 at days 5 and 7).
CONCLUSION
Er:YAG laser-assisted flapless corticotomy appears to be an effective treatment method for accelerating canine retraction and was accompanied by a mild degree of pain and discomfort.
TRIAL REGISTRATION
ClinicalTrials.gov (No.: NCT04316403), retrospectively registered on the 20th of March 2020. URL: https://clinicaltrials.gov/ct2/show/NCT04316403.
目的
评估激光辅助无瓣骨切开术在加速尖牙内收方面的疗效，与传统技术相比，并评估患者在骨切开术后的疼痛和不适水平。
材料和方法
在需要第一上尖牙拔除后进行尖牙内收的 18 名 II 类 1 分类患者（7 名男性，11 名女性；年龄范围：16 至 24 岁）中进行了单中心随机对照试验。采用半口设计，随机分配 Er:YAG 激光辅助无瓣骨切开术到一侧，另一侧作为对照侧。主要观察指标是激光应用后即刻、激光应用后 1、2、4、8 和 12 周的尖牙内收率。同时，评估激光应用后第一周的疼痛和不适程度。使用配对 t 检验或 Wilcoxon 配对符号秩检验来检测显著差异。
结果
所有选择的 18 名患者均进入统计分析阶段。在基线至第 1 周、第 1 周至第 2 周、第 2 周至第 4 周和第 4 周至第 8 周间隔，实验组和对照组的尖牙内收率均存在显著差异（P<0.001）。在第 8 周至第 12 周间隔，两侧之间无显著差异。与基线数据相比，在所有评估时间点，进食时疼痛的平均评分均显著降低（第 2 天 P=0.002，第 5 天和第 7 天 P<0.001）。
结论
Er:YAG 激光辅助无瓣骨切开术似乎是加速尖牙内收的有效治疗方法，且伴有轻度疼痛和不适。
试验注册
ClinicalTrials.gov（编号：NCT04316403），于 2020 年 3 月 20 日进行回顾性注册。网址：https://clinicaltrials.gov/ct2/show/NCT04316403。
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