Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil.
Universidade Paulista, Faculdade de Odontologia, Departamento de Cirurgia, Goiânia, Brasil.
Acta Odontol Latinoam. 2022 Apr 30;35(1):31-38. doi: 10.54589/aol.35/1/31.
The aim of this study was to test two low-level laser therapy protocols by evaluating pain control, swelling and trismus in the postoperative period of lower third molar surgeries. This was a randomized, double-blind, placebo-controlled, crossover trial. Patients presenting two symmetrically impacted mandibular third molars were included. One side was randomly assigned for LLLT applied immediately after surgery (T1) and then after 24 (T2) and 48 hours (T3) (Protocol A). The other side received LLLT applied immediately after surgery and placebo after 24 and 48 hours (Protocol B). LLLT was given by intraoral application (660nm, 5 J/cm2, 10 s, 20 mW, 4 points) followed by extraoral application (789 nm, 30 J/cm2, 20 s, 60 mW, 8 points). The placebo application was similar to that of the experimental side but with laser simulation. The primary outcomes were pain control, swelling and trismus intensity at T1, T2, T3 and 7 days after surgery (T4). Data were analyzedbyANOVArepeated measures and Wilcoxon test (p<.05). The final sample consisted of 21 patients (42 teeth). There were no statistical differences for pain level between protocols A and B over time (p= .909), although the amount of analgesic medication was lower with protocol A at T2 (p=.022). There were no differences in swelling (p=.958) or trismus (p=.837) between the protocols used over time. Both protocols performed similarly for pain control, swelling and trismus. Therefore, for practical reasons, a single laser application in the immediate postoperative period could be indicated for the management of postoperative discomfort in lower third molar surgery.
本研究旨在通过评估下颌第三磨牙手术后的疼痛控制、肿胀和牙关紧闭情况，测试两种低水平激光疗法方案。这是一项随机、双盲、安慰剂对照、交叉试验。纳入了具有双侧对称埋伏下颌第三磨牙的患者。一侧随机分配接受术后即刻应用低水平激光疗法（T1），然后在 24 小时（T2）和 48 小时（T3）时应用（方案 A）。另一侧接受术后即刻应用低水平激光疗法和 24 小时和 48 小时时应用安慰剂（方案 B）。低水平激光疗法通过口腔内应用（660nm，5 J/cm2，10s，20mW，4 点）和口腔外应用（789nm，30J/cm2，20s，60mW，8 点）进行。安慰剂应用与实验组相似，但采用激光模拟。主要结局是在术后即刻（T1）、24 小时（T2）、48 小时（T3）和 7 天（T4）时疼痛控制、肿胀和牙关紧闭的严重程度。采用重复测量方差分析和 Wilcoxon 检验进行数据分析（p<.05）。最终样本包括 21 例患者（42 颗牙）。在方案 A 和 B 之间，随着时间的推移，疼痛水平没有统计学差异（p=.909），尽管在 T2 时方案 A 应用的镇痛药剂量较低（p=.022）。在肿胀（p=.958）或牙关紧闭（p=.837）方面，两种方案之间没有差异。随着时间的推移，两种方案在疼痛控制、肿胀和牙关紧闭方面表现相似。因此，出于实际原因，在术后即刻单次应用激光可能是下颌第三磨牙手术术后不适管理的一种选择。
