Khwanda Mohamed Abdulkarim, Burhan Ahmad S, Hajeer Mohammad Y, Ajaj Mowaffak A, Parker Steven, Nawaya Fehmieh R, Hamadah Omar
Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR.
Department of Oral Medicine and Radiology, Leicester School of Pharmacy, De Montfort University, Leicester, GBR.
Cureus. 2022 Jun 13;14(6):e25897. doi: 10.7759/cureus.25897. eCollection 2022 Jun.
Despite the positive effect of the photobiomodulation therapy (PBMT) application on animals, the primary role of this technique on the human condyle is still unclear. Several experimental reports have shown the efficacy of PBMT in inducing cellular changes in the temporomandibular joint (TMJ) region during functional treatment of patients with skeletal deformities. Still, the lack of information about its effects on human condyles requires further studies.
This study aimed to evaluate the effect of PBMT on the TMJ components following Class III treatment with the reversed twin block (RTB) appliance in growing patients. Materials and Method: Forty children (12 females, 28 males) between the age of nine and eleven years with skeletal Class III were assigned randomly to the RTB group with photobiomodulation (RTB+PBMT) or the control group (RTB). The PBMT was applied to the TMJ region using an 808-nm wavelength Ga-Al-As semiconductor laser device with 5 Joules/cm energydensity on days 1, 3, 7, and 14 of the first month. Afterwards, the irradiation was conducted every 15 days until the end of the treatment. Cone-beam computerized tomography (CBCT) images were taken before (T1) treatment and following the end of treatment (T2) to assess TMJ and skeletal changes.
Condylar volume was significantly increased in the RTB group only by a mean of 287.97 mm (p<0.001). The significantly backward and upward condylar movement was observed in the RTB and RTB+PBMT groups (superior joint space (SJS): 0.26 mm, 0.15 mm; posterior joint space (PJS): 0.42mm, 0.11mm, respectively). The RTB group showed the most remarkable changes. Significant improvement of the sagittal maxilla-mandibular relationship was greater in the RTB+PBMT group compared to the RTB group (p=0.02).
There were no considerable differences in the condylar position after Class III treatment between the RTB and the RTB+PBMT groups. But a difference in the condylar volume was noticed between the two group.
尽管光生物调节疗法（PBMT）在动物实验中有积极作用，但其对人类髁突的主要作用仍不明确。一些实验报告显示，在对骨骼畸形患者进行功能治疗期间，PBMT在诱导颞下颌关节（TMJ）区域细胞变化方面具有疗效。然而，关于其对人类髁突影响的信息匮乏，仍需进一步研究。
本研究旨在评估在生长发育期患者中，采用反向双阻板矫治器（RTB）进行III类错颌治疗后，PBMT对TMJ各组成部分的影响。
将40名年龄在9至11岁之间的骨骼III类错颌儿童（12名女性，28名男性）随机分为接受光生物调节的RTB组（RTB+PBMT）或对照组（RTB）。在第一个月的第1、3、7和14天，使用波长为808nm、能量密度为5焦耳/平方厘米的Ga-Al-As半导体激光装置对TMJ区域进行PBMT治疗。此后，每15天进行一次照射，直至治疗结束。在治疗前（T1）和治疗结束后（T2）拍摄锥形束计算机断层扫描（CBCT）图像，以评估TMJ和骨骼变化。
仅RTB组的髁突体积显著增加，平均增加287.97立方毫米（p<0.001）。在RTB组和RTB+PBMT组中均观察到髁突明显向后上方移动（上关节间隙（SJS）：分别为0.26毫米、0.15毫米；后关节间隙（PJS）：分别为0.42毫米、0.11毫米）。RTB组的变化最为显著。与RTB组相比，RTB+PBMT组矢状位上颌-下颌关系的显著改善更为明显（p=0.02）。
RTB组和RTB+PBMT组在III类错颌治疗后髁突位置上没有显著差异。但两组在髁突体积上存在差异。
