光生物调节治疗干槽症的随机对照试验
Photobiomodulation for Managing "Dry Socket": A Randomised Controlled Trial.
机构信息
Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
Department of General Dental Practice, Kuwait University, Safat, Kuwait.
出版信息
Int Dent J. 2023 Apr;73(2):267-273. doi: 10.1016/j.identj.2022.06.002. Epub 2022 Jul 5.
OBJECTIVE
There are no studies that have evaluated the effect of Alveogyl with and without adjunct photobiomodulation therapy (PBMT) in reducing self-rated post-operative pain (SPP) in patients with alveolar osteitis (AO; dry socket). The aim of the present randomised controlled trial was to assess the effectiveness of Alveogyl with and without PBMT for the management of SPP in patients with AO.
METHODS
Adult nonsmokers with diagnosed AO were included. Patients were randomly divided into 4 groups. In Group 1, patients underwent mechanical curettage (MC) with copious normal saline irrigation. In Group 2, patients underwent MC + Alveogyl dressings in extraction sites which were changed every 48 hours until cessation of pain. In Group 3, patients underwent MC + Alveogyl followed by PBMT using a 660-nm indium-gallium-aluminum-phosphide diode laser. In Group 4, patients were treated solely with PBMT. The visual analogue scale was used up to 3 postoperative days to assess SPP up to 3 days at 6- (T0) and 12-hour (T1) intervals. Statistical analyses were performed using the analysis of variance and Bonferroni post hoc adjustment tests. Correlation between SPP scores and age, sex, and eruption status of teeth was assessed using logistic regression models. P values <.01 were nominated as being statistically significant.
RESULTS
In all, 14, 13, 14, and 14 individuals with AO were included in groups 1, 2, 3 and 4, respectively. All patients had undergone extraction of mandibular third molars. At baseline and on day 1, there was no difference in SPP in all groups. On days 2 and 3, mean visual analogue scale (VAS) scores at T1 (P < .01) and T2 (P < .01) intervals were significantly high in Group 2 compared with Group 3. On days 2 and 3, mean VAS scores at T1 (P < .01) and T2 (P < .01) intervals were significantly high in Group 4 compared with Group 3. There was no difference in SPP in groups 3 and 4 on day 3 at T0 and T1 intervals.
CONCLUSIONS
PBMT following MC and Alveogyl dressing is more efficient in reducing SPP compared with MC with or without Alveogyl dressing in patients with AO.
目的
目前尚无研究评估使用和不使用光生物调节疗法（PBMT）的艾维格（Alveogyl）在减轻牙槽突炎（AO；干槽症）患者术后自评疼痛（SPP）中的作用。本随机对照试验旨在评估使用和不使用 PBMT 的艾维格治疗 AO 患者 SPP 的效果。
方法
纳入患有确诊 AO 的成年非吸烟者。患者被随机分为 4 组。在第 1 组中，患者接受机械刮除术（MC）并用大量生理盐水冲洗。在第 2 组中，患者在拔牙部位接受 MC+艾维格膏治疗，每 48 小时更换一次，直至疼痛停止。在第 3 组中，患者在 MC 后接受 PBMT，使用 660nm 铟镓铝磷二极管激光。第 4 组仅接受 PBMT 治疗。在术后 3 天内使用视觉模拟量表（VAS）评估 SPP，在术后 6 小时（T0）和 12 小时（T1）时评估 SPP。使用方差分析和 Bonferroni 事后调整检验进行统计分析。使用逻辑回归模型评估 SPP 评分与年龄、性别和牙齿萌出状态之间的相关性。P 值<.01 被认为具有统计学意义。
结果
第 1、2、3 和 4 组分别纳入了 14、13、14 和 14 名患有 AO 的患者。所有患者均接受下颌第三磨牙拔除术。在基线和第 1 天，所有组的 SPP 均无差异。在第 2 和第 3 天，T1（P<.01）和 T2（P<.01）间隔的 VAS 评分均值在第 2 组中明显高于第 3 组。在第 2 和第 3 天，T1（P<.01）和 T2（P<.01）间隔的 VAS 评分均值在第 4 组中明显高于第 3 组。在第 3 天的 T0 和 T1 间隔，第 3 组和第 4 组的 SPP 无差异。
结论
与 AO 患者接受 MC 加或不加艾维格治疗相比，MC 加艾维格治疗后加用 PBMT 可更有效地降低 SPP。
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