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光生物调节疗法对下颌神经损伤的疗效:系统评价和荟萃分析。

The effectiveness of photobiomodulation therapy on inferior alveolar nerve injury: A systematic review and META-analysis.

机构信息

Department of Oral and Maxillofacial Surgery, Dalian Stomatological Hosipital, Dalian City, Liaoning Province, China.

Department of Implantation, Dalian Stomatological Hosipital, Dalian City, Liaoning Province, China.

出版信息

PLoS One. 2023 Aug 10;18(8):e0287833. doi: 10.1371/journal.pone.0287833. eCollection 2023.

Abstract

OBJECTIVE

The aim of this META-analysis was to evaluate the efficacy of photobiomodulation (PBM) therapy in the treatment of inferior alveolar nerve (IAN) injury due to orthognathic surgeries, extraction of impacted third molars and mandibular fractures.

METHODS AND MATERIALS

A electric search was conducted by a combination of manual search and four electric databases including Pubmed, Embase, Cochrane library and Web of Science, with no limitation on language and publication date. Gray literature was searched in ClinicalTrials.gov and googlescholar. All retrieved articles were imported into ENDNOTE software (version X9) and screened by two independent reviewers. All analysis was performed using the REVMAN software (version 5.3).

RESULTS

Finally, 15 randomized controlled trials met the inclusion criteria for qualitative analysis and 14 for META-analysis from 219 articles. The results showed that PBM therapy had no effect on nerve injury in a short period of time (0-48h, 14 days), but had significant effect over 30 days. However, the effect of photobiomodulation therapy on thermal discrimination was still controversial, most authors supported no significant improvement. By calculating the effective rate of PBM, it was found that there was no significant difference in the onset time of treatment, whether within or over 6 months.

CONCLUSIONS

The results of this META-analysis show that PBM therapy is effective in the treatment of IAN injures no matter it begins early or later. However, due to the limited number of well-designed RCTs and small number of patients in each study, it would be necessary to conduct randomized controlled trials with large sample size, long follow-up time and more standardized treatment and evaluation methods in the future to provide more accurate and clinically meaningful results.

摘要

目的

本荟萃分析旨在评估光生物调节(PBM)疗法治疗正颌手术、阻生第三磨牙拔除和下颌骨骨折引起的下牙槽神经(IAN)损伤的疗效。

方法和材料

通过手动搜索和四个电子数据库(Pubmed、Embase、Cochrane 图书馆和 Web of Science)的组合进行电子搜索,不限制语言和出版日期。在 ClinicalTrials.gov 和 googlescholar 中搜索灰色文献。将所有检索到的文章导入 ENDNOTE 软件(版本 X9),并由两名独立评审员进行筛选。所有分析均使用 REVMAN 软件(版本 5.3)进行。

结果

最终,从 219 篇文章中,有 15 项随机对照试验符合定性分析的纳入标准,有 14 项符合荟萃分析的纳入标准。结果表明,PBM 治疗在短时间内(0-48 小时,14 天)对神经损伤没有影响,但在 30 天以上有显著效果。然而,光生物调节治疗对热觉辨别力的影响仍存在争议,大多数作者认为没有显著改善。通过计算 PBM 的有效率,发现治疗开始时间无论是在 6 个月内还是超过 6 个月,都没有显著差异。

结论

本荟萃分析的结果表明,无论开始治疗的时间是早是晚,PBM 疗法对 IAN 损伤都是有效的。然而,由于设计良好的 RCT 数量有限,且每项研究的患者数量较少,未来有必要开展更大样本量、更长随访时间和更标准化的治疗和评估方法的随机对照试验,以提供更准确和具有临床意义的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0bd/10414610/78d68cc10bd6/pone.0287833.g001.jpg

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