Fekrazad Reza, Gholami Gholam Ali, Sadr Eshkevari Pooyan, Nokhbatolfoghahaei Hanieh, Mohaghegh Sadra
Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran
International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
Dent Med Probl. 2023 Jul-Sep;60(3):467-472. doi: 10.17219/dmp/147048.
Low-level laser therapy (LLLT) has been applied for the management of craniomaxillofacial disorders, including intraoral wounds, as well as recurrent aphthous stomatitis (RAS) lesions. However, the proper combination of laser features and tissue characteristics remains the major challenge in the realm of photobiomodulation (PBM).
The aim of the present study was to assess the feasibility of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy in treating RAS lesions, and to compare 2 techniques, different with regard to the distance between the fiber tip and the ulcer.
A total of 138 patients (94 males and 44 females) with untreated RAS were divided into 3 groups: focused laser (energy density: 48 J/cm2; power density: 0.797 W/cm2; spot size: 0.1256 cm2); defocused laser (energy density: 21 J/cm2; power density: 0.354 W/cm2; spot size: 0.2826 cm2); and placebo. In the focused group, laser irradiation was performed with the laser tip kept 1 mm away from the lesion. Acrylic cylinders were prepared to precisely fit the handpiece tip and hold it in the proper position. In the defocused group, acrylic cylinders were prepared to set the laser tip 6 mm away from the lesion to obtain defocused irradiation. Finally, in the placebo group, a routine laser therapy procedure was carried out with a helium-neon (He-Ne) red light laser. The lesion size, and pain intensity and duration were recorded.
Photobiomodulation showed a significantly more efficient pain relief as compared to the placebo group (p < 0.001) and also significantly better results in decreasing pain duration (p < 0.001). Besides, the diameter of the lesions in the exposed cases decreased during the 3 consecutive days of the study, while an increase in the diameter of the lesions was noticed in the placebo group.
The Nd:YAG laser therapy, with the conditions and adjustments of the present study, may be successfully applied to manage RAS lesions, using either focused and defocused scanning techniques.
低强度激光疗法（LLLT）已应用于颅颌面疾病的治疗，包括口腔内伤口以及复发性阿弗他口炎（RAS）病变。然而，激光特性与组织特征的恰当组合仍是光生物调节（PBM）领域的主要挑战。
本研究旨在评估掺钕钇铝石榴石（Nd:YAG）激光疗法治疗RAS病变的可行性，并比较两种技术，这两种技术在光纤尖端与溃疡之间的距离方面有所不同。
将138例未经治疗的RAS患者（94例男性和44例女性）分为3组：聚焦激光组（能量密度：48 J/cm²；功率密度：0.797 W/cm²；光斑尺寸：0.1256 cm²）；散焦激光组（能量密度：21 J/cm²；功率密度：0.354 W/cm²；光斑尺寸：0.2826 cm²）；以及安慰剂组。在聚焦组中，激光照射时激光尖端与病变保持1 mm的距离。制备丙烯酸圆柱体以精确适配手持件尖端并将其保持在适当位置。在散焦组中，制备丙烯酸圆柱体以使激光尖端与病变相距6 mm以获得散焦照射。最后，在安慰剂组中，使用氦氖（He-Ne）红光激光进行常规激光治疗程序。记录病变大小、疼痛强度和持续时间。
与安慰剂组相比，光生物调节在缓解疼痛方面显示出显著更高的效率（p < 0.001），并且在缩短疼痛持续时间方面也有显著更好的效果（p < 0.001）。此外，在研究的连续3天内暴露病例的病变直径减小，而安慰剂组中病变直径增大。
在本研究的条件和调整下，Nd:YAG激光疗法可通过聚焦和散焦扫描技术成功应用于管理RAS病变。
