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评价激光辅助活髓治疗术治疗未成熟恒牙术后不适的光生物调节作用:一项初步的回顾性研究。

Evaluation of photobiomodulation for postoperative discomfort following laser-assisted vital pulp therapy in immature teeth: A preliminary retrospective study.

机构信息

Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, Poland.

Department of Dental Surgery, Wroclaw Medical University, Poland.

出版信息

Adv Clin Exp Med. 2024 Jul;33(7):709-716. doi: 10.17219/acem/171812.

Abstract

BACKGROUND

Minimally invasive endodontics is recommended for young, immature teeth to preserve healthy pulp and dentin tissue.

OBJECTIVES

The aim of the study was to examine the cold sensitivity of immature teeth that received photobiomodulation (PBM) after vital pulp therapy (VPT).

MATERIAL AND METHODS

The study followed the STROBE guidelines and included 123 healthy patients aged 8-13. The immature teeth (incisors, premolars and molars) that qualified for VPT received the bioceramic material - Biodentine. In this experiment, teeth were treated immediately and at 24 h post-VPT with a 635-nm diode laser using a power of 100 mW, a power density of 200 mW/cm2 and a total energy of 4 J (PBM group, n = 43), while those not treated were the control group (n = 43). The tooth sensitivity to cold was measured using a visual analogue scale (VAS) before and at 6 h, 1 day, 7, 30, and 90 days after treatment. The predictor variable was PBM skills regarding the ability to decrease cold sensitivity after VPT. The primary endpoint was the time to reverse hypersensitivity to cold, and the secondary endpoint was the occurrence of possible side effects. The Mann-Whitney U test, Friedman test along with Dunn's post hoc test, and the χ2 test were used to investigate tooth sensitivity.

RESULTS

Eighty-six immature permanent teeth of 86 children were included in the study. It was shown that the difference was significant for sensitivity to a cold stimulus between the groups at 6 h, 24 h, 7 days, and 30 days, but no difference was found preoperatively and at 90 days (6 h, 24 h, 7 days, and 30 days, p < 0.001, and 90 days, p = 0.079). However, patients in both groups reported a decrease in discomfort provoked by cold stimuli throughout the follow-up period.

CONCLUSIONS

Photobiomodulation decreased postoperative sensitivity and was more acceptable for patients. Further randomized clinical studies with placebo-controlled groups are needed.

摘要

背景

微创牙髓治疗推荐用于年轻、未成熟的牙齿,以保存健康的牙髓和牙本质组织。

目的

本研究旨在检查活髓治疗(VPT)后接受光生物调节(PBM)的未成熟牙的冷敏感性。

材料和方法

本研究遵循 STROBE 指南,纳入 8-13 岁的 123 名健康患者。符合 VPT 条件的未成熟牙(切牙、前磨牙和磨牙)接受生物陶瓷材料-Biodentine 治疗。在本实验中,牙齿在 VPT 后即刻和 24 小时用 635nm 二极管激光处理,功率为 100mW,功率密度为 200mW/cm2,总能量为 4J(PBM 组,n=43),而未处理的牙齿为对照组(n=43)。使用视觉模拟量表(VAS)在治疗前和治疗后 6 小时、1 天、7 天、30 天和 90 天测量牙齿对冷的敏感性。预测变量为 PBM 技能,以评估其在 VPT 后降低冷敏感性的能力。主要终点是逆转冷敏感的时间,次要终点是可能出现的副作用。使用 Mann-Whitney U 检验、Friedman 检验加 Dunn 事后检验和 χ2 检验来研究牙齿敏感性。

结果

本研究纳入了 86 名儿童的 86 颗未成熟恒牙。结果表明,在治疗后 6 小时、24 小时、7 天和 30 天,两组对冷刺激的敏感性差异有统计学意义,但在术前和 90 天差异无统计学意义(6 小时、24 小时、7 天和 30 天,p<0.001,90 天,p=0.079)。然而,两组患者在整个随访期间都报告了冷刺激引起的不适程度降低。

结论

光生物调节降低了术后敏感性,且更受患者接受。需要进一步开展随机临床试验,并设立安慰剂对照组。

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