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铒:YAG 激光治疗下颌第三磨牙术后牙槽突炎:一项随机对照临床研究。

Er:YAG Laser Therapy on Alveolar Osteitis After Mandibular Third Molar Surgery: A Randomized Controlled Clinical Study.

机构信息

Department of Stomatology, Peking University International Hospital, Beijing, China.

出版信息

Photobiomodul Photomed Laser Surg. 2024 Mar;42(3):238-245. doi: 10.1089/photob.2023.0151. Epub 2024 Feb 28.

Abstract

Alveolar osteitis (AO) or "dry socket" affects the quality of life of patients, and there is a high clinical demand for its effective treatment. To evaluate the effect of Er:YAG laser therapy (ErLT) on AO after mandibular third molar surgery. Eighty-three patients were randomly divided into Er ( = 43) and control groups ( = 40). In the Er group, the Er:YAG laser (2940 nm; AT Fidelis Fotona, Ljubljana, Slovenia) was used to irradiate the AO site directly in micro short-pulsed mode (pulse duration 0.1 ms, pulse energy 100 mJ, frequency 40 Hz, water 4, and air 2) until all debris and necrotic material had been removed, exposing fresh bone and soft tissue surfaces with blood exudation. The control group received mechanical therapy until the treated lesions resembled those in the Er group. Pain assessment was performed at baseline and on days 1-7 post-intervention using the visual analog scale (VAS). Wound healing was assessed using the wound healing index (WHI). The operating times of the two therapies were also recorded. Group Er had lower VAS scores than the control group on days 1-3 ( = 0.00). There was no significant difference between the two groups on days 4-7 ( = 0.15). The WHI scores were better in the Er group than those in the control group ( = 2.65,  = 0.01), especially in terms of redness ( = 2.70,  = 0.01). There was no significant difference in the operating time between the two groups ( = 0.76,  = 0.45). Compared with mechanical therapy, ErLT for AO provides rapid pain relief and improved wound healing.

摘要

牙槽突炎(AO)或“干槽症”会影响患者的生活质量,临床对其有效治疗的需求很高。评估 Er:YAG 激光治疗(ErLT)在下颌第三磨牙手术后对 AO 的疗效。83 名患者被随机分为 Er 组( = 43)和对照组( = 40)。在 Er 组中,使用 Er:YAG 激光(2940nm;AT Fidelis Fotona,卢布尔雅那,斯洛文尼亚)直接以微短脉冲模式(脉冲持续时间 0.1ms,脉冲能量 100mJ,频率 40Hz,水 4,空气 2)照射 AO 部位,直到所有的碎片和坏死组织被清除,露出有血液渗出的新鲜骨和软组织表面。对照组接受机械治疗,直到治疗后的病变与 Er 组相似。在干预后第 1-7 天使用视觉模拟量表(VAS)评估疼痛程度。使用伤口愈合指数(WHI)评估伤口愈合情况。还记录了两种治疗方法的手术时间。在第 1-3 天,Er 组的 VAS 评分低于对照组( = 0.00)。在第 4-7 天,两组间无显著差异( = 0.15)。Er 组的 WHI 评分优于对照组( = 2.65, = 0.01),尤其是在红肿方面( = 2.70, = 0.01)。两组手术时间无显著差异( = 0.76, = 0.45)。与机械治疗相比,ErLT 治疗 AO 可迅速缓解疼痛,促进伤口愈合。

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