Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pediatric Dentistry, School of Dentistry, Qazvin University of Medical Sciences, Tehran, Iran.
Lasers Med Sci. 2024 Jun 3;39(1):148. doi: 10.1007/s10103-024-04096-x.
In pediatric dentistry, complications arising from extended soft tissue anesthesia can negatively impact patient comfort and trust in dental care. This study evaluates the clinical efficacy of diode laser-based photobiomodulation therapy (PBMT) in expediting the resolution of anesthesia in children aged 6-9 receiving inferior alveolar nerve block (IANB) injections. In this split-mouth double-blind randomized clinical trial, 36 pediatric subjects aged 6-9, requiring pulpotomy procedures on both sides of the mandible, received IANBs (single cartridge of 2% lidocaine/1:100,000 epinephrine). PBMT and sham laser were alternately applied to each side of the mandible, in two separate sessions, with the envelope method determining treatment allocation and intervention side on the first treatment day. During the laser session, laser (808 nm, 250 mW, 23s continuous, 0.5 cm², 11.5 J/cm², direct contact) irradiated two points at the injection site, five intra-oral and five extra-oral points along the infra-alveolar nerve's pathway. Soft tissue anesthesia reversal was quantified through tactile assessment. Soft tissue trauma was also assessed by the researcher and reported by parents 24 h post-dental visit. All data were analyzed using IBM SPSS Statistics v25.0 via Paired T-test, two-way repeated measures ANOVA, and McNemar's test. The laser group exhibited a mean lip anesthesia duration of 122.78 ± 2.26 min, while the sham laser group experienced 134.44 ± 21.8 min, indicating an 11.66-minute reduction in anesthesia duration for the laser group. (P < 0.001) Soft tissue trauma occurred in two sham laser group patients and one laser group patient, with no significant difference. (P = 1) The findings indicate that employing laser with defined parameters can reduce the length of IANB-induced anesthesia.
在儿童牙科中,由于软组织麻醉时间延长而引起的并发症可能会影响患者对牙科护理的舒适度和信任度。本研究评估了二极管激光光生物调节疗法(PBMT)在加速接受下颌神经阻滞(IANB)注射的 6-9 岁儿童麻醉消退方面的临床疗效。在这项分割口腔的双盲随机临床试验中,36 名 6-9 岁需要在下颌骨两侧进行牙髓切断术的儿科患者接受了 IANB(2%利多卡因/1:100,000 肾上腺素,单个小瓶)。PBMT 和假激光以信封法确定治疗分配和干预侧,在第一天的两个单独疗程中交替应用于下颌骨的两侧。在激光治疗过程中,激光(808nm,250mW,23s 连续,0.5cm²,11.5J/cm²,直接接触)在注射部位照射两点,沿下牙槽神经路径在五个口腔内和五个口腔外点照射。通过触觉评估来量化软组织麻醉的逆转。研究者还评估了软组织创伤,并在牙科就诊后 24 小时由家长报告。所有数据均使用 IBM SPSS Statistics v25.0 通过配对 T 检验、双向重复测量方差分析和 McNemar 检验进行分析。激光组的唇部麻醉持续时间平均为 122.78±2.26 分钟,而假激光组为 134.44±21.8 分钟,表明激光组的麻醉持续时间缩短了 11.66 分钟。(P<0.001)假激光组有两名患者和激光组有一名患者发生了软组织创伤,但无显著差异。(P=1)研究结果表明,使用具有明确参数的激光可以减少 IANB 诱导麻醉的持续时间。