激光光生物调节作为一种术前组织管理技术，可减少儿童注射疼痛。
The use of laser photobiomodulation as pre-anesthetic tissue management technique in reducing injection pain in children.
机构信息
Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champollion St, Azarita, Alexandria, 21527, Egypt.
出版信息
BMC Oral Health. 2024 Jun 22;24(1):717. doi: 10.1186/s12903-024-04430-3.
BACKGROUND
One of the main goals for pediatric dentists is to offer a painless anesthesia experience. Laser photobiomodulation is among the suggested strategies to decrease injection pain. So, this study aimed to assess the impact of laser photobiomodulation on local anesthesia (LA) injection pain in children and its effect on the efficacy of LA during pulpotomy and SSC procedures.
METHODS
The research was carried out as a randomized controlled clinical trial with two parallel group design. It involved 64 cooperative healthy children, age range from 5 to 7 years, each having at least one maxillary molar indicated for pulpotomy. Children were randomly allocated to one of the two groups based on the pre-anesthetic tissue management technique used: test group received laser photobiomodulation, while control group received topical anesthetic gel. Pain during injection, pulpotomy, and SSC procedures was assessed using physiological measures (Heart Rate (HR)), subjective evaluation (modified Face-Pain-Scale (FPS), and objective analysis (Sound-Eye-Motor scale (SEM)).
RESULTS
A total of 64 children with mean age 6.23 ± 0.78 participated in this research. The mean HR scores were significantly lower in the laser PBM group during buccal and palatal infiltration injections. The SEM mean scores were significantly lower in the laser PBM group during both injections. For the FPS scale, the number of children who recorded satisfaction during injection was significantly higher in laser PBM group. There was no statistically significant difference in mean HR as well as in SEM and FPS scores between the two groups during pulpotomy and SSC procedures. Comparisons between the two study groups were performed using independent samples t- and Mann-Whitney U tests. Significance was set at p value < 0.05.
CONCLUSION
Laser photobiomodulation is a promising non-pharmacological pre-anesthetic tissue management technique in children that offered less painful injection compared to topical anesthetic gel without compromising the effectiveness of LA.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT05861154. Registered on 16/5/2023.
背景
儿科牙医的主要目标之一是提供无痛的麻醉体验。激光光生物调节是减少注射疼痛的建议策略之一。因此，本研究旨在评估激光光生物调节对儿童局部麻醉（LA）注射疼痛的影响及其对牙髓切断术和SSC 手术中 LA 效果的影响。
方法
该研究是一项随机对照临床试验，采用平行组设计。共纳入 64 名合作的健康儿童，年龄 5-7 岁，每个儿童至少有一颗上颌磨牙需要进行牙髓切断术。根据使用的预麻醉组织管理技术，将儿童随机分配到两组之一：实验组接受激光光生物调节，对照组接受局部麻醉凝胶。使用生理指标（心率（HR））、主观评估（改良面部疼痛量表（FPS））和客观分析（声音-眼-运动量表（SEM））评估注射、牙髓切断术和 SSC 手术过程中的疼痛。
结果
共有 64 名平均年龄为 6.23±0.78 岁的儿童参与了这项研究。在颊侧和腭侧浸润注射时，激光 PBM 组的平均 HR 评分显著降低。在两次注射中，激光 PBM 组的 SEM 平均评分均显著降低。对于 FPS 量表，在注射过程中记录满意度的儿童数量，激光 PBM 组显著更高。在牙髓切断术和 SSC 手术过程中，两组之间的平均 HR 以及 SEM 和 FPS 评分均无统计学差异。使用独立样本 t 检验和 Mann-Whitney U 检验对两组进行比较。p 值<0.05 时具有统计学意义。
结论
与局部麻醉凝胶相比，激光光生物调节是一种有前途的非药物预麻醉组织管理技术，可为儿童提供更无痛的注射，同时不影响 LA 的效果。
试验注册
ClinicalTrials.gov 标识符：NCT05861154。于 2023 年 5 月 16 日注册。
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