Sharma Sneha D, Vidya B, Gupta Ashish, Bansal Pankaj, Gupta Himani, Dahiya Prashant
Department of Oral & Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences Research, Sector 89, kheri more, Faridabad, Haryana 121002 India.
Department of Oral & Maxillofacial Surgery, Oxford Dental College, Bommanahalli, Bangalore, India.
J Maxillofac Oral Surg. 2025 Feb;24(1):279-285. doi: 10.1007/s12663-022-01759-6. Epub 2022 Jul 12.
To compare the effects of cryotherapy and LLLT in minimizing edema, post-operative pain, trismus and post-operative discomfort after surgical removal of impacted mandibular third molars under local anesthesia.
80 patients between the ages 18-50 years of either gender fulfilling the inclusion criteria were selected for the randomized, prospective, single-blind clinical trial. Bilaterally symmetrical mandibular impacted third molars were selected for the study and randomly designated into two groups (Group 1- LLLT, Group 2- CRYOTHERAPY) each. Along with pain, trismus and swelling, POSSe (post-symptom severity scale) was used for assessment of postoperative discomfort throughout the 7 days.
Pain and swelling scores were generally better in cryotherapy group when compared to LLLT Group, specifically in first 3 postoperative days. However, trismus in first 3 postoperative days was significantly less in LLLT group than in the cryotherapy group. Postoperative mouth opening exhibited a reduction of 3.60% in the laser group, where LLLT irradiation was done, whereas in the cryotherapy group, it was much larger, around 17.96%. On evaluating the POSSe, in LLLT group, mostly patients reported that they were affected in enjoyment of food, approximately 40% more than cryotherapy group.
The mechanism of action and result outcomes for cryotherapy and LLLT has the potential to improve the quality of patient care provided by vast majority of clinicians in third molar surgery but when compared pain and swelling were better controlled with cryotherapy and trismus was better dealt with LLLT.
比较冷冻疗法和低强度激光疗法在局部麻醉下手术拔除下颌阻生第三磨牙后减轻水肿、术后疼痛、牙关紧闭和术后不适方面的效果。
选择80名年龄在18 - 50岁之间、符合纳入标准的男女患者进行随机、前瞻性、单盲临床试验。选择双侧对称的下颌阻生第三磨牙进行研究,并随机分为两组(第1组 - 低强度激光疗法,第2组 - 冷冻疗法)。除疼痛、牙关紧闭和肿胀外,使用症状后严重程度量表(POSSe)在7天内评估术后不适情况。
与低强度激光疗法组相比,冷冻疗法组的疼痛和肿胀评分总体上更好,特别是在术后的前3天。然而,术后第1至3天,低强度激光疗法组的牙关紧闭情况明显少于冷冻疗法组。在进行低强度激光疗法照射的激光组中,术后开口度降低了3.60%,而在冷冻疗法组中,降低幅度更大,约为17.96%。在评估POSSe时,在低强度激光疗法组中,大多数患者报告他们在享受食物方面受到影响,比冷冻疗法组多约40%。
冷冻疗法和低强度激光疗法的作用机制和结果有可能改善绝大多数临床医生在第三磨牙手术中提供的患者护理质量,但相比之下,冷冻疗法对疼痛和肿胀的控制更好,而低强度激光疗法对牙关紧闭的处理更好。