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光生物调节对牙种植体植入后骨密度影响的评估:一项使用锥形束CT分析的初步研究。

Evaluation of the Effects of Photobiomodulation on Bone Density After Placing Dental Implants: A Pilot Study Using Cone Beam CT Analysis.

作者信息

Luca Ruxandra-Elena, Del Vecchio Alessandro, Munteanu Ioana-Roxana, Margan Mădălin-Marius, Todea Carmen Darinca

机构信息

Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.

Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, Revolutiei 1989 Avenue No. 9, 300070 Timisoara, Romania.

出版信息

Clin Pract. 2025 Mar 17;15(3):64. doi: 10.3390/clinpract15030064.

DOI:10.3390/clinpract15030064
PMID:40136600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11941610/
Abstract

One of the parameters of maximum interest regarding the quality of the intraoral hard tissues is represented by the bone density, with direct clinical implications. The evaluation of this extremely important clinical parameter can be achieved by several imaging methods, of which the most known in dentistry is represented by the cone beam computed tomography (CBCT). : The purpose of the study is to obtain a quantitative analysis of bone mineral density changes in patients who underwent treatments of photobiomodulation (PBM), as complementary to a surgical approach in oral surgery and implantology. The study included the retrospective analysis of maxillary cone beam computed tomography of 28 patients without pathology or medication known to affect bone metabolism or its qualitative and quantitative properties. All patients from the study group followed the same laser PBM treatment protocol after placing dental implants; the PBM protocol implied the intraoral use of a gallium aluminum arsenide laser (GaAlAs) of 808 nm, 450 mW, in pulsed mode, administering an energy of 6 J in 3 points corresponding to each inserted dental implant-mesial, distal, and apical-totaling 18 J/implant. Treatment sessions were performed immediately postoperatively and at a subsequent distance of 48 h for 2 weeks (a total of eight sessions). For every patient, bone density was analyzed before and after PBM treatment, in the same areas of interest, within the same anatomical landmarks. A comparison was also made between the results obtained for the anterior maxilla and the posterior maxilla. All the measurements made were analyzed statistically, the results being presented in the dedicated section. Based on the data analysis, the comparison between the lasered and non-lasered groups reveals that patients who underwent PBM showed a statistically significant improvement in bone mineral density, with the mean increasing from 530.91 HU before treatment to 842.55 HU after treatment (-test: < 0.001). In contrast, the non-lasered group showed no significant improvement, with a slight decrease in bone mineral density, as the mean dropped from 495.19 HU before treatment to 462.16 HU after treatment (-test: = 0.47). The study demonstrated results with statistical significance regarding the mineral bone density improvement of patients who underwent laser PBM treatment. This positive effect of laser therapy has been shown, both at the level of the vestibular cortical bone and at level of the trabecular bone, independent of the patient's sex, for the anterior maxilla and at the lateral areas also.

摘要

关于口腔内硬组织质量最受关注的参数之一是骨密度,它具有直接的临床意义。对这一极其重要的临床参数的评估可以通过多种成像方法实现,其中在牙科领域最广为人知的是锥形束计算机断层扫描(CBCT)。本研究的目的是对接受光生物调节(PBM)治疗的患者的骨矿物质密度变化进行定量分析,作为口腔外科和种植牙学手术方法的补充。该研究包括对28例无已知影响骨代谢或其质和量特性的病理或药物治疗的患者的上颌锥形束计算机断层扫描进行回顾性分析。研究组的所有患者在植入牙种植体后均遵循相同的激光PBM治疗方案;PBM方案意味着在口腔内使用波长808 nm、功率450 mW的砷化镓铝激光(GaAlAs),采用脉冲模式,在对应于每个植入牙种植体的三个点(近中、远中及根尖)给予6 J的能量,每个种植体总计18 J。治疗在术后立即进行,并在随后的48小时间隔内进行,共两周(总共八次治疗)。对于每位患者,在相同的解剖标志内,在相同的感兴趣区域,在PBM治疗前后分析骨密度。还对上颌前部和后部获得的结果进行了比较。对所有测量结果进行统计学分析,结果在专门部分呈现。基于数据分析,激光治疗组和未激光治疗组的比较显示,接受PBM治疗的患者骨矿物质密度有统计学意义的改善,平均值从治疗前的530.91 HU增加到治疗后的842.55 HU(t检验:P < 0.001)。相比之下,未激光治疗组没有显著改善,骨矿物质密度略有下降,平均值从治疗前的495.19 HU降至治疗后的462.16 HU(t检验:P = 0.47)。该研究证明了接受激光PBM治疗的患者在骨矿物质密度改善方面具有统计学意义的结果。激光治疗的这种积极效果在前上颌骨的前庭皮质骨水平和小梁骨水平均已显示,且与患者性别无关,在上颌前部和外侧区域也是如此。

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