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接受常规牙科治疗的老年患者的激光介导止血

Laser-Mediated Hemostasis for Older Patients Receiving Routine Dental Treatment.

作者信息

Tanya Suwat, Prajaneh Saengsome, Patcharanuchat Piyachat, Sattayut Sajee

机构信息

Graduate School, Faculty of Dentistry, Khon Kaen University, Khon Kaen 40002, Thailand.

Lasers in Dentistry Research Group, Khon Kaen University, Khon Kaen 40002, Thailand.

出版信息

Dent J (Basel). 2025 Jul 11;13(7):315. doi: 10.3390/dj13070315.

Abstract

Laser therapy has gained attention in dental practice to minimize bleeding and enhance blood clot formation. This study aimed to explore the utilization and to compare the clinical efficacy of laser-mediated hemostasis for older patients receiving routine dental treatment. A prospective observational study was conducted across research networks between October 2023 and August 2024, involving 60 patients aged 50 years and older (average = 63.35 years) at risk of postoperative bleeding following dental treatments. Additionally, laser therapy for hemostasis was selected and provided among calibrated operators. A single researcher performed data collection. Before statistical analysis, data verification and clinical assessment were conducted by the operators and researcher. A clinical cut-off for hemostasis was set at 5 min. Two diode laser machines were used namely, an 810 nm and dual wavelengths of 635 nm and 980 nm. There were 94 extraction sockets, 28 procedures of scaling and root planing and 18 procedures of minor oral surgery. Combining laser ablating sulcular fiber and photobiomodulation initiating blood clot formation was a preferable hemostatic technique for extraction socket, while photobiomodulation alone was a preferred technique for soft tissue hemostasis ( < 0.001). All operators confirmed that 97.86 percent of bleeding events achieved more rapid hemostasis. 61.43 percent of bleeding events clinically achieved hemostasis within 5 min by using laser-mediated hemostasis alone ( = 0.092). Full recovery of the extraction socket was significantly observed during the 2- to 4-week follow-up period ( = 0.005). No clinical complications were reported. Laser-mediated hemostasis effectively reduced hemostatic duration, prevented postoperative bleeding and promoted wound healing in older patients undergoing routine dental treatment.

摘要

激光治疗在牙科实践中已受到关注,可减少出血并促进血凝块形成。本研究旨在探讨老年患者接受常规牙科治疗时激光介导止血的应用情况,并比较其临床疗效。2023年10月至2024年8月在多个研究网络中开展了一项前瞻性观察性研究,纳入60例年龄在50岁及以上(平均年龄 = 63.35岁)、牙科治疗后有术后出血风险的患者。此外,在经过校准的操作人员中选择并提供激光止血治疗。由一名研究人员进行数据收集。在进行统计分析之前,由操作人员和研究人员进行数据核查和临床评估。将止血的临床截止时间设定为5分钟。使用了两台二极管激光机,即波长为810 nm以及波长为635 nm和980 nm的双波长激光机。共有94个拔牙创口、28次龈下刮治及根面平整操作和18次小型口腔外科手术。对于拔牙创口,联合使用激光消融龈沟纤维和光生物调节启动血凝块形成是一种较好的止血技术,而单独使用光生物调节是软组织止血的首选技术(<0.001)。所有操作人员均证实,97.86%的出血事件实现了更快止血。61.43%的出血事件仅使用激光介导止血在临床上5分钟内实现了止血(=0.092)。在2至4周的随访期内显著观察到拔牙创口完全愈合(=0.005)。未报告临床并发症。激光介导止血有效缩短了老年患者接受常规牙科治疗时的止血时间,预防了术后出血并促进了伤口愈合。

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