低水平半导体激光治疗对恒牙Ⅰ类龋洞机械预备疼痛控制的有效性分析

王婷婷; 黄永松; 徐丽; 田瑞雪

doi:10.16766/j.cnki.issn.1674-4152.003370

低水平半导体激光治疗对恒牙Ⅰ类龋洞机械预备疼痛控制的有效性分析

doi: 10.16766/j.cnki.issn.1674-4152.003370

蚌埠医科大学第一附属医院口腔科，安徽蚌埠 233004

基金项目:

安徽高校自然科学研究项目 KJ2021A0790

2022年度蚌埠医学院一般新技术项目 2022105

蚌埠医学院自然科学重点项目 2022byzd034

详细信息

通讯作者:
田瑞雪，E-mail：helen20040516@163.com

中图分类号: R781.1 R783.3
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- 文章访问数: 38
- HTML全文浏览量: 18
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2023-06-19
- 网络出版日期: 2024-03-27

Analysis of the effect of low level semiconductor laser on the pain of permanent tooth caries mechanical preparation of Class Ⅰ cavities

Department of Stomatology, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China

摘要

摘要: 目的评估对疼痛耐受性低的成年患者，在成人恒牙Ⅰ类洞机械预备之前应用低水平激光治疗(LLLT)的镇痛效果。方法选取2022年10月—2023年9月在蚌埠医科大学第一附属医院口腔科就诊的成年恒牙Ⅰ类洞(D2)患者。治疗前患者均使用机械去腐法对疼痛阈值(PTPT)进行初步测试，并使用VAS评分进行疼痛评分后，选取7分≤VAS < 10分的患者20例，40颗牙齿，激光组(20颗)和安慰组(20颗)。激光组在窝洞预备前行LLLT，安慰组激光行同位置模拟照射但激光为未工作模式，窝洞预备后使用VAS评分表对疼痛强度进行评分，并比较组间及治疗前后的VAS评分。结果治疗后激光组的VAS评分低于安慰组[4.0(4.0, 4.5)分vs. 6.0(6.0, 6.8)分, P < 0.001]；与PTPT测试期间感觉到的疼痛相比，激光组降低42.9%[7.0(7.0, 8.0)分vs. 4.0(4.0, 4.5)分，P < 0.001]，安慰组降低14.3%[7.0(7.0, 8.0)分vs. 6.0(6.0, 6.8)分，P < 0.001]。结论在恒牙Ⅰ类洞机械预备之前使用LLLT，能大大降低恒牙牙体治疗时的疼痛强度。
- 半导体激光 /
- 低水平激光治疗 /
- 恒牙龋洞机械预备 /
- 疼痛 /
- 有效性
Abstract: Objective To evaluate the effectiveness of low-level laser therapy (LLLT) in the treatment of pain during mechanical cavity preparation of Class Ⅰ cavities in adult permanent teeth in adult patients with low pain tolerance. Methods This study selected adult patients with Class Ⅰ permanent tooth cavities (D2) who visited the Department of Stomatology at the First Affiliated Hospital of Bengbu Medical University from October 2022 to September 2023. Before the treatment, the preliminary test of pain threshold (PTPT) was initially tested by the mechanical removal method, and the pain score was evaluated by the visual analogue scale (VAS) score. Twenty patients with 7 points≤VAS < 10 points, 40 teeth were selected, laser group (20 teeth) and placebo group (20 teeth). The laser group was treated with LLLT before the cavity preparation, and the placebo group was treated with simulated laser irradiation at the same position but the laser was not in working mode. The VAS score was used to evaluate the pain intensity after the cavity preparation, and the VAS scores were compared between the two groups and before and after the treatment. Results The VAS score of all subjects in the laser group was lower than that in the placebo group [4.0 (4.0, 4.5) points vs. 6.0 (6.0, 6.8) points, P < 0.001]; Compared with the pain felt during PTPT, the laser group decreased by 42.9% [7.0 (7.0, 8.0) points vs. 4.0 (4.0, 4.5) points, P < 0.001] and the placebo group decreased by 14.3% [7.0 (7.0, 8.0) points vs. 6.0 (6.0, 6.8) points, P < 0.001]. Conclusion The use of LLLT before cavity mechanical preparation can greatly reduce the pain intensity during permanent tooth treatment.
- Semiconductor laser /
- Low-level laser therapy /
- Mechanical preparation of permanent tooth caries /
- Pain /
- Effectiveness

HTML全文

表 1 PTPT组及激光组和安慰组成年恒牙Ⅰ类洞患者(D2)的VAS评分(分)

Table 1. VAS score of adult patients with Class Ⅰ permanent tooth cavities (D2) in the PTPT group, laser group, and placebo group (points)

编号	初始PTPT测试	激光组(治疗后)	安慰组(治疗后)
1	7.0	3.0	6.0
2	7.0	3.5	7.0
3	7.0	2.0	5.0
4	8.0	4.0	6.0
5	7.0	4.0	6.0
6	9.0	6.5	7.0
7	7.0	4.0	6.0
8	7.0	4.5	6.0
9	7.0	4.0	5.0
10	8.0	4.0	7.0
11	7.0	5.0	6.0
12	7.0	4.0	6.0
13	7.0	4.0	6.0
14	8.0	4.5	6.0
15	9.0	5.0	8.0
16	7.0	5.0	6.5
17	8.0	4.0	7.0
18	7.0	3.5	5.0
19	7.0	4.0	6.0
20	8.0	4.0	6.5

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参考文献(16)

[1]	MOEINTAGHAVI A, AHRARI F, NASRABADI N, et al. Low level laser therapy, Er, Cr: YSGG laser and fluoride varnish for treatment of dentin hypersensitivity after periodontal surgery: a randomized clinical trial[J]. Lasers Med Sci, 2021, 36(9): 1949-1956. doi: 10.1007/s10103-021-03310-4
[2]	石慧清. 心理诱导缓解乳牙根管治疗患者焦虑和恐惧的临床疗效研究[J]. 内蒙古医科大学学报, 2019, 41(S1): 105-108. https://www.cnki.com.cn/Article/CJFDTOTAL-NMYX2019S1034.htm SHI H Q. To study the clinical effect of psychological induction on anxiety and fear in patients with root canal treatment of primary teeth[J]. Journal of Inner Mongolia Medical University, 2019, 41(S1): 105-108. https://www.cnki.com.cn/Article/CJFDTOTAL-NMYX2019S1034.htm
[3]	AL-JEWAIR T, FARSAII A. Low-level laser therapy may reduce pain associated with orthodontic separator placement[J]. J Evid Based Dent Pract, 2022, 22(3): 101752. DOI: 10.1016/j.jebdp.2022.101752.
[4]	FEMIANO F, FEMIANO R, FEMIANO L, et al. Effectiveness of low-level diode laser therapy on pain during cavity preparation on permanent teeth[J]. Am J Dent, 2018, 31(5): 267-271.
[5]	MOHAMMADIAN F, SOUFI S, DIBAJI F, et al. Push-out bond strength of calcium-silicate cements following Er: YAG and diode laser irradiation of root dentin[J]. Lasers Med Sci, 2019, 34(1): 201-207. doi: 10.1007/s10103-018-02705-0
[6]	XUE V W, YIN I X, NIU J Y, et al. Combined effects of topical fluorides and semiconductor lasers on prevention of enamel caries: a systematic review and meta-analysis[J]. Photobiomodul Photomed Laser Surg, 2022, 40(6): 378-386.
[7]	陈济贤. 半导体激光联合牙周基础治疗对慢性牙周炎患者的临床疗效[J]. 医学信息, 2022, 35(20): 90-92. https://www.cnki.com.cn/Article/CJFDTOTAL-YXXX202220023.htm CHEN J X. Clinical effect of semiconductor laser combined with periodontal basic treatment on patients with chronic periodontitis[J]. Journal of Medical Information, 2022, 35(20): 90-92. https://www.cnki.com.cn/Article/CJFDTOTAL-YXXX202220023.htm
[8]	薛一卓, 宋静, 张文欣, 等. 化学机械去腐技术治疗龋病的Meta分析[J]. 中华全科医学, 2019, 17(7): 1225-1229. doi: 10.16766/j.cnki.issn.1674-4152.000907 XUE Y Z, SONG J, ZHANG W X, et al. Meta-analysis of chemical-mechanical oral decontamination techniques for dental caries[J]. Chinese Journal of General Practice, 2019, 17(7): 1225-1229. doi: 10.16766/j.cnki.issn.1674-4152.000907
[9]	XIE Y H, LIAO M X, LAM F M H, et al. The effectiveness of high-intensity laser therapy in individuals with neck pain: a systematic review and meta-analysis[J]. Physiotherapy, 2023, 121: 23-36. doi: 10.1016/j.physio.2023.07.003
[10]	ALVES L V G L, CURYLOFO-ZOTTI F A, BORSATTO M C, et al. Influence of antimicrobial photodynamic therapy in carious lesion. Randomized split-mouth clinical trial in primary molars[J]. Photodiagnosis Photodyn Ther, 2019, 26: 124-130. doi: 10.1016/j.pdpdt.2019.02.018
[11]	GARZÓN J, BALDION P A, GRAJALES M, et al. Response of osteoblastic cells to low-level laser treatment: a systematic review[J]. Lasers Med Sci, 2022, 37(8): 3031-3049. doi: 10.1007/s10103-022-03587-z
[12]	KERMANSHAH H, CHINIFORUSH N, KOLAHDOUZ MOHAMMADI M, et al. Effect of photobiomodulation therapy with 915 nm diode laser on pain perception during local anesthesia of maxillary incisors: a randomized controlled trial[J]. Photochem Photobiol, 2022, 98(6): 1471-1475. doi: 10.1111/php.13644
[13]	SHAKYA V K, BHATTACHARJEE A, SINGH R K, et al. Shear bond strengths of bur or Er: YAG laser prepared dentine to composite resin with or without low-level laser conditioning: an in vitro study[J]. Lasers Med Sci, 2023, 38(1): 161. doi: 10.1007/s10103-023-03824-z
[14]	AMAROLI A, PASQUALE C, ZEKIY A, et al. Photobiomodulation and oxidative stress: 980 nm diode laser light regulates mitochondrial activity and reactive oxygen species production[J]. Oxid Med Cell Longev, 2021, 2021: 6626286. DOI: 10.1155/2021/6626286.
[15]	GUERREIRO M Y R, MONTEIRO L P B, DE CASTRO R F, et al. Effect of low-level laser therapy on postoperative endodontic pain: an updated systematic review[J]. Complement Ther Med, 2021, 57: 102638. DOI: 10.1016/j.ctim.2020.102638.
[16]	DE OLIVEIRA M F, JOHNSON D S, DEMCHAK T, et al. Low-intensity LASER and LED (photobiomodulation therapy) for pain control of the most common musculoskeletal conditions[J]. Eur J Phys Rehabil Med, 2022, 58(2): 282-289.