Clinical and radiographic effects of low intensity laser after extraction of unerupted third molars
Efeitos clínicos e radiográficos do laser em baixa intensidade após a extração de terceiros molares inclusos
Junior, Paulo Villela Santos; Costa, Giselly Parizoto; Leite, Deise Silva; Rossoni, Rodnei Dennis; Jorge, Antonio Olavo Cardoso; Junqueira, Juliana Campos
Rev. odontol. UNESP, vol.41, n3, p.192-197, 2012
Abstract
The low intensity laser therapy (LLLT) has been indicated as coadjuvant treatment of postoperative dental extraction surgery. Objective: The aim of this study was to evaluate the clinical and radiological findings of LLLT in the surgery for extraction of unerupted third molars. Material and method: Eight patients were submitted to extraction of mandibular third molar. The left tooth was treated with laser during surgery and for another 2 days after surgery (Laser Group). The right tooth surgery was performed after 15 days and did not receive laser therapy (control group). Clinical evaluation of the postoperative period was based on the measuring of edema and analysis of a questionnaire to assess pain. After 40 days of each surgery, digital periapical radiographs were made and measured the optical density of bone repair were analyzed using the Image J. The data obtained in the measurement of edema and analysis of optical density were tested using Student t test. Result: The level of pain in postoperative patients was lower in the laser group compared to the control group. However, in the measurement of edema and analysis of optical density of radiographs there was no statistically significant difference in the laser group compared to control. Conclusion: According to the parameters used in this study, we can concluded that the application of LLLT promoted analgesia postoperatively, but did not show effects on edema and bone repair.
Keywords
Laser therapy, surgery oral, third molar, edema.
Resumo
O laser em baixa intensidade tem sido indicado como tratamento coadjuvante no pós-operatório da cirurgia de extração dentária. Objetivo: O objetivo desse trabalho foi avaliar os efeitos clínicos e radiográficos do laser em baixa intensidade na cirurgia de exodontia de terceiros molares inclusos. Material e método: Oito pacientes foram submetidos à extração dos terceiros molares inferiores inclusos. O dente esquerdo foi tratado com laser durante a cirurgia e por mais 2 dias do pós-operatório (Grupo Laser). A cirurgia do dente direito foi realizada após 15 dias e não recebeu laserterapia (Grupo Controle). A avaliação clínica do pós-operatório foi baseada na medida do edema e análise de questionário para avaliação da dor. Após 40 dias de cada cirurgia, foram feitas radiografias periapicais digitais para medida das densidades ópticas da reparação óssea por meio do programa Image J. Os dados obtidos na medida do edema e análise de densidade óptica foram submetidos ao teste estatístico t de Student. Resultado: O nível de dor dos pacientes no pós-operatório foi menor no grupo laser em relação ao grupo controle. Entretanto, na medida do edema e na análise de densidade óptica das radiografias não houve diferença estaticamente significante do grupo laser em relação ao grupo controle. Conclusão: De acordo com os parâmetros utilizados nesse estudo, concluiu-se que a aplicação do laser em baixa intensidade promoveu analgesia no pós-operatório, porém não teve efeito sobre o edema e a reparação óssea.
Palavras-chave
Terapia a laser, cirurgia bucal, terceiro molar, edema.
References
1. Larrazabal C, García B, Peñarrocha M, Peñarrocha M. Influence of oral hygiene and smoking on pain and swelling after surgical extraction of impacted mandibular third molars. J Oral Maxillofac Surg. 2010;68:43-6.
2. Aras MH, Güngörmüs M. The effect of low-level laser therapy on trismus and facial swelling following surgical extraction of a lower third molar. Photomed Laser Surg. 2009;27:21-4.
3. Mehrabi M, Allen JM, Roser SM. Therapeutic agents in perioperative third molar surgical procedures. Oral Maxillofac Surg Clin North Am. 2007;19:69-84.
4. Cauwels RG, Martens LC. Low level laser therapy in oral mucositis: a pilot study. Eur Arch Paediatr Dent. 2011;12:118‑23.
5. Petrucci A, Sgolastra F, Gatto R, Mattei A, Monaco A. Effectiveness of low-level laser therapy in temporomandibular disorders: a systematic review and meta-analysis. J Orofac Pain. 2011;25:298-307.
6. Sgolastra F, Petrucci A, Gatto R, Monaco A. Effectiveness of laser in dentinal hypersensitivity treatment: a systematic review. J Endod. 2011;37:297-303.
7. Leung YY, Fung PP, Cheung LK. Treatment modalities of neurosensory deficit after lower third molar surgery: a systematic review. J Oral Maxillofac Surg. 2011. http://dx.doi.org/10.1016/j.joms.2011.08.032
8. Obradović R, Kesić L, Mihailović D, Antić S, Jovanović G, Petrović A, et al. A histological evaluation of a low-level laser therapy as an adjunct to periodontal therapy in patients with diabetes mellitus. Lasers Med Sci. 2012. http://dx.doi.org/10.1007/s10103-012-1058-7
9. Pinheiro AL, Gerbi ME. Photoengineering of bone repair processes. Photomed Laser Surg. 2006;24:169-78.
10. Markovic AB, Todorovic L. Postoperative analgesia after lower third molar surgery: contribution of the use of long-acting local anesthetics, low-power laser, and diclofenac. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:e4-8.
11. López-Ramírez M, Vílchez-Pérez MA, Gargallo-Albiol J, Arnabat-Domínguez J, Gay-Escoda C. Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction. A preliminary study. Lasers Med Sci. 2011. http://dx.doi.org/10.1007/s10103-011-0936-8
12. Oliveira P, Sperandio E, Fernandes KR, Pastor FA, Nonaka KO, Renno AC. Comparison of the effects of low-level laser therapy and lowintensity pulsed ultrasound on the process of bone repair in the rat tibia. Rev Bras Fisioter. 2011;15:200-5.
13. Khadra M, Lyngstadaas SP, Haanaes HR, Mustafa K. Effect of laser therapy on attachment, proliferation and differentiation of human osteoblast-like cells cultured on titanium implant material. Biomaterials. 2005; 26:3503-9.
14. Stein A, Benayahu D, Maltz L, Oron U. Low-level laser irradiation promotes proliferation and differentiation of human osteoblasts in vitro. Photomed Laser Surg. 2005; 23:161-6.
15. Kucerová H, Dostálová T, Himmlova L, Bártová J, Mazánek J. Low-level laser therapy after molar extraction. J Clin Laser Med Surg. 2000;18:309-15.
16. Santos Junior PV, Martins JS, Toyama R, Vieira RB, Jorge AOC, Junqueira JC. Avaliação clínica, microbiológica e radiográfica do pós-operatório de exodontia de dentes inclusos utilizando o laser de baixa intensidade como recurso terapêutico. Rev Assoc Paul Cir Dent. 2009;63:475‑80.
17. Markovic A, Todorovic LJ. Effectiveness of dexamethasone and low-power laser in minimizing oedema after third molar surgery: a clinical trial. Int J Oral Maxillofac Surg. 2007;36:226‑9.
18. Aras MH, Güngörmüş M. Placebo-controlled randomized clinical trial of the effect two different low-level laser therapies (LLLT)--intraoral and extraoral--on trismus and facial swelling following surgical extraction of the lower third molar. Lasers Med Sci. 2010;25:641‑5.
19. Lizarelli RFZ. Protocolos clínicos odontológicos: uso do laser de baixa intensidade. Gorham Design: São Carlos; 2007.
20. Maver-Biscanin M, Mravak-Stipetic M, Jerolimov V. Effect of low-level laser therapy on Candida albicans growth in patients with denture stomatitis. Photomed Laser Surg. 2005;23:328‑32.
21. Pöntinen PJ. Low level laser therapy as a medical treatment modality. Tampere: Art Urpo. 1992; 13-17.
22. Hashmi JT, Huang YY, Sharma SK, Kurup DB, De Taboada L, Carroll JD, et al. Effect of pulsing in low-level light therapy. Lasers Surg Med. 2010;42:450-66.
23. Amarillas-Escobar ED, Toranzo-Fernández JM, Martínez-Rider R, Noyola-Frías MA, Hidalgo-Hurtado JA, Serna VM, et al. Use of therapeutic laser after surgical removal of impacted lower third molars. J Oral Maxillofac Surg. 2010;68:319-24.
24. Cavalcanti TM, Almeida-Barros RQ, Catão MH, Feitosa AP, Lins RD. Knowledge of the physical properties and interaction of laser with biological tissue in dentistry. An Bras Dermatol. 2011;86:955-60.
25. Wathier J, Contar CMM, Alanis LRA, Ignácio SA, Machado MAN. Avaliação da efetividade do laser de baixa potência na redução da dor pós-operatória em cirurgia de terceiros molares inclusos. Odonto. 2011;19:131-8.
26. Almeida-Lopes L, Rigau J, Zangaro RA, Guidugli-Neto J, Jaeger MM. Comparison of the low level laser therapy effects on cultured human gingival fibroblasts proliferation using different irradiance and same fluence. Lasers Surg Med. 2001;29:179-84.
27. Pinheiro AL, Martinez Gerbi ME, de Assis Limeira F Jr, Carneiro Ponzi EA, Marques AM, Carvalho CM, et al. Bone repair following bone grafting hydroxyapatite guided bone regeneration and infra-red laser photobiomodulation: a histological study in a rodent model. Lasers Med Sci. 2009;24:234–40.
28. De Souza Merli LA, de Medeiros VP, Toma L, Reginato RD, Katchburian E, Nader HB, et al. The Low Level Laser Therapy Effect on the Remodeling of Bone Extracellular Matrix. Photochem Photobiol. 2012. http://dx.doi.org/10.1111/j.1751-1097.2012.01172.x
29. Barbosa D, de Souza RA, Xavier M, da Silva FF, Arisawa EA, Villaverde AG. Effects of low-level laser therapy (LLLT) on bone repair in rats: optical densitometry analysis. Lasers Med Sci. 2012 (Jun). http://dx.doi.org/10.1007/s10103-012-1125-0
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email