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Carvalho ÉDS, Souza ARDN, Melo DFC, de Farias AS, Macedo BBDO, Sartim MA, Caggy MC, Rodrigues BDA, Ribeiro GS, Reis HN, Araújo FQ, da Silva IM, Sachett A, Sampaio VDS, Balieiro AADS, Zamuner SR, Vissoci JRN, Cabral LN, Monteiro WM, Sachett JDAG. Photobiomodulation Therapy to Treat Snakebites Caused by Bothrops atrox: A Randomized Clinical Trial. JAMA Intern Med 2024; 184:70-80. [PMID: 38048090 PMCID: PMC10696517 DOI: 10.1001/jamainternmed.2023.6538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/08/2023] [Indexed: 12/05/2023]
Abstract
Importance Bothrops venom acts almost immediately at the bite site and causes tissue damage. Objective To investigate the feasibility and explore the safety and efficacy of low-level laser therapy (LLLT) in reducing the local manifestations of B atrox envenomations. Design, Setting, and Participants This was a double-blind randomized clinical trial conducted at Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, Brazil. A total of 60 adult participants were included from November 2020 to March 2022, with 30 in each group. Baseline characteristics on admission were similarly distributed between groups. Data analysis was performed from August to December 2022. Intervention The intervention group received LLLT combined with regular antivenom treatment. The laser used was a gallium arsenide laser with 4 infrared laser emitters and 4 red laser emitters, 4 J/cm2 for 40 seconds at each application point. Main Outcomes and Measures Feasibility was assessed by eligibility, recruitment, and retention rates; protocol fidelity; and patients' acceptability. The primary efficacy outcome of this study was myolysis estimated by the value of creatine kinase (U/L) on the third day of follow-up. Secondary efficacy outcomes were (1) pain intensity, (2) circumference measurement ratio, (3) extent of edema, (4) difference between the bite site temperature and that of the contralateral limb, (5) need for the use of analgesics, (6) frequency of secondary infections, and (7) necrosis. These outcomes were measured 48 hours after admission. Disability assessment was carried out from 4 to 6 months after patients' discharge. P values for outcomes were adjusted with Bonferroni correction. Results A total of 60 patients (mean [SD] age, 43.2 [15.3] years; 8 female individuals [13%] and 52 male individuals [87%]) were included. The study was feasible, and patient retention and acceptability were high. Creatine kinase was significantly lower in the LLLT group (mean [SD], 163.7 [160.0] U/L) 48 hours after admission in relation to the comparator (412.4 [441.3] U/L) (P = .03). Mean (SD) pain intensity (2.9 [2.7] vs 5.0 [2.4]; P = .004), circumference measurement ratio (6.6% [6.6%] vs 17.1% [11.6%]; P < .001), and edema extent (25.8 [15.0] vs 40.1 [22.7] cm; P = .002) were significantly lower in the LLLT group in relation to the comparator. No difference was observed between the groups regarding the mean difference between the bite site temperature and the contralateral limb. Secondary infections, necrosis, disability outcomes, and the frequency of need for analgesics were similar in both groups. No adverse event was observed. Conclusions and Relevance The data from this randomized clinical trial suggest that the use of LLLT was feasible and safe in a hospital setting and effective in reducing muscle damage and the local inflammatory process caused by B atrox envenomations. Trial Registration Brazilian Registry of Clinical Trials Identifier: RBR-4qw4vf.
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Affiliation(s)
- Érica da Silva Carvalho
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - Andrea Renata do Nascimento Souza
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - Dessana Francis Chehuan Melo
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
- School of Medicine, Universidade Federal do Amazonas, Manaus, Brazil
| | - Altair Seabra de Farias
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | | | - Marco Aurélio Sartim
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
- Universidade Nilton Lins, Manaus, Brazil
| | - Mariela Costa Caggy
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | | | - Heloísa Nunes Reis
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | - Iran Mendonça da Silva
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - André Sachett
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - Vanderson de Souza Sampaio
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | | | | | | | - Lioney Nobre Cabral
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
| | - Wuelton Marcelo Monteiro
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
| | - Jacqueline de Almeida Gonçalves Sachett
- School of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil
- Department of Teaching and Research, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
- Department of Teaching and Research, Fundação Alfredo da Matta, Manaus, Brazil
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Miroshnychenko A, Ibrahim S, Azab M, Roldan Y, Diaz Martinez JP, Tamilselvan D, He L, Urquhart O, Tampi M, Polk DE, Moore PA, Hersh EV, Carrasco-Labra A, Brignardello-Petersen R. Injectable and topical local anesthetics for acute dental pain: 2 systematic reviews. J Am Dent Assoc 2023; 154:53-64.e14. [PMID: 36608963 PMCID: PMC10871026 DOI: 10.1016/j.adaj.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/14/2022] [Accepted: 10/10/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Local anesthesia is essential for pain control in dentistry. The authors assessed the comparative effect of local anesthetics on acute dental pain after tooth extraction and in patients with symptomatic irreversible pulpitis. TYPES OF STUDIES REVIEWED The authors searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and the US Clinical Trials registry through November 21, 2020. The authors included randomized controlled trials (RCTs) comparing long- vs short-acting injectable anesthetics to reduce pain after tooth extraction (systematic review 1) and evaluated the effect of topical anesthetics in patients with symptomatic pulpitis (systematic review 2). Pairs of reviewers screened articles, abstracted data, and assessed risk of bias using a modified version of the Cochrane risk of bias 2.0 tool. The authors assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS Fourteen RCTs comparing long- vs short-acting local anesthetics suggest that bupivacaine may decrease the use of rescue analgesia and may not result in additional adverse effects (low certainty evidence). Bupivacaine probably reduces the amount of analgesic consumption compared with lidocaine with epinephrine (mean difference, -1.91 doses; 95% CI, -3.35 to -0.46; moderate certainty) and mepivacaine (mean difference, -1.58 doses; 95% CI, -2.21 to -0.95; moderate certainty). Five RCTs suggest that both benzocaine 10% and 20% may increase the number of people experiencing pain reduction compared with placebo when managing acute irreversible pulpitis (low certainty). PRACTICAL IMPLICATIONS Bupivacaine may be superior to lidocaine with epinephrine and mepivacaine with regard to time to and amount of analgesic consumption. Benzocaine may be superior to placebo in reducing pain for 20 through 30 minutes after application.
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Cetira Filho EL, Silva PGB, Wong DVT, Choquenaira-Quispe C, Cesário FRAS, de Sousa Nogueira G, de Sousa AVC, de Aguiar ASW, da Cruz Fonseca SG, Costa FWG. Effect of preemptive photobiomodulation associated with nimesulide on the postsurgical outcomes, oxidative stress, and quality of life after third molar surgery: a randomized, split-mouth, controlled clinical trial. Clin Oral Investig 2022; 26:6941-6960. [PMID: 35948699 PMCID: PMC9365445 DOI: 10.1007/s00784-022-04649-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/16/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of this study is to compare the effect of photobiomodulation with low-level laser therapy (LLLT) and nimesulide on inflammatory parameters, biomarkers of oxidative stress and inflammation, and quality of life after lower third molar (L3M) surgery. MATERIAL AND METHODS A randomized, two-factor, triple-blind, controlled, split-mouth clinical trial was performed with 40 volunteers who required bilateral L3M removal. Patients were allocated depending on the use or not of 100 mg nimesulide 1 hbefore surgery, as well as the use or not of LLLT in the preoperative period. RESULTS Pain peaks occurred after 6 h (nimesulide-placebo [N-P] group) and 8 h (nimesulide group). In the N-P group, LLLT resulted in significantly lower mean pain scores than the subgroup without LLLT after 4 h (p = 0.009) and 6 h (p = 0.048). As for edema, a shorter distance between the mandibular angle and the outer canthus of the eyes after 7 days (p = 0.037) and a smaller cumulative effect (p = 0.036) were observed in the N-P group associated with LLLT. A direct effect between LLLT (p = 0.047) and a reduction in the mean scores of overall dissatisfaction with quality of life was detected. CONCLUSIONS Preemptive use of nimesulide only delayed peak pain. LLLT reduced edema, trismus, and contributed to a better perception of quality of life. Nimesulide inhibits peroxidation by increasing GSH and stopping neutrophil migration. The benefit of the association of both strategies was not superior to the use of LLLT alone. CLINICAL RELEVANCE Translational study with impact on clinical-surgical protocols involving L3M surgery related to pharmacological and non-pharmacological methods.
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Affiliation(s)
- Edson Luiz Cetira Filho
- Division of Oral and Maxillofacial Surgery, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.,UNICHRISTUS, Fortaleza, Ceará, Brazil
| | | | - Deysi Viviana Tenazoa Wong
- Department of Physiology and Pharmacology - FAMED, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Celia Choquenaira-Quispe
- Laboratory of Pharmacology of Inflammation and Cancer (LAFICA), Postgraduate Program in Pharmaceutical Sciences, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Ceará, Brazil
| | - Francisco Rafael Alves Santana Cesário
- Laboratory of Pharmacology of Inflammation and Cancer (LAFICA), Postgraduate Program in Pharmacology, Federal University of Ceará, Fortaleza, Ceará, Brazil.,Federal University of Ceará, Fortaleza, Ceará, Brazil
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Ferreira GM, Prado LF, Santos KV, Rodrigues LG, Valladares-Neto J, Torres ÉM, Silva MA. Efficacy of two low-level laser therapy protocols following lower third molar surgery - a randomized, double-blind, controlled clinical trial. ACTA ODONTOLOGICA LATINOAMERICANA : AOL 2022; 35:31-38. [PMID: 35700539 DOI: 10.54589/aol.35/1/31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/01/2021] [Indexed: 06/15/2023]
Abstract
The aim of this study was to test two low-level laser therapy protocols by evaluating pain control, swelling and trismus in the postoperative period of lower third molar surgeries. This was a randomized, double-blind, placebo-controlled, crossover trial. Patients presenting two symmetrically impacted mandibular third molars were included. One side was randomly assigned for LLLT applied immediately after surgery (T1) and then after 24 (T2) and 48 hours (T3) (Protocol A). The other side received LLLT applied immediately after surgery and placebo after 24 and 48 hours (Protocol B). LLLT was given by intraoral application (660nm, 5 J/cm2, 10 s, 20 mW, 4 points) followed by extraoral application (789 nm, 30 J/cm2, 20 s, 60 mW, 8 points). The placebo application was similar to that of the experimental side but with laser simulation. The primary outcomes were pain control, swelling and trismus intensity at T1, T2, T3 and 7 days after surgery (T4). Data were analyzedbyANOVArepeated measures and Wilcoxon test (p<.05). The final sample consisted of 21 patients (42 teeth). There were no statistical differences for pain level between protocols A and B over time (p= .909), although the amount of analgesic medication was lower with protocol A at T2 (p=.022). There were no differences in swelling (p=.958) or trismus (p=.837) between the protocols used over time. Both protocols performed similarly for pain control, swelling and trismus. Therefore, for practical reasons, a single laser application in the immediate postoperative period could be indicated for the management of postoperative discomfort in lower third molar surgery.
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Affiliation(s)
- Geovane M Ferreira
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil
| | - Lucianna F Prado
- Universidade Paulista, Faculdade de Odontologia, Departamento de Cirurgia, Goiânia, Brasil
| | - Kleber Vr Santos
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil
| | - Lívia G Rodrigues
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil
| | - José Valladares-Neto
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Reabilitação Oral, Goiânia, Brasil
| | - Érica M Torres
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Reabilitação Oral, Goiânia, Brasil
| | - Maria Ag Silva
- Universidade Federal de Goiás, Faculdade de Odontologia, Departamento de Estomatologia, Goiânia, Brasil.
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Deo SP, Ahmad MS, Singh A. Effectiveness of dexamethasone or adrenaline with lignocaine 2% for prolonging inferior alveolar nerve block: a randomized controlled trial. J Korean Assoc Oral Maxillofac Surg 2022; 48:21-32. [PMID: 35221304 PMCID: PMC8890966 DOI: 10.5125/jkaoms.2022.48.1.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/18/2021] [Accepted: 09/27/2021] [Indexed: 11/07/2022] Open
Abstract
Objectives Inferior alveolar nerve block (IANB) is commonly used for mandibular dentoalveolar surgery. The objective of this study was to evaluate and compare the effectiveness of coadministration of dexamethasone (4 mg/mL) or adrenaline (0.01 mg/mL) as an adjuvant with lignocaine 2% in IANB during third molar surgery (TMS). Patients and Methods This double-blind, randomized controlled trial was conducted between March and August 2020. The investigators screened patients needing elective TMS under local anesthesia. Based on strict inclusion and exclusion criteria, patients were enrolled in this study. These patients were assigned randomly into two study groups dexamethasone group (DXN) or adrenaline group (ADN). Outcome variables were postoperative edema, trismus, visual analogue scale (VAS), perioperative analgesia, onset time, and duration of IANB. Results Eighty-three patients were enrolled in this study, of whom 23 (27.7%) were eliminated or excluded during follow-up. This study thus included data from 60 samples. Mean age was 32.28±11.74 years, including 28 females (46.7%) in the ADN (16 patients, 57.1%) and DXN (12 patients, 42.9%) groups. The duration of action for DXN (mean±standard deviation [SD], 40207±03401 hours; standard error [SE], 00600 hours; log-rank P=0.001) and for ADN (mean±SD, 15834±02452 hours; SE, 00442 hours; log-rank P=0.001) were found. Similarly, time at which 1st analgesic consume and total number of nonsteroidal antiinflammatory drugs need to rescue postoperative analgesia was found statistically significant between study groups (t (58)=–11.95; confidence interval, –22541 to –14353; P=0.001). Early-hours VAS was also significantly different between the study groups. Conclusion A single injection of dexamethasone prolongs the duration of action of lignocaine 2% IANB. Additionally, it can be used in cases where adrenaline is contraindicated.
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Affiliation(s)
- Saroj Prasad Deo
- Department of Oral and Maxillofacial Surgery, National Medical College, Birgunj, Nepal
| | - Md Shakeel Ahmad
- Department of Dentistry, National Medical College, Birgunj, Nepal
| | - Abanish Singh
- Department of Community Dentistry, MB Kedia Dental College, Birgunj, Nepal
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Shekarchi F, Nokhbatolfoghahaei H, Chiniforush N, Mohaghegh S, Haeri Boroojeni HS, Amini S, Biria M. Evaluating the Preemptive Analgesic Effect of Photo-biomodulation Therapy on Pain Perception During Local Anesthesia Injection in Children: A Split-mouth Triple-blind Randomized Controlled Clinical Trial. Photochem Photobiol 2022; 98:1195-1200. [PMID: 35122442 DOI: 10.1111/php.13605] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/15/2022] [Accepted: 01/15/2022] [Indexed: 11/29/2022]
Abstract
To evaluate the impact of photobiomodulation therapy (PBMT) on injection pain perception and compare it with a topical oral anesthetic gel. A total of 30 patients of six to nine years old seeking pulpotomy treatment of maxillary secondary primary molars of both sides were considered for this split-mouth triple-blind randomized clinical trial. On one side of the maxilla, the low-level-laser (diode laser, 808 nm, 250 mW; 16.25 J; 32.5 J/cm2 ) was irradiated upon the buccal gingiva of the tooth, while a Benzocaine 20% topical anesthetic gel was applied on the other side. A gel with the same taste (strawberry) was applied for the placebo. The Wong-Baker Faces Pain Rating Scale was used to evaluate the injection pain and post-operation pain at two timestamps, one hour and 24 hours after treatment. Patients' heart rate was also evaluated. Paired-T, Wilcoxon-signed-rank test, McNemar and Friedman tests were used for statistical analyses. Results demonstrated that PBMT could significantly decrease the injection pain perception and heart rate alternations compared to the topical anesthetic gels (P=0.000). However, no significant differences were documented between the two methods concerning the 1hour (P=0.26) and 24-hours (P=1.00) post-operation pain. PBMT can be an effective non-pharmacological technique for controlling injection pain.
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Affiliation(s)
- Fatemeh Shekarchi
- Department of Pedodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Sadra Mohaghegh
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Helia Sadat Haeri Boroojeni
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soroush Amini
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Biria
- Department of Pedodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yüksek MN, Eroğlu CN. Clinical evaluation of single and repeated sessions of photobiomodulation with two different therapeutic wavelengths for reducing postoperative sequelae after impacted mandibular third molar surgery: a randomized, double-blind clinical study. J Appl Oral Sci 2021; 29:e20210383. [PMID: 34787280 PMCID: PMC8673830 DOI: 10.1590/1678-7757-2021-0383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/15/2021] [Indexed: 12/04/2022] Open
Abstract
The effects of the number of photobiomodulation (PBM) sessions on the postoperative inflammatory process remain controversial. The current literature comparing single and repeated PBM sessions is limited.
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Affiliation(s)
- Mehmet Nuri Yüksek
- Yuzuncu Yil University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Van, Turkey
| | - Cennet Neslihan Eroğlu
- Yuzuncu Yil University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Van, Turkey
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Sattayut S, Chotiwutthiphatthana D, Inprakhon T, Tiansongjai R. An Efficacy of Photobiomodulation of 850 nm on Pain Reduction in a Human Oral Capsaicin Pain Model. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:734-740. [PMID: 34762533 DOI: 10.1089/photob.2020.4892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: The aim of this clinical trial was to evaluate the efficacy of photobiomodulation (PBM) to reduce oral pain initiated by capsaicin. Background: PBM has been used for pain reduction in oral regions; however, its clinical efficacy to alleviate burning sensations is still unknown. Methods: This clinical study was divided into two phases. There were 10 subjects in each phase. In Phase I, the burning sensation was stimulated using 0.05% in 95% ethanol capsaicin (prepared by the Faculty of Pharmaceutical Sciences, Khon Kaen University, Thailand) on filter paper and recorded with a 10-cm horizontal visual analog scale (VAS) every 1 min until the subject experienced no more pain. The area under the curve (AUC) of the graph between VAS and time was calculated. The washout period was 24 h. In Phase II, a crossover clinical trial was conducted in subjects who received the pain model as stated. Four interventions were included: (1) PBM before & after pain stimulation, (2) PBM before pain stimulation, (3) PBM after pain stimulation, and (4) Placebo. For PBM intervention, a single exposure of 850 nm Laser (AsGaAl; TOP 250 Soft Laser, Berkmed Medikal, distributed by Medical Innovation-MI, Istanbul, Turkey) with 0.10 cm2 spot size laser probe continuous wave at 1 W/cm2 and 30 J/cm2 for 30 sec was used. Results: In Phase I, there was no statistically significant difference (p = 0.09) between the average AUC of day 1 [55.63 (23.38)] and day 2 [48.99 (27.20)]. In phase II, there was no statistical difference (p = 0.20) of the average AUC among the interventions and the placebo; group 1 [56.24 (30.11)], group 2 [45.46 (45.46)], group 3 [64.15 (32.89)], and group 4 [58.59 (30.16)]. Conclusions: The human capsaicin model was suitable for a crossover design clinical trial. The PBM used in this study did not reduce oral burning sensations from capsaicin.
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Affiliation(s)
- Sajee Sattayut
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.,Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | | | - Todsaphon Inprakhon
- Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Ravi Tiansongjai
- Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Chaudhry K, Rustagi N, Bali R, Khatana S, Kumar S, Kaur A, Kumar P. Efficacy of adjuvant ozone therapy in reducing postsurgical complications following impacted mandibular third-molar surgery: A systematic review and meta-analysis. J Am Dent Assoc 2021; 152:842-854.e1. [PMID: 34579810 DOI: 10.1016/j.adaj.2021.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Results from several randomized controlled trials have shown a beneficial effect of ozone in reducing postsurgical complications after impacted mandibular third-molar surgery, but the literature is lacking a systematic review and meta-analysis. METHODS The authors conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines after exclusion and inclusion criteria were applied and the following outcome parameters were evaluated: pain, swelling, trismus, quality of life, number of analgesics consumed, and adverse events. RevMan Cochrane Collaboration software, Version 5.3, was used to perform meta-analysis and the Grading of Recommendation Assessment, Development and Evaluation approach was used to rate the certainty of evidence. RESULTS Patients who underwent adjuvant ozone application reported lower pain scores than patients in the control group at 24 hours after surgery (95% CI, -3.94 to -1.56) and at 7 days (95% CI, -1.67 to -0.78). Pooled analysis of all 4 included trials revealed a standardized mean difference (SMD) in swelling of -0.44 at 24 hours, 0.63 at 72 hours, and -0.87 at 7 days after surgery in the experimental group. Higher mean estimates in mouth opening were experienced by patients who received ozone at 24 hours (SMD, 2.74; 95% CI, -1.93 to 7.41; 4 studies, 133 patients), 72 hours (SMD, 2.77; 95% CI, -0.63 to 6.17; 4 studies, 133 patients), and 7 days after surgery (SMD, 1.42 SMD; 95% CI, -1.34 to 4.18; 4 studies, 133 patients). PRACTICAL IMPLICATIONS Evidence suggests that adjuvant ozone application can offer some benefit for reducing pain, improving quality of life, and decreasing mean intake of analgesics after impacted mandibular third-molar surgery, but it is not effective in reducing facial swelling and trismus, which paves the way for future research.
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Duarte de Oliveira FJ, Brasil GMLC, Araújo Soares GP, Fernandes Paiva DF, de Assis de Souza Júnior F. Use of low-level laser therapy to reduce postoperative pain, edema, and trismus following third molar surgery: A systematic review and meta-analysis. J Craniomaxillofac Surg 2021; 49:1088-1096. [PMID: 34217567 DOI: 10.1016/j.jcms.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/16/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022] Open
Abstract
This Systematic Review and Meta-analysis was conducted with the following PICOS question: patients undergoing third molar surgery (P) can benefit from low-intensity laser therapy (I) as compared to other postoperative management (C) to reduce pain, edema, and trismus (O), evaluated in previous randomized clinical trials (S). Databases used were PubMed, SCOPUS, Web of Science, and Biblioteca Virtual em Saúde, screening for studies published between 2015 and 2020. The meta-analysis was based on the standardized mean difference (SMD), under a 95% confidence interval (CI). 246 studies were initially included, and after the screening of data, 10 studies were selected for the final sample. The qualitative analysis resulted in favorable results for pain and edema management in most studies, whereas trismus remained controversial. Meta-analysis resulted in (SMD, -0.53; 95% CI, -0.82,-0.24), (SMD, -0.60; 95% CI, -0.81,-0.39), and (SMD, -0.62; 95% CI, -2.63, 1.39) for pain, edema, and trismus, respectively, indicating statistical success on pain and edema reduction, but not for trismus. LLLT can act on reducing postoperative pain and edema following third molar surgery, whereas, trismus remains not significantly changed.
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Nejat AH, Eshghpour M, Danaeifar N, Abrishami M, Vahdatinia F, Fekrazad R. Effect of Photobiomodulation on the Incidence of Alveolar Osteitis and Postoperative Pain following Mandibular Third Molar Surgery: A Double-Blind Randomized Clinical Trial. Photochem Photobiol 2021; 97:1129-1135. [PMID: 34048061 DOI: 10.1111/php.13457] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/16/2021] [Indexed: 11/30/2022]
Abstract
The current study aimed to evaluate the effectiveness of photobiomodulation therapy for the prevention of incidence of alveolar osteitis (AO) and postoperative pain following third molar surgery. In this double-blind clinical trial, the impacted teeth of patients having bilateral impacted mandibular third molars were surgically extracted; for each participant, one socket was randomly assigned to receive photobiomodulation treatment, the other received sham treatment. 660 nm 200 mW CW was applied at a distance of ~1cm to 4 points on the occlusal area of extraction socket (beam area at the tissue ~0.64 cm2 , 312.5 mW cm-2 , 1J, 1.6 J cm-2 ). Also, 810 nm 200 mW CW was applied at tissue surface at three points on the buccal and three points on the lingual gingiva, for 15 s (400 mW cm-2 , 3 J, 6 J cm-2 ). There was a statistically meaningful difference in AO frequency between the two groups, and the photobiomodulation group showed lower AO frequency compared with the sham PBM treatment (P-value = 0.035). According to the findings of this study, photobiomodulation therapy reduced the incidence of AO following surgical removal of impacted mandibular third molars. The incidence of AO typically occurs 3-7 days post-extraction, and our results suggest that PBM treatment within the 7 days could help reduce the risk of AO development.
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Affiliation(s)
- Amir Hossein Nejat
- Department of Prosthodontics, Louisiana State University Health Science Center, New Orleans, LA, USA
| | - Majid Eshghpour
- Oral and Maxillofacial Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasrin Danaeifar
- Department of Pediatric Dentistry, Louisiana State University Health Science Center, New Orleans, LA, USA
| | - Majid Abrishami
- Oral and Maxillofacial Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farshid Vahdatinia
- Dental Implants Research Center, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center- Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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12
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Keković V, Schicho K, Figl M, Arany P, Jezdić Z, Soldatović I, Petrović M. Light distribution of 635 nm LED for PBM treatments in the maxillofacial region. ORAL AND MAXILLOFACIAL SURGERY CASES 2021. [DOI: 10.1016/j.omsc.2021.100208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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13
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Hakobyan G, Evsyukova Z, Ribakova E, Haruthyunyan A, Hovsepyan N. Evaluation of the effectiveness of neodymium laser therapies for Rosacea of the face. MGM JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.4103/mgmj.mgmj_89_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Camps-Font O, Figueiredo R, Sánchez-Torres A, Clé-Ovejero A, Coulthard P, Gay-Escoda C, Valmaseda-Castellón E. Which is the most suitable local anaesthetic when inferior nerve blocks are used for impacted mandibular third molar extraction? A network meta-analysis. Int J Oral Maxillofac Surg 2020; 49:1497-1507. [PMID: 32473767 DOI: 10.1016/j.ijom.2020.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/11/2020] [Accepted: 04/27/2020] [Indexed: 11/29/2022]
Abstract
The aim of this study was to compare the efficacy and safety of the different local anaesthetic agents for the extraction of impacted lower third molars. A network meta-analysis was performed of all published reports of randomized controlled clinical trials assessing efficacy (anaesthetic success and absence of need for supplementary anaesthesia during the surgical procedure) and/or safety (number of adverse events) of anaesthetic agents. Three electronic databases were searched, from their earliest records up to April 2019. Additionally, the grey literature was searched to identify further potential candidates for inclusion. Anaesthesia had to be delivered by an inferior alveolar nerve block, complemented with infiltration anaesthesia of the buccal nerve. The quality of the studies was assessed using the Cochrane Collaboration tool. This study included a total of 21 trials (2021 molars) assessing the efficacy and 19 trials (1977 molars) assessing the safety of 11 anaesthetic solutions. Seven of the studies included were considered to have a high risk of bias. The most effective local anaesthetic for the extraction of impacted mandibular third molars appeared to be 4% articaine, with significant differences when compared with 2% lidocaine, 0.5% bupivacaine, and 1% ropivacaine. Lidocaine is the safest local anaesthetic, although all investigated solutions can be used safely.
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Affiliation(s)
- O Camps-Font
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - R Figueiredo
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain.
| | - A Sánchez-Torres
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - A Clé-Ovejero
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - P Coulthard
- Oral and Maxillofacial Surgery, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - C Gay-Escoda
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - E Valmaseda-Castellón
- Oral Surgery and Implantology, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain
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15
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Santos PL, Marotto AP, Zatta da Silva T, Bottura MP, Valencise M, Marques DO, Queiroz TP. Is Low-Level Laser Therapy Effective for Pain Control After the Surgical Removal of Unerupted Third Molars? A Randomized Trial. J Oral Maxillofac Surg 2020; 78:184-189. [DOI: 10.1016/j.joms.2019.08.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
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16
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Singh V, Garg A, Bhagol A, Savarna S, Agarwal SK. Photobiomodulation Alleviates Postoperative Discomfort After Mandibular Third Molar Surgery. J Oral Maxillofac Surg 2019; 77:2412-2421. [DOI: 10.1016/j.joms.2019.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
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17
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Tijanic M, Buric N. A randomized anesthethic potency comparison between ropivacaine and bupivacaine on the perioperative regional anesthesia in lower third molar surgery. J Craniomaxillofac Surg 2019; 47:1652-1660. [DOI: 10.1016/j.jcms.2019.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/08/2019] [Accepted: 07/14/2019] [Indexed: 11/16/2022] Open
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18
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Safdari R, Pouremadi N, Talebzadeh E, Mottaghi A, Amini S, Hossienzadeh A, Movahedian Attar B. The Impacts of Low-Level Laser Therapy - A Complementary Treatment in the Management of Side Effects After Implant Surgery. J Lasers Med Sci 2019; 9:207-211. [PMID: 30809333 DOI: 10.15171/jlms.2018.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: One of the most important medical applications of laser is low-level laser therapy (LLLT). In this method, laser radiation penetrates easily into the target tissue. The aim of this study was to investigate whether LLLT can reduce the side effects of advanced implant surgery. Methods: In this triple-blind clinical trial, 30 patients aged 25 to 65 years were selected for implant insertion and divided into two groups. In the laser group, immediately after the surgery, 72 hours and 1 week after the surgery, the surgical site was irradiated with an 830 nm laser. The dose required for the laser therapy was 5 J/cm2 . The degree of pain, facial swelling and wound healing were analyzed using statistical methods. Results: Our results showed that at 12, 24, 48, and 72 hours after the surgery, the pain level was reduced in the laser group compared with the placebo group (P<0.05). Swelling of the face was also significantly reduced 7 days after surgery in the laser group (P<0.05). The investigation on the recovery conditions of the surgical site showed that on the 3rd, 7th and 14th days after the surgery, higher levels of wound healing have been achieved (P<0.05). Conclusion: Our results suggest that laser, as a complementary therapy; can be used to reduce the severity and duration of pain. Also, laser can reduce facial swelling and accelerate wound healing.
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Affiliation(s)
- Roya Safdari
- Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Narges Pouremadi
- Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Ehsan Talebzadeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Arash Mottaghi
- Department of Oral Diseases, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Shahram Amini
- Department of Periodontics, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Abolfath Hossienzadeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Bijan Movahedian Attar
- Dental Implant Research and Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran
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Sampaio-Filho H, Bussadori SK, Gonçalves MLL, da Silva DDFT, Borsatto MC, Tortamano IP, Longo PL, Pavani C, Fernandes KPS, Mesquita-Ferrari RA, Horliana ACRT. Low-level laser treatment applied at auriculotherapy points to reduce postoperative pain in third molar surgery: A randomized, controlled, single-blinded study. PLoS One 2018; 13:e0197989. [PMID: 29920521 PMCID: PMC6007895 DOI: 10.1371/journal.pone.0197989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 05/07/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Evaluate the effectiveness of LLL (Low level laser therapy) in auriculotherapy points for pain reduction following lower third molar extractions. STUDY DESIGN Randomized, controlled, single-blinded study. METHODS Eighty-four bilateral, symmetrical third molar surgeries were performed in 42 healthy patients using a split-mouth design. In the immediate postoperative period, each side was randomly treated in a single-blind method with an LLL at the auriculotherapy points or simulation of its use (contralateral side) over a 21-day interval. This protocol was repeated 24 and 48 hours after surgery. All patients used the same analgesic (paracetamol) but only in case of pain. The primary variable was postoperative pain according to the visual analogue scale, and the secondary variables were mouth opening, edema, local temperature, dysphagia, and the presence of infection (systemic temperature, lymphadenopathy). These variables were evaluated at baseline and at 24 hours, 48 hours and seven days after surgery. Adverse effects were recorded and reported. RESULTS There was no difference between the groups in relation to any of the evaluated parameters (p>0.05). CONCLUSION For this experimental model, application of a low-intensity laser at auriculotherapy points did not prevent postoperative pain following lower third molar surgery. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov; the registration number is NCT02657174 and the Unique Protocol ID number is 1.100.869. (https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=View&listmode=Edit&uid=U0002BEY&ts=11&sid=S0006026&cx=6g4wff).
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Affiliation(s)
- Hélio Sampaio-Filho
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | - Marcela Leticia Leal Gonçalves
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | | | | | | | | - Christiane Pavani
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | | - Raquel Agnelli Mesquita-Ferrari
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
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20
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Koparal M, Kucuk AO, Alan H, Asutay F, Avci M. Effects of low-level laser therapy following surgical extraction of the lower third molar with objective measurement of swelling using a three-dimensional system. Exp Ther Med 2018; 15:3820-3826. [PMID: 29581740 PMCID: PMC5863601 DOI: 10.3892/etm.2018.5921] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 07/11/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to evaluate and compare the effects of single- and two-dose low-level laser therapy (LLLT) on the postoperative swelling, trismus and pain of patients undergoing extraction of impacted mandibular third molars. In addition, edema was volumetrically measured with a 3dMD face system. A total of 45 patients were randomly divided into three treatment groups (15 patients in each group) as follows: Group 1, receiving routine management with ice application and serving as the control group; Group 2, receiving a single dose of LLLT immediately following surgery; and Group 3, receiving two doses of LLLT, immediately following surgery and on day 2 after surgery. In the present study, a gallium-aluminum-arsenide (0.3 W, 40 sec, 4 J/cm2) diode laser device was applied extraorally at the insertion point of the masseter muscle. The trismus, pain level and facial swelling of the patients were evaluated. The visual analog scale (VAS) was used to examine the pain degree, while a 3dMD face photogrammetric system was used to evaluate the volumetric alterations of the swelling. The results indicated no statistically significant differences in the mean swelling or trismus among the three groups. The mean VAS measurements did not differ significantly among the groups at postoperative day 2; however, significantly reduced VAS values were observed in Group 2 compared with Group 1 at postoperative day 7 (P<0.05). The present study demonstrated that, although single-dose or two-dose LLLT had beneficial effects on the swelling, trismus and pain level, a significant reduction was only observed in the pain level at postoperative day 7.
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Affiliation(s)
- Mahmut Koparal
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adiyaman University, Adiyaman 02200, Turkey
| | - Ayse Ozcan Kucuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Inonu University, Malatya 44280, Turkey
| | - Hilal Alan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Inonu University, Malatya 44280, Turkey
| | - Fatih Asutay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyon Kocatepe University, Afyon 03030, Turkey
| | - Mehmet Avci
- Department of Orthodontics, Faculty of Dentistry, Inonu University, Malatya 44280, Turkey
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21
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Lauriti L, de Cerqueira Luz JG, Agnelli Mesquita-Ferrari R, Fernandes KPS, Deana AM, Tempestini Horliana ACR, Costa-Santos L, Brugnera Junior A, Bussadori SK. Evaluation of the Effect of Phototherapy in Patients with Mandibular Fracture on Mandibular Dynamics, Pain, Edema, and Bite Force: A Pilot Study. Photomed Laser Surg 2017; 36:24-30. [PMID: 29023221 DOI: 10.1089/pho.2017.4334] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of phototherapy on bite force, facial swelling, mandibular movements, and pain in patients having undergone surgical treatment for mandibular fractures. BACKGROUND These are among the predominant types of facial fractures, and treatment involving surgical fixation with titanium plates is one of the most common procedures in oral-maxillofacial surgery. Phototherapy has been used to accelerate the muscle healing process and significantly improves muscle regeneration by inducing the formation of new muscle fibers. METHODS The patients were divided into two groups: Group 1-active phototherapy, and Group 2-sham phototherapy. Both groups underwent the surgical procedure by the same surgeon using the same surgical technique. Dosimetric parameters are wavelength, 660 nm; power, 108 mW; radiant energy, 21.6 J; fluency, 21.6 J/cm2; radiance, 38197 mW/cm2; exposure time, 200 sec per point, 10 points bilaterally. Photobiomodulation was performed in 15 sessions. RESULTS The primary variable was bite force measured with a gnathodynamometer and the secondary variables were facial swelling, mandibular movements (measured with digital calipers), and pain. The Student's t-test was used to determine intergroup differences. CONCLUSIONS The findings suggest improvements in the laser group in comparison with the sham group with regard to mandibular dynamics, a reduction in postoperative facial swelling, a reduction in pain, and an increase in bite force.
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Affiliation(s)
- Leandro Lauriti
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil
| | | | - Raquel Agnelli Mesquita-Ferrari
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | - Kristianne Porta Santos Fernandes
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | - Alessandro Melo Deana
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
| | | | - Larissa Costa-Santos
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil
| | - Aldo Brugnera Junior
- 4 National Institute of Science and Technology-INCT, IFSC, University of São Paulo , São Carlos, Brazil
| | - Sandra Kalil Bussadori
- 1 Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University , São Paulo, Brazil .,3 Postgraduate Program in Rehabilitation Sciences, Nove de Julho University , São Paulo, Brazil
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Kahraman SA, Cetiner S, Strauss RA. The Effects of Transcutaneous and Intraoral Low-Level Laser Therapy After Extraction of Lower Third Molars: A Randomized Single Blind, Placebo Controlled Dual-Center Study. Photomed Laser Surg 2017; 35:401-407. [DOI: 10.1089/pho.2016.4252] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sevil Altundag Kahraman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Türkiye
| | - Sedat Cetiner
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Türkiye
| | - Robert A. Strauss
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia
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MILETO TN, AZAMBUJA FG. Low-intensity laser efficacy in postoperative extraction of third molars. ACTA ACUST UNITED AC 2017. [DOI: 10.1590/1981-863720170001000023084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT The search for means that enable a better quality of life for postoperative patients should be incessant. The surgical extraction of third molars can result in potential complications such as pain, swelling and trismus, along with discomfort in the recovery phase. Therefore, this narrative review was to analyze, from systematic reviews and randomized clinical trials, the use of low level laser therapy as influencer the clinical state after third molar surgery. Scientific articles were searched through PubMed and Science Direct database. In spite of the evaluated studies have cited the effectiveness of laser therapy such as tissue repair, anti-inflammatory and analgesic, variety of analysis models and diversity of dosimetry leaves a gap on their true efficacy. Based on the research conducted, we suggest the adjuvant use of diode laser GaAlAs with 810 nm (λ), 100 mW constant power and 4 J/cm2 of energy, intra and extra oral form at least three sections to minimize possible occurrences of third molar surgery.
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Raiesian S, Khani M, Khiabani K, Hemmati E, Pouretezad M. Assessment of Low-Level Laser Therapy Effects After Extraction of Impacted Lower Third Molar Surgery. J Lasers Med Sci 2017; 8:42-45. [PMID: 28912943 PMCID: PMC5420364 DOI: 10.15171/jlms.2017.08] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: The aim of this study was to assess the effect of low-level laser therapy (LLLT) on pain, swelling and maximum mouth opening in patients undergoing third molar surgery. Methods: A prospective, randomized double-blind study was undertaken on 44 patients at the Dental School, Ahvaz Jundishapur University of Medical Sciences, in 2015. A low-level laser was randomly applied on one of the two sides after surgery of 15 patients. The experimental side received 18 J/cm2 of energy density, wavelength of 980 nm, and output power of 1.8 W. On the control side, a hand-piece was applied intra-orally, but laser was not activated. In addition, in order to evaluate trismus, 13 patients were treated by unilateral laser therapy and 16 patients did not receive laser therapy at all. The laser was administered intraorally on two points of vestibular and lingual sides at 1 cm from the surgery site, and extraorally at the emergence of the masseter muscle, immediately after surgery, and repeated 24 hours later. The pain, swelling and maximum mouth opening (MMO) were compared between the two groups at 24 hours and a week after surgery. Results: The mean score of pain 24 hours after surgery in the laser therapy group (2.3 ± 3.5) was significantly lower than the mean score of pain in the drug therapy (4.19 ± 3.09) (P = 0.036). Moreover, the mean score of pain at one week after surgery in the laser therapy group (0.13 ± 2.33) was significantly lower than the drug therapy group (1.43 ± 2.45) (P = 0.046). The amount of swelling according to different measurements did not significantly differ between the two groups neither at 24 hours nor at 1 week after surgery. Conclusion: Our findings showed that LLLT was useful in reducing pain and could slightly reduce swelling compared to drug therapy in impacted third molar surgery.
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Affiliation(s)
- Shahrokh Raiesian
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Khani
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kazem Khiabani
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ershad Hemmati
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Pouretezad
- Department of Physiotherapy, Faculty of Rehabilitation, Jundishapur University of Medical Sciences, Ahvaz, Iran
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25
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Hamid MA. Low-level Laser Therapy on Postoperative Pain after Mandibular Third Molar Surgery. Ann Maxillofac Surg 2017; 7:207-216. [PMID: 29264287 PMCID: PMC5717896 DOI: 10.4103/ams.ams_5_17] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: The analgesic effect of low-level laser therapy (LLLT) after mandibular third molar (MTM) extraction is controversial. The aim is to evaluate the effect of intraoral LLLT on postoperative pain after MTMs extraction. Methods: Thirty patients with bilateral symmetrical impacted MTMs underwent surgical extractions. Experimental and control sides were randomly selected to receive LLLT or placebo. Following suturing, a dental assistant applied 810 nm gallium aluminum arsenide (GaAlAs) at three points for 30 s each with a total energy of 9 J. Pain was recorded on a visual analog scale on the 7 successive days. Results: Data analyzed by IBM SPSS Statistics 23 for Windows with P ≤ 0.05 significance level. LLLT appeared to have a high significant effect on pain reduction; however, there was a mild increase in pain after the 4th day. Conclusion: Intraoral 810 nm GaAlAs is effective in reducing postoperative pain when a dose of 32.86 J/cm2 is used.
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Affiliation(s)
- May Ayad Hamid
- Department of Oral Surgery and Implantology, Maktoum Bin Hamdan Dental University College, Dubai, UAE
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26
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Sattayut S. Low intensity laser for reducing pain from anesthetic palatal injection. Photomed Laser Surg 2016; 32:658-62. [PMID: 25372219 DOI: 10.1089/pho.2014.3770] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of pain reduction techniques for palatal injection, namely, low intensity laser therapy (LILT), topical anesthesia, pressure, and light touch. BACKGROUND DATA Previous evidence indicates that LILT may prevent pain from palatal injection. However, no clinical trials evaluating this clinical question have been performed. METHODS A double-blind clinical trial was conducted using 80 healthy volunteers, 18-25 years of age. The subjects were randomly allocated into four groups with 10 females and 10 males each group. Pain reduction techniques were administered at an injection point that was 10 mm from the margin of the palatal gingiva of the upper left first molar according to the following groups: (1) a 790 nm 30 mW continuous wave with a 0.13 cm2 focal spot at an applied energy of 3.6 J and fluence of 27.69 J/cm2, (2) 20% benzocaine, (3) pressure, and (4) light touch as the control. Then, 2% lidocaine with 1:100,000 epinephrine was injected using a 27-gauge needle with a pressure and volume control intraligamentary syringe. All subjects recorded pain on a 10 cm visual analog scale (VAS). RESULTS The pain score in the LILT group was <50 mm. The median of pain scores of the LILT, 20% benzocaine, pressure, and light touch groups were 11, 23, 27, and 31 mm, respectively. There was no statistically significant difference in VAS among the groups, using Kruskal-Wallis test (p=0.385). CONCLUSIONS No statistically significant differences in pain scores were noted among low intensity laser, 20% benzocaine, pressure, and light touch.
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Affiliation(s)
- Sajee Sattayut
- Oral Surgery Department, Faculty of Dentistry and Lasers in Dentistry Research Group, Khon Kaen University , Khon Kaen, Thailand
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Sampaio-Filho H, Sotto-Ramos J, Pinto EH, Cabral MR, Longo PL, Tortamano IP, Marcos RL, Silva DFT, Pavani C, Horliana ACRT. Evaluation of low-level laser at auriculotherapy points to reduce postoperative pain in inferior third molar surgery: study protocol for a randomized controlled trial. Trials 2016; 17:432. [PMID: 27590454 PMCID: PMC5010672 DOI: 10.1186/s13063-016-1540-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 08/05/2016] [Indexed: 11/10/2022] Open
Abstract
Background A comfortable postoperative return to daily activities has increased the need to control inflammation after third molar surgery. Anti-inflammatory drugs and analgesics are not exempt from adverse effects such as allergies and chronic gastritis, and they are not without cost. The association between low-level laser and auricular acupuncture can be an alternative when conventional drugs are contraindicated. Among its advantages, we can mention the low risk of side effects, low cost and simplicity of application. The objective of this study is to evaluate the efficiency of low-level laser at auriculotherapy points in reducing postoperative pain in lower third molar surgery. Methods/design Ninety bilateral, symmetrical lower third molar surgeries will be performed in 45 healthy patients. Each patient will be their own control, through a split-mouth crossover study. One side of the mouth will be randomly chosen and, immediately after surgery, will be treated with low-level laser. After 21 days, the contralateral side will be operated on with low-level laser simulation used postoperatively. This regimen (laser application or not) will be repeated at 24 and 48 h after surgery. All patients will be requested to take analgesics (acetaminophen) if they have pain, i.e. in case of pain. Neither the surgeon nor the patients will know the assigned treatment. The primary variable will be postoperative pain assessed using a Visual Analog Scale, and the secondary variables will be trismus, edema, local temperature, dysphagia, presence of infection and painkiller ingestion. These variables will be assessed at baseline, 24 h, 48 h and 7 days after surgery. Blood samples for systemic inflammatory cytokine (TNF-α, IL-1, IL-6 and IL-8) analysis will be assessed at baseline and 24 h after surgery. Discussion Some authors believe that using a wavelength of 633 to 670 nm is a good option for laser therapy in the field of acupuncture. This wavelength can penetrate biological tissue to a depth of about 3 mm. However, for auriculotherapy points, the stimulus (mustard seeds, needles 1 to 2.5 mm) does not penetrate so deeply. For this reason, we chose a laser wavelength of 660 nm (red wavelength). Trial registration ClinicalTrials.gov Identifier: NCT02657174, registered on 11 January 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1540-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hélio Sampaio-Filho
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Juliane Sotto-Ramos
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Erika Horácio Pinto
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Marcia Regina Cabral
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Priscila Larcher Longo
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | | | - Rodrigo Labat Marcos
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Daniela Fátima Teixeira Silva
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Christine Pavani
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil
| | - Anna Carolina Ratto Tempestini Horliana
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP 01504-001, São Paulo, Brazil.
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Is Low-Level Laser Therapy Effective in the Management of Pain and Swelling After Mandibular Third Molar Surgery? J Oral Maxillofac Surg 2016; 74:1322.e1-8. [DOI: 10.1016/j.joms.2016.02.030] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 01/30/2016] [Accepted: 02/27/2016] [Indexed: 11/19/2022]
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de Freitas LF, Hamblin MR. Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy. IEEE JOURNAL OF SELECTED TOPICS IN QUANTUM ELECTRONICS : A PUBLICATION OF THE IEEE LASERS AND ELECTRO-OPTICS SOCIETY 2016; 22:7000417. [PMID: 28070154 PMCID: PMC5215870 DOI: 10.1109/jstqe.2016.2561201] [Citation(s) in RCA: 700] [Impact Index Per Article: 87.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Photobiomodulation (PBM) also known as low-level laser (or light) therapy (LLLT), has been known for almost 50 years but still has not gained widespread acceptance, largely due to uncertainty about the molecular, cellular, and tissular mechanisms of action. However, in recent years, much knowledge has been gained in this area, which will be summarized in this review. One of the most important chromophores is cytochrome c oxidase (unit IV in the mitochondrial respiratory chain), which contains both heme and copper centers and absorbs light into the near-infra-red region. The leading hypothesis is that the photons dissociate inhibitory nitric oxide from the enzyme, leading to an increase in electron transport, mitochondrial membrane potential and ATP production. Another hypothesis concerns light-sensitive ion channels that can be activated allowing calcium to enter the cell. After the initial photon absorption events, numerous signaling pathways are activated via reactive oxygen species, cyclic AMP, NO and Ca2+, leading to activation of transcription factors. These transcription factors can lead to increased expression of genes related to protein synthesis, cell migration and proliferation, anti-inflammatory signaling, anti-apoptotic proteins, antioxidant enzymes. Stem cells and progenitor cells appear to be particularly susceptible to LLLT.
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Affiliation(s)
- Lucas Freitas de Freitas
- Programa de Pós-Graduação
Interunidades Bioengenharia, University of São Paulo, São Carlos -
SP, Brazil
- Wellman Center for Photomedicine, Harvard Medical School,
Boston, MA 02114, USA
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Harvard Medical School,
Boston, MA 02114, USA
- Department of Dermatology, Harvard Medical School, Boston,
MA 02115, USA
- Harvard-MIT Division of Health Sciences and Technology,
Cambridge, MA 02139, USA
- Correspondence: Michael R Hamblin,
; Tel 1-617-726-6182
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Pol R, Ruggiero T, Gallesio G, Riso M, Bergamasco L, Mortellaro C, Mozzati M. Efficacy of Anti-Inflammatory and Analgesic of Superpulsed Low Level Laser Therapy After Impacted Mandibular Third Molars Extractions. J Craniofac Surg 2016; 27:685-90. [DOI: 10.1097/scs.0000000000002523] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Elbay ÜŞ, Tak Ö, Elbay M, Uğurluel C, Kaya C. Efficacy of Low-Level Laser Therapy in the Management of Postoperative Pain in Children After Primary Teeth Extraction: A Randomized Clinical Trial. Photomed Laser Surg 2016; 34:171-7. [DOI: 10.1089/pho.2015.4045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ülkü Şermet Elbay
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Önjen Tak
- Department of Prosthodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Mesut Elbay
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Ceren Uğurluel
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Can Kaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
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Esteves SRMS, Huhtala MFRL, Gomes APM, Ye Q, Spencer P, De Paiva Gonçalves SE. Longitudinal Effect of Surface Treatments Modified by NaOCl-Induced Deproteinization and Nd:YAG Laser on Dentin Permeability. Photomed Laser Surg 2016; 34:68-75. [DOI: 10.1089/pho.2015.3977] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Ana Paula Martins Gomes
- Department of Restorative Dentistry, São José dos Campos School of Dentistry, University Estadual Paulista, SP, Brazil
| | - Qiang Ye
- Bioengineering Research Center Laboratories The University of Kansas, School of Engineering, Bioengineering Research Center, Lawrence, Kansas
| | - Paulette Spencer
- Bioengineering Research Center Laboratories The University of Kansas, School of Engineering, Bioengineering Research Center, Lawrence, Kansas
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Deo SP. Role of addition of dexamethasone to lignocaine 2% with adrenaline in dental nerve blocks for third molar surgery: A prospective randomized control trial. Ann Maxillofac Surg 2016; 6:260-266. [PMID: 28299268 PMCID: PMC5343638 DOI: 10.4103/2231-0746.200341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Context: Dexamethasone has been frequently used in oral surgical procedure and accepted by oral and maxillofacial surgeon community worldwide. However, this is the first clinical trial that used dexamethasone as adjuvant with lignocaine in dental nerve block (DNB). Aims: The purpose of this double-blind, randomized control trial (RCT) was to compare the effect of dexamethasone with normal saline (NS) in a lignocaine DNB. Settings and Design: This prospective, double-blind, RCT was carried out after obtaining approval from the Institutional Ethical Committee. Subjects and Methods: In forty patients, the present placebo-controlled clinical trial was conducted; allocated randomly into two groups: study group (SG) or control group (CG). The single-dose submucosal dexamethasone or NS injection was administered immediately after 2% lignocaine with epinephrine 1:2,00,000 nerves block during mandibular third molar surgery (TMS). Visual analog scale score, number, and exact time nonsteroidal anti-inflammatory drugs were administered were used to measure postoperative analgesia in 2nd and 7th days. Statistical Analysis Used: All the data were entered into the Spreadsheet (Excel, Microsoft) and Chi-square test, Mann–Whitney U-test, Student's paired and unpaired t-test, and Fisher exact test were used. Results: This study found maximum duration of DNB in SG was 248.88 min and in CG was 175.44 min, whereas minimum duration in SG was 197 min and in CG was 140.78 min. Conclusions: Dexamethasone prolongs the action of lignocaine 2% in DNB for TMS.
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Affiliation(s)
- Saroj Prasad Deo
- Department of Oral and Maxillofacial Surgery, National Medical College, Birgunj, Nepal
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Landucci A, Wosny AC, Uetanabaro LC, Moro A, Araujo MR. Efficacy of a single dose of low-level laser therapy in reducing pain, swelling, and trismus following third molar extraction surgery. Int J Oral Maxillofac Surg 2015; 45:392-8. [PMID: 26691932 DOI: 10.1016/j.ijom.2015.10.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/24/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Abstract
The clinical efficacy of low-level laser therapy (LLLT) for the reduction of pain, swelling, and trismus following the surgical extraction of third molars was evaluated. Mandibular third molars, with similar radiographic positions on two distinct sections, were extracted from 22 patients. Immediately after extraction from the randomly selected right or left side, LLLT was applied (study group). The same extraction procedure was performed 21 days later on the other third molar, without the application of LLLT (control group). LLLT was applied at 10 points: four intraoral in close proximity to the socket and six extraoral along the masseter muscle. Pain intensity was assessed using a visual analogue scale, swelling was measured as the distance from the tragus to the median base of the mentum, and trismus was assessed by the extent of mouth opening. Data were collected at four time points: before surgery, immediately after surgery, 48h postoperatively, and 7 days postoperatively. Compared with the control group, the study group showed significant reductions in pain, swelling, and trismus at 48h and 7 days postoperatively. In conclusion, a single dose of LLLT was effective at reducing the postoperative discomforts (pain, swelling, and trismus) associated with third molar extraction surgery.
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Affiliation(s)
- A Landucci
- Graduate Program in Clinical Dentistry, Positivo University, Curitiba, Paraná, Brazil
| | - A C Wosny
- Graduate Program in Clinical Dentistry, Positivo University, Curitiba, Paraná, Brazil
| | - L C Uetanabaro
- Graduate Program in Clinical Dentistry, Positivo University, Curitiba, Paraná, Brazil
| | - A Moro
- Graduate Program in Clinical Dentistry, Positivo University, Curitiba, Paraná, Brazil
| | - M R Araujo
- Graduate Program in Clinical Dentistry, Positivo University, Curitiba, Paraná, Brazil.
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Effect of low-intensity laser treatment on pain after extraction of impacted mandibular third molars: a randomised, controlled, clinical trial. Br J Oral Maxillofac Surg 2015; 53:996-1000. [DOI: 10.1016/j.bjoms.2015.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 09/04/2015] [Indexed: 11/20/2022]
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Comparative efficacy of nimesulide and ketoprofen on inflammatory events in third molar surgery: a split-mouth, prospective, randomized, double-blind study. Int J Oral Maxillofac Surg 2015; 44:876-84. [DOI: 10.1016/j.ijom.2014.10.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 09/30/2014] [Accepted: 10/22/2014] [Indexed: 11/20/2022]
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Fabre HSC, Navarro RL, Oltramari-Navarro PVP, Oliveira RF, Pires-Oliveira DAA, Andraus RAC, Fuirini N, Fernandes KBP. Anti-inflammatory and analgesic effects of low-level laser therapy on the postoperative healing process. J Phys Ther Sci 2015; 27:1645-8. [PMID: 26180289 PMCID: PMC4499952 DOI: 10.1589/jpts.27.1645] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/07/2015] [Indexed: 12/21/2022] Open
Abstract
[Purpose] This study aimed to evaluate the anti-inflammatory and analgesic effects of
intraoral application of low-level laser therapy (660 nm) to control pain, swelling and
interincisal opening following the extraction of mandibular third molars. [Subjects and
Methods] Ten patients underwent removal of lower third molars using the same surgical
protocol and pharmacological approach. In the postoperative period, all patients received
four consecutive daily sessions of low-level laser therapy, beginning 24 hours after the
surgery. Intraoral applications using the diode laser with 660 nm wavelength in the
continuous scan mode were performed covering the entire surgical area, which was divided
into four quadrants, each of 1 cm2 area at a distance of 1 cm. The energy
applied at each point was 5 J/cm2 during 8 seconds. [Results] The swelling and
interincisal opening returned to normal 24 hours after the first low-level laser therapy
application (Friedman test). Moreover, the pain intensity was reduced on the third
postoperative day, according to the Friedman test. [Conclusion] Low-level laser therapy
(660 nm), at the dosimetry used in this study, was effective in reducing postoperative
pain and swelling following oral surgery.
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Affiliation(s)
| | | | | | | | | | | | - Nelson Fuirini
- School of Medical Sciences, Pontifical University Catholic of Campinas, Brazil
| | - Karen B P Fernandes
- Health Sciences Research Center, University of Northern Parana, Brazil ; School of Medicine, Pontificial University Catholic of Paraná, Brazil
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Ozturan S, Sirali A, Sur H. Effects of Nd:YAG laser irradiation for minimizing edema and pain after sinus lift surgery: randomized controlled clinical trial. Photomed Laser Surg 2015; 33:193-9. [PMID: 25764523 DOI: 10.1089/pho.2014.3823] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of the present study was to evaluate the effectiveness of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser used for low-level laser therapy (LLLT) on pain, oral health-related quality of life (OHRQoL), and swelling after sinus lift procedure. MATERIALS AND METHODS Ten healthy patients, requiring bilateral direct sinus lift surgery, were included in this prospective, randomized study. The treatment sides were randomly assigned to LLLT or control groups. The experimental side received 8 J/cm(2) of energy density, a wavelength of 1064 nm, for 60 sec, and 0.5 W laser immediately after surgery. Swelling, pain perception, and OHRQoL were evaluated at different time intervals. The data were analyzed by the one way ANOVA. RESULTS Evaluations of postoperative pain, OHRQoL, and swelling were made. We observed that the swelling and the OHRQoL in the Nd:YAG group were significantly improved when compared with the control group on the 3rd day after surgery (p<0.05). The pain levels after surgery was almost the same for both groups, without statistically significant differences (p>0.05). There were no statistically significant differences between groups with regard to any of the parameters evaluated on the 7th day. CONCLUSIONS The results demonstrate that the 1064 nm Nd:YAG laser was effective in improving OHRQoL and reducing swelling after sinus lift surgery. Within the limitations of this study, we concluded that the 1064 nm Nd:YAG laser has beneficial effects on swelling and OHRQoL, making it suitable for LLLT.
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Affiliation(s)
- Seda Ozturan
- 1 Faculty of Dentistry, Department of Periodontology, Biruni University , Istanbul, Turkey
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Chan A, Punnia-Moorthy A, Armati P. Low-power pulsed Nd:YAG laser irradiation for pre-emptive anaesthesia: A morphological and histological study. Laser Ther 2015; 23:255-62. [PMID: 25705081 DOI: 10.5978/islsm.14-or-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 10/10/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS To determine if tooth structure or dental pulp of normal healthy human premolar teeth to be extracted for orthodontic reasons exhibit morphological or histological changes following dental anaesthesia by pulsed Nd:YAG laser and subsequent cavity preparation (CP). Materials (Subjects) and Methods: 54 bilateral paired of human, healthy premolar teeth identified for inclusion in a clinical trial of Nd:YAG-induced anaesthesia and subsequently extracted for orthodontic reasons, were randomly divided into 4 treatment groups: Group 1 - teeth (n=44) were irradiated with 150 µs pulsed Nd:YAG laser-1064 nm (American Dental Laser, dLase300, Sunrise Technologies Inc., Folsom, CA, USA; Average power: 1.1 ± 0.2 W, power density: 39+ 0.7 W/cm(2), area 0.28 cm(2), 15 Hz; energy density:0. 260+ 0.047 J/cm(2)) +Sham EMLA (cream without active component) followed by cavity preparation (CP); Group 2 - Teeth (n=44) - were treated with EMLA + Sham Laser (1 mW 632.8-nm He:Ne laser aiming beam only) with CP; Group 3 Teeth (n=10) - were irradiated with pulsed Nd:YAG laser as above but minus CP; Group 4 (n=10)- was a Control group with teeth untreated (no Laser, EMLA or CP). Clinical anaesthesia was assessed by electric pulp testing (EPT) and CP. Teeth in each of the 4 groups were processed for examination by i) scanning electron microscopy (SEM); ii) longitudinal undecalcified ground sectioning (LUGS); iii) light microscopy of pulpal tissues or iv) dye penetration. RESULTS Both Laser and EMLA groups demonstrated no alteration to mineralized tooth structure and dentinal permeability. Mild superficial pulpal changes were found in both groups (3/18 teeth) and of no statistical difference (p>0.99, the McNemar test). Neither Laser nor the Control groups minus CP, showed pulpal changes. CONCLUSIONS Low-power pulsed Nd:YAG laser dose, as used in the clinical trial to induce anaesthesia, does not cause morphological damage to the mineralized tooth structure. Both Laser and EMLA groups showed minor superficial pulpal change following cavity preparation which was not statistically significant. Laser and Control groups minus preparation had no pulpal changes.
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Affiliation(s)
- Ambrose Chan
- Brain & Mind Research Institute, The University of Sydney, Sydney, Australia
| | | | - Patricia Armati
- Brain & Mind Research Institute, The University of Sydney, Sydney, Australia
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Milward MR, Holder MJ, Palin WM, Hadis MA, Carroll JD, Cooper PR. Low level light therapy (LLLT) for the treatment and management of dental and oral diseases. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/denu.2014.41.9.763] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael R Milward
- Senior Lecturer/Honorary Consultant in Periodontology, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham
| | - Michelle J Holder
- Research Technician in Oral Biology, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham
| | - William M Palin
- Reader in Biomaterials, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham
| | - Mohammed A Hadis
- Research Fellow in Biomaterials, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham
| | - James D Carroll
- Founder/CEO at THOR Photomedicine Ltd, 18A East Street, Chesham, HP5 1HQ
| | - Paul R Cooper
- Professor of Oral Biology, University of Birmingham, School of Dentistry, St Chad's Queensway, Birmingham, B4 6NN, UK
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Mesgarzadeh AH, Afsari H, Pourkhamne S, Shahamfar M. Efficacy of bilateral mental nerve block with bupivacaine for postoperative pain control in mandibular parasymphysis fractures. J Dent Res Dent Clin Dent Prospects 2014; 8:172-5. [PMID: 25346837 PMCID: PMC4206760 DOI: 10.5681/joddd.2014.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 10/09/2014] [Indexed: 11/21/2022] Open
Abstract
Background and aims. Postoperative pain control is extremely important for both patients and surgeons; in this context, long-acting local anesthesia can play an important role after open reduction of maxillofacial fractures. The purpose of this study was to evaluate the effect of bilateral mental nerve block with bupivacaine on postoperative pain control in mandibular symphyseal fractures. Materials and methods. Fifty patients with pure mandibular symphyseal fractures were studied in two control and study groups. In contrast to the control group, the study group received bilateral mental nerve block with bupivacaine postoperatively. Patients were examined in relation to pain severity and opioid analgesic drug need sequences. Results. The study group needed significantly less opioid than the control group (P<0.01, U=141). The control and study groups were different in first opioid administration time. The control and study groups received first opioid dose in 0-2 and 2-4 hours, respectively. Conclusion. Bilateral mental nerve blocks with bupivacaine can reduce opioid analgesic need and it has a positive effect on postoperative pain control in mandibular symphyseal fractures.
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Affiliation(s)
- Ali Hossein Mesgarzadeh
- Associate Professor, Department of Oral and MaxilloFacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hosein Afsari
- Oral and Maxillofacial Surgeon, Private Practice, Tehran, Iran
| | - Sohrab Pourkhamne
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Ardebil University of Medical Sciences, Ardebil, Iran
| | - Mohamadreza Shahamfar
- Post-graduate Student, Department of Orthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Postoperative pain after bupivacaine supplementation in mandibular third molar surgery: splint-mouth randomized double blind controlled clinical trial. Oral Maxillofac Surg 2014; 18:387-91. [PMID: 25338961 DOI: 10.1007/s10006-014-0471-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Efficacy of anesthetic supplementation with bupivacaine to control both pain and the number of analgesics ingested after surgery has been proposed; however, no report was found in the literature regarding supplemental use of bupivacaine. Thus, the aim of this study was to evaluate the clinical efficacy of bupivacaine in appeasing postoperative pain, when used as supplemental anesthesia at the end of surgeries to extract mandibular third molars. METHODS Eighty surgeries were performed in 40 healthy ASA I patients of mandibular bilateral, semi-enclosed, and symmetrical third molars, in a randomized, double-blind, placebo-controlled, and split-mouth clinical trial. Two procedures were performed. In one case, a preoperative anesthetic block was performed with bupivacaine (0.5 %) and epinephrine (1:200,000). Supplementation with the same anesthetic composition was used at the end of the surgery (test group). In the second case (control group), the procedure was identical to that used in the test group, but was supplemented in a randomized double-blind trial with saline (placebo), using the split-mouth method. Postoperative pain (measured with a visual analog scale) was the primary variable studied, and analgesic consumption was the secondary variable. Nonparametric analysis of variance (Wilcoxon test) and a two-tailed test to determine the ratio was used. P value was set at 0.05. RESULTS No statistically significant difference (P > 0.05) was found in the variables studied. An adverse effect related to the anesthetic under study was not observed. CONCLUSION There is no appreciable value to the second injection regarding pain and analgesia use, but there was a difference regarding patient acceptance in surgeries of mandibular semi-enclosed and impacted third molars.
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Zor ZF, Isik B, Cetiner S. Efficacy of preemptive lornoxicam on postoperative analgesia after surgical removal of mandibular third molars. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:27-31. [PMID: 24332324 DOI: 10.1016/j.oooo.2013.08.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 08/20/2013] [Accepted: 08/28/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Pain is the most encountered complication following third molar surgery. Although nonsteroidal anti-inflammatory drugs are often used for pain control, the effect of preemptive lornoxicam has not been detailed. We compare the analgesic efficacy of preemptive lornoxicam versus postoperative lornoxicam. STUDY DESIGN Forty-three participants aged 18 to 33 years who had bilateral, symmetrical third molars were included in this double-blind, randomized, placebo-controlled study. All participants took part in each of the 2 groups for a 1-month interval (crossover design). Group Pre received lornoxicam 8 mg intravenously 25 minutes before surgery and 2 mL serum saline postoperatively. Group Post was given the opposite protocol. Pain was evaluated by visual analog scale in the first 12 hours. RESULTS We observed statistically significant differences in the reduction of the pain level in group Pre (P < .05). These participants felt less pain in the first 5 postoperative hours and needed fewer analgesics in the first 12 postoperative hours. CONCLUSIONS Preemptive lornoxicam is effective for postoperative pain control.
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Affiliation(s)
- Zeynep Fatma Zor
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey.
| | - Berrin Isik
- Associate Professor, Anesthesiology and Reanimation Specialist, Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Sedat Cetiner
- Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
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A systematic review and meta-analysis on the efficacy of low-level laser therapy in the management of complication after mandibular third molar surgery. Lasers Med Sci 2014; 30:1779-88. [DOI: 10.1007/s10103-014-1634-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 07/10/2014] [Indexed: 10/24/2022]
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Olurotimi AO, Gbotolorun OM, Ibikunle AA, Emeka CI, Arotiba GT, Akinwande JA. A comparative clinical evaluation of the effect of preoperative and postoperative antimicrobial therapy on postoperative sequelae after impacted mandibular third molar extraction. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2014; 5:e2. [PMID: 25089174 PMCID: PMC4115594 DOI: 10.5037/jomr.2014.5202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 12/09/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare the effect of preoperative and postoperative antibiotics therapy on postoperative sequelae after impacted mandibular third molar extractions. MATERIAL AND METHODS This was a prospective study conducted at Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospitalon consecutive patients with impacted third molar extractions for a 12 month period. Group I (n = 31) had administration of 1 gram of oral metronidazole and 1 gram of amoxicillin capsules 30 minutes preoperative and Group II (n = 31) had 500 milligrams of amoxicillin capsule 8 hourly and 400 milligrams of metronidazole tablets administered post operatively for 5 days. Pain, facial swelling and mouth opening assessment were done postoperatively and on days 1, 3 and 7. RESULTS The general pattern of postoperative pain, regardless of antimicrobial use revealed that pain increased from day 1 to day 3 postoperatively and began to decrease in intensity subsequently up to the seventh day. There was however a statistically significant difference (P = 0.0001) between the two groups on the 7th postoperative day with the subjects in Group I showing lower pain intensity. The mean difference of the facial width on days 1 and 3 was significant (P = 0.04 and P = 0.0001 respectively) with subjects in Group II having a reduced facial width compared to those in Group I. CONCLUSIONS This study suggested that the administration of preoperative or postoperative antibiotics showed no marked differences in the degree of postoperative sequaele that occur after impacted mandibular third molar extractions.
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Affiliation(s)
| | | | - Adebayo Aremu Ibikunle
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos Nigeria
| | - Christian Ibezi Emeka
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos Nigeria
| | - Godwin Toyin Arotiba
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos Nigeria
| | - Jelili Adisa Akinwande
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos Nigeria
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Kazancioglu H, Kurklu E, Ezirganli S. Effects of ozone therapy on pain, swelling, and trismus following third molar surgery. Int J Oral Maxillofac Surg 2014; 43:644-8. [DOI: 10.1016/j.ijom.2013.11.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/13/2013] [Accepted: 11/04/2013] [Indexed: 11/28/2022]
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Carroll JD, Milward MR, Cooper PR, Hadis M, Palin WM. Developments in low level light therapy (LLLT) for dentistry. Dent Mater 2014; 30:465-75. [PMID: 24656472 DOI: 10.1016/j.dental.2014.02.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 02/12/2014] [Accepted: 02/12/2014] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Low level light/laser therapy (LLLT) is the direct application of light to stimulate cell responses (photobiomodulation) in order to promote tissue healing, reduce inflammation and induce analgesia. There have been significant studies demonstrating its application and efficacy at many sites within the body and for treatment of a range of musculoskeletal injuries, degenerative diseases and dysfunction, however, its use on oral tissues has, to date, been limited. The purpose of this review is to consider the potential for LLLT in dental and oral applications by providing background information on its mechanism of action and delivery parameters and by drawing parallels with its treatment use in analogous cells and tissues from other sites of the body. METHODS A literature search on Medline was performed on laser and light treatments in a range of dental/orofacial applications from 2010 to March 2013. The search results were filtered for LLLT relevance. The clinical papers were then arranged to eight broad dental/orofacial categories and reviewed. RESULTS The initial search returned 2778 results, when filtered this was reduced to 153. 41 were review papers or editorials, 65 clinical and 47 laboratory studies. Of all the publications, 130 reported a positive effect in terms of pain relief, fast healing or other improvement in symptoms or appearance and 23 reported inconclusive or negative outcomes. Direct application of light as a therapeutic intervention within the oral cavity (rather than photodynamic therapies, which utilize photosensitizing solutions) has thus far received minimal attention. Data from the limited studies that have been performed which relate to the oral cavity indicate that LLLT may be a reliable, safe and novel approach to treating a range of oral and dental disorders and in particular for those which there is an unmet clinical need. SIGNIFICANCE The potential benefits of LLLT that have been demonstrated in many healthcare fields and include improved healing, reduced inflammation and pain control, which suggest considerable potential for its use in oral tissues.
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Affiliation(s)
- James D Carroll
- THOR Photomedicine Ltd., 18A East Street, Chesham HP5 1HQ, UK
| | | | | | - Mohammed Hadis
- Biomaterials, University of Birmingham, School of Dentistry, St Chads Queensway, Birmingham B4 6NN, UK
| | - William M Palin
- Biomaterials, University of Birmingham, School of Dentistry, St Chads Queensway, Birmingham B4 6NN, UK.
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Oliveira Sierra S, Melo Deana A, Mesquita Ferrari RA, Maia Albarello P, Bussadori SK, Santos Fernandes KP. Effect of low-level laser therapy on the post-surgical inflammatory process after third molar removal: study protocol for a double-blind randomized controlled trial. Trials 2013; 14:373. [PMID: 24195796 PMCID: PMC3832037 DOI: 10.1186/1745-6215-14-373] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 10/21/2013] [Indexed: 11/10/2022] Open
Abstract
Background Low-level laser therapy (LLLT) has been shown to modulate the inflammatory process without adverse effects , by reducing pain and swelling and promoting the repair of damaged tissues. Because pain, swelling and muscle spasm are complications found in virtually all patients following oral surgery for the removal of impacted teeth, this model has been widely used to evaluate the effects of LLLT on the inflammatory process involving bone and, connective tissue and the muscles involved in mastication. Methods/Design After meeting the eligibility criteria, 60 patients treated at a Specialty Dental Center for the removal of impacted lower third molars will be randomly divided into five groups according to the type of laser therapy used at the end of surgery (intraoral irradiation with 660 nm laser; extraoral irradiation with 660 nm laser; intraoral irradiation with 808 nm laser; extraoral irradiation with 808 nm laser and no irradiation). To ensure that patients are blinded to the type of treatment they are receiving, the hand piece of the laser apparatus will be applied both intraorally and extraorally to all participants, but the device will be turned on only at the appropriate time, as determined by the randomization process. At 2 and 7 days after surgery, the patients will be evaluated by three blinded evaluators who will measure of swelling, mouth opening (muscle spasm evaluation) and pain (using two different pain scales). The 14-item Oral Health Impact Profile (OHIP-14) will be used to assess QOL. All data will be analyzed with respect to the normality of distribution using the Shapiro-Wilk test. Statistically significant differences between the experimental groups will be determined using analysis of variance, followed by a suitable post hoc test, when necessary. The significance level will be set at α = 0.05. Discussion The lack of standardization in studies with regard to the samples, methods and LLLT parameters complicates the determination of the actual effect of laser therapy on this model. The present study aims to provide a randomized, controlled, double-blind trial to compare four different LLLT parameters in relation to the outcomes of pain, swelling and muscle spasm following surgery for the extraction of impacted third molars and evaluate the effects os surgery on patients' quality os life (QOL). Trial registration Brazilian Registry of Clinical Trials - Rebec (RBR-6XSB5H).
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Affiliation(s)
| | | | | | | | | | - Kristianne Porta Santos Fernandes
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Rua Vergueiro, 235, São Paulo, SP CEP: 01504-001, Brazil.
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Herrera-Briones FJ, Prados Sánchez E, Reyes Botella C, Vallecillo Capilla M. Update on the use of corticosteroids in third molar surgery: systematic review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e342-51. [DOI: 10.1016/j.oooo.2012.02.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 01/17/2012] [Accepted: 02/01/2012] [Indexed: 10/28/2022]
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Su N, Wang H, Zhang S, Liao S, Yang S, Huang Y. Efficacy and safety of bupivacaine versus lidocaine in dental treatments: a meta-analysis of randomised controlled trials. Int Dent J 2013; 64:34-45. [PMID: 24117122 DOI: 10.1111/idj.12060] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The objective of this study was to assess the efficacy and safety of bupivacaine compared with lidocaine in local anaesthesia in dental treatment. Medline, Cochrane Central Register of Controlled Trials, EMBASE, Chinese BioMedical Literature Database, China National Knowledge Infrastructure, and the World Health Organisation (WHO) International Clinical Trials Registry Platform were searched electronically. Relevant journals and references of studies included were hand-searched for randomised controlled trials comparing bupivacaine with lidocaine in terms of efficacy and safety. Sixteen studies were included, of which nine had low, six had moderate and one had high risk of bias. In comparison with 2% lidocaine plus 1:100,000 adrenaline, 0.5% bupivacaine plus 1:200,000 adrenaline showed a higher success rate in inflamed pulp (P = 0.03) but a lower success rate in vital pulp (P < 0.00001), a lower percentage of patients using postoperative analgesics (P < 0.00001), a longer onset times of pulpal anaesthesia and a longer duration of pulpal anaesthesia (P < 0.00001). In comparison with 2% lidocaine plus 1:80,000 adrenaline, 0.75% bupivacaine plus 1:200,000 adrenaline had same level of success rate (P = 0.29), and was better in postoperative pain control (P = 0.001) while 0.75% levobupivacaine had same level of postoperative pain control (P = 0.16); 0.5% levobupivacaine had higher success rate (P = 0.04) and was better in postoperative pain control (P = 0.001) than 2% lidocaine. There was no statistically significance in adverse events between two groups. Given the efficacy and safety, the bupivacaine group is better than the lidocaine group in dental operations that take a relatively long time, especially in endodontic treatments or where there is a need for postoperative pain management.
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Affiliation(s)
- Naichuan Su
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Prosthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
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