半导体激光照射预防下颌阻生第三磨牙拔除术后肿痛的自身对照研究

Semiconductor laser irradiation on preventing pain and swelling after extraction of impacted mandibular third molars: self-control study

目的探讨半导体激光预防下颌阻生第三磨牙拔除术后肿胀和疼痛的效果。方法选择需拔除双侧下颌阻生第三磨牙的患者20例,其中男性9例，女性11例；年龄17～42岁，平均年龄27,55岁。随机将一侧设为试验组，另一侧为对照组。试验组采用左布比卡因行下牙槽神经、舌神经及颊长神经麻醉，切开翻瓣，采用涡轮钻去骨劈冠，用微创牙挺分块拔除患牙，缝合伤口．术后口服阿莫西林,并用激光口腔治疗仪照射口内拔牙创口及拔牙创口对应颊部各5min，每天1次，连续5d，术后7d拆线。对照组除不用激光照射治疗外,其他治疗措施同试验组。观察术后肿胀和疼痛情况。结果术后第1、2、3、5天肿胀程度和第1、2、3天疼痛程度两组间差异有统计学意义（P〈0.05）。术后第7天的肿胀程度和第5、7天疼痛程度两组间差异无统计学意义（P〉0.05）。结论半导体激光照射治疗能减轻下颌阻生第三磨牙拔除术后肿胀、疼痛。

Objective To survey the effect of semiconductor laser irradiation on preventing swelling and pain after surgical removal of impacted lower third molars. Methods A total of 20 patients with removal bilateral mandibular impacted lower third molars were enrolled, which included 9 males and 11 females; aged 17 - 42 years old with mean age of 27.55. The patients were randomly set as experimental group on one side and the control group on the other side. In experimental group, levobupivacaline was used for the anesthesia of inferior alveolar nerve, lingual nerve and buccal nerve. Then disc and incision were cut and flap bone chisel was removed with turbine drill. The teeth were extracted with minimally invasive block method and the wound was stitched up. The patients were took oral amoxicillin after surgery and illuminate extraction wound in mouth and buccal mueosa of extraction 5 minutes with laser oral therapy once a day for 5 consecutive days. The surgical suture was taken out on 7th day after surgery. Therapy measure in control group was the same as that in experimental group except laser treatment. The postoperative pain and the degree of swelling were evaluated. Results The difference of postoperative swelling at 1st, 2nd, 3rd, 5th and pain at 1st, 2nd, 3rd were statistically significant between 2 groups（P 〈 0.05）. About the 7th days after swelling degree and pain degree of 5th, 7th days was no statistically significant difference between the two groups（P 〉 0.05）. There was no significant difference in both swelling at 7th day and pain at 5th, 7th days between 2 groups. Conclusion It is demonstrated that semiconductor laser irradiation is useful for the reduction of postoperative pain and swelling after third molars surgery.