系统评价低强度半导体激光治疗正畸疼痛的有效性

Efficacy of Low-Level Diode Laser Therapy on Orthodontic Pain Management:A Systematic Review and Meta-Analysis

目的:评价低强度半导体激光(LLLT)在治疗缓解正畸过程中疼痛有效性方面的研究。方法:通过计算机检索PubMed、Cochrane Library、Web of Science及ScienceDirect数据库关于LLLT治疗缓解正畸过程中疼痛的有效性随机对照临床试验的文献,并依据Cochrane操作员手册进行文献的筛选、提取资料数据及风险评估。应用RevMan 5.3版本的软件进行数据处理分析。结果:系统纳入10篇随机对照实验,1篇临床对照实验,共730名患者。通过Meta分析结果显示LLLT治疗可使正畸治疗后疼痛发生率减少25%[RR=0.75,95%CI(0.67,0.84),P<0.000 01],与对照组相比,LLLT治疗使最大疼痛强度明显降低[MD=-2.23,95%CI(-3.86,-0.59),P=0.008],并且使疼痛持续时间缩短[MD=-2.28,95%CI(-2.77,-1.78),P<0.001]。结论:低强度半导体激光在治疗缓解正畸过程中疼痛具有良好效果,但由于纳入文献方法学缺陷和偏倚风险,还需要更多更好的证据去证明其有效性。

Objective：To systematically evaluate the efficacy of diode low-level laser therapy（LLLT）on orthodontic pain alleviation.Methods：LLLT therapy for orthodontic pain validity of randomized controlled clinical trials in the process of literature was performed by using the database such as PubMed,Cochrane Library,Web of Science,and ScienceDirect.Inclusion and exclusion criteria,extracted data and the methodological quality were assessed according to the Cochrane methods handbook.Then,data were analyzed by RevMan 5.3software.Results：Ten randomized controlled trials and 1clinical controlled trials involving 730 patients were included in this analysis.The meta-analysis showed that diode LLLT significantly reduced orthodontic pain by 25% in comparison with placebo groups（RR=0.75,95%CI（0.67,0.84）,P〈0.000 01）.Diode LLLT significantly reduced the maximum pain intensity（MD=-2.23,95%CI（-3.86,-0.59）,P=0.008）,and shorten the duration of the pain（MD=-2.28,95%CI（-2.77,-1.78）,P〈0.000 01）.Conclusion：LLLT is a effective therapy on orthodontic pain.However,due to meth-odological weakness and risk of bias of included trials,larger and better-designed RCTs will be required to provide the strong evidence for diode LLLT＇s clinical applications.