低剂量激光治疗对下颌阻生第三磨牙拔除术后并发症疗效的Meta分析

A Meta Analysis of the Efficacy of Low-dose Laser Therapy in the Treatment of Complications After Extraction of Mandibular Impacted Third Molars

为评价低剂量激光治疗对下颌阻生第三磨牙术后并发症的临床效果,搜索CNKI、万方、CBM、Pubmed、Embase、Cochrane library数据库,获得有关低剂量激光治疗下颌阻生第三磨牙并发症的临床随机对照研究22篇,通过Cochrane Handbook 5.1.0"偏倚风险评估"工具进行文献质量评估,采用Review Manager 5.3软件进行Meta分析,以敏感性分析和亚组分析检测异质性来源,利用漏斗图检测发表偏倚。Meta分析的结果显示,低剂量激光治疗在术后第2天、第7天可显著缓解张口受限、术后疼痛和肿胀。按不同照射位置和不同输出功率进行亚组分析,结果显示:口内口外联合照射和口内照射可显著减少术后第2天张口受限、肿胀和疼痛,口外照射不能显著减少术后第2天张口受限、肿胀和疼痛;输出功率≤100 mW可显著减少术后第2天张口受限、肿胀和疼痛,输出功率>100~≤300 mW或>300~≤500 mW可以显著减少术后疼痛,但不能显著减少术后第2天张口受限和肿胀。结论:低剂量激光治疗可以有效缓解阻生第三磨牙拔除术后的疼痛、肿胀和张口受限,照射方式和输出功率可能对效果产生影响。

In order to evaluate the clinical effect of low dose laser therapy on postoperative complications of mandibular impacted third molars, 22 randomized controlled clinical trials on complications of mandibular impacted third molars treated with low dose laser were obtained from CNKI, Wanfang, CBM, Pubmed, Embase and Cochrane library databases. The literature quality was evaluated by Cochrane Handbook 5.1.0 "bias risk assessment" tool. The meta analysis was conducted by Review Manager 5.3 software. The sources of heterogeneity were detected by sensitivity analysis and subgroup analysis, and publication bias was detected by funnel chart. The results of Meta analysis showed that low-dose laser therapy could significantly relieve the trismus, postoperative pain and swelling on the 2 nd and 7 th day after operation. The subgroup analysis was carried out according to different irradiation location and different output power. the results showed that combined intraoral and extraoral irradiation and intraoral irradiation could significantly relieve the trismus, swelling and pain 2 days after operation. Extraoral irradiation could not significantly relieve the trismus, swelling and pain 2 days after operation. Output power ≤ 100 mW could significantly relieve trismus, swelling and pain 2 days after operation, output power 100~≤300 mW or >300~≤500 mW could significantly relieve postoperative pain, but could not significantly relieve the trismus and swelling 2 days after operation. Conclusion: low dose laser therapy can effectively relieve the pain, swelling and the trismus caused by impacted third molar extraction, and the irradiation mode and output power may affect the effect.