低水平半导体激光治疗对恒牙Ⅰ类龋洞机械预备疼痛控制的有效性分析

Analysis of the effect of low level semiconductor laser on the pain of permanent tooth caries mechanical preparation of Class Ⅰ cavities

目的评估对疼痛耐受性低的成年患者,在成人恒牙Ⅰ类洞机械预备之前应用低水平激光治疗(LLLT)的镇痛效果。方法选取2022年10月—2023年9月在蚌埠医科大学第一附属医院口腔科就诊的成年恒牙Ⅰ类洞(D2)患者。治疗前患者均使用机械去腐法对疼痛阈值(PTPT)进行初步测试,并使用VAS评分进行疼痛评分后,选取7分≤VAS<10分的患者20例,40颗牙齿,激光组(20颗)和安慰组(20颗)。激光组在窝洞预备前行LLLT,安慰组激光行同位置模拟照射但激光为未工作模式,窝洞预备后使用VAS评分表对疼痛强度进行评分,并比较组间及治疗前后的VAS评分。结果治疗后激光组的VAS评分低于安慰组[4.0(4.0,4.5)分vs.6.0(6.0,6.8)分,P<0.001];与PTPT测试期间感觉到的疼痛相比,激光组降低42.9%[7.0(7.0,8.0)分vs.4.0(4.0,4.5)分,P<0.001],安慰组降低14.3%[7.0(7.0,8.0)分vs.6.0(6.0,6.8)分,P<0.001]。结论在恒牙Ⅰ类洞机械预备之前使用LLLT,能大大降低恒牙牙体治疗时的疼痛强度。

Objective To evaluate the effectiveness of low-level laser therapy(LLLT)in the treatment of pain during mechanical cavity preparation of Class Ⅰ cavities in adult permanent teeth in adult patients with low pain tolerance.Methods This study selected adult patients with Class Ⅰ permanent tooth cavities(D2)who visited the Department of Stomatology at the First Affiliated Hospital of Bengbu Medical University from October 2022 to September 2023.Before the treatment,the preliminary test of pain threshold(PTPT)was initially tested by the mechanical removal method,and the pain score was evaluated by the visual analogue scale(VAS)score.Twenty patients with 7 points≤VAS<10 points,40 teeth were selected,laser group(20 teeth)and placebo group(20 teeth).The laser group was treated with LLLT before the cavity preparation,and the placebo group was treated with simulated laser irradiation at the same position but the laser was not in working mode.The VAS score was used to evaluate the pain intensity after the cavity preparation,and the VAS scores were compared between the two groups and before and after the treatment.Results The VAS score of all subjects in the laser group was lower than that in the placebo group[4.0(4.0,4.5)points vs.6.0(6.0,6.8)points,P<0.001];Compared with the pain felt during PTPT,the laser group decreased by 42.9%[7.0(7.0,8.0)points vs.4.0(4.0,4.5)points,P<0.001]and the placebo group decreased by 14.3%[7.0(7.0,8.0)points vs.6.0(6.0,6.8)points,P<0.001].Conclusion The use of LLLT before cavity mechanical preparation can greatly reduce the pain intensity during permanent tooth treatment.