拔除第三磨牙是口腔颌面外科中执行最多的外科手术之一。疼痛,水肿,和三联体是手术术后最常见的并发症。文献表明PBM是减少这些并发症的潜在辅助方法。这篇综述和荟萃分析的目的是评估PBM,作为改善患者体验和降低术后发病率的最佳方法。此外,我们试图确定哪个波长,site,和频率的应用是最有效的。
本综述在PROSPERO(CRD42023429966)中注册,并遵循PRISMA指南。搜索是在主要数据库中进行的,PubMed/MEDLINE,科克伦图书馆,Embase,Scopus,还有丁香,包括口腔外科和激光应用于口腔外科领域最重要的期刊的评论。此外,回顾了所有的文章参考文献和灰色文献。在研究选择之后,收集了相关数据。所有研究均为随机对照试验,患者分为两组:活动性PBM和非活动性PBM。采用Statav.16进行统计学分析,分别采用Jadad量表和RoB2.0评估方法学质量和偏倚风险。
其中包括22项研究和989名受试者,至少随访7天。疼痛和水肿显示出有利于活性PBM组的统计学显著结果。特别是当激光在红外模式下应用时,对于48小时的疼痛和水肿,MD=-1.80(CI95%-2.88,-0.72)I²=92.13%,MD=-1.45(CI95%-2.42,-0.48)I²=65.01%,分别。对于48小时的三端子来说,情况并非如此,MD=0.07(CI95%-0.06,0.21)I²=3.26%。荟萃分析还提供了有关激光应用地点和PBM会议次数的结果。
带红外激光的PBM,在口腔内和口腔外的联合应用中,在术后即刻的一个疗程中,已被证明是有效实现的目的,减轻疼痛和水肿后第三磨牙拔除。
The extraction of third molars is one of the most performed surgical procedures in oral and maxillofacial surgery. Pain, oedema, and trismus are the most frequently complications related in the surgical postoperative period. The literature has indicated PBM as a potential adjuvant method to reduce these complications. The aim of this
review and meta-analysis is evaluate the PBM, as an optimal method to improve patient experience and minimize postoperative morbidity. Additionally, we seek to determine which wavelength, site, and frequency of application are most effective.
This
review was registered in PROSPERO (CRD42023429966) and followed PRISMA guidelines. The search was carried out in the main databases, PubMed/MEDLINE, Cochrane Library, Embase, Scopus, and Lilacs, including reviews in the most important journals in the area of oral surgery and laser applied to oral surgery. In addition, all article references and also gray literature were reviewed. After the studies selection, the relevant data was collected. All the studies were randomized controlled trials and the patients were allocated into two groups: active PBM and inactive PBM. The statistical analysis was carried out using Stata v.16, and the methodological quality and risk of bias were assessed by the Jadad scale and RoB 2.0, respectively.
Where included 22 studies and 989 subjects, to all with a minimum follow-up of 7 days. Pain and oedema showed statistically significant results in favor to the active PBM group. Especially when laser applied in infrared mode, for pain and oedema at 48 h, MD = -1.80 (CI95% -2.88, -0.72) I² = 92.13% and MD = -1.45 (CI95% -2.42, -0.48) I² = 65.01%, respectively. The same is not true for trismus at 48 h, MD = 0.07 (CI95% -0.06, 0.21) I² = 3.26%. The meta-analysis also presented results in respect of laser site of application and number of PBM sessions.
PBM with infrared laser, in a combination intraoral and extraoral application, in one session in the immediate postoperative period, has been shown to be effective to achieve the objectives of reducing pain and oedema after third molar extraction.