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The Effect of Soft laser Therapy in Reducing the Edema after Maxillofacial Surgery

أثر تطبيق الليزر اللين في تخفيف الوذمة التالية للجراحة الوجهية الفكّية

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 Publication date 2004
  fields Dentistry
and research's language is العربية
 Created by Shamra Editor




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Although the use of Soft Laser appliances has become common in dental practice especially in the field of oral and maxillofacial surgery as an important method for controlling the edema that may occur after oral and maxillofacial surgery (as said by the manufacturing companies ),there are just a few neutral researches that deal scientifically with this subject, so that is our motive to do in this research .In this study, and between May 1996 and May 2003, 80 patients were carefully selected so 160 lower third molars were surgically extracted , the soft laser was applied on the left side and after that the results compared with the results of the right side operations which were not subjected to any method for controlling edema. The results were disappointing and the great advantages that were confirmed by the manufacturing companies were not true while the neutral comparative research emphasized that the usage of Soft laser treatment has no magical effect in reducing or preventing the occurrence of severe edema after the surgery of impacted lower third molars , so we want to warn every dentist to be careful when reading a research sponsored by the manufacturing companies of Soft laser appliances.


Artificial intelligence review:
Research summary
تتناول هذه الدراسة تأثير العلاج بالليزر الناعم في تقليل الوذمة بعد جراحة الفكين والوجه. على الرغم من أن استخدام أجهزة الليزر الناعم أصبح شائعًا في الممارسات السنية وخاصة في مجال جراحة الفم والوجه والفكين كوسيلة مهمة للتحكم في الوذمة التي قد تحدث بعد الجراحة، إلا أن هناك عدد قليل من الأبحاث المحايدة التي تتناول هذا الموضوع علميًا. في هذه الدراسة، تم اختيار 80 مريضًا بعناية وتم استخراج 160 ضرسًا من الأضراس الثالثة السفلية جراحيًا بين مايو 1996 ومايو 2003. تم تطبيق الليزر الناعم على الجانب الأيسر ومقارنة النتائج مع الجانب الأيمن الذي لم يخضع لأي طريقة للتحكم في الوذمة. كانت النتائج مخيبة للآمال، حيث لم تؤكد الأبحاث المحايدة الفوائد الكبيرة التي أكدت عليها الشركات المصنعة لأجهزة الليزر الناعم. لذا، تحذر الدراسة من الاعتماد على الأبحاث التي ترعاها الشركات المصنعة لأجهزة الليزر الناعم.
Critical review
دراسة نقدية: على الرغم من أن الدراسة تقدم نظرة شاملة حول تأثير الليزر الناعم على الوذمة بعد جراحة الفكين، إلا أنها تفتقر إلى بعض الجوانب الهامة. أولاً، لم يتم توضيح تفاصيل الجرعات المستخدمة أو مدة التعرض للليزر بشكل كافٍ، مما يجعل من الصعب تكرار الدراسة أو مقارنة النتائج بدقة. ثانياً، لم يتم أخذ العوامل النفسية والاجتماعية للمشاركين في الاعتبار، والتي قد تؤثر على نتائج العلاج. ثالثاً، الدراسة تعتمد بشكل كبير على مقارنة الجانب الأيسر بالجانب الأيمن من نفس المريض، وهو ما قد لا يكون كافيًا لتعميم النتائج على نطاق أوسع. وأخيراً، كان من المفيد تضمين مجموعة تحكم إضافية لمزيد من التحقق من النتائج.
Questions related to the research
  1. ما هو الهدف الرئيسي من الدراسة؟

    الهدف الرئيسي من الدراسة هو تقييم فعالية العلاج بالليزر الناعم في تقليل الوذمة بعد جراحة الفكين والوجه.

  2. ما هي الفترة الزمنية التي غطتها الدراسة؟

    الدراسة غطت الفترة من مايو 1996 إلى مايو 2003.

  3. ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟

    النتائج الرئيسية أظهرت أن العلاج بالليزر الناعم ليس له تأثير كبير في تقليل الوذمة بعد جراحة الفكين، مما يتعارض مع الادعاءات التي قدمتها الشركات المصنعة.

  4. ما هي النصيحة التي تقدمها الدراسة للأطباء؟

    الدراسة تنصح الأطباء بتوخي الحذر عند قراءة الأبحاث التي ترعاها الشركات المصنعة لأجهزة الليزر الناعم.


References used
Lyons ,G.P., Levy G., Jefery,R.,H., – Biostimulation of wound healing in vivo by He-Ne laser – Annals of plastic surgery 3:18-19- 1999
Kaufman . H.W.- clinical applications of lasers in dentistry – Compend. Contin.Educ.Dent.IX :7-1998
Kana T.,K., Kinersly D.S. ,Melcer C.L.,– Effects of low power density laser therapy of pain _ Laser in dentistry B.D.J. 3: 40-43, 1995
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several articles on animal model and laboratory investigations Indicate that soft laser induce cellular and tissue motivation and heals wounds. Ami of the study: to investigate histological modification in oral squamous non-keratinized epithelium upon applying soft laser in several doses and studding the alteration in keratinization and the possibility to have neoplastic transformation.
The objective of this study was to Compare between The Effect Of secondary closure and Rubber Drain post surgical Extraction to Impacted Lower Third Molars On edema, pain, and trismus level. Clinical trial included symmetric bilateral 40 lower thi rd molar in 20 patients whose ages between18-45 years. The sample was randomly divided into two groups: Group 1: included 20 molars ,a 4–5 mm wedge of mucosa adjacent to the second molar was removed to obtain secondary healing. Group 2: included 20 molars ,a rubber drain was inserted into the extraction socket near the buccal fold after surgery and left for 72h. Edema, pain and trismus were measured On first , third and seventh day following surgery. The findings showed a significant difference between the effect of secondary closure and rubber drain on the Edema, pain and trismus after surgical Extraction of Impacted Lower Third Molars. The Edema, pain and trismus were less in secondary closure group.
Despite of the great evolution in the field of radiological technologies , panoramic radiography is still the most important radiological –diagnostic method in the maxillofacial area . Panoramic radiographs reveal a wide area of tissue in one x-ra y. In addition . It seems to be preferred by the maxillofacial surgeon due to its simplicity and rapidity of application , and low dose of radiation. In oral and maxillofacial fractures , panoramic radiography is still the best way of having a quick and preliminary diagnosis of most of these fractures. In our study we made a precise diagnosis of about 88.79% of our cases by using this method . For that we recommend to use panoramic radiography in most cases of oral and maxillofacial injuries . In cases that clinical diagnosis does not match the panoramic radiography diagnosis we must look for another radiological method.
Soft laser applications continue to improve local bone mineral density which is considered the most important factor in dental implant success. This study aims to evaluate the Trabecular to Cortical bone ratio (TCr) index -as a simple easy measureme nt index- that expresses the bone mineral density. This is to be able to predict the success of dental implants. The study included 40 patients, who had a single implant in the lower molar region. The patients are divided into two groups: 20 patients had an implant with a soft laser application, i.e. GaAlAs laser (wavelength 830 nm), and 20 patients had an implant without a soft laser application. Ordinary Analog periapical radiographs were used with calibration Stepwedge of pure aluminum, a medical Dijora program was used to measure radiographically local bone density in the periapical radiographs, and a panoramic Tomography was made to study TCr and two bone density indices (thickness ratio x density ratio) and (equivalent Aluminium thickness). All were measured during the period before implantation and 3, 6, and 9 months after the implantation. The study found a strong linear correlation between the TCr and (thickness ratio x density ratio) 0.001>P, R2= 0.842 36(r = 0.8. and equivalent Aluminium thickness( 0.001> P, R2 = 0.656735, (r = 0.8). The study shows that TCr index expresses both radiographic indices which reflect the local bone density, which means that the TCr is associated with such density. Therefore, it can be used as an easy way to predict the quality of bone, and prognosticate the success of dental implants.
The aim of this study was to evaluate the efficacy of dexamethasone, as a single 4-mg dose, which was injected into the masseter muscle upon completion of extraction of impacted lower third molars . this study is A prospective, randomized controll ed study . This study involves 40 healthy patients of both sexes with impacted mandibular third molars in this study . The difficulty of extraction was similar in all cases. The test side received 4 mg of dexamethasone This dose was injected into the masseter muscle via the intrabuccal approach, immediately after suturing of the surgical wound. The control side received 4 mg of dexamethasone injected into the gluteal area.

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