Evaluation of the effect of low level laser in patients with mandibular fracture on mandibular dynamics and bite force: a clinical trial pilot study

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-06-21T18:49:26Z No. of bitstreams: 1 Leandro Lauriti.pdf: 1122104 bytes, checksum: 723249c6bdf2f01f0de75515602a5180 (MD5) Made available in DSpace on 2018-06-21T18:49:26Z (GMT). No. of bitstreams: 1 Leandro Lauriti.pdf: 1122104 bytes, checksum: 723249c6bdf2f01f0de75515602a5180 (MD5) Previous issue date: 2015-12-04 The aim of the present study was to perform an evaluation of the effect of low-level laser therapy (LLLT) on bite force, facial swelling, mandibular movements and pain in patients having undergone surgical treatment for mandibular fracture. The patients were divided into two groups: Group 1 ??? active LLLT; and Group 2 ??? sham LLLT. Both groups took anti-inflammatory agents postoperatively. Group 2 underwent the surgical reduction and rigid internal fixation, the use of postoperative an anti-inflammatory agent and sham LLLT with the equipment switched off. Fifteen sessions were performed using the point application methods and wavelength: 660 nm; power; 108 mW; radiant energy: 21.6 J; fluence: 21.6 J/cm2; radiance: 38197 mW/cm2; exposure time: 200 seconds per point. The active laser group received LLLT in the region of the incision and over the masseter (3 points: superior, medial and inferior) and temporal (anterior region) muscles, with five application points on each side, totaling 10 points bilaterally. The Shapiro-Wilk test was used for the analysis of the results and normal distribution was demonstrated. Thus, the Student???s t-test was used to determine inter-group differences and repeated-measures ANOVA was used to determine whether significant differences occurred at different times. The level of significance was set to 5% (??? = 0.05). The findings we can see considerable improvement in the group submitted to active LLLT with regard to mandibular dynamics, a reduction in postoperative facial swelling, a reduction in pain and an increase in bite force in comparison to the sham group, which only used postoperative corticosteroids. O objetivo deste estudo foi avaliar o efeito da LBI (laserterapia em baixa intensidade) sobre a for??a de mordida, edema, movimentos mandibulares e presen??a de dor em pacientes acometidos por fraturas mandibulares. Os pacientes foram divididos em dois grupos: Grupo 1 (LBI) e Grupo 2 (Placebo). No grupo experimental (Grupo 1), al??m de anti-inflamat??rios no p??s operat??rio foi aplicada a LBI. No grupo Placebo (Grupo 2) foi realizado somente o tratamento cir??rgico de redu????o e fixa????o interna r??gida, o uso de anti-inflamat??rios no p??s-operat??rio e aplica????o do equipamento de laser desligado. Foram realizadas um total de 15 sess??es pelo m??todo de aplica????o pontual com comprimento de onda de 660nm, pot??ncia de 108 mW, energia radiante de 21,6 J, flu??ncia de 21,6 J/cm2, irradi??ncia de 38197 mW/cm2, durante 200 segundos por ponto. Receberam o tratamento com laser os grupos com fraturas de mand??bula, na ??rea da incis??o e nos m??sculos masseteres (3 pontos: superior, m??dio e inferior) e temporais (regi??o anterior) em um total de 5 pontos de aplica????o em cada lado, totalizando 10 pontos bilateralmente. Para an??lise dos resultados foi empregado o teste de Shapiro-Wilk. Como os dados apresentaram distribui????o normal foi utilizado o teste t de Student para determinar as diferen??as entre os grupos e o teste de ANOVA para medidas repetidas e verificar se houve diferen??a significante nos diferentes tempos. Adotou-se o n??vel de signific??ncia de 5% (???=0,05). Com base nos resultados apresentados podemos verificar uma melhora consider??vel no grupo experimental tratado com LBI em rela????o a din??mica mandibular, redu????o do edema facial p??s-operat??rio, menor sintomotalogia dolorosa e aumento da for??a de mordida em rela????o aos pacientes que utilizaram apenas corticoster??ides no p??s cir??rgico.