بررسی تأثیر مدت زمان تابش لیزر در دوز یکسان در درمان آفت عودکننده‌ی دهان

نوع مقاله : مقاله‌های پژوهشی

چکیده

مقدمه: آفت عود‌کننده، یک زخم شایع و دردناک در ناحیه‌ی دهان است. هدف از این مطالعه، بررسی زمان تابش لیزر در دوز یکسان در درمان آفت عود‌کننده‌ی دهان بود و مطالعه‌ی مشابهی دیده نشد.
مواد و روش‌ها: در این کارآزمایی بالینی دوسوکور، تعداد 30 بیمار مراجعه‌کننده به بخش بیماری‌های دهان دانشکده‌ی دندان‌پزشکی دانشگاه آزاد اسلامی واحد اصفهان (خوراسگان)، با آفت دهانی کوچک و به روش نمونه‌گیری آسان و بر اساس معیارهای ورود و خروج انتخاب شده و به صورت تصادفی به دو گروه مشابه تقسیم شدند. لیزر دیود کم توان nm660، در گروه A با 200 میلی‌وات و20 ثانیه و در گروه B با 20 میلی‌وات و 200 ثانیه به تعداد دو جلسه در روزهای اول و سوم تابانده شد و مدت زمان بهبودی بالینی و شدت درد در دو گروه باهم مقایسه گردید. داده‌ها با استفاده آزمون‌های آماری Independent t-test و Mann-Whitney تجزیه و تحلیل شدند (0/05 > p value).
یافته‌ها: میانگین درد روز اول بعد از لیزر تا روز هفتم در گروه B، به طور معنی‌داری کمتر از گروه A بود (0/001 > p value). میانگین اندازه‌ی ضایعه در روزهای سوم (0/03 = p value)، پنجم (0/001 > p value) و هفتم (0/001 = p value) در گروه B به طور معنی‌داری کمتر از گروه A بود. میانگین مدت زمان بالینی بر طرف شدن ضایعه در گروه B به طور معنی‌داری کمتر از گروه A بود (0/001 > p value).
نتیجه‌گیری: بر اساس نتایج این مطالعه، توان پایین‌تر و زمان تابش طولانی‌تر لیزر دیود 660 نانومتر برای درمان زخم‌های آفت دهانی پیشنهاد می‌شود.
کلید واژه‌ها: زخم آفت، لیزر کم توان، مدت زمان بهبودی زخم، درد. 

عنوان مقاله [English]

The Effect of Duration of Laser Radiation with the Same Dose in the Treatment of Recurrent Aphthous Stomatitis

چکیده [English]

Introduction: Recurring aphthous ulcers is a common and painful ulcer in the oral area. The aim of this study was to evaluate the impact of length of radiation in the same dose for the treatment of recurrent aphthous stomatitis. To date no similar study is available.
Materials & Methods: In this double-blinded clinical trial, 30 patients with minor aphthous ulcer that were referred to Oral medicine department of Islamic Azad university were selected according to convenience sampling and inclusion exclusion criteria and were randomly divided into two similar groups. Low level laser therapy with diode 660nm was used in group A with 200 mW and 20 seconds setting and in group B with 20 mW and 200 seconds setting in two sessions on the first and third days were used. The time of clinical healing and the pain intensity as VAS were recorded. Data were analyzed by Independent t-test and Mann-Whitney test (p value < 0.05).
Results: The pain intensity from first day after the laser until the seventh day in group B was significantly less than group A (p value < 0.001). The mean size of lesion was significantly lower in the third day (p value = 0.03), fifth (p value < 0.001) and seventh (p value = 0.001). The mean clinical healing time in group B was significantly lower than group A (p value < 0.001).
Conclusion: According to this study's findings, longer time of irradiation in lower output power of 660 nm diode laser was suggested for treatment of recurrent aphthous ulcer.
Key words: Aphthous ulcer, Low level laser therapy, Wound healing time, Pain.

1. Glick M. Burket‘s oral medicine. 12th Ed. Shelton, US: People's Medical Publishing House; 2015.
p. 29-51, 73-77.
2. Natah SS, Konttinen YT, Enattah NS, Ashammakhi N, Sharkey KA, Häyrinen-Immonen R. Recurrent aphthous ulcers today: a review of the growing knowledge. Int J Oral Maxillofac Surg 2004; 33(3): 221-34.
3. Farhad-Mollashahi L, Pouramir M, Motalebnejad M, Honarmand M, Bijani A, Shirzad A. Comparison of salivary total antioxidant capacity and lipid peroxidation in patients with recurrent aphthous stomatitis and healthy persons. J Babol Univ Med Sci 2013; 15(5): 39-44. [In Persian].
4. Toche P, Salinas L, Guzman MM, Afani S, Jadue A. Recurrent oral ulcer: clinical characteristic and differential diagnosis. Rev Chilena Infectol 2007; 24(3): 215-9. [In Spanish].
5. Navabi N, Zarei MR, Falsafi F, Sadeghi B. Assessment the role of hematologic agent deficiencies in the etiology of recurrent aphthous stomatitis. J Babol Univ Med Sci 2013; 15(3): 88-95. [In Persian].
6. Quijano D, Rodriguez M. Topical corticosteroids in recurrent aphthous stomatitis. Systematic review. Acta Otorrinolaringol Esp 2008; 59(6): 298-307. [In Spanish].
7. Hello M, Barbarot S, Bastuji-Garin S, Revuz J, Chosidow O. Use of thalidomide for severe recurrent aphthous stomatitis: a multicenter cohort analysis. Medicine (Baltimore) 2010; 89(3): 176-82.
8. Gavanji S, Larki B, Doostmohammadi M, Mortezaeinezad F. Production of a new mixed herbal medicine for minor Aphthous Ulcers. J Med Plant 2012; 4(1): 49-51.
9. Motalebnejad M, Moghadamnia A, Mohammadi E. The effect of bio adhesive in reduction of pain and healing time of Aphtha. J Babol Univ Med Sci 2003; 5(1): 12-6. [In Persian].
10. Nammour S. Chronology of the use of the laser beam in dentistry, and the state of postgraduate university education programs in this domain. Photomed Laser Surg 2016; 34(1): 1-2.
11. Kotlow L. Lasers and soft tissue treatments for the pediatric dental patient. Alpha Omegan 2008; 101(3); 140-51.
12. De Souza TO, Martins MA, Bussadori SK, Fernandes KP, Tanji EY, Mesquita-Ferrari RA, et al. Clinical evaluation of low-level laser treatment for recurring aphthous stomatitis. Photomed Laser Surg 2010; 28(Suppl 2): S85-8.
13. Pavlić V, vujić-Aleksić V, Aoki A, Nežić L. Treatment of recurrent aphthous stomatitis by laser therapy: A systematic review of the literature. Vojnosanit Pregl 2015; 72(8): 722-8.
14. Eghballi F. Appling low level laser therapy in dentistry. Tehran, Iran: Shayan Nemodar; 2010. p. 54-64. [In Persian].
15. Mortiz A, Beer F. Oral laser application. 1st ed. Berlin, Germany: Quintessenz Verlags; 2006.
16. Takahashi K, Onoda C, Sugiyama S, Noro A, Makiishi T, Ishikawa T. Clinical evaluation of Ga-Al-As semiconductor laser diode (UNI-LASER) irradiation in treatment of solitary aphtha, erosion and hypersensitive dentin. Shikwa Gakuho 1987; 87(2): 295-303. [In Japanese].
17. Prikuls VF. Experience in irradiating with helium-neon lasers to treat patients with relapsing aphthous stomatitis. Stomatologiia (Mosk) 2000; 79(6): 20-2. [In Russian].
18. Eslami Farsani R, Ashtiani Araghi B, Camrava SK, Rezvan F. Laser therapy. Basic & clinical practice of low level laser. Tehran, Iran: Boshri Publications; 2005. p. 113-231. [In Persian].
19. Vale FA, Moreira MS, de Almeida FC, Ramalho KM. Low-Level Laser therapy in the treatment of recurrent aphthous ulcer. Scientific World Journal 2015; 2015: 150412.
20. Zeini Jahromi N, Ghapanchi J, Pourshahidi S, Zahed M, Ebrahimi H. Clinical evaluation of high and low-level laser treatment (CO2vsInGaAlP Diode Laser) for recurrent aphthous stomatitis. J Dent (Shiraz) 2017; 18(1): 17-23.
21. Amorim Dos Santos J, Normando AGC, de Toledo IP, Melo G, De Luca Canto G, Santos-Silva AR, et al. Laser therapy for recurrent aphthous stomatitis: an overview. Clin Oral Investig 2020; 24(1): 37-45.
22. Alberketson M, Hedström L, Bergh H. Recurrent aphthous stomatitis and pain management with low-level lasertherapy. Oral surg Oral Med Oral Pathol Oral Radiol2014; 117(5): 590-4.
23. Aggarwal H, Singh MP, Nahar P, Mathur H, Gv S. Efficacy of low-level laser therapy I treatment recurrent aphthous ulcer. J Clin Diagn Res 2014; 8(2): 218-21.
24. Anand V, Gulati M, Govila V, Anand B. Low level laser therapy in the treatment of aphthous ulcer. Indian J Dent Res 2013; 24(2): 267-70.
25. Prasad RS, Pai A. Assessment of immediate pain relief with laser treatment of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116(2): 189-93.
26. Khademi H, Shirani AM, Nikegbal F. Evaluation of low level laser therapy in recurrent aphthous stomatitis. Shiraz Univ Dent J 2009; 10(2): 159-61. [In Persian].
27. Najeeb S, Khurshid Z, Zohaib S, Najeeb B, Qasim SB, Zafar MS. Management of recurrent aphthous ulcers using low-level lasers: A systematic review. Medicina (Kaunas) 2016; 52(5): 263-8.
28. Suter VGA, Sjölund S, Bornstein MM. Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review. Lasers Med Sci 2017; 32(4): 953-63.