低水平激光治疗对正畸牙齿移动的疗效  

Effects of low level laser in treatment of orthodontic tooth movement

作　　者：李颖 杨一鸣[2] 陆珮珺[2] 刘海霞 LI Ying;YANG Yi-ming;LU Pei-jun;LIU Hai-xia(Department of Stomatology,Shanghai Hospital of integrated traditional Chinese and Western medicine,Shanghai 200082,China;Department of Orthodontics,the Ninth People’s Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200011,China;Shanghai Yangpu District Central Hospital,Shanghai 200090,China)

机构地区：[1]上海市中西医结合医院口腔科,上海200082 [2]上海交通大学医学院附属第九人民医院口腔正畸科,上海200011 [3]上海市杨浦区中心医院,上海200090

出　　处：《医药论坛杂志》2022年第12期18-22,共5页Journal of Medical Forum

基　　金：上海市卫生和计划生育委员会科研课题计划(201840205)。

摘　　要：目的探讨低水平激光治疗(LLLT)对正畸牙齿移动的治疗效果。方法选取自2019年12月—2021年12月上海市中西医结合医院收治的接受正畸治疗患者48例共96颗上颌尖牙,采用自身对照、随机分组的方法分为A组、B组、对照组,每组32颗牙齿,采用上颌微种植钉支抗150 g力拉双侧上颌尖牙向远中移动,A组、B组在首次加力后的第0 h、2 h、24 h、3 d、7 d、14 d分别接受LLLT治疗,此后每4周治疗1次,A组照射20s/位点,B组照射40 s/位点,共治疗16周;对照组未接受LLLT治疗。比较尖牙移动距离、尖牙疼痛程度、牙周相关指标以及白细胞介素1β(IL-1β)、细胞核因子-kB受体活化子配体(RANKL)、骨保护素(OPG)水平。结果A组尖牙远中移动距离(4.51±0.54)mm大于B组(3.68±0.36)mm及对照组(3.55±0.43)mm,A组VAS评分(1.49±0.69)低于B组(2.13±0.74)(P<0.05);治疗后7 d、14 d、4周、8周、16周A组牙周探诊深度(1.77±0.44)mm、(2.12±0.38)mm、(2.17±0.33)mm、(2.11±0.30)mm、(2.05±0.31)mm,牙龈指数(0.47±0.13)、(0.97±0.18)、(1.26±0.17)、(1.24±0.14)、(1.22±0.13)、龈沟液质量(3.17±0.65)μL、(4.29±0.93)μL、(5.33±1.19)μL、(5.27±1.10)μL、(5.26±1.24)μL低于B组(P<0.05);治疗后A组IL-1β(24.86±3.18)ng/L、26.28±3.47)ng/L、29.72±3.24)ng/L、32.27±4.27)ng/L、(31.48±4.28)ng/L、RANKL(814.82±18.72)pg/mL、(826.72±23.71)pg/mL、(887.24±21.73)pg/mL、(1058.62±18.72)pg/mL、(913.82±24.82)pg/mL低于B组,OPG(148.84±4.89)pg/mL、(132.83±5.74)pg/mL、(114.82±4.27)pg/mL、(105.72±4.83)pg/mL、(94.24±5.72)pg/mL高于B组(P<0.05)。结论低水平LLLT治疗可加速正畸牙齿移动,减轻牙齿疼痛,改善正畸治疗期间牙龈健康及口腔微生态。Objective To investigate the effect of low level laser therapy(LLLT)on orthodontic tooth movement.Methods Totally 48 patients receiving orthodontic treatment from December 2019 to December 2021 were selected.96 maxillary cusps from 48 patients were randomly divided into group A,group B and control group by self-control and ran⁃dom grouping method,with 32 teeth in each group.Maxillary microimplant screw anchorage 150g force was used to pull bilateral maxillary cusps to move toward the distal.Group A and B were treated with LLLT at 0 h,2 h,24 h,3 d,7 d and 14 d after the first foraging,and then treated once every 4 weeks.Group A was irradiated 20 s/site,group B was irradia⁃ted 40 s/site,for A total of 16 weeks.The control group did not receive LLLT treatment.The distal movement distance,pain degree,periodontal related indexes,interleukin 1β(IL-1β),nuclear factor-KB receptor activator ligand(RANKL)and osteoprotegerin(OPG)levels were compared among all groups.Results The distal movement distance of the teeth in group A(4.51±0.54)mm was higher than that in group B(3.68±0.36)mm and control group(3.55±0.43)mm,VAS score of group A(1.49±0.69)was lower than that of group B(2.13±0.74)(P<0.05).7 d,14 d,4,8 and 16 weeks after treatment,periodontal probing depth(1.77±0.44)mm,(2.12±0.38)mm,(2.17±0.33)mm,(2.11±0.30)mm,(2.05±0.31)mm,gingival index(0.47±0.13),(0.97±0.18),(1.26±0.17),(1.24±0.14),(1.22±0.13),the quality of gingival creval fluid(3.17±0.65)μL,(4.29±0.93)μL,(5.33±1.19)μL,(5.27±1.10)μL,(5.26±1.24)μL in group A were lower than those of group B(P<0.05);IL-1β(24.86±3.18)ng/L,(26.28±3.47)ng/L,(29.72±3.24)ng/L,(32.27±4.27)ng/L,(31.48±4.28)ng/L and RANKL(814.82±18.72)Pg/mL,(826.72±23.71)pg/mL,(887.24±21.73)pg/mL,(1058.62±18.72)pg/mL,(913.82±24.82)pg/mL in group A were lower than those of group B,OPG(148.84±4.89)pg/mL,(132.83±5.74)pg/mL,(114.82±4.27)pg/mL,(105.72±4.83)pg/mL,(94.24±5.72)pg/mL was higher than those in group B(P<0.05).Conclusion Low level LLLT treatment can accelerat

关 键 词：激光治疗 正畸 牙齿移动 龈沟液 

分 类 号：R783.5[医药卫生—口腔医学]