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Effectiveness of lasertherapy, laseracupuntura and systemic medication for treatment of parestesia in patients who underwent implants and mandibular third molar surgeries

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Author(s):
Karolyne Dias Carvalho Moschella de Oliveira
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Odontologia (FO/SDO)
Defense date:
Examining board members:
Patricia Moreira de Freitas Costa e Silva; Luciane Hiramatsu Azevedo; Ricardo Scarparo Navarro; Marina Cleia Palo Prado
Advisor: Patricia Moreira de Freitas Costa e Silva
Abstract

Mandibular third molar extractions and implant surgeries are common in the dental clinical practice and can promote, even with precautions, paresthesia. Photobiomodulation Therapy (PBMT) using low power laser stimulates tissue repair due to the absorption of light. The PBMT can be performed with the laser application over the entire trajectory on the compromised nerve (laser therapy) or only in acupuncture\'s face points (laser acupuncture). This randomized, blinded, parallel, controlled trial study aimed to evaluate the sensitive return when one of the two PBM techniques were used in patients with paresthesia caused by mandibular third molar extraction or implant surgery. Sixty volunteers reporting sensory deficiency on the inferior alveolar nerve were selected. Volunteers were randomly divided into three groups (n=20): Group 1 - systemic medication: pyrimidine ribonucleotides, uridine triphosphate trisodium, dissodium cytidine monophosphate (ETNA®, 01 capsules, 8/8 hrs, 30 days); Group 2 - laser therapy: 808 nm, 100 mw, 40s /point, 4 J energy /point, 1 cm distance between each irradiation point, intra- and extra-oral, continuous mode, beam diameter of 0.0434 cm2, following the injured alveolar laser pathway; Group 3 - laseracupuncture: irradiated in the same conditions as group 2, but only at the extra-oral region, in acupuncture points of the compromised side: E-4 (dicang), M-CP-18 (Jiachengjiang), VC-24 (chengjiang), E-5 (daying), E-6 (jiache) e ponto A1 (YNSA). Then, volunteers underwent a standardized protocol of evaluation, which consisted of 6 tests: test of perception of paresthesia; thermal perception (hot/cold); mechanical vibration perception; two-point discrimination test; and threshold of pain and tatil surface perceptions. Group 1 was evaluated at the first clinical session (pre-intervention), immediately after the end of the intervention (after 4 weeks) and 1 month after the end of the intervention (after 8 weeks of the first evaluation). Groups 2 and 3 were evaluated at the first clinical session (pre-intervention), after 10 treatment sessions (5 weeks) and after 20 treatment sessions (10 weeks of the first evaluation). The data collected in the evaluations were transcribed for specific records and considered for statistical analysis. The only threshold that presented interaction effect between group and evaluation (first, second and third) was the perception threshold of paresthesia, p = 0.002. From Tukey statistically significant difference was found between the groups in the tests of perception thresholds : thermal to cold (group 1 = 3; 1 ? 2; 2 = 3), p = 0.04; of surface of anterior mucosal pain (group 1 = 2 = 3), p = 0.04; posterior mandibular body (group 1 = 2; 1 ? 3,2 = 3), p = 0.01; lip (group 1 = 2; 1 ? 3; 2 ? 3), p = 0.04; (group 1 = 2; 1 ? 3; 2 ? 3), p = 0.05. No other significant differences were found between the groups in other tests. These results indicate that both photobiomodulation therapies have been beneficial in the treatment of paresthesia. (AU)

FAPESP's process: 16/16701-6 - Effectiveness of lasertherapy and laseracupuncture for the treatment of paresthesia in patients who underwent implants and third molars surgeries
Grantee:Karolyne Dias Carvalho Moschella de Oliveira
Support Opportunities: Scholarships in Brazil - Master