Therapeutic Effect of a Low-Level Laser on Acute Pain and Post-operative Mouth Opening After Closed Reduction of Mandibular-Condylar Fracture Low-Level Laser Therapy in patients with closed reduction of mandibular-condylar fractur
Journal of Lasers in Medical Sciences,
Vol. 13 (2022),
10 January 2022
,
Page e30
Abstract
Introduction: The purpose of this study was to determine the therapeutic effect of low-level laser therapy (LLLT) on acute pain and the range of mouth opening after condylar closed reduction surgery. The use of low-level lasers, especially to reduce inflammation and pain, has received more attention in recent years. The results of many studies performed in this field are contradictory, and the effectiveness of low-level lasers in the treatment of patients is still uncertain. Methods: This study was performed as a randomized, double-blinded clinical trial on 40 patients with condylar closed reduction surgery. Patients were randomly assigned to two groups of 20 patients, including the placebo and intervention groups. In the intervention group, the patients received LLLT ( 100 mw, 2 J/cm 2 , 20 S/point, 14 extraoral points, 7 days) . The range of jaw movements after opening the intermaxillary-fixation was measured. Patients’ pain was assessed using the visual analog scale (VAS). Data were analyzed using SPSS software version 21, the chi-square test, and repeated measures ANOVA. Results: There was no significant difference between the study groups in terms of the range of jaw motions. The mean VAS score was 56.85 (SD = 3.817) in the intervention group and 60.95 (SD = 4.861) in the placebo group, showing a statistically significant difference between the two groups at the end of the study ( P= 0.007) Conclusion: The results of this study indicated the effectiveness of low-level lasers in reducing acute pain in patients undergoing closed condylar surgery. Iranian Registry of Clinical Trials (IRCT20200520047519N1)
Keywords:
- low level laser therapy
- mandibular condyle
- surgery
- closed reduction
- fractur
How to Cite
Bahari Bandari, A., Hajmohammadi, S. ., & Mafi, S. (2022). Therapeutic Effect of a Low-Level Laser on Acute Pain and Post-operative Mouth Opening After Closed Reduction of Mandibular-Condylar Fracture: Low-Level Laser Therapy in patients with closed reduction of mandibular-condylar fractur. Journal of Lasers in Medical Sciences, 13, e30. Retrieved from https://journals.sbmu.ac.ir/jlms/article/view/35821
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25. Padalhin AR. Brief Retrospect on the Use of Photobiomodulation (PBM) Therapy for Augmented Bone Regeneration (ABR). Medical Lasers; Engineering, Basic Research, and Clinical Application. 2021;10(1):15-21. https://doi.org/10.25289/ML.2021.10.1.15
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28. Kheiri A, Amid R, Kheiri L, Namdari M, Mojahedi M, Kadkhodazadeh M. Effect of Low-Level Laser Therapy on Bone Regeneration of Critical-Size Bone Defects: A Systematic Review of In Vivo Studies and Meta-Analysis. Archives of Oral Biology. 2020;117:104782. doi: 10.1016/j.archoralbio.2020.104782.
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35. Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA. Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomedicine and laser surgery. 2006;24(2):158-68. doi: 10.1089/pho.2006.24.158.
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37. Vase L, Wartolowska K. Pain, placebo, and test of treatment efficacy: a narrative review. British journal of anaesthesia. 2019;123(2):e254-e62. doi: 10.1016/j.bja.2019.01.040.
38. Colloca L. The Placebo Effect in Pain Therapies. Annual review of pharmacology and toxicology. 2019;59:191-211. doi: 10.1146/annurev-pharmtox-010818-021542.
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40. Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiatry. 2018;87(Pt B):168-82. doi: 10.1016/j.pnpbp.2018.01.017
2. Di Paolo C, D’Urso A, Papi P, Di Sabato F, Rosella D, Pompa G, et al. Temporomandibular disorders and headache: a retrospective analysis of 1198 patients. Pain research and management. 2017;2017. doi: 10.1155/2017/3203027.
3. Bender SD. Orofacial pain and headache: a review and look at the commonalities. Current pain and headache reports. 2014;18(3):1-6. doi: 10.1007/s11916-013-0400-5
4. Xia L, An J, He Y, Xiao E, Chen S, Yan Y, et al. Association between the clinical features of and types of temporomandibular joint ankylosis based on a modified classification system. Scientific reports. 2019;9(1):1-7. doi: 10.1038/s41598-019-46519-8.
5. Zachariades N, Mezitis M, Mourouzis C, Papadakis D, Spanou A. Fractures of the mandibular condyle: a review of 466 cases. Literature review, reflections on treatment and proposals. Journal of Cranio-Maxillofacial Surgery. 2006;34(7):421-32. doi: 10.1016/j.jcms.2006.07.854.
6. Shiju M, Rastogi S, Gupta P, Kukreja S, Thomas R, Bhugra AK, et al. Fractures of the mandibular condyle–open versus closed–a treatment dilemma. Journal of Cranio-Maxillofacial Surgery. 2015;43(4):448-51. doi: 10.1016/j.jcms.2015.01.012.
7. Forssell H, Sipilä K, Teerijoki-Oksa T, Vartiainen P, Kautiainen H, Sintonen H, et al. The impact of chronic orofacial pain on health-related quality of life. Scandinavian journal of pain. 2020;20(2):329-38. doi: 10.1515/sjpain-2019-0131.
8. Oghli I, List T, Su N, Häggman‐Henrikson B. The impact of oro‐facial pain conditions on oral health‐related quality of life: a systematic review. Journal of oral rehabilitation. 2020;47(8):1052-64. doi: 10.1111/joor.12994.
9. Ellis III E. Condylar process fractures of the mandible. Facial plastic surgery. 2000;16(02):193-206. doi: 10.1055/s-2000-12579.
10. Khiabani K, Zinhaghayegh B, Amirzade-Iranaq MH. Does Dynamic Intermaxillary Fixation With Elastics Improve Outcomes Following Unilateral Condylar Fracture? Journal of Oral and Maxillofacial Surgery. 2021;79(1):192-9. doi: 10.1016/j.joms.2020.08.040.
11. Weiss JP, Sawhney R. Update on mandibular condylar fracture management. Current opinion in otolaryngology & head and neck surgery. 2016;24(4):273-8. doi: 10.1097/MOO.0000000000000272.
12. Chrcanovic BR. Surgical versus non-surgical treatment of mandibular condylar fractures: a meta-analysis. International journal of oral and maxillofacial surgery. 2015;44(2):158-79. doi: 10.1016/j.ijom.2014.09.024.
13. Choi K-Y, Yang J-D, Chung H-Y, Cho B-C. Current concepts in the mandibular condyle fracture management part I: overview of condylar fracture. Archives of Plastic Surgery. 2012;39(4):291. doi: 10.5999/aps.2012.39.4.301.
14. de Oliveira FJD, Brasil GMLC, Soares GPA, Paiva DFF, de Souza Júnior FdA. Use of low-level laser therapy to reduce postoperative pain, edema, and trismus following third molar surgery: a systematic review and meta-analysis. Journal of Cranio-Maxillofacial Surgery. 2021. doi: 10.1016/j.joms.2020.09.018.
15. Mansouri V, Arjmand B, Tavirani MR, Razzaghi M, Rostami-Nejad M, Hamdieh M. Evaluation of Efficacy of Low-Level Laser Therapy. Journal of Lasers in Medical Sciences. 2020;11(4):369. doi: 10.34172/jlms.2020.60
16. Mussttaf RA, Jenkins DFL, Jha AN. Assessing the impact of low level laser therapy (LLLT) on biological systems: a review. International journal of radiation biology. 2019;95(2):120-43. doi: 10.1080/09553002.2019.1524944.
17. Ezzati K, Fekrazad R, Raoufi Z. The Effects of Photobiomodulation Therapy on Post-Surgical Pain. J Lasers Med Sci. 2019;10(2):79-85. doi: 10.15171/jlms.2019.13.
18. D'ávila R P, Espinola LVP, de Freitas PM, Silva AC, Landes C, Luz JGC. Longitudinal evaluation of the effects of low-power laser phototherapy on mandibular movements, pain, and edema after orthognathic surgery. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. 2019;47(5):758-65. doi: 10.1016/j.jcms.2019.01.038.
19. David I. Enhanced Healing and Bone re-Modelling by Low-Level Laser Therapy for Rapid Pain Control in Pediatric Fractures. International Journal of Pain Management. 2019;1(1):23-8. DOI : 10.14302/issn.2688-5328.ijp-19-2717
20. Dostalova T, Kroulikova V, Podzimek S, Jelinková H. Low-level laser therapy after wisdom teeth surgery: evaluation of immunologic markers (secretory immunoglobulin A and lysozyme levels) and thermographic examination: placebo controlled study. Photomedicine and laser surgery. 2017;35(11):616-21. doi: 10.1089/pho.2016.4214.
21. Momeni E, Barati H, Arbabi MR, Jalali B, Moosavi M-S. Low‐level laser therapy using laser diode 940 nm in the mandibular impacted third molar surgery: double-blind randomized clinical trial. BMC Oral Health. 2021;21(1):1-8. doi: 10.1186/s12903-021-01434-1.
22. Baek WY, Byun IH, Yun IS, Kim JY, Roh TS, Lew DH, et al. The effect of light-emitting diode (590/830 nm)-based low-level laser therapy on posttraumatic edema of facial bone fracture patients. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. 2017;45(11):1875-7. doi: 10.1016/j.jcms.2017.08.027.
23. Gasperini G, Rodrigues de Siqueira IC, Rezende Costa L. Does low-level laser therapy decrease swelling and pain resulting from orthognathic surgery? International journal of oral and maxillofacial surgery. 2014;43(7):868-73. doi: 10.1016/j.ijom.2014.02.015.
24. Chang WD, Wu JH, Wang HJ, Jiang JA. Therapeutic outcomes of low-level laser therapy for closed bone fracture in the human wrist and hand. Photomedicine and laser surgery. 2014;32(4):212-8. doi: 10.1089/pho.2012.3398.
25. Padalhin AR. Brief Retrospect on the Use of Photobiomodulation (PBM) Therapy for Augmented Bone Regeneration (ABR). Medical Lasers; Engineering, Basic Research, and Clinical Application. 2021;10(1):15-21. https://doi.org/10.25289/ML.2021.10.1.15
26. Hanna R, Dalvi S, Amaroli A, De Angelis N, Benedicenti S. Effects of photobiomodulation on bone defects grafted with bone substitutes: A systematic review of in vivo animal studies. Journal of biophotonics. 2021;14(1):e202000267. DOI: 10.1002/jbio.202000267
27. Domah F, Shah R, Nurmatov UB, Tagiyeva N. The Use of Low-Level Laser Therapy to Reduce Postoperative Morbidity After Third Molar Surgery: A Systematic Review and Meta-Analysis. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 2021;79(2):313.e1-.e19. doi: 10.1016/j.joms.2020.09.018.
28. Kheiri A, Amid R, Kheiri L, Namdari M, Mojahedi M, Kadkhodazadeh M. Effect of Low-Level Laser Therapy on Bone Regeneration of Critical-Size Bone Defects: A Systematic Review of In Vivo Studies and Meta-Analysis. Archives of Oral Biology. 2020;117:104782. doi: 10.1016/j.archoralbio.2020.104782.
29. Tengrungsun T, Mitrirattanakul S, Buranaprasertsuk P, Suddhasthir T. Is low level laser effective for the treatment of orofacial pain?: A systematic review. CRANIO®. 2012;30(4):280-5. doi: 10.1179/crn.2012.042.
30. Neff A, Cornelius C-P, Rasse M, Torre DD, Audigé L. The Comprehensive AOCMF Classification System: Condylar Process Fractures - Level 3 Tutorial. Craniomaxillofac Trauma Reconstr. 2014;7(Suppl 1):S044-S58. doi: 10.1055/s-0034-1389559.
31. Neff A. Open reduction and internal fixation in temporomandibular joint traumatology: current concepts and future perspectives. Stomatological Disease and Science. 2019;3. 10.20517/2573-0002.2018.27
32. de Rezende RA, Silva DN, Frigo L. Effect of GaAlAs low-level laser therapy on mouth opening after orthognathic surgery. Lasers in medical science. 2018;33(6):1271-7. doi: 10.1007/s10103-018-2477-x.
33. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis care & research. 2011;63(S11):S240-S52. doi: 10.1002/acr.20543.
34. Karu TI, Afanasyeva NI, Kolyakov SF, Pyatibrat LV, Welser L. Changes in absorbance of monolayer of living cells induced by laser radiation at 633, 670, and 820 nm. IEEE Journal of selected topics in quantum electronics. 2001;7(6):982-8. dio: 10.1109/2944.983303
35. Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA. Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomedicine and laser surgery. 2006;24(2):158-68. doi: 10.1089/pho.2006.24.158.
36. Kaptchuk TJ, Hemond CC, Miller FG. Placebos in chronic pain: evidence, theory, ethics, and use in clinical practice. BMJ. 2020;370:m1668. doi: https://doi.org/10.1136/bmj.m1668
37. Vase L, Wartolowska K. Pain, placebo, and test of treatment efficacy: a narrative review. British journal of anaesthesia. 2019;123(2):e254-e62. doi: 10.1016/j.bja.2019.01.040.
38. Colloca L. The Placebo Effect in Pain Therapies. Annual review of pharmacology and toxicology. 2019;59:191-211. doi: 10.1146/annurev-pharmtox-010818-021542.
39. Whittaker P. Laser acupuncture: past, present, and future. Lasers Med Sci. 2004;19(2):69-80. doi: 10.1007/s10103-004-0296-8.
40. Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiatry. 2018;87(Pt B):168-82. doi: 10.1016/j.pnpbp.2018.01.017
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