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Doctoral Thesis
DOI
https://doi.org/10.11606/T.23.2021.tde-30082021-084307
Document
Author
Full name
Ricardo Pimenta D'Avila
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2021
Supervisor
Committee
Luz, Joao Gualberto de Cerqueira (President)
Araújo, Marcelo Marotta
Deboni, Maria Cristina Zindel
Pereira Filho, Valfrido Antonio
 
Title in Portuguese
Efeitos da terapia de fotobiomodulação com laser de 940 nm no controle da dor, edema, parestesia e trismo após cirurgia ortognática: ensaio clínico randomizado
Keywords in Portuguese
Cirurgia ortognática
Dor
Edema
Fototerapia
Parestesia
Trismo
Abstract in Portuguese
A cirurgia ortognática é um procedimento cirúrgico muito utilizado para correção das deformidades dento-faciais podendo causar dor, edema, perda da sensibilidade e limitação de abertura bucal. Uma possibilidade de tratamento para essas consequências é a terapia de fotobiomodulação (PBMT). O objetivo deste estudo foi realizar uma avaliação da ocorrência de dor, edema, parestesia e trismo em pacientes submetidos a cirurgia ortognática bimaxilar com mentoplastia após PBMT com laser de 940 nm. Foram avaliados 20 pacientes, divididos em grupo experimental (n=10) e grupo controle (n= 10) de forma randomizada. O grupo experimental recebeu PBMT de 940 nm e o grupo controle placebo de PBMT por 11 sessões. O protocolo de PBMT consistiu em aplicações em pontos extra orais no pós-operatório imediato, 24 e 48 h, e 2 vezes por semana durante 4 semanas. Os grupos foram comparados quanto a dor - Escala visual analógica, edema - medidas entre pontos cefalométricos, parestesia - testes táteis e térmicos e trismo - abertura máxima em mm nos períodos de 0 a 30 dias após a cirurgia. Foram aplicados os testes de Mann-Whitney e Exato de Fisher para comparação entre os grupos (p<0,05). Houve diferença significante para dor na maioria das comparações, nos períodos 24 h a 4 semanas, sendo que o grupo experimental atingiu o valor 0 na terceira semana. Para o trismo houve diferença significante, nos períodos de 14 e 30 dias. Ocorreu redução do edema, sem diferença estatisticamente significante para a maioria das mensurações. Não houve melhora significante da parestesia. Foi possível concluir que após a PBMT com laser 940 nm houve uma diminuição da ocorrência de dor e uma melhora significante na ocorrência de trismo porém sem melhora significante na ocorrência de edema e parestesia.
 
Title in English
Effects of photobiomodulation therapy with 940 nm laser in the control of pain, edema, parestesia and trismus, after ortognactic surgery: randomized clinical trial
Keywords in English
Edema
Orthognathic surgery
Pain
Paresthesia
Phototherapy
Trismus
Abstract in English
Orthognathic surgery is a surgical procedure widely used to correct dentofacial deformities and can cause pain, edema, loss of sensation and limited mouth opening. A possibility of treatment for these consequences is photobiomodulation therapy (PBMT). The aim of this study was to carry out an assessment of occurrence of pain edema, paresthesia and trismus in patients undergoing bimaxillary orthognathic surgery with genioplasty after PBMT with a 940 nm laser. Twenty patients were evaluated, divided into an experimental group (n = 10) and a control group (n = 10) randomly. The experimental group received PBMT at 940 nm and the control group a PBMT placebo for 11 sessions. The PBMT protocol consisted of applications at extraoral points in the immediate postoperative period, 24 and 48 h, and twice a week for 4 weeks. The groups were compared in terms of pain - visual analogue scale, edema - measurements between cephalometric points, paraesthesia - tactile and thermal tests and trismus - maximum opening in mm between 0 and 30 days after surgery. MannWhitney and Fisher's Exact tests were applied for comparison between groups (p <0.05). There was a significant difference for pain in most comparisons, from 24 h to 4 weeks, with the experimental group reaching a value of 0 in the third week. There was a significant difference for trismus in the periods of 14 and 30 days. There was a reduction in edema, with no statistically significant difference for most measurements. There was no significant improvement in paresthesia. It was possible to conclude that after PBMT with a 940 nm laser there was a decrease in the occurrence of pain and a significant improvement in the occurrence of trismus, but without a significant improvement in the occurrence of edema and paresthesia.
 
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Publishing Date
2021-11-03
 
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