Eficácia do laser de diodo de alta intensidade em gengivectomias de pacientes ortodônticos: ensaio clínico randomizado do tipo Split-Mouth
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Data
2021-02-10
Autores
Mesquita, Tatyane Ribeiro
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Universidade Estadual Paulista (Unesp)
Resumo
Objetivo: comparar a eficácia do laser de diodo de alta intensidade com a cirurgia periodontal convencional em pacientes ortodônticos com aumento de volume gengival. Materiais e Métodos: 16 pacientes com aumento de volume gengival nos dentes da arcada inferior foram inicialmente tratados com a terapia periodontal básica de suporte, e após 1 mês foram submetidos a dois tipos de intervenções cirúrgicas simultâneas, gengivectomia convencional e à laser de diodo, em um desenho boca dividida de forma randomizada. A comparação e análise da resposta ao tratamento foi através da coleta dos parâmetros clínicos gengivais e periodontais: antes, após a terapia básica e após a cirurgia, com 1, 3 e 6 meses de acompanhamento. O Teste U de Mann-Whitney foi aplicado nessas três etapas para as variáveis quantitativas e Teste Qui-Quadrado nas binárias. O Teste de Kaplan-Meier comparou os tipos de cirurgias ao longo do tempo para verificar o comportamento dos parâmetros. Em seguida, o Teste de Kruskal-Wallis e o de comparação múltipla de Nemenyi foram utilizados para verificar diferença entre os tratamentos ao longo do tempo. A Análise de Cluster criou grupos para avaliar os questionários de dor e ansiedade ao procedimento cirúrgico. Resultados: A terapia básica mostrou resultados positivos para a variável placa visível. As técnicas cirúrgicas aplicadas para o aumento de volume gengival foram semelhantes e eficazes na melhora dos parâmetros avaliados, especialmente no primeiro mês de pós-operatório. As curvas de sobrevivência exibiram uma diminuição gradual dos efeitos cirúrgicos ao longo do tempo. Conclusão: O laser de diodo mostrou ser tão eficaz quanto a cirurgia convencional na melhora dos parâmetros clínicos de pacientes ortodônticos.
Objective: compare the efficacy of high-intensity diode laser with conventional periodontal surgery in orthodontic patients with increased gingival volume. Materials and Methods: 16 patients with increased lower gingival volume underwent two distinct simultaneous surgical interventions: conventional gingivectomy and diode laser surgery in a split mouth design. Response to both procedures was assessed through clinical gingival and periodontal parameters collected before and after surgery, with 1-, 3-, and 6-month follow-up. Statistical analysis was performed using the Mann-Whitney U test for the quantitative variables, the Chi-Square test for the qualitative ones, and the Kaplan-Meier, Kruskal-Wallis test, and the Nemenyi multiple comparisons tests for analyzing the parameters over time. Cluster Analysis of questionnaire data was used to evaluate pain and anxiety during the procedure. Results: Both procedures were similarly effective at improving the evaluated parameters, especially within the first postoperative month. The survival curves showed a gradual decrease of effects over time. Pain and anxiety were shown to be proportional to each other but not with the type of treatment. Conclusion: Diode laser proved to be as effective as the conventional surgery for gingivectomy based on the assessed parameters in orthodontic patients.
Objective: compare the efficacy of high-intensity diode laser with conventional periodontal surgery in orthodontic patients with increased gingival volume. Materials and Methods: 16 patients with increased lower gingival volume underwent two distinct simultaneous surgical interventions: conventional gingivectomy and diode laser surgery in a split mouth design. Response to both procedures was assessed through clinical gingival and periodontal parameters collected before and after surgery, with 1-, 3-, and 6-month follow-up. Statistical analysis was performed using the Mann-Whitney U test for the quantitative variables, the Chi-Square test for the qualitative ones, and the Kaplan-Meier, Kruskal-Wallis test, and the Nemenyi multiple comparisons tests for analyzing the parameters over time. Cluster Analysis of questionnaire data was used to evaluate pain and anxiety during the procedure. Results: Both procedures were similarly effective at improving the evaluated parameters, especially within the first postoperative month. The survival curves showed a gradual decrease of effects over time. Pain and anxiety were shown to be proportional to each other but not with the type of treatment. Conclusion: Diode laser proved to be as effective as the conventional surgery for gingivectomy based on the assessed parameters in orthodontic patients.
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Palavras-chave
Ortodontia, Periodontia, Lasers, Gengivectomia, Dor, Orthodontics, Periodontics, Lasers, Gingivectomy, Pain