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초록
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구강안면통증환자에서 저출력 레이저의 임상 효과는 많은 임상가에 의해 연구되었으나 그 결과에 대해서는 아직도 논란중이다. 이에 본 연구는 두 가지 방법으로 시행하여 구강안면부위의 발통점에 대한 저출력 레이저의 효과를 평가하였다. 첫 번째 방법은 저작근 중 교근, 측두근과 경부근육 중 승모근에 발통점을 가진 부산대학교 치과대학생 69명중 37명은 레이저 조사군, 32명은 레이저 모의 조사군으로 무작위로 분류하여 저출력 레이저의 치료효과를 평가하였다. 둘째 방법으로 동일 근육에 발통점이 있는 19명의 환자와 발통점이 전혀 없는 20명의 정상인을 무작위로 환자군과 정상 대조군으로 분류하고, 각 군을 다시 레이저 조사군과 모의 조사군으로 나누어 실제 저출력 레이저의 치료효과와 위약효과를 평가하였다. 50mW, 820nm의 GaAlAs 반도체 레이저를 이용하여 4주 동안 첫 주는 2회, 이후 3주 동안 각 1회씩 총 5회를 조사하였고, 레이저 모의 조사군에서도 동일한 방법으로 시행하였다. 치료반응은 전자통각계를 이용하여 압력통각역치를 치료 전, 치료 2주 및 4주에 측정하여 이를 비교한 바 다음과 같은 결과를 얻었다. 1. 레이저 조사군의 각 근육에서 측정한 압력통각역치는 치료 2주 후부터 유의하게 높아졌으며(P<0.05), 모의 조사군과의 차이는 이후 점점 더 증가하였다(P<0.001). 모의 조사군에서는 압력통각역치의 유의한 변화가 없었다. 2. 레이저 조사-환자군에서 측정한 압력통각역치는 레이저 모의조사-환자군의 압력통각역치보다 그 증가폭이 더 크게 나타났다(P<0.05). 정상 대조군은 레이저 조사와 관계없이 압력통각역치에 유의성이 없었다. 3. 약간의 위약 반응이 레이저 모의조사 환자군과 정상 대조군에서 관찰되나, 레이저 조사 환자군의 실제 레이저 치료효과가 위약 반응보다 우세하였다.

AI 본문요약
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제안 방법

  • To clarify the reliability of LLLT, 39 subjects, 19 patients and 20 controls, took part in the second study. All of the subjects were randomly classified into four various groups; 10 in the LLLT-patient group, 9 in the sham LLLT-patient group, 10 in the LLLT-control group and 10 in the sham LLLT-control group. We used the same apparatus and the method was identical to the previous study.
  • For reliability, the measurements were taken three times at each marked trigger point and the mean value of the three measurements was accepted. Before treatment, on the 2nd week and after treatment, the PPT was taken on both the LLLT and the sham LLLT group, both two patient and two control groups.
  • The same unit was used for the placebo treatment, for which no laser beam was emitted. Each subject was treated twice at the first weeks and once a week during the following three weeks. A total treatment was 5 times during 4weeks.
  • All measurements in each group were averaged. Statistical analysis was performed to evaluate the increase of the PPT values. Differences in the PPT between the LLLT and sham LLLT group, patient and control groups, inter-patient and inter-control groups before treatment were analyzed with the unpaired t-test.
  • The electronic algometer type I used in this study consists of a gun shaped application handle with a round rubber tip (diameter = 11mm) and a main body that has a digital display panel, calibration knob, control knob of application rate slope, and a patient-operated switch(Fig. 1).
  • We performed two steps in this double-blind study. The first study was to evaluate the effect of LLLT within patient groups, and the second study was mainly to compare the effects of actual laser therapy with placebo treatment between the patient and control groups. In the first study, 69 dental students, 39 males and 30 females, at Pusan National University, were studied by pressure algometer after laser application.
  • In this double blind study, one of the popular 820nm GaAlAs diode laser was used at the sensitive trigger points. The therapeutic effect in both the LLLT and sham LLLT group and the comparison between laser treatment and placebo in both patient and control groups were assessed by pressure pain threshold measurements. In the first study, A significant increase of the PPT values was found in the LLLT group from the third day of laser exposure (P<0.
  • To clarify the reliability of LLLT, 39 subjects, 19 patients and 20 controls, took part in the second study. All of the subjects were randomly classified into four various groups; 10 in the LLLT-patient group, 9 in the sham LLLT-patient group, 10 in the LLLT-control group and 10 in the sham LLLT-control group.

대상 데이터

  • The first study was to evaluate the effect of LLLT within patient groups, and the second study was mainly to compare the effects of actual laser therapy with placebo treatment between the patient and control groups. In the first study, 69 dental students, 39 males and 30 females, at Pusan National University, were studied by pressure algometer after laser application. The mean age of male subjects was 23.
  • The laser apparatus is a handylaser 50-SL class B which is fitted with a 820nm, 50mW, GaAlAs diode(Fig. 2). The power output can be regulated with ease and precision using the handylaser; In 40 seconds, 2 Joules are emitted with continuous beam and when the frequency modulation is in operation, 1 Joule is emitted.
  • They were randomly assigned to either a LLLT group or a sham LLLT group. To clarify the reliability of LLLT, 39 subjects, 19 patients and 20 controls subjects, were randomly classified into four various groups; 10 in the LLLT-patient group, 9 in the sham LLLT-patient group, 10 in the LLLT-control group and 10 in the sham LLLT-control group.

데이터처리

  • Statistical analysis was performed to evaluate the increase of the PPT values. Differences in the PPT between the LLLT and sham LLLT group, patient and control groups, inter-patient and inter-control groups before treatment were analyzed with the unpaired t-test. The repeated-measure ANOVA was performed to analyze the treatment and time effect for the PPT changes within each muscle.
  • Differences in the PPT between the LLLT and sham LLLT group, patient and control groups, inter-patient and inter-control groups before treatment were analyzed with the unpaired t-test. The repeated-measure ANOVA was performed to analyze the treatment and time effect for the PPT changes within each muscle. The statistical comparison of P-values of the LLLT and sham LLLT group, inter-patient and inter-control groups was carried out with the paired t-test separately at each session.
  • The repeated-measure ANOVA was performed to analyze the treatment and time effect for the PPT changes within each muscle. The statistical comparison of P-values of the LLLT and sham LLLT group, inter-patient and inter-control groups was carried out with the paired t-test separately at each session. P-values of less than 0.

이론/모형

  • The intermuscle regional differences in both temporalis and masseter muscles have been reported21). Therefore, this study was designed to obtain the reliability and reproducibility of the algometer by using specific marked trigger point detected from Travell and Simmons' technique.
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