Usporedba različitih vrsta visokoenergetskih lasera u kirurškoj terapiji benignih oralnih lezija metodom infracrvene termografije

doctoral thesis

• Title (english): Comparsion of different types of high-energy lasers in surgical treatment of benign oral lesions using infrared thermography
• Author: Goran Batinjan
• Mentor: Irina Filipović Zore (mentor)
• Mentor: Damir Aumiler (komentor)
• Committee member: Marinka Mravak-Stipetić (predsjednik povjerenstva)
• Committee member: Darko Macan (član povjerenstva)
• Committee member: Hrvoje Skenderović (član povjerenstva)
• Committee member: Tihomir Kuna (član povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2021-03-10, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery
• Universal decimal classification (UDC): 616.31 - Stomatology

Abstract

Posljednjih godina laseri su našli višestruku primjenu u mnogim poljima znanosti pa tako i u području dentalne medicine. Stručna literatura se gotovo svakodnevno nadopunjava novim rezultatima koji pokazuju pozitivan učinak lasera na tkiva te se sve više proširuju indikacije i za lasersku kirurgiju u području orofacijalne regije. Svrha ovog istraživanja bila je procijeniti učinkovitost visokoenergetskog diodnog LaserHF, Er,Cr:YSGG, Er:YAG i Nd:YAG lasera u kirurškoj terapiji benignih oralnih lezija u usporedbi s konvencionalnom kirurškom metodom te praćenje i usporedba temperaturnih razlika i promjena tijekom operativnog zahvata laserom. U istraživanje je bilo uključeno 250 pacijenata podijeljenih u 5 skupina slučajnim odabirom. Temperatura operativnog područja bilježila se pomoću termografske kamere Flir T335 prije, tijekom i nakon zahvata. Termografska očitanja vršila su se naknadno na temelju snimljenih termografa. Trećeg i sedmog postoperativnog dana pacijenti su popunjavali Upitnik o
zadovoljstvu pacijenta OHIP – CRO 14. Rezultati ukazuju da postoje statistički značajne termografske razlike (p<0,05) tijekom i
nakon zahvata između laserskih skupina. Postoji statistički značajna razlika postoperativne kvalitete života (OHIP-CRO 14) (p<0,01) između pacijenata ispitnih skupina koje su operativno bile podvrgnute laserskoj terapiji uklanjanja intraoralnih
benignih lezija i kontrolne skupine. Rezultati pokazuju da Er:YAG laser ima statistički značajno manji intenzitet zagrijavanja okolnog tkiva tijekom i nakon terapije (p<0,05). Ne postoji statistički značajna razlika između postoperativnog tijeka i dužine trajanja oporavka pacijenata nakon terapije visokoenergetskim laserima ili konvencionalnom metodom (p>0,05). Rezultati ukazuju da je hlađenje vodom i zrakom, prilikom terapije visokoenrgetskim laserima, neophodno kako bi se smanjio porast temperature u operativnom području.

Abstract (english)

Aim: The purpose of this study was to evaluate the effectiveness of high-energy diode LaserHF; Er,Cr:YSGG; Er:YAG and Nd:YAG lasers in surgical treatment of benign oral lesions compared to conventional surgical methods, and to monitor and compare temperature differences and changes during laser surgery. Materials and methods: The study included 250 patients, randomly divided into 5 groups. The temperature of the treated area was recorded using a Flir T335 thermographic camera before, during and after the treatment. Thermographic readings were subsequently made on the basis of recorded thermographs. On the third and seventh postoperative day, the patients completed the OHIP-CRO 14 Patient Satisfaction Questionnaire. Results: The results indicate that there are statistically significant thermographic differences (p<0.05) during and after the intervention between different laser groups. There was a statistically significant difference in the postoperative quality of life (OHIP-CRO 14) (p<0.01) between the patients in the test groups who had undergone laser therapy to have intraoral benign lesions removed and the control group. The results showed that the Er: YAG laser had statistically significantly lower intensitiy of heating of the surrounding tissue during and after therapy (p <0.05). There is no statistically significant difference in the postoperative course and the length of recovery between the patients who had undergone laser tratment and those who were treated using the conventional method (p> 0.05).
Conclusion: Er:YAG (λ=2940 nm) and Er,Cr:YSGG (λ=2780 nm) lasers generate lower levels of heat compared to diode and Nd:YAG lasers and may provide safer surgery of soft tissues without destructive effects of temperature increase.
There is a difference in wound healing after surgical removal of benign lesions using a laser and conventional surgery; however it is not statistically significant. There is a difference in pain intensity after the procedure depending on therapeutic
protocol used. Recovery after the procedure and return of quality of life to the preoperative level differs depending on the therapeutic protocol. There is a statistically significant difference between four laser test groups in energy dissipation and the temperature of the surrounding tissues after the therapy. This research confirms that when high-energy lasers are used, cooling with water and air is necessary to reduce the temperature rise in the operating area.

• Keywords: oralnokirurški postupci; terapija laserom; benigne novotvorine
• Keywords (english): Oral Surgical Proceduress; Laser Therapy; Benign Neoplasms
• Language: croatian
• URN:NBN: urn:nbn:hr:127:467166
• Promotion: 2021
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina (doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-07-09 07:29:44