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2 - - %-/ -%" 0 1 " ) '*! + %, # 2&$!% + ; K, Rosane J Giles )'I :H 3 3, 3,?, M & N %5 L A t(test) 3 24 A83+ O ' A A# O+ < -/+ & P & &Q :' 1! = H O,, ;/,?39 L3, A&,?, M & N, :)8+ A3 5 / & E %" 9 4! ' 340

3 Clinical Comparison between Ga Al As Laser and Drug Therapy on Apicectomy Pain and Swell Mohammad Salem Rekab * Rowaida Saimah ** Abstract Background: Laser is one of the new biotechniques which may open a new world wide dentistry Low level laser therapy or soft laser intensity possesses an eminently analgesic and biostimulant effect,by producting endorfin alpha and beta and increasing the local microcirculation Although apicectomy at 20th century have opened the door for new dentistry by increasing the treatment possibilities and improved the functional and esthetics results for patients Material and methods: The aim of our resereach is to evaluate the influence of GaAlAs laser therapy on pain and swelling which occure after apicectomy compared with drug therapy The sample consisted of 36 Clinic patients and divided in 3 groups : GI- The apicectomy surgicaly was done without laser application, but with analgesic and anti inflammatory GII- The apicectomy was done with laser therapy sessions in the postoperative immedite, of 24 hs and of 72 hs, but without analgesic and anti inflammatory GIII- The apicectomy surgicaly and laser therapy sessions in the preoperative and immedite, of 24 hs and of 72 hs, but without analgesic and anti inflammatory The laser equipment was of Semi conductor Ga Al As 904 nm and power 15 j\cm 2 Results:The statistical study of the pain and swelling effect by Giles index of pain and Rosane index of swelling,by sample t(test) with significance degree at level 5 % Showed that soft laser for analgesic and anti swelling if we use it pre and post operated within 24 hs and this result agrees with many studies which confirm the soft laser analgesic and anti inflammatory effect Conclusion: We can use soft laser as a drug alternative therapy for patients who can not use drugs or can be usefull in big operations * Ass Prof Chairman Department of Endodontics, Faculty of Dentistry- Damascus University ** Ass Prof Chief of Laser Research Unit, Dept of Periodontics, Faculty of Dentistry - Damascus University 341

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7 -+ S Z,% 2M 6 Y( 1 6-= 1?" KA A 1 *+ % '*! 7 +' " 6- - % 3L! 9L 2! 7 (5) ( 1995 ) Niccoli Filho,= <Photo Chemical ) M ) F+ 1 ) M- -) 7N!!% 6? BioPhoto ) M 7'*! [" -&%N : - H -! - -% ) M - -)1L (6) -$& +!-I *-+ K 7=,= (1987)Karu " Electromagnetic Mitochondrial -%! 7-L #-'B+ -!! 1 ML% (7) S - 1L &,! 9 M *+ (1991) Riberio 7 K <Functions (8),= (1984) Kubasova " 8 9N 5!? 7N! (! 6= :A %B+ : 7I+! 6= He- Ne 1 '*! 8 +! (9) Biomedical - -+& 7N! + $ (1985) P,= Mester 7'*-! S- 81- G " :M!=!% 7% 1 * P,= Pourreau Schneider <W #+ 6= 1%A (10) -+ %J % ' 6= fibroblast:;<=> # ; % 7 3! % 1L! 7 O? " +!= He Ne 1 7+ :! (11) 6-= 3- #- ; Ga Al As P,= Nara! 8 '! 6= #1 \;= %J % 6+ (12) 2, + 6% \! % 1992 P,= Oliveria 1%" 2- -%, 9L- 6-= G-! "!%! <Ga As PM! 1 (! 6! #? 345

8 - - %-/ -%" 0 1 " ) '*! + %, # 2&$!% (13) - -! 6-= 1 '*! 1997 Dylevsky Navratil S! 8 - (!+ L" = %A) X! X! 1+ " $ X -? <2-$ - X;0 1: 6= % 7;+,!+! 7;+,! O? ;0A & X%! S]- A 8@! 1 7 " (14) 1998 Takac,Stojanovic " K ATP, RNA, "! 7! : 6= \ GL! DNA -+ ) - H! #1 X;M= %E M=" N! " %? " X% :Aim of research :' - 1- G!! % & 6= S &! 7%,! 0 -% - -A # -+ < + % &+ M + <- 1-9L- G '*! S! = '*! %! 3: B= # 2&$ + 7LM < %-E # 2&$ % 3L! 6= 1 ) 2 %,+ :Materials and Methods N " :' ?" 7! (X 20 <'%" 16) XM 36 7%M! 6- ; + %I & 6= # # X 1 S + # 6= 5 <2006\2005 % ; S & =! 7 9J?@ M 2 G %" G % 8" %! I 1: (" % I L ; 6= :-A -&+ % 2!! < 0 / :% $ < 346

9 -,&% 6-= 7- %" :; +$! G;$J 7++&!I \% (N+ X % A % L - " " 6++! M!,=?% 6! #! (- -! 6 H!+ 5 5!! I +,! *+ : K +$ #%, M!! X+% X+,! % 6-= -! % L M M 2M <%L! +,+ 1A :!+ -" 6 6= %+! :&$ # 3 + 6! 9%'" %,! 3\%! 6&A Castellini MINI LASER G % S+ 6=! 1 1: 904nm Ga Al As Semi Conductor $ % 3%" 71? 2% -+&!+ %$ (:' + 4 $)) <! 6:= ;&A " 30 mw! $&+ -? = -&$ _+ <+!+ 6 + & E 3, " U XM 12 :%! 7 3 A M,!! 347

10 - - %-/ -%" 0 1 " ) '*! + %, # 2&$!% 7-+ -M M!! S #? 6? : (Maxicilin 500 mg 4 Xdaily Paracytamol 3X :+-% 7% daily) -? 1 7,! 2 " 3 # #+ 6 + K W <7% " 7+ &N! M M!! : # :M!! <7% " 7+ &N! M M!! : $ 1 :M!! (9) Kubasova -?" 6! 7 A X%! + & $&!! - '*-! 1; $& 6? 2 / 5 05! 6! ; $& 8 1: 2 = 2 =!+ &% %' (! 1 2- / % %*! S M 2 1 " +&!+ %$ 7+'! 2) %+ H 6$ 9! 2 +!+ 6,&% - -$ -+"! M%!,&% 3L!+ %$ (6 X-\% <- 91 # [a' :% %E 1 - M%! X ",!+ %$ +!+ % %b% 6,&% *% 6 '! 348

11 :7%= 8 %,! 6=?%! 6! indexs 7 " (16) 1984 Pain Index Giles O' R Pain Index -1 M 0 -/ $ " A' 10 (17) 1999 Swell Index Rosane N+ R -2 M 0 //+ 1 " 2 $ 3 K <# 2&$ %! 7-+' -$ +$ ' " cl!%i +$ <+ PA ('+) : Result H S;' 7 6= 7;! 1 $ dm

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13 < t (test) +! 9B+ )J R7eRf]" - 6-!!= ;- X+! :%+ L?" 8! K (7224) ( % 5 I )?" 5! " K :S;' 7 + 7;! )J g)!% :I " :%'! + 7;! 6= L?" +! : ,, -= 8" - - A t(test) 6)J +!I!%! -+!I -$ 7N+ S K! " (2,0739), N" 6? <(0,9449) (1,050) 6! X)A : 0! + L [a' % 5?" 5! :''! + 7;! 6= L?" +! :2-1 # - 2-&$ -+ -, 72< )J +!I $ 7N+ -" (2,0739), 2 :!%,+ < 6! (1,9713)(1,0926) X)A : 0! + L [a' % 5?" 5! :'' %'! + 7;! 6= L?"! :3-1 7-% S- G(2,2562) 2&, )J +!I $ 7N+ 5!- -" (2,0739) 8! 6! :!+, +" +!I $ -= - A X)A :! + L [a' %5?" 6,, -$ S- -,, = A 2&, !I g)!%! -" (2,0738), N" 6? (1,2539) 6)J +!I X)A : 0! + L [a' %5?" 5! 351

14 - - %-/ -%" 0 1 " ) '*! + %, # 2&$!% S 2H 1H H 1H H 2H S 2H 1H H 1H H 2H % 5 L A t(test) )'I +M )'I H A Discussion # 7,= ) &N! [A :, <:A %! 6! g)!% ; -% N %/ 1 +&! P@ 8 := 6= P+! 2&$ 6- -+, +$ +& 9! P!$ S 2 7% $ <S;' 7 + = " \;% S <,= O+ " O+ 6? <(2) " (1) :\ 3L $ M 7;! 7;! 6= \; L " 8 6 %! " O+ 2&, +$ 1 +&! " A = '' %'! + -+ X;: L &,= 2&, 24 ; + 3L 72 (12) P,= Oliveria PA! 2 =! PA %! [A A :, % (17) (14) (13) O@;--1 Rosane Stojanovisc HTakacH Navratil dylevsky (18) <%- G1 + 6= 1 '*! P! 6=, (19) + 3L! 6= 1 = := " 6! O@;1 Kreisler 1 6! 7 X;M= XM 26 % # 2&$ 352

15 Seija taube O 2 (!! :% < 3L! 9L 2! 6= (21) (20) 1 = :! 6= Wilder smith O@;1 :Suggestions and Recommendations 1) 1' -! (- ) + 1! -1 +&! M : M 5 I # 2&$ ) 7 6-= X X 1 8@ " (2 6 ) 7I 6= -2 ' 3L! P!,+&! 1 S A -3 -& 6= #! P %*+ 1 6= S + 1 9%A -4 % & 6= -+ +! =/ / %,! O : % 353

16 - - %-/ -%" 0 1 " ) '*! + %, # 2&$!%! 1-American Association of EndodontistsGlossary Contemporary Terminology for Endodontics Sixth edition, Chicago,1L: American Association of Endodontists; %6,+ % #! <<H<6% HS+ 3-miserendino,L,pick,R,1995-lasersindentistry Quintessence,vol6, Swedish Laser-medical society LLLT, Internet guide- 1998wwwlasernu/lllt/fag1htmupdated 08/01/ Niccoli,W, Filho, photo chemical effects of different types of low energy laser ( He-Ne ) ( Ga Al As ) 1995 unesp, p68 6- Karu,T Photo biological fundamentals of low power therapy Journal of Quantum Electronics, 1987 vol23,10,oct 7- Riberio,M, experimental effect of polarized light on vivo 1991H USP 8-Kubasova,A,Somsoy,Z,Unk,P, Biological effect of He-Nelaser Investigations on functional and micromorphological altrations of sell membranes, in vitro lasers medicine, 1984 vol4p , 9-mester,E,mester,F,mester,A, the biomedical effects of laser applications Lasers surgery medicine, 1985 vol5 p Pourreau,N,Schneider,Soudry,M,Remusat,M, modification of growth dynamics and ultrastructure after He Ne treatment of human gingival fibroblasts, Quintessence International, 1989 vol 20, 12 p Dec 11-Nara,Y,Okamoto,H,etal, Growth acceleration of human dental pulpal fibroblasts by semi conductor laser surgical and medical lasers, 1990 vol 3 4 P , Dec 12-Oliveria,J histological study in the alveolar repair of wounds after teeth extraction and radiated by Ga As laser 1992, UNESP, P Navratil,L,Dylevsky,I, Mechanisms of the analgesic effect of theraptic lasers in vivo laser therapy, 1997 vol 9,p Takac,S,Stojanovic,S, Diagnostic and biostimulating lasers med pergl,1998,vol, may-jun,(5-6), JPeriodontology 2000 May, 71 (5), Giles,R, Evaluation of pain after surgery JPerio, 1984 vol15 p

17 17- Rosane,ZLizarell,PKaren,CCiconell,C, Low Powered Laser Therapy Associated To Oral Implantology SPIE, 1999 V 3593, p " ) '*! + %, Z, -18 S-+ 6% G1!% %/ %" H<2:25 <+& 19- Kreisler MB, Haj HA, Noroozi N, Willershausen B, Efficacy of low level laser therapy in reducing postoperative pain after endodontic surgery-- a randomized double blind clinical study Int J Oral Maxillo fac Surg 2004 Jan;33(1): Taube,S, piironen,j,ylipaavalniemi,p, He - Ne laser therapy in the prevention of postoperative swelling and pain after wisdom tooth extraction Proc Finn Dent Soc1990, 86, Smith,W, the soft laser therapeutic tool or popular placebo? Oral Pathol,1998,vol 66, /4/24 : A S+ h! 2008/6/4:% P +$ h! 355