Efeito imediato de dois protocolos de fotobiomodulação no pH e fluxo salivar: ensaio clínico quasi-experimental

Abstract

Salivary parameters, such as reduced flow, changes in pH and composition, can lead to changes in oral health. Saliva is responsible for the homeostasis of the mouth and, therefore, it is directly related to the occurrence of caries, periodontitis, fungal and bacterial infections. These situations compromise the population's quality of life and, for this reason, prevention and treatment strategies need to be studied and developed. Photobiomodulation is an alternative that has been increasingly practiced by health professionals. It consists of applying light to a biological system that can induce a photochemical process, mainly in mitochondria, thus stimulating the production of energy in the form of adenosine triphosphate (ATP), which can increase cell metabolism and produce effects as analgesia and tissue regeneration. In dentistry, studies using photobiomodulation show improving some salivary parameters. This study aimed to compare the action of infrared light on salivary flow and ph, using two application techniques: extraoral (G1) and intra and extraoral (G2), with the application interval between 7 days. The sample consisted of 20 healthy adults, who participated in both groups. Stimulated saliva was collected, in both groups, before and immediately after laser application. In G1 a cluster with 3 spots was used, at a wavelength of 808 nanometers, 120 mW power, with 24J of energy on the extraoral surface, for 67 seconds, in the parotid gland region, bilaterally submandibular and sublingual gland region, totaling 4 application regions, with a total deposited energy of 96 joules. In G2, the laser was applied for 60 seconds, at 2 intraoral and 2 extraoral points in the parotid gland region bilaterally, 1 intraoral point and 1 extraoral point in the submandibular and sublingual glands regions (totaling 16 points), with wavelength 808 nm; continuous operating mode; 100mW power; radiant energy of 6J per point, totaling 96 joules of energy. In the present study, we confirmed the hypothesis that there would be a statistically significant difference in the stimulation of immediate salivary flow using only the headgear technique (G1) (p=0.037). However, the same stimulus was not observed in G2. To verify whether there was a difference in salivary flow between before and immediately after the application of photobiomodulation, the percentage of volume variation (ml) per minute was considered, and after the extraoral application with an infrared laser cluster the mean salivary flow passed from 0.86 ml/min to 1.2 ml/min, an increase of 7%. No pH change was observed in either group. It was concluded that the protocol of application only extraoral techinique was able to stimulate salivary flow and the same was not observed in the protocol with application intra and extraoral.