Advance in Functional Restoration of Injured Nerve with Low Level Laser and its Utilization in the Dental and Maxillofacial Region.

The inferior alveolar nerve and facial nerve are the two most important nerves in the dental and maxillofacial region. The injury to them is one of the major postoperative complications after alveolar surgery and orthognathic surgery. However, recovering the nerve function after injury takes a long time and the recovery effect tends to be unsatisfactory. In recent years, an intensively investigated technique, low level laser which has been applying in assisting the recovery of nerve function, has been gradually proved to be effective in clinically treating postoperative nerve injury. In this article we review in terms of the mechanisms involved in low level laser-assisted functional restoration of nerve injury and its clinical application in the recovery of nerve function in the dental and maxillofacial area as well.

Photobiomodulation Therapy to Treat Facial Paralysis of 8 Years: Case Report.

Background: Paralysis of the facial muscles produces functional and aesthetic disturbance that has a negative impact for the patient's quality of life. Objective: To evaluate the effects of a photobiomodulation (PBM) with low-level laser (LLL) on the treatment of a patient with 8 years of facial paralysis. Methods: PBM with two different wavelengths of LLL (660 and 808 nm), applied only on the affected side, three times a week for 8 consecutive weeks. Evaluations were performed before starting treatments, after the 12th session of treatment and after the 24th session, using the House-Brackmann scale and electroneuromyography. Results: The House-Brackmann and electroneuromyography tests showed improvements in the movement of the facial muscles when tested in the middle and at the end of the treatment with LLL. Conclusions: PBM with LLL at the wavelength of 660 and 808 nm with the parameters used in this case report was an effective and noninvasive treatment for facial paralysis in this long-standing, chronic case of 8 years.

Three-Dimensional Printed Plate-Guided 125I Brachytherapy for Malignant Parotid Tumors.

PURPOSE: The treatment of malignant parotid tumors with 125I brachytherapy is rarely reported. This study evaluated the efficacy and dose and response of 125I brachytherapy in patients with malignant tumors. MATERIALS AND METHODS: From July 2014 through August 2017, 39 patients with malignant parotid tumors were treated with 125I brachytherapy. Thirty-five patients were treated with conservative surgical resection before brachytherapy. Four patients were treated with brachytherapy alone. Clinical outcomes and side effects were evaluated. Clinical factors were investigated to determine correlations with local control (LC) and side effects. RESULTS: Mean follow-up was 25 months (range, 7 to 47 months). The LC rate was 87.2% and the overall survival rate was 97.4%. High tumor grade and large tumor showed a propensity for local recurrence. Acute skin toxicity occurred in 87.2% of patients and grade 3 and 4 radioepidermitis was found in 20.5% of patients. In total, 89.7% of patients with facial nerve dysfunction recovered within 12 months. CONCLUSIONS: 125I brachytherapy was a feasible treatment option for patients with malignant parotid tumors. Although side effects were minimal, strict follow-up was necessary for patients treated with a high dose.

Efficacy of Laser Photobiomodulation on Morphological and Functional Repair of the Facial Nerve.

OBJECTIVE: Evaluate the efficacy of low-level laser therapy (LLLT) on qualitative, quantitative, and functional aspects in the facial nerve regeneration process. MATERIALS AND METHODS: Forty-two male Wistar rats were used, randomly divided into a control group (CG; n = 10), in which the facial nerve without lesion was collected, and four experimental groups: (1) suture experimental group (SEG) and (2) fibrin experimental group (FEG), consisting of 16 animals in which the buccal branch of the facial nerve was sectioned on both sides of the face; an end-to-end epineural suture was performed on the right side, and a fibrin sealant was used on the left side for coaptation of the stumps; and (3) laser suture experimental group (LSEG) and (4) laser fibrin experimental group (LFEG), consisting of 16 animals that underwent the same surgical procedures as SEG and FEG with the addition of laser application at three different points along the surgical site (pulsed laser of 830 nm wavelength, optical output power of 30 mW, power density of 0.2586 W/cm2, energy density of 6.2 J/cm2, beam area of 0.116 cm2, exposure time of 24 sec per point, total energy per session of 2.16 J, and cumulative dose of 34.56 J). The animals were submitted to functional analysis (subjective observation of whisker movement) and the data obtained were compared using Fisher's exact test. Euthanasia was performed at 5 and 10 weeks postoperative. The total number and density of regenerated axons were analyzed using the unpaired t-test (p < 0.05). RESULTS: Laser therapy resulted in a significant increase in the number and density of regenerated axons. The LSEG and LFEG presented better scores in functional analysis in comparison with the SEG and FEG. CONCLUSIONS: LLLT enhanced axonal regeneration and accelerated functional recovery of the whiskers, and both repair techniques allowed the growth of axons.

The new heterologous fibrin sealant in combination with low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve.

This study aimed to evaluate the effects of low-level laser therapy (LLLT) in the repair of the buccal branch of the facial nerve with two surgical techniques: end-to-end epineural suture and coaptation with heterologous fibrin sealant. Forty-two male Wistar rats were randomly divided into five groups: control group (CG) in which the buccal branch of the facial nerve was collected without injury; (2) experimental group with suture (EGS) and experimental group with fibrin (EGF): The buccal branch of the facial nerve was transected on both sides of the face. End-to-end suture was performed on the right side and fibrin sealant on the left side; (3) Experimental group with suture and laser (EGSL) and experimental group with fibrin and laser (EGFL). All animals underwent the same surgical procedures in the EGS and EGF groups, in combination with the application of LLLT (wavelength of 830 nm, 30 mW optical power output of potency, and energy density of 6 J/cm(2)). The animals of the five groups were euthanized at 5 weeks post-surgery and 10 weeks post-surgery. Axonal sprouting was observed in the distal stump of the facial nerve in all experimental groups. The observed morphology was similar to the fibers of the control group, with a predominance of myelinated fibers. In the final period of the experiment, the EGSL presented the closest results to the CG, in all variables measured, except in the axon area. Both surgical techniques analyzed were effective in the treatment of peripheral nerve injuries, where the use of fibrin sealant allowed the manipulation of the nerve stumps without trauma. LLLT exhibited satisfactory results on facial nerve regeneration, being therefore a useful technique to stimulate axonal regeneration process.

[Laser therapy and cryomassage in rehabilitation of patients with facial nerve neuropathy]. / Lazeroterapiia i kriomassazh v vosstanovitel'nom lechenii bol'nykh s nevropatiei litsevogo nerva.

Cryomassage and its combination with low-intensity infra-red laser radiation have been introduced as a novel treatment of facial nerve neuropathy (FNN) in 32 patients. Electrophysiological investigations (facial thermography, classical electrodiagnosis, electromyography of the mimic muscles) and clinical data including those of long-term follow-up show that neither cryomassage nor infra-red laser radiation studied promote transformation of facial tissues in FNN patients. Use of the above factors is effective in a preclinical stage of forming contracture of the mimic muscles. Special techniques of application of local hypothermia and laser radiation can be used in multimodality treatment of both the established contracture and sluggish paresis of the facial muscles.