Laser Biophotomodulation in Patients with Neurosensory Disturbance of the Inferior Alveolar Nerve After Sagittal Split Ramus Osteotomy: A 2-Year Follow-Up Study.

OBJECTIVE: To evaluate the effect of the application of photobiomodulation in a 2-year follow-up period in patients who have been intervened with a sagittal ramus split osteotomy and present neurosensory disturbance of the inferior alveolar nerve. BACKGROUND: Photobiomodulation is a common clinical tool in dentistry, for its beneficial effects have been shown in surgical and periodontal wound healing, reducing of swelling and pain, neurosensory recovery, and treatment of temporomandibular joint disorders. METHODS: This is a 2-year follow-up study with an experimental (Laser) group (n = 33) that received photobiomodulation, and a control (Sham) group (n = 9), placebo. All patients from the Laser group received laser applications (continuous wave of 0.353 W/cm2, 27 J in 270 sec per session) on days 1, 2, 3, 5, 10, 14, 21, and 28 after surgery. Neurosensory disturbance was evaluated with five tests: Visual Analog Scale (VAS) for pain and sensitivity, sensitivity threshold test, two-point discrimination, and thermal discrimination. All tests were performed before (24 h before surgery) and after surgery (24 h, 28 days, 60 days, 6 months, 1 year, 2 years, more than 2 years). Participants and evaluator were blinded to intervention. Variables were described with absolute frequencies, percentages, and medians. Ordinal and dichotomous variables were compared with Mann-Whitney's and Fisher's tests, respectively. RESULTS: Clinical improvement was observed during the follow-up period for the Laser group; general VAS for sensitivity was normal in 11 participants from the Laser group at 2 years postsurgery (40.74%), while no participants from the Sham group achieved this (p = 0.0341). Twenty-three participants recovered initial values for two-point discrimination (69.7%) after 2 years of follow-up (p = 0.0025) as well as sensitivity threshold test. General VAS for pain was normal in 31 patients from the Laser group after 2 years of follow-up (93.94%, p = 0.0254). CONCLUSIONS: Photobiomodulation was effective for neurosensory recovery on sample studied.