Adjunctive Effect of Photobiomodulation Therapy with Nd:YAG Laser in the Treatment of Inferior Alveolar Nerve Paresthesia.

Background: Disruption of peripheral branches of the trigeminal nerve in the field of maxillofacial surgery is a known risk due to the close connection of these branches with the bony structures of the maxilla and mandible. As a result, injuries of the lingual nerve and inferior alveolar nerve take place within routine maxillofacial surgery procedures, including local anesthetic injection, wisdom tooth surgery, and dental implant placement, resulting in paresthesia and dysesthesia. During the last three decades, low-level lasers (LLL) have been frequently used in various medical fields. Lately, this application has increased in several sectors. Methods and materials: This experiment was designed to explore the effect of low-level laser therapy (LLLT) with Nd:YAG on the paresthesia and dysesthesia of the lower lip. This ethics committee of Tbzmed, Tabriz, Iran, proved the present experiment with ethical code: IR.TBZMED.REC.1401.839. Results: After completing 10 sessions of laser therapy for the case group consisting of 25 patients with lower lip anesthesia, the visual analog scale index results revealed that following six sessions of laser therapy, a significant difference appeared in contrast to the control group. Also, according to the two-point tests, significant difference among the experimental and the control group appeared after ninth session of the laser therapy. Conclusions: Altogether, these data suggested LLLT with Nd:YAG as an effective treatment option for decreasing the anesthesia of the lower lip.

Low-level laser therapy for treatment of neurosensory disorders after orthognathic surgery: A systematic review of randomized clinical trials.

BACKGROUND: Low-level laser has been widely used in Dentistry and many studies have focused on its application in oral surgeries. This study was conducted with the aim of searching for scientific evidence concerning the effectiveness of laser to reduce pain or paresthesia related to orthognathic surgery. MATERIAL AND METHODS: An electronic search was performed in PubMed, Scopus, Science Direct, LILACS, SciELO, CENTRAL, Google Scholar, OpenGrey, and ClinicalTrials.gov, up to November 2016, with no restrictions on language or year of publication. Additionally, a hand search of the reference list of the selected studies was carried out. The PICOS strategy was used to define the eligibility criteria and only randomized clinical trials were selected. RESULTS: Out of 1,257 identified citations, three papers fulfilled the criteria and were included in the systematic review. The risk of bias was assessed according to the Cochrane Guidelines for Clinical Trials and results were exposed based on a descriptive analysis. One study showed that laser therapy was effective to reduce postoperative pain 24 hours (P=0.007) and 72 hours (P=0.007) after surgery. Other study revealed the positive effect of laser to improve neurosensory recovery 60 days after surgery, evaluated also by the two-point discrimination (P=0.005) and sensory (P=0.008) tests. The third study reported an improvement for general sensibility of 68.75% for laser group, compared with 21.43% for placebo (P=0.0095), six months after surgery. CONCLUSIONS: Individual studies suggested a positive effect of low-level laser therapy on reduction of postoperative pain and acceleration of improvement of paresthesia related to orthognathic surgery. However, due to the insufficient number and heterogeneity of studies, a meta-analysis evaluating the outcomes of interest was not performed, and a pragmatic recommendation about the use of laser therapy is not possible. This systematic review was conducted according to the statements of PRISMA and was registered at PROSPERO under the number CRD42016043258.

Laser Therapy in the Treatment of Paresthesia: A Retrospective Study of 125 Clinical Cases.

OBJECTIVE: The aim of this retrospective study was to evaluate the effectiveness of laser therapy for acceleration and recovery of nerve sensitivity after orthognathic or minor oral surgeries, by analysis of clinical records of patients treated at the Special Laboratory of Lasers in Dentistry (LELO, School of Dentistry, University of São Paulo), throughout the period 2007-2013. BACKGROUND DATA: Nerve tissue lesions may occur during various dental and routine surgical procedures, resulting in paresthesia. Laser therapy has been shown to be able to accelerate and enhance the regeneration of the affected nerve tissue; however, there are few studies in the literature that evaluate the effects of treatment with low-power laser on neural changes after orthognathic or minor oral surgeries. METHODS: A total of 125 clinical records were included, and the data on gender, age, origin of the lesion, nerve, interval between surgery and onset of laser therapy, frequency of laser irradiation (one or two times per week), final evolution, and if there was a need to change the irradiation protocol, were all recorded. These data were related to the recovery of sensitivity in the affected nerve area. Descriptive analyses and modeling for analysis of categorical data (α=5%) were performed. RESULTS: The results from both analyses showed that the recovery of sensitivity was correlated with patient age (p=0.015) and interval between surgery and onset of laser therapy (p=0.002). CONCLUSIONS: Within the limits of this retrospective study, it was found that low- power laser therapy with beam emission band in the infrared spectrum (808 nm) can positively affect the recovery of sensitivity after orthognathic or minor oral surgeries.

Benefits of laser phototherapy on nerve repair.

Post-traumatic nerve repair represents a major challenge to health sciences. Although there have been great advances in the last few years, it is still necessary to find methods that can effectively enhance nerve regeneration. Laser therapy has been widely investigated as a potential method for nerve repair. Therefore, in this article, a review of the existing literature was undertaken with regard to the effects of low-power laser irradiation on the regeneration of traumatically/surgically injured nerves. The articles were selected using either electronic search engines or manual tracing of the references cited in key papers. In electronic searches, we used the key words as "paresthesia", "laser therapy", "low-power laser and nerve repair", and "laser therapy and nerve repair", considering case reports and clinical studies. According to the findings of the literature, laser therapy accelerates and improves the regeneration of the affected nerve tissues, but there are many conflicting results about laser therapy. This can be attributed to several variables such as wavelength, radiation dose, and type of radiation. All the early in vivo studies assessed in this research were effective in restoring sensitivity. Although these results indicate a potential benefit of the use of lasers on nerve repair, further double-blind controlled clinical trials should be conducted in order to standardize protocols for clinical application.

Preliminary study of low-level laser for treatment of long-standing sensory aberrations in the inferior alveolar nerve.

PURPOSE: The incidence of inferior alveolar nerve (IAN) damage during removal of third molar teeth has been reported to be as high as 5.5% and up to 100% during sagittal split osteotomy. Sensory aberrations in the IAN persisting for longer than 6 months leave some degree of permanent disability. The purpose of this double-blind, clinical trial was to examine the effects of low-level laser (LLL) treatment using a GaAIAs laser (820 nm, Rønvig, Denmark) on touch and temperature sensory perception after a long-standing postsurgical IAN injury. PATIENTS AND METHODS: Thirteen patients were divided into two groups, one of which received real LLL (4 x 6 J per treatment along the distribution of the IAN to a total of 20 treatments) and the other placebo LLL. The degree of mechanoreceptor injury as assessed by Semmes Weinstein Monofilaments (North Coast Medical, San Jose, CA) were comparable in the two groups before treatment. The degree of thermal sensitivity disability as assessed using a Thermotester (Somedic AB, Stockholm, Sweden) to examine the indifferent temperature threshold was also comparable between the two groups before LLL. RESULTS: Subsequent to LLL, the real laser-treated group showed a significant improvement in mechanoreceptor sensory testing (P = .01) compared with the placebo group, as manifested by a decrease in load threshold (g) necessary to elicit a response from the most damaged area. In addition, the real LLL group reported a subjective improvement in sensory function. There was no significant improvement in thermal sensitivity post-LLL for either the real or placebo laser-treated groups. CONCLUSION: It was concluded that LLL can improve mechanoreceptor perception in long-standing sensory aberrations in the IAN.