Low-Level Laser Therapy in the Treatment of Inferior Alveolar Nerve Paresthesia After Surgical Exeresis of a Complex Odontoma

Abstract

Introduction: Orofacial paresthesia is due to trauma to the neural structure of a particular nerve. In dentistry alterations caused by nerve damage in most cases are presented with transient symptomatology. However, it has been agreed by several authors that persistent inferior alveolar sensory aberrations for more than 6 months leave some degree of disability or are considered permanent. The objective of the present study is to report the clinical case of a young patient submitted to low-level laser therapy for the treatment of paresthesia of the inferior alveolar nerve after removal of a complex odontoma in the posterior region of the mandible. Methods: Twenty-four hours after the surgical procedure the patient started the low-level laser therapy with the following parameters: 100 mW of potency, 140 J/cm² of energy density, 4 J of energy per application point, 40 seconds of application per point and 0.028 cm² of spot area. For this particular case, the technique of alternation of laser wavelengths was used, in the first session of which visible red of 660 nm was applied, followed by near-infrared of 808 nm and so on. Results: In the first session, the score on the visual analog scale (VAS) was "3". In the tenth and last sessions, the patient reported a VAS "9". Conclusions: It seems that the early initiation of the low-level laser therapy favors a better outcome in cases like the one presented in this paper. The technique of alternation of laser wavelengths between sessions seems to have some role in the outcome possibly because of the constant stimulation of different chromophores along the treatment course. These two factors need further confirmation and validation through randomized clinical trials.

Mitochondrial Bioenergetic, Photobiomodulation and Trigeminal Branches Nerve Damage, What’s the Connection? A Review

“…PRISMA guidelines screening ( Supplementary Figure S1 ) resulted in 16 articles ( Table 2 and Table 3 ) [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 ] suitable for the review, covering a total of 459 patients. Two were case reports, one was a retrospective study of clinical cases: one was a prospective study, six were case series studies and six were RCT (five double-blind and one triple-blind).…”

“…However, thanks to not-designed and observational studies, various authors have described the effectiveness of PBM for the treatment of IAN [ 53 , 54 , 55 , 56 , 57 , 58 , 59 ], lingual [ 53 , 59 ] and maxillary [ 53 ] nerves, injured by third molar and odontoma removal, osteotomy, dental implant placement and facial trauma. These results were supported by up to 2 years of follow-up [ 54 , 56 , 57 , 58 ].…”

Inferior Alveolar Nerve Lateralization Surgery for Implant Installation in Atrophic Posterior Mandible With Accessory Mental Foramen: A Challenge for the Usual Technique

“…4,6 There are some accessories that may be used to minimize or even restore the sensitivity. Piezoelectric and low-level laser devices are excellent supporting accessories to reduce nerve damage 7,8 and it is part of our routine for IANL. In this case report, the use of both accessories and the decision to keep the AMF were particularly decisive to the maintenance of the integrity of the nerve structure.…”

“…7 In another method, an autospreader flap is used, in which the dorsal part of the upper lateral cartilage is folded and used as a graft. 8 The advantage of the latter technique is that it eliminates the need to harvest septal cartilage. Furthermore, it avoids additional morbidity by eliminating the need to remove cartilage tissue from the ear or rib in patients who have undergone nasal surgery previously.…”

Remoção parcial de odontoma complexo de grandes dimensões em mandíbula

“…A laserterapia de baixa frequência apresenta bons resultados em cirurgias semelhantes à executada 25 e foi de fundamental auxílio na recuperação neural da paciente, promovendo melhora na percepção sensorial a curto prazo. O planejamento cirúrgico, a colaboração da paciente no pós-operatório e um assíduo acompanhamento clínico e radiográfico foram essenciais para o sucesso do tratamento.…”