Top

Head & Face Medicine

Published in:

Open Access 01-12-2006 | Research

Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve

Authors: Tuncer Ozen, Kaan Orhan, Ilker Gorur, Adnan Ozturk

Published in: Head & Face Medicine | Issue 1/2006

Abstract

Background

The most severe complication after the removal of mandibular third molars is injury to the inferior alveolar nerve or the lingual nerve. These complications are rather uncommon (0.4% to 8.4%) and most of them are transient. However, some of them persist for longer than 6 months, which can leave various degrees of long-term permanent disability. While several methods such as pharmacologic therapy, microneurosurgery, autogenous and alloplastic grafting can be used for the treatment of long-standing sensory aberrations in the inferior alveolar nerve, there are few reports regarding low level laser treatment. This paper reports the effects of low level laser therapy in 4 patients with longstanding sensory nerve impairment following mandibular third molar surgery.

Methods

Four female patients had complaints of paresthesia and dysesthesia of the lip, chin and gingiva, and buccal regions. Each patient had undergone mandibular third molar surgery at least 1 year before. All patients were treated with low level laser therapy. Clinical neurosensory tests (the brush stroke directional discrimination test, 2-point discrimination test, and a subjective assessment of neurosensory function using a visual analog scale) were used before and after treatment, and the responses were plotted over time.

Results

When the neurosensory assessment scores after treatment with LLL therapy were compared with the baseline values prior to treatment, there was a significant acceleration in the time course, as well as in the magnitude, of neurosensory return. The VAS analysis revealed progressive improvement over time.

Conclusion

Low level laser therapy seemed to be conducive to the reduction of long-standing sensory nerve impairment following third molar surgery. Further studies are worthwhile regarding the clinical application of this treatment modality.

Available only for authorised users

Benediktsdottir IS, Wenzel A, Petersen JK, Hintze H: Mandibular third molar removal: risk indicators for extended operation time, postoperative pain, and complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004, 97: 438-446.CrossRefPubMed

Renton T, Smeeton N, McGurk M: Factors predictive of difficulty of mandibular third molar surgery. Br Dent J. 2001, 190: 607-610. 10.1038/sj.bdj.4801052a.PubMed

Gulicher D, Gerlach KL: Sensory impairment of the lingual and inferior alveolar nerves following removal of impacted mandibular third molars. Int J Oral Maxillofac Surg. 2001, 30: 306-312. 10.1054/ijom.2001.0057.CrossRefPubMed

Smith AC, Barry SE, Chiong AY, Hadzakis D, Kha SL, Mok SC, Sable DL: Inferior alveolar nerve damage following removal of mandibular third molar teeth. A prospective study using panoramic radiography. Aust Dent J. 1997, 42: 149-152.CrossRefPubMed

Miloro M, Halkias LE, Mallery S, Travers S, Rashid RG: Low-level laser effect on neural regeneration in Gore-Tex tubes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002, 93: 27-34.CrossRefPubMed

Tay AB, Go WS: Effect of exposed inferior alveolar neurovascular bundle during surgical removal of impacted lower third molars. J Oral Maxillofac Sur. 2004, 62: 592-600. 10.1016/j.joms.2003.08.033.CrossRef

Rood JP: Permanent damage to inferior alveolar and lingual nerves during the removal of impacted mandibular third molars. Comparison of two methods of bone removal. Br Dent J. 1992, 172: 108-110.CrossRefPubMed

Bruce RA, Frederickson GC, Small GS: Age of patients and morbidity associated with mandibular third molar surgery. J Am Dent Assoc. 1980, 101: 240-245.CrossRefPubMed

Sisk AL, Hammer WB, Shelton DW, Joy ED: Complications following removal of impacted third molars: the role of the experience of the surgeon. J Oral Maxillofac Surg. 1986, 44: 855-859.CrossRefPubMed

10.

Khullar SM, Brodin P, Barkvoll P, Haanaes HR: Preliminary study of low-level laser for treatment of long-standing sensory aberrations in the inferior alveolar nerve. J Oral Maxillofac Surg. 1996, 54: 2-7. 10.1016/S0278-2391(96)90290-6.CrossRefPubMed

11.

Haug RH, Perrott DH, Gonzalez ML, Talwar RM: The American Association of Oral and Maxillofacial Surgeons Age-Related Third Molar Study. J Oral Maxillofac Surg. 2005, 63: 1106-1114. 10.1016/j.joms.2005.04.022.CrossRefPubMed

12.

Bataineh AB: Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg. 2001, 59: 1012-1017. 10.1053/joms.2001.25827.CrossRefPubMed

13.

Pogrel MA: The results of microneurosurgery of the inferior alveolar and lingual nerve. J Oral Maxillofac Surg. 2002, 60: 485-489. 10.1053/joms.2002.31841.CrossRefPubMed

14.

Greenwood M, Corbett IP: Observations on the exploration and external neurolysis of injured inferior alveolar nerves. Int J Oral Maxillofac Surg. 2005, 34: 252-256. 10.1016/j.ijom.2004.06.002.CrossRefPubMed

15.

Robinson PP, Loescher AR, Yates JM, Smith KG: Current management of damage to the inferior alveolar and lingual nerves as a result of removal of third molars. Br J Oral Maxillofac Surg. 2004, 42: 285-292. 10.1016/j.bjoms.2004.02.024.CrossRefPubMed

16.

Zuniga JR, LaBanc JP: Advances in microsurgical nerve repair. J Oral Maxillofac Surg. 1993, 62-68. Suppl 1

17.

Pollock M: Nerve regeneration. Curr Opin Neurol. 1995, 8: 354-348.CrossRefPubMed

18.

Yoshimoto M, Konig B, Allegrini S, de Carvalho Lopes C, Carbonari MJ, Liberti EA, Adami N: Bone healing after the inferior alveolar nerve lateralization: a histologic study in rabbits (Oryctolagus cuniculus). J Oral Maxillofac Surg. 2004, 131-135. 10.1016/j.joms.2004.03.011. Suppl 2

19.

Rutner TW, Ziccardi VB, Janal MN: Long-term outcome assessment for lingual nerve microsurgery. J Oral Maxillofac Surg. 2005, 63: 1145-1149. 10.1016/j.joms.2005.04.023.CrossRefPubMed

20.

Seo K, Tanaka Y, Terumitsu M, Someya G: Characterization of different paresthesias following orthognathic surgery of the mandible. J Oral Maxillofac Surg. 2005, 63: 298-303. 10.1016/j.joms.2004.07.015.CrossRefPubMed

21.

Abergel RP, Lyons RF, Castel JC, Dwyer RM, Uitto J: Biostimulation of wound healing by lasers: experimental approaches in animal models and in fibroblast cultures. J Dermatol Surg Oncol. 1987, 13: 127-133.CrossRefPubMed

22.

Walker J: Relief from chronic pain by low power laser irradiation. Neurosci Lett. 1983, 43: 339-344. 10.1016/0304-3940(83)90211-2.CrossRefPubMed

23.

Naeser MA, Hahn KA, Lieberman BE, Branco KF: Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: A controlled study. Arch Phys Med Rehabil. 2002, 83: 978-988. 10.1053/apmr.2002.33096.CrossRefPubMed

24.

Miloro M, Repasky M: Low-level laser effect on neurosensory recovery after sagittal ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000, 89: 12-8. 10.1016/S1079-2104(00)70091-6.CrossRefPubMed

25.

Poole TE, Holland I, Peterson LJ: Clinical efficacy of low level laser treatment of oro-facial neurosensory deficits. J Oral Maxillofac Surg. 1993, 182-Suppl 3

26.

Walsh LJ: The current status of low level laser therapy in dentistry. Part 1. Soft tissue applications. Aust Dent J. 1997, 42: 247-254.CrossRefPubMed

27.

Midamba Ed, Haanaes HR: Low reactive-level 830 nm Ga Al As diode laser therapy (LLLT) successfully accelerates regeneration of peripheral nerves in human. Laser Therapy. 1993, 5: 125-CrossRef

28.

Mester AF, Snow JB, Shaman P: Photochemical effects of laser irradiation on neuritic outgrowth of olfactory neuroepithelial explants. Otolaryngol Head Neck Surg. 1991, 105: 449-456.PubMed

29.

Solomon A, Lavie V, Ben-Bassat S, Belkin M, Schwartz M: New surgical approach to overcome the inability of injured mammalian axons to grow within their environment. J Neural Transplant Plast. 1991, 2: 243-248.CrossRefPubMedPubMedCentral

30.

Seddon HJ: Three types of nerve injury. Brain. 1943, 66: 247-288.CrossRef

31.

Sunderland S: A classification of peripheral nerve injuries producing loss of function. Brain. 1951, 74: 491-516.CrossRefPubMed

32.

Graff-Radford SB, Evans RW: Lingual nerve injury. Headache. 2003, 43: 975-983. 10.1046/j.1526-4610.2003.03189.x.CrossRefPubMed

33.

Hakguder A, Birtane M, Gurcan S, Kokino S, Turan FN: Efficacy of low level laser therapy in myofascial pain syndrome: an algometric and thermographic evaluation. Lasers Surg Med. 2003, 33: 339-343. 10.1002/lsm.10241.CrossRefPubMed

34.

Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C: Inferior alveolar nerve damage after lower third molar surgical extraction: a prospective study of 1117 surgical extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001, 92: 377-383.CrossRefPubMed

35.

Robinson PP: Observations on the recovery of sensation following inferior alveolar nerve injuries. Br J Oral Maxillofac Surg. 1988, 26: 177-189. 10.1016/0266-4356(88)90061-7.CrossRefPubMed

36.

Stark M, McCormick S, Buchbinder D: Medial antebrachial nerve: potentially superior alternative donor site for maxillofacial nerve grafting. J Oral Maxillofac Surg. 1991, 137-141. Suppl

37.

Colin W, Donoff RB: Restoring sensation after trigeminal nerve injury: a review of current management. J Am Dent Assoc. 1992, 123: 80-85.CrossRefPubMed

38.

Miloro M, Stoner JA: Subjective outcomes following sural nerve harvest. J Oral Maxillofac Surg. 2005, 63: 1150-1154. 10.1016/j.joms.2005.04.031.CrossRefPubMed

39.

Donoff RB: Surgical management of inferior alveolar nerve injuries. Part I: The case for early repair. J Oral Maxillofac Surg. 1995, 53: 1327-1329. 10.1016/0278-2391(95)90719-X.CrossRefPubMed

40.

Meyer A: Applications of microneurosurgery to the repair of trigeminal nerve injuries. Oral Maxillofac Surg Clin North Am. 1992, 4: 405-

41.

Hillerup S, Hjorting-Hansen E, Reumert T: Repair of the lingual nerve after iatrogenic injury: a follow-up study of return of sensation and taste. J Oral Maxillofac Surg. 1994, 52: 1028-1331.CrossRefPubMed

42.

Robinson PP, Smith KG: A study on the efficacy of late lingual nerve repair. Br J Oral Maxillofac Surg. 1996, 34: 96-103. 10.1016/S0266-4356(96)90144-8.CrossRefPubMed

43.

Pogrel MA, McDonald AR, Kaban LB: Gore-Tex tubing as a conduit for repair of lingual and inferior alveolar nerve continuity defects: a preliminary report. J Oral Maxillofac Surg. 1998, 56: 319-321. 10.1016/S0278-2391(98)90107-0.CrossRefPubMed

44.

Pitta MC, Wolford LM, Mehra P, Hopkin J: Use of Gore-Tex tubing as a conduit for inferior alveolar and lingual nerve repair: experience with 6 cases. J Oral Maxillofac Surg. 2001, 59: 493-496. 10.1053/joms.2001.22671.CrossRefPubMed

45.

Khullar SM, Emami B, Westermark A, Haanaes HR: Effect of low-level laser treatment on neurosensory deficits subsequent to sagittal split ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996, 82: 132-138.CrossRefPubMed

46.

Zuniga JR, Chen N, Phillips CL: Chemosensory and somatosensory regeneration after lingual nerve repair in humans. J Oral Maxillofac Surg. 1997, 55: 2-13. 10.1016/S0278-2391(97)90434-1.CrossRefPubMed

47.

Pogrel MA, Thamby S: The etiology of altered sensation in the inferior alveolar, lingual, and mental nerves as a result of dental treatment. J Calif Dent Assoc. 1999, 27: 531, 534-8.

48.

MacIntosh RB: Experience with the sagittal osteotomy of the mandibular ramus: a 13-year review. J Maxillofac Surg. 1981, 9: 151-65. 10.1016/S0301-0503(81)80036-7.CrossRefPubMed

49.

Aziz SR, Pulse C, Dourmas MA, Roser SM: Inferior alveolar nerve paresthesia associated with a mandibular dentigerous cyst. J Oral Maxillofac Surg. 2002, 60: 457-459. 10.1053/joms.2002.31238.CrossRefPubMed

50.

Jerjes W, Swinson B, Banu B, Al Khawalde M, Hopper C: Paraesthesia of the lip and chin area resolved by endodontic treatment: A case report and review of literature. Br Dent J. 2005, 198: 743-745. 10.1038/sj.bdj.4812412.CrossRefPubMed

51.

Grotz KA, Al-Nawas B, de Aguiar EG, Schulz A, Wagner W: Treatment of injuries to the inferior alveolar nerve after endodontic procedures. Clin Oral Investig. 1998, 2: 73-76. 10.1007/s007840050048.CrossRefPubMed

52.

Kraut RA, Chahal O: Management of patients with trigeminal nerve injuries after mandibular implant placement. J Am Dent Assoc. 2002, 133: 1351-1354.CrossRefPubMed

53.

Rehman K, Webster K, Dover MS: Links between anaesthetic modality and nerve damage during lower third molar surgery. Br Dent J. 2002, 193: 43-45. 10.1038/sj.bdj.4801479a.CrossRefPubMed

54.

Pogrel MA, Thamby S: Permanent nerve involvement resulting from inferior alveolar nerve blocks. J Am Dent Assoc. 2000, 13: 901-907.CrossRef

55.

Pogrel MA, Schmidt BL, Sambajon V, Jordan RC: Lingual nerve damage due to inferior alveolar nerve blocks: a possible explanation. J Am Dent Assoc. 2003, 134: 195-199.CrossRefPubMed

56.

Mikesell P, Nusstein J, Reader A, Beck M, Weaver J: A comparison of articaine and lidocaine for inferior alveolar nerve blocks. J Endod. 2005, 31: 265-270. 10.1097/01.don.0000140576.36513.cb.CrossRefPubMed

57.

Haas DA, Lennon D: A 21 year retrospective study of reports of paresthesia following local anesthetic administration. J Can Dent Assoc. 1995, 61: 319-20. 323-6, 329-30PubMed

58.

Chiapasco M, Crescentini M, Romanoni G: Germectomy or delayed removal of mandibular impacted third molars: the relationship between age and incidence of complications. J Oral Maxillofac Surg. 1995, 53: 418-422. 10.1016/0278-2391(95)90715-7.CrossRefPubMed

59.

Sandstedt P, Sorensen S: Neurosensory disturbances of the trigeminal nerve: a long-term follow-up of traumatic injuries. J Oral Maxillofac Surg. 1995, 53: 498-505. 10.1016/0278-2391(95)90055-1.CrossRefPubMed

60.

Ylikontiola L, Kinnunen J, Oikarinen K: Factors affecting neurosensory disturbance after mandibular bilateral sagittal split osteotomy. J Oral Maxillofac Surg. 2000, 58: 1234-1239. 10.1053/joms.2000.16621.CrossRefPubMed

61.

Susarla SM, Lam NP, Donoff RB, Kaban LB, Dodson TB: A comparison of patient satisfaction and objective assessment of neurosensory function after trigeminal nerve repair. J Oral Maxillofac Surg. 2005, 63: 1138-144. 10.1016/j.joms.2005.04.021.CrossRefPubMed

62.

Ahn H, Lin DL, Esparza N, Damaser MS: Short-term timecourse of bilateral pudendal nerve injury on leak-point pressure in female rats. J Rehabil Res Dev. 2005, 42: 109-114.PubMed

63.

Yu WH, McGinnis MY: Androgen receptors in cranial nerve motor nuclei of male and female rats. J Neurobiol. 2001, 46: 1-10. 10.1002/1097-4695(200101)46:1<1::AID-NEU1>3.0.CO;2-U.CrossRefPubMed

64.

Jordan CL, Price RH, Handa RJ: Androgen receptor messenger RNA and protein in adult rat sciatic nerve: implications for site of androgen action. J Neurosci Res. 2002, 69: 509-518. 10.1002/jnr.10324.CrossRefPubMed

65.

Khullar SM, Brodin P, Messelt EB, Haanaes HR: The effects of low level laser treatment on recovery of nerve conduction and motor function after compression injury in the rat sciatic nerve. Eur J Oral Sci. 1995, 103: 299-305.CrossRefPubMed

66.

Brugnera A: Low level laser therapy in treatment of lesions in the indferior alveolar and mental nerves. Proceedings of 3rd Congress of World Association For Laser Therapy: May 2000. 2000, Athens, Greece, 126-

Title: Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve
Authors: Tuncer Ozen
Kaan Orhan
Ilker Gorur
Adnan Ozturk
Publication date: 01-12-2006
Publisher: BioMed Central
Published in: Head & Face Medicine / Issue 1/2006
Electronic ISSN: 1746-160X
DOI: https://doi.org/10.1186/1746-160X-2-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2006

Experience versus complication rate in third molar surgery

Circulating Immune Complexes and trace elements (Copper, Iron and Selenium) as markers in oral precancer and cancer : a randomised, controlled clinical trial

Bilateral spontaneous hemotympanum: Case report

Kinetic oxygen measurements by CVC96 in L-929 cell cultures

Angiolymphoid hyperplasia with eosinophilia: efficacy of isotretinoin?

Use of the intraosseous screw for unilateral upper molar distalization and found well balanced occlusion