Qi Wei, Wang Yuguang, Huang Ying-Ying, Jiang Yuxi, Yuan Lintian, Lyu Peijun, Arany Praveen R, Hamblin Michael R
Department of General Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.
National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.
Lasers Dent Sci. 2020 Mar;4(1):25-32. doi: 10.1007/s41547-019-00075-6. Epub 2019 Dec 17.
Inferior alveolar nerve (IAN) injury is one of the most serious complications after extraction of impacted lower third molars. Photobiomodulation (PBM) therapy has been noted to reduce pain and inflammation while promoting tissue healing. This study examined the efficacy of PBM therapy tested in a case series of patients with postoperative IAN injury.
20 patients with post-extraction IAN injury were involved in this study and divided into two groups. In the study group, PBM therapy (808-nm laser, 16 mW, 3 J/cm) was used every other day for 2 weeks solely on post-extraction sockets in 10 patients diagnosed with IAN injury. In the control group, mecobalamine was prescribed to 10 patients with IAN injury. Objective and subjective recovery of IAN paresthesia was evaluated using clinical neurosensory testing and visual analog score.
All patients showed improvement in both objective and subjective examination. Notably, the visual analog score was significantly improved after PBM treatment compared to the mecobalamine treatment ( < 0.05).
PBM therapy with 808-nm laser appears to be an effective approach to manage paresthesia post-IAN injury following impacted third molar surgery. Given the limited sample size in this study, large-scale, placebo-controlled, multi-center randomized controlled trials are needed for further validation of this innovative treatment.
下牙槽神经(IAN)损伤是阻生下颌第三磨牙拔除术后最严重的并发症之一。光生物调节(PBM)疗法已被证实可减轻疼痛和炎症,同时促进组织愈合。本研究在一系列IAN损伤术后患者中检验了PBM疗法的疗效。
本研究纳入20例拔牙后IAN损伤患者并分为两组。研究组中,10例诊断为IAN损伤的患者仅在拔牙窝处每隔一天使用PBM疗法(808纳米激光,16毫瓦,3焦/平方厘米),持续2周。对照组中,10例IAN损伤患者服用甲钴胺。使用临床神经感觉测试和视觉模拟评分评估IAN感觉异常的客观和主观恢复情况。
所有患者在客观和主观检查中均有改善。值得注意的是,与甲钴胺治疗相比,PBM治疗后视觉模拟评分有显著改善(<0.05)。
808纳米激光PBM疗法似乎是治疗阻生第三磨牙手术后IAN损伤后感觉异常的有效方法。鉴于本研究样本量有限,需要大规模、安慰剂对照、多中心随机对照试验来进一步验证这种创新治疗方法。