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低强度激光疗法与显微手术对下牙槽神经和舌神经损伤后神经感觉恢复的疗效:一项系统评价

Efficacy of low-level laser therapy and microsurgery on neurosensory recovery following inferior alveolar and lingual nerve injuries: A systematic review.

作者信息

Alharbi Gharam, Rao Jingade Krishnojirao Dayashankara, Alnaim Tariq, Alzamil Norah, Nagarajappa Ramesh

机构信息

College of Dentistry, Qassim University, Qassim, Saudi Arabia.

Department of Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Qassim University, Qassim, Saudi Arabia.

出版信息

J Oral Biol Craniofac Res. 2024 Sep-Oct;14(5):631-637. doi: 10.1016/j.jobcr.2024.08.006. Epub 2024 Aug 24.

Abstract

PURPOSE

This systematic review evaluates the relative effectiveness of low-level laser therapy (LLLT) and microsurgery for neurosensory recovery following sustained iatrogenic injuries to the inferior alveolar nerve (IAN) and lingual nerve (LN) more than 6 months in Oral and Maxillofacial surgery procedures.

METHODS

Six articles were included. The mean age of microsurgery studies was 41.5 years and that of LLLT studies was 31.5 with female predominance in all studies. The majority of the included studies have been based on both subjective and objective assessments for neurosensory, two investigating microsurgery and four investigating LLLT following a Six-month post-IAN and LN injury.

RESULTS

Each modality demonstrated positive outcomes in both subjective and objective assessments of neurosensory function. Notably, LLLT exhibited efficacy even when employed beyond a six-month interval following the initial injury. Early intervention is generally recommended, particularly for microsurgical approaches.

CONCLUSION

LLLT shows exciting promise as a minimally invasive approach for neurosensory rehabilitation even after six months of injury, while microsurgery studies revealed an improvement and the recommendation for early intervention post-nerve injury, the potential of LLLT and optimize its use for neurosensory rehabilitation, additional randomized controlled trials with larger sample sizes, longer follow-up periods, and blinding protocols are necessary.

摘要

目的

本系统评价评估了低强度激光治疗(LLLT)和显微外科手术在口腔颌面外科手术中对下牙槽神经(IAN)和舌神经(LN)持续医源性损伤超过6个月后神经感觉恢复的相对有效性。

方法

纳入6篇文章。显微外科手术研究的平均年龄为41.5岁,LLLT研究的平均年龄为31.5岁,所有研究中女性占主导。纳入的大多数研究基于神经感觉的主观和客观评估,两项研究显微外科手术,四项研究IAN和LN损伤6个月后的LLLT。

结果

两种治疗方式在神经感觉功能的主观和客观评估中均显示出积极结果。值得注意的是,即使在初次损伤6个月后采用LLLT,仍显示出疗效。一般建议早期干预,特别是对于显微外科手术方法。

结论

LLLT作为一种微创神经感觉康复方法,即使在损伤6个月后也显示出令人兴奋的前景,而显微外科手术研究显示有改善,并建议神经损伤后早期干预,为了LLLT的潜力并优化其在神经感觉康复中的应用,有必要进行更多样本量更大、随访期更长且采用盲法方案的随机对照试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d73/11387345/d70ceb9621b3/gr1.jpg

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