Brito Aubert V, Angulo Arlyn, Almon Ricardo
Patologia Bucal y Cirugia Maxilofacial, Hospital Jose Gregorio Hernandez, Caracas, VEN.
Oral Medicine, IPD Institute, Caracas, VEN.
Cureus. 2024 Dec 21;16(12):e76147. doi: 10.7759/cureus.76147. eCollection 2024 Dec.
Oral paresthesia occurs when one of the nerves in the region is injured, usually the inferior alveolar and/or lingual nerve, after dental procedures such as the extraction of lower third molars. The objective of this study was to describe the case of a patient who received photobiomodulation (PBM) therapy for paresthesia of the inferior alveolar nerve (IAN) caused by the extraction of mandibular third molars. The protocol used involved a super-pulsed diode laser with dual wavelengths of 810 nm and 980 nm, 1 W, 60 seconds, 12.15 J/cm², with a spot size of 25 mm in the extraoral area. In the intraoral region, 0.3 W, 60 seconds, 46.77 J/cm², with a 7 mm tip, was applied. Before starting each PBM session, mapping of the area was performed to delineate the regions with paresthesia, and the degree of sensitivity was evaluated using a visual analog scale (VAS). On the first day, before the first laser therapy session, the VAS assessment was 7, indicating partial loss of sensitivity. After 48 hours and before the second PBM session, the patient reported a slight tingling sensation and substantial improvement in chin sensitivity, with a VAS score of 4.5. After nine sessions, the patient reported recovery of sensitivity in all affected regions (VAS = 0), with positive and normal responses to touch with a dental explorer. Within the parameters established for this clinical case, our results suggest that PBM therapy may improve the loss of sensation observed in IAN paresthesia following injury or surgical trauma.
口腔感觉异常通常发生在诸如拔除下颌第三磨牙等牙科手术后，该区域的某一神经（通常是下牙槽神经和/或舌神经）受到损伤时。本研究的目的是描述一名因拔除下颌第三磨牙导致下牙槽神经（IAN）感觉异常而接受光生物调节（PBM）治疗的患者的病例。所采用的方案涉及一台双波长为810 nm和980 nm的超脉冲二极管激光器，功率1 W，照射60秒，能量密度12.15 J/cm²，在口外区域光斑尺寸为25 mm。在口内区域，使用7 mm的探头，功率0.3 W，照射60秒，能量密度46.77 J/cm²。在每次PBM治疗开始前，对该区域进行绘图以描绘感觉异常的区域，并使用视觉模拟量表（VAS）评估感觉敏感程度。第一天，在第一次激光治疗前，VAS评估为7分，表明感觉部分丧失。48小时后且在第二次PBM治疗前，患者报告有轻微刺痛感，下巴感觉有显著改善，VAS评分为4.5分。经过九次治疗后，患者报告所有受影响区域的感觉均已恢复（VAS = 0），用牙科探针触碰时反应正常且呈阳性。在为本临床病例设定的参数范围内，我们的结果表明，PBM治疗可能会改善IAN感觉异常损伤或手术创伤后出现的感觉丧失。
