Nasiri Maryam, Ghannadpour Akram, Hakimiha Neda
Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Dentist, Private Practice, Tehran, Iran.
J Lasers Med Sci. 2025 Feb 19;16:e5. doi: 10.34172/jlms.2025.05. eCollection 2025.
Inferior alveolar nerve (IAN) injury is among the most common complications associated with orthognathic surgery. Managing these injuries poses significant challenges due to the lack of a standardized treatment protocol. This study aimed to systematically review the literature on the efficacy of blood products and photobiomodulation (PBM) therapy for neurosensory recovery in patients with IAN injuries after orthognathic surgery. This systematic review involved a comprehensive search of Scopus, Embase, and PubMed databases, as well as the initial 100 search results from Google Scholar, to identify relevant articles published between 2015 and 2024. The articles were selected using defined eligibility criteria. The research paper reviewed 170 articles, ultimately including 14 studies that focused on IAN injury related to surgical procedures such as genioplasty, sagittal split mandibular ramus osteotomy (SSRO), and bilateral sagittal split osteotomy (BSSO). Among these studies, five assessed the effectiveness of various blood products-specifically platelet-rich fibrin (PRF), leukocyte-rich PRF (L-PRF), advanced PRF (A-PRF), and concentrated growth factor (CGF)-all of which were found to alleviate hypoesthesia. Nine studies evaluated the efficacy of PBM, primarily utilizing wavelengths of 810 and 808 nm over 5 to 10 sessions. PBM also successfully enhanced the recovery of IAN. Moreover, one article highlighted the synergistic effect of using L-PRF in conjunction with PBM. It appears that neurosensory recovery following IAN injury due to orthognathic surgery may be enhanced by blood-derived products such as PRF, CGF, A-PRF, and L-PRF, which release growth factors that facilitate tissue repair. Additionally, PBM further supports recovery by reducing inflammation in the initial weeks and stimulating cellular metabolism to promote regeneration in the subsequent weeks.
下牙槽神经(IAN)损伤是正颌外科手术最常见的并发症之一。由于缺乏标准化的治疗方案,处理这些损伤面临重大挑战。本研究旨在系统回顾关于血液制品和光生物调节(PBM)疗法对正颌外科手术后IAN损伤患者神经感觉恢复疗效的文献。 这项系统评价全面检索了Scopus、Embase和PubMed数据库,以及谷歌学术搜索的前100条结果,以识别2015年至2024年发表的相关文章。文章根据既定的纳入标准进行选择。 该研究论文审查了170篇文章,最终纳入了14项研究,这些研究聚焦于与颏成形术、下颌升支矢状劈开截骨术(SSRO)和双侧矢状劈开截骨术(BSSO)等手术相关的IAN损伤。在这些研究中,五项评估了各种血液制品的有效性,具体为富血小板纤维蛋白(PRF)、富白细胞PRF(L-PRF)、高级PRF(A-PRF)和浓缩生长因子(CGF),所有这些都被发现可减轻感觉减退。九项研究评估了PBM的疗效,主要使用810和808 nm波长,治疗5至10次。PBM也成功促进了IAN的恢复。此外,一篇文章强调了联合使用L-PRF和PBM的协同效应。 看来,正颌外科手术导致的IAN损伤后的神经感觉恢复可能会通过PRF、CGF、A-PRF和L-PRF等血液衍生产品得到增强,这些产品可释放促进组织修复的生长因子。此外,PBM通过在最初几周减轻炎症,并在随后几周刺激细胞代谢以促进再生,进一步支持恢复。