Khullar S M, Brodin P, Barkvoll P, Haanaes H R
Department of Oral Surgery and Oral Medicine, University of Oslo, Blindern, Norway.
J Oral Maxillofac Surg. 1996 Jan;54(1):2-7; discussion 7-8. doi: 10.1016/s0278-2391(96)90290-6.
The incidence of inferior alveolar nerve (IAN) damage during removal of third molar teeth has been reported to be as high as 5.5% and up to 100% during sagittal split osteotomy. Sensory aberrations in the IAN persisting for longer than 6 months leave some degree of permanent disability. The purpose of this double-blind, clinical trial was to examine the effects of low-level laser (LLL) treatment using a GaAIAs laser (820 nm, Rønvig, Denmark) on touch and temperature sensory perception after a long-standing postsurgical IAN injury.
Thirteen patients were divided into two groups, one of which received real LLL (4 x 6 J per treatment along the distribution of the IAN to a total of 20 treatments) and the other placebo LLL. The degree of mechanoreceptor injury as assessed by Semmes Weinstein Monofilaments (North Coast Medical, San Jose, CA) were comparable in the two groups before treatment. The degree of thermal sensitivity disability as assessed using a Thermotester (Somedic AB, Stockholm, Sweden) to examine the indifferent temperature threshold was also comparable between the two groups before LLL.
Subsequent to LLL, the real laser-treated group showed a significant improvement in mechanoreceptor sensory testing (P = .01) compared with the placebo group, as manifested by a decrease in load threshold (g) necessary to elicit a response from the most damaged area. In addition, the real LLL group reported a subjective improvement in sensory function. There was no significant improvement in thermal sensitivity post-LLL for either the real or placebo laser-treated groups.
It was concluded that LLL can improve mechanoreceptor perception in long-standing sensory aberrations in the IAN.
据报道，拔除第三磨牙时下牙槽神经（IAN）损伤的发生率高达5.5%，在矢状劈开截骨术中这一发生率可达100%。IAN感觉异常持续超过6个月会导致一定程度的永久性残疾。本双盲临床试验的目的是研究使用GaAIAs激光（820 nm，丹麦伦维格）进行低水平激光（LLL）治疗对IAN长期术后损伤后触觉和温度感觉的影响。
13名患者被分为两组，一组接受真正的LLL治疗（沿IAN分布每次治疗4×6 J，共20次治疗），另一组接受安慰剂LLL治疗。治疗前，两组通过Semmes Weinstein单丝（加利福尼亚州圣何塞市北海岸医疗公司）评估的机械感受器损伤程度相当。在进行LLL治疗前，两组使用Thermotester（瑞典斯德哥尔摩Somedic AB公司）检测冷感温度阈值评估的热敏感残疾程度也相当。
与安慰剂组相比，真正接受激光治疗的组在接受LLL治疗后，机械感受器感觉测试有显著改善（P = 0.01），表现为引发最受损区域反应所需的负荷阈值（g）降低。此外，真正接受LLL治疗的组报告感觉功能有主观改善。真正接受激光治疗组和安慰剂激光治疗组在LLL治疗后热敏感性均无显著改善。
得出的结论是，LLL可改善IAN长期感觉异常中的机械感受器感知。
