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      Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve

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      1 , 2 , , 3 , 3
      Head & Face Medicine
      BioMed Central

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          Abstract

          Background

          The most severe complication after the removal of mandibular third molars is injury to the inferior alveolar nerve or the lingual nerve. These complications are rather uncommon (0.4% to 8.4%) and most of them are transient. However, some of them persist for longer than 6 months, which can leave various degrees of long-term permanent disability. While several methods such as pharmacologic therapy, microneurosurgery, autogenous and alloplastic grafting can be used for the treatment of long-standing sensory aberrations in the inferior alveolar nerve, there are few reports regarding low level laser treatment. This paper reports the effects of low level laser therapy in 4 patients with longstanding sensory nerve impairment following mandibular third molar surgery.

          Methods

          Four female patients had complaints of paresthesia and dysesthesia of the lip, chin and gingiva, and buccal regions. Each patient had undergone mandibular third molar surgery at least 1 year before. All patients were treated with low level laser therapy. Clinical neurosensory tests (the brush stroke directional discrimination test, 2-point discrimination test, and a subjective assessment of neurosensory function using a visual analog scale) were used before and after treatment, and the responses were plotted over time.

          Results

          When the neurosensory assessment scores after treatment with LLL therapy were compared with the baseline values prior to treatment, there was a significant acceleration in the time course, as well as in the magnitude, of neurosensory return. The VAS analysis revealed progressive improvement over time.

          Conclusion

          Low level laser therapy seemed to be conducive to the reduction of long-standing sensory nerve impairment following third molar surgery. Further studies are worthwhile regarding the clinical application of this treatment modality.

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          Most cited references61

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          THREE TYPES OF NERVE INJURY

          H. SEDDON (1943)
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            The current status of low level laser therapy in dentistry. Part 1. Soft tissue applications.

            Despite more than 30 years of experience with low level laser therapy (LLLT) or 'biostimulation' in dentistry, concerns remain as to its effectiveness as a treatment modality. Controlled clinical studies have demonstrated that while LLLT is effective for some specific applications, it is not a panacea. This paper provides an outline of the biological basis of LLLT and summarizes the findings of controlled clinical studies of the use of LLLT for specific soft tissue applications in dentistry. Areas of controversy where there is a pressing need for further research are identified.
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              Factors predictive of difficulty of mandibular third molar surgery.

              Historically the difficulty of third molar surgery has been judged using radiologically assessed dental factors specifically tooth morphology and position. This study investigated additional factors that have a bearing on the difficulty of extraction. A prospective study undertaken by three clinical assistant grade surgeons who removed 354 single mandibular third molar teeth under day case anaesthesia over the 4-year period (1994-1998). Data relating to patient, dental and surgical variables were collected contemporaneously as the patients were treated. The difficulty of extraction was estimated by the surgeons pre-operatively using dental radiographic features and compared by the same surgeon within the actual surgical difficulty encountered at surgery. Operation time strongly related to both pre and post treatment assessments of difficulty and proved to be the best measure of surgical difficulty. Univariate analysis identified increased patient age, ethnic background, male gender, increased weight, bone impaction, horizontal angulation, depth of application, unfavourable root formation, proximity to inferior alveolar canal and surgeon as factors increasing operative time. Multivariate analysis showed that increasing age (P = 0.014), patient weight (P = 0.024), ethnicity (P = 0.019), application depth (P = 0.001), bone impaction (p=0.008) and unfavourable root formation (P = 0.009) were independent predictors for difficulty of extraction. Half of the six independent factors that predicted surgical difficulty of third molar extraction were patient variables.
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                Author and article information

                Journal
                Head Face Med
                Head & Face Medicine
                BioMed Central (London )
                1746-160X
                2006
                15 February 2006
                : 2
                : 3
                Affiliations
                [1 ]Gülhane Military Medical Academy, Department of Oral Diagnosis and Radiology, 06018, Etlik, Ankara, Turkey
                [2 ]Ankara University, Faculty of Dentistry Department of Oral Diagnosis and Radiology, 06500, Besevler, Ankara, Turkey
                [3 ]Ankara University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery, 06500, Besevler, Ankara, Turkey
                Article
                1746-160X-2-3
                10.1186/1746-160X-2-3
                1386654
                16480503
                c4eb6715-579b-447c-8262-ec1779200314
                Copyright © 2006 Ozen et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 6 November 2005
                : 15 February 2006
                Categories
                Research

                Orthopedics
                Orthopedics

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