Abstract
BackgroundOrthognathic surgery such as bilateral sagittal split ramus osteotomy (BSSRO) for the treatment of mandibular deformities is one of the most common procedures in maxillofacial operations that may lead to neurosensory disturbance. In this study, we aimed to evaluate the effectiveness of low-level laser therapy (LLLT) on augmenting recovery of neurosensory disturbance of inferior alveolar nerve (IAN) in patients who underwent BSSRO surgery.MethodsA comprehensive literature search was conducted by two independent authors in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Embase, and Google Scholar electronic databases. Besides, a manual search of all textbooks and relevant articles were conducted. Searches took place in August 2020 and were limited to published and peer-reviewed articles from 2000 to 2020. All analysis was performed using the comprehensive meta-analysis (CMA) and the STATA MP (version:16) software. The weighted mean difference (WMD) using the inverse variance method and the standard mean difference (SMD) was considered for continuous variables.ResultsSeventy-four papers were retrieved after removing duplicate studies and finally, eight studies were assessed for qualitative synthesis and five for meta-analysis. Totally, 94 patients were included in the meta-analysis. Based on the meta-analysis, it was shown that LLLT was not effective in a short interval (0 to 48 h) after surgery, but in a period of more than 1 month after surgery, the positive results of treatment can be observed strikingly. Also, LLLT side/group showed no significant difference in some aspects of neurosensory recovery such as thermal sensation compared to the placebo side/group.ConclusionsThe meta-analysis of randomized controlled trials revealed that LLLT generally improves IAN sensory disturbance caused by BSSRO. Further high-quality clinical trials with longer follow-up periods and larger sample sizes are recommended.
Highlights
Orthognathic surgery such as bilateral sagittal split ramus osteotomy (BSSRO) for the treatment of mandibular deformities is one of the most common procedures in maxillofacial operations that may lead to neurosensory disturbance
Titles and abstracts screened based on inclusion and exclusion criteria and 14 studies were retrieved and assessed for full-text evaluation based on the pre-determined inclusion and exclusion criteria and the assumed research question
Adverse effects No remarkable complications related to level laser therapy (LLLT) have been described in all included RCTs. This meta-analysis was aimed to evaluate the effectiveness of LLLT on augmenting recovery of neurosensory disturbance (NSD) of the inferior alveolar nerve caused by BSSRO surgery
Summary
Orthognathic surgery such as bilateral sagittal split ramus osteotomy (BSSRO) for the treatment of mandibular deformities is one of the most common procedures in maxillofacial operations that may lead to neurosensory disturbance. We aimed to evaluate the effectiveness of low-level laser therapy (LLLT) on augmenting recovery of neurosensory disturbance of inferior alveolar nerve (IAN) in patients who underwent BSSRO surgery. Bilateral sagittal split ramus osteotomy (BSSRO) is a technique of orthognathic surgery that is utilized to adjust excess, deficiency, and asymmetry of the mandible [1]. The most-reported complications include bad splits (pooled:2.3%), postoperative infection (pooled:9.6%), removal of osteosynthesis material (pooled:11.2%), and neurosensory disturbances (pooled:33.9%) [3]. Neurosensory disturbance (NSD) is one of the most common complications of the bilateral sagittal split ramus osteotomy. Postoperative care, surgeons’ skills, and surgical time are correlated with the aforementioned complications [4]
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