Low-level laser effect in patients with neurosensory impairment of mandibular nerve after sagittal split ramus osteotomy. Randomized clinical trial, controlled by placebo

Abstract

Objectives: Evaluate the effect on the application of low level laser therapy, in patients that have been previously intervened with a sagittal ramus split osteotomy and present neurosensory impairment due to this surgery, compared with placebo. Study Design: This preliminary study is a randomized clinical trial, with an experimental group (n=17) which received laser light and a control group (n=14), placebo. All participants received laser applications, divided after surgery in days 1, 2, 3, 5, 10, 14, 21 and 28. Neurosensory impairment was evaluated clinically with 5 tests; visual analog scale (VAS) for pain and sensitivity, directional and 2 point discrimination, thermal discrimination, each one of them performed before and after surgery on day 1, and 1, 2 and 6 months. Participants and results evaluator were blinded to intervention. Variables were described with absolute frequencies, percentages and medians. Ordinal and dichotomous variables were compared with Mann Whitney’s and Fisher’s test respectively. Results: Results demonstrate clinical improvement in time, as well as in magnitude of neurosensory return for laser group; VAS for sensitivity reached 5 (normal), 10 participants recovered initial values for 2 point discrimination (62,5%) and 87,5% recovered directional discrimination at 6 months after surgery. General VAS for sensitivity showed 68,75% for laser group, compared with placebo 21,43% (p-value = (0.0095). Left side sensitivity (VAS) showed 3.25 and 4 medians for placebo and laser at 2 months, respectively (p-value = (0.004). Conclusions: Low-level laser therapy was beneficial for this group of patients on recovery of neurosensory impairment of mandibular nerve, compared to a placebo. Key words:Laser Therapy, low-level, LLLP, osteotomy, sagittal split ramus, paresthesia, mandibular nerve.