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Keykha E, Tahmasebi E, Hadilou M. Therapeutic modalities for iatrogenic late paresthesia in oral tissues innervated by mandibular branch of trigeminal nerve: a systematic review. Maxillofac Plast Reconstr Surg 2024; 46:25. [PMID: 39008167 DOI: 10.1186/s40902-024-00438-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND The present systematic review intended to evaluate the current evidence on the modalities used for treating iatrogenic late paresthesia in the oral tissues innervated by the mandibular branch of the trigeminal nerve. MAIN TEXT As a common side effect of dental procedures, paresthesia can exert a profound adverse effect on patients' quality of life. The inferior alveolar nerve (IAN) and lingual nerve (LN) have the highest chance of injury during several dental procedures, including mandibular orthognathic surgeries, implant placement, extraction of the third molar, anesthetic injections, flap elevation, and endodontic treatments. Moreover, several methods have been proposed for treating iatrogenic late paresthesia, including photobiomodulation (PBM), microsurgery, medication, and close observation until achieving spontaneous recovery of sensation. However, no gold standard treatment for iatrogenic paresthesia has been agreed upon up to now. The present study included a comprehensive search of the databases of PubMed, Embase, Scopus, and Web of Science up to December 04, 2023, resulting in a total of 3122 related studies. Then, the titles, abstracts, and full texts of the studies were evaluated. Ultimately, seven controlled randomized trials (RCTs) were included in the final analysis. Also, the risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Among all fields, randomization, allocation concealment, and data analysis were found to have the highest chance of bias in the included studies. CONCLUSIONS In conclusion, PBM, vitamin B12, and corticosteroids could accelerate the recovery of late paresthesia. However, considering the low sample size of the included studies and the high risk of methodological bias, it is recommended to perform further RCTs with robust study designs following Good Clinical Practice (GCP) guidelines to achieve more reliable results.
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Affiliation(s)
- Elham Keykha
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahdi Hadilou
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
- Faculty of Dentistry, Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, 1435916471, Iran.
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Yari A, Fasih P, Sadeghi S, Movahed E, Hallajmoghaddam Sarand S, Goodarzi A. The Effect of Delayed Photobiomodulation Therapy on Inferior Alveolar Nerve Recovery After Third Molar Removal: A Triple-Blinded Randomized Clinical Trial. Photobiomodul Photomed Laser Surg 2024; 42:463-472. [PMID: 38900722 DOI: 10.1089/pho.2024.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024] Open
Abstract
Background: Third molar removal is the primary reason for inferior alveolar nerve (IAN) damage, with 2% causing persistent neurosensory deficits. This study aimed to investigate how delayed photobiomodulation therapy affects long-lasting neurosensory disturbances. Methods: This study was conducted on patients with neurosensory disturbances lasting longer than 6 months. Patients were randomly allocated to the study and control groups, with the study group receiving a low-power diode laser (continuous wavelength of 810 nm, power of 200 mW) on 16 points (30 sec at each) for 12 sessions (2 sessions/week), while the control group received a placebo treatment by switched-off laser probe. Visual analog scale (VAS; ranging from 1 to 5), static light touch, two-point discrimination, direction discrimination, pinprick, and thermal discrimination tests were performed on each visit up to 9 months post-therapy to evaluate the recovery status. Results: Each group comprised 18 participants. The mean time since injury was 8.26 ± 2.05 and 8.38 ± 1.98 months for the control and intervention groups, respectively (p = 0.81). There was a significant improvement in the intervention group on the static light touch (p = 0.041), two-point discrimination (p = 0.028), VAS (p = 0.031), and pinprick (p = 0.014) tests on the 11th session and subsequent visits and also on direction discrimination test on the 12th session (p = 0.044) and after that. There was no significant difference in the thermal discrimination tests between the two groups (p > 0.05). Conclusion: Photobiomodulation demonstrated potential benefits in resolving persistent neurosensory deficits of the IAN, with noticeable improvements typically observed after around 35 days of treatment initiation (10 sessions).
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Affiliation(s)
- Amir Yari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Paniz Fasih
- Department of Prosthodontics, School of Dentistry, Kashan University of Medical Sciences, Kashan, Iran
| | - Saeideh Sadeghi
- Department of Prosthodontics, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Emad Movahed
- Department of Prosthodontics and Dental Materials, School of Dentistry, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Ali Goodarzi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Alam M, Karami S, Mohammadikhah M, Badkoobeh A, Golkar M, Abbasi K, Soufdoost RS, Hakim LK, Talebi S, Namanloo RA, Hussain A, Heboyan A, Tebyaniyan H. The effect of photobiomodulation therapy in common maxillofacial injuries: Current status. Cell Biochem Funct 2024; 42:e3951. [PMID: 38349051 DOI: 10.1002/cbf.3951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/28/2024] [Indexed: 02/15/2024]
Abstract
The use of photobiomodulation therapy (PBMT) may be used for treating trauma to the maxillofacial region. The effects of PBMT on maxillofacial injuries were discussed in this review article. The electronic databases Pubmed, Scopus, and Web of Science were thoroughly searched. This review included in vitro, in vivo, and clinical studies describing how PBMT can be used in maxillofacial tissue engineering and regenerative medicine. Some studies suggest that PBMT may offer a promising therapy for traumatic maxillofacial injuries because it can stimulate the differentiation and proliferation of various cells, including dental pulp cells and mesenchymal stem cells, enhancing bone regeneration and osseointegration. PBMT reduces pain and swelling after oral surgery and tooth extraction in human and animal models of maxillofacial injuries. Patients with temporomandibular disorders also benefit from PBMT in terms of reduced inflammation and symptoms. PBMT still has some limitations, such as the need for standardizing parameters. PBMT must also be evaluated further in randomized controlled trials in various maxillofacial injuries. As a result, PBMT offers a safe and noninvasive treatment option for patients suffering from traumatic maxillofacial injuries. PBMT still requires further research to establish its efficacy in clinical practice and determine the optimal parameters.
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Affiliation(s)
- Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ahmed Hussain
- School of Dentistry, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
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Scribante A, Pellegrini M, Pulicari F, Porrini M, Bosotti M, Spadari F. Nerve Injury and Photobiomodulation, a Promising Opportunity: A Scoping Review on Laser Assisted Protocols for Lesions in the Oral Region. APPLIED SCIENCES 2023; 13:9258. [DOI: 10.3390/app13169258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
The currently available therapeutic options for restoring function and sensitivity in long-term nervous injuries pose challenges. Microsurgery interventions for direct nerve repair often lead to serious complications and limited success. Non-surgical methods, although somewhat effective, have limited benefits. These methods involve drug administration, such as with analgesics or corticosteroids. Photobiomodulation therapy (PBMT) has emerged as a promising approach based on clinical and laboratory studies. PBMT stimulates the migration and proliferation of neuronal fiber cellular aggregates, as reported in the literature. Experimental studies on animal models with peripheral nerve compression injuries have shown that PBMT can enhance the functionality of damaged nerves, preserving their activity and preventing scar tissue formation. The mechanism of action depends on the wavelength, which can positively or negatively affect photo acceptor resonances, influencing their conformation and activities. These findings suggest that photobiomodulation may accelerate and improve nerve regeneration. This review explores various methodologies used in photobiomodulation for regenerating nerve sensitivity after surgical trauma involving nerve structures, in the oral and peri-oral region. Research was conducted to evaluate which laser-assisted therapeutic protocols are used to improve the recovery of nervous sensitivity, using the JBI methodology for scoping reviews and following the PRISMA methodology.
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Affiliation(s)
- Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Matteo Pellegrini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Federica Pulicari
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Massimo Porrini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Moreno Bosotti
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Francesco Spadari
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
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Ma Y, Yang M, Chen X, Qu W, Qu X, He P. The effectiveness of photobiomodulation therapy on inferior alveolar nerve injury: A systematic review and META-analysis. PLoS One 2023; 18:e0287833. [PMID: 37561792 PMCID: PMC10414610 DOI: 10.1371/journal.pone.0287833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/14/2023] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVE The aim of this META-analysis was to evaluate the efficacy of photobiomodulation (PBM) therapy in the treatment of inferior alveolar nerve (IAN) injury due to orthognathic surgeries, extraction of impacted third molars and mandibular fractures. METHODS AND MATERIALS A electric search was conducted by a combination of manual search and four electric databases including Pubmed, Embase, Cochrane library and Web of Science, with no limitation on language and publication date. Gray literature was searched in ClinicalTrials.gov and googlescholar. All retrieved articles were imported into ENDNOTE software (version X9) and screened by two independent reviewers. All analysis was performed using the REVMAN software (version 5.3). RESULTS Finally, 15 randomized controlled trials met the inclusion criteria for qualitative analysis and 14 for META-analysis from 219 articles. The results showed that PBM therapy had no effect on nerve injury in a short period of time (0-48h, 14 days), but had significant effect over 30 days. However, the effect of photobiomodulation therapy on thermal discrimination was still controversial, most authors supported no significant improvement. By calculating the effective rate of PBM, it was found that there was no significant difference in the onset time of treatment, whether within or over 6 months. CONCLUSIONS The results of this META-analysis show that PBM therapy is effective in the treatment of IAN injures no matter it begins early or later. However, due to the limited number of well-designed RCTs and small number of patients in each study, it would be necessary to conduct randomized controlled trials with large sample size, long follow-up time and more standardized treatment and evaluation methods in the future to provide more accurate and clinically meaningful results.
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Affiliation(s)
- Yongqing Ma
- Department of Oral and Maxillofacial Surgery, Dalian Stomatological Hosipital, Dalian City, Liaoning Province, China
| | - Miaomiao Yang
- Department of Implantation, Dalian Stomatological Hosipital, Dalian City, Liaoning Province, China
| | - Xiaodong Chen
- Department of Prosthodontics, Dalian Stomatological Hosipital, Dalian City, Liaoning Province, China
| | - Weiguo Qu
- Department of Oral and Maxillofacial Surgery, Dalian Stomatological Hosipital, Dalian City, Liaoning Province, China
| | - Xiaofu Qu
- VIP Clinic, Dalian Stomatological Hosipital, Dalian City, Liaoning Province, China
| | - Ping He
- Department of Oral Surgery, Dalian Stomatological Hosipital, Dalian City, Liaoning Province, China
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Öztürk K, Kuzu TE, Gürgan CA, Önder GÖ, Yay A. The effect of different treatment protocols with diode laser on regeneration in axonetmesis ınjuries of the ınferior alveolar nerve: an animal study. Lasers Med Sci 2023; 38:169. [PMID: 37515606 DOI: 10.1007/s10103-023-03834-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Abstract
The inferior alveolar nerve can be damaged during dental procedures, leading to symptoms, such as tingling, numbness, and reduced quality of life. Recovery depends on factors such as medications, surgery, and photobiomodulation therapy. Photobiomodulation therapy has shown the potential to improve nerve function and reduce regeneration time; however, there is no standard treatment protocol yet. This study aimed to examine the effect of diode lasers on nerve regeneration in patients with axonetmesis injuries. In this experiment on animals, Wistar rats' damaged sensory systems were treated with lasers to restore them. Animals were randomly divided into six groups: a sham group, a control group, and four laser treatment groups(1st group: performed every day, 10 sessions; 2nd group: performed every 2 days, 10 sessions; 3rd group: performed every day, 20 sessions; and 4th group: performed every 2 days, 20 sessions). Sensory function was determined using the Semmes-Weinstein monofilament test, which was repeated after the surgical procedure. The results showed that the 20-session group had the best improvement, most closely resembling the group without sensory test damage. The histomorphometric results showed that the number of axons was significantly lower in the group that received 10 daily sessions and in the control group than in the undamaged nerve. Axon diameter was lower in all groups than in the sham group. In conclusion, the remarkable aspect of this study is that consecutive-day 20-session laser treatment showed better improvement than the over-the-day 20-session treatment protocol.
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Affiliation(s)
- Kübra Öztürk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey.
| | - Turan Emre Kuzu
- Department of Periodontology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Cem A Gürgan
- Department of Periodontology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Gözde Özge Önder
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Arzu Yay
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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A Fused Deep Learning Architecture for the Detection of the Relationship between the Mandibular Third Molar and the Mandibular Canal. Diagnostics (Basel) 2022; 12:diagnostics12082018. [PMID: 36010368 PMCID: PMC9407570 DOI: 10.3390/diagnostics12082018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022] Open
Abstract
The study aimed to generate a fused deep learning algorithm that detects and classifies the relationship between the mandibular third molar and mandibular canal on orthopantomographs. Radiographs (n = 1880) were randomly selected from the hospital archive. Two dentomaxillofacial radiologists annotated the data via MATLAB and classified them into four groups according to the overlap of the root of the mandibular third molar and mandibular canal. Each radiograph was segmented using a U-Net-like architecture. The segmented images were classified by AlexNet. Accuracy, the weighted intersection over union score, the dice coefficient, specificity, sensitivity, and area under curve metrics were used to quantify the performance of the models. Also, three dental practitioners were asked to classify the same test data, their success rate was assessed using the Intraclass Correlation Coefficient. The segmentation network achieved a global accuracy of 0.99 and a weighted intersection over union score of 0.98, average dice score overall images was 0.91. The classification network achieved an accuracy of 0.80, per class sensitivity of 0.74, 0.83, 0.86, 0.67, per class specificity of 0.92, 0.95, 0.88, 0.96 and AUC score of 0.85. The most successful dental practitioner achieved a success rate of 0.79. The fused segmentation and classification networks produced encouraging results. The final model achieved almost the same classification performance as dental practitioners. Better diagnostic accuracy of the combined artificial intelligence tools may help to improve the prediction of the risk factors, especially for recognizing such anatomical variations.
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The effect of photobiomodulation on regeneration of crushed inferior alveolar nerve caused by iatrogenic injuries in oral and maxillofacial surgeries: A systematic review. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2021.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Therapy of Neurophysiological Changes after Oral and Maxillofacial Surgery—A Systematic Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: The purpose of this systematic review was to critically analyze the recent literature to present a guideline for management of neurophysiological changes after implant placement and oral and maxillofacial surgical procedures. Materials and methods: Three electronic databases and manual search approaches were used to identify relevant articles on neurophysiological changes. Only studies with a randomized controlled study design were included. Primary outcome was defined as the status of recovery and relief of pain states under various therapies. Two independent reviewers evaluated the data. Results: A total of eight studies from 2891 records identified met the inclusion criteria. Therapy options for patients with neurophysiological changes after implant placement and oral and maxillofacial surgery were low-level laser (LLL), stellate ganglion block (SGB), medication, and surgical removal of implants. Six studies dealt with LLL, providing a significant improvement in mechanical sensation. Only one study revealed the whole neurosensory profile including neuropathic pain states. All the included RCT studies presented at least one bias, and a considerable heterogeneity of the included studies was revealed. Conclusions: Reduced thermal sensation may be due to irritation of small fibers. LLL might help to improve nerve recovery.
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Weyh A, Pucci R, Valentini V, Fernandes R, Salman S. Injuries of the Peripheral Mandibular Nerve, Evaluation of Interventions and Outcomes: A Systematic Review. Craniomaxillofac Trauma Reconstr 2021; 14:337-348. [PMID: 34707795 PMCID: PMC8543599 DOI: 10.1177/19433875211002049] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Trigeminal nerve injuries are common and there is currently no consensus on both timing and type of intervention to achieve the best outcomes. A systematic review was performed to compare the outcomes of the many different types of therapeutic interventions for nerve injury. PubMed, EBSCO, and Cochrane Review databases were used to search for studies published from January 1, 2000 to December 31, 2019. Included studies detailed treatment of an injury to peripheral branches of the trigeminal nerve, either known transection or injury causing persistent alteration in sensation. The primary outcome was functional sensory recovery via the Medical Research Council scale. Twenty studies were included, detailing outcomes of 608 subjects undergoing intervention for 622 nerve injuries. Surgical interventions were able to achieve functional sensory recovery in approximately >80% or more of the subjects. There was heterogeneity among how procedures were performed, timing to intervention, and methods of measuring recovery. The data of this study supports the ability of surgical intervention to achieve functional sensory recovery in a significant number of subjects, and found evidence for better outcomes with intervention closer to the time of injury.
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Affiliation(s)
- Ashleigh Weyh
- Department of Oral and Maxillofacial Surgery, University of Florida Health - Jacksonville, Jacksonville, FL, USA
| | - Resi Pucci
- Department of Maxillofacial Surgery, Sapienza University of Rome, Rome, Italy
| | - Valentino Valentini
- Department of Maxillofacial Surgery, Sapienza University of Rome, Rome, Italy
| | - Rui Fernandes
- Department of Oral and Maxillofacial Surgery, University of Florida Health - Jacksonville, Jacksonville, FL, USA
| | - Salam Salman
- Department of Oral and Maxillofacial Surgery, University of Florida Health - Jacksonville, Jacksonville, FL, USA
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Hakimiha N, Rokn AR, Younespour S, Moslemi N. Photobiomodulation Therapy for the Management of Patients With Inferior Alveolar Neurosensory Disturbance Associated With Oral Surgical Procedures: An Interventional Case Series Study. J Lasers Med Sci 2021; 11:S113-S118. [PMID: 33995979 DOI: 10.34172/jlms.2020.s18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Inferior alveolar nerve (IAN) injury is a serious complication during intraoral surgeries. We aimed to evaluate the outcome of photobiomodulation (PBM) therapy in patients with IAN injury associated with third molar or implant procedures. Methods: Eight patients with an alteration of sensory function of the IAN after third molar or implant surgeries were enrolled in this case series study. The patients received 10 sessions of PBM therapy (810 nm diode laser, 200 mW, 10 J/cm2 per point, three times a week). Pinprick (PP) and visual analogue scale (VAS) neurosensory tests were recorded at each treatment session and 14 days after the last treatment. The association between explanatory variables and the outcome of interest was analyzed using generalized estimating equations. Results: The median percentage change of outcomes from the first to the last visit was as follows: VAS score: +125.00% (range: 50.00 to 166.67); PP score: +350% (range: 150 to 800). The duration of paresthesia was inversely correlated with changes in VAS and PP scores. No significant association was found between patients' gender or age and changes in VAS and PP scores. Conclusion: Considering the limitations of this study, PBM with the parameters used in this study presented positive effects on neurosensory recovery in patients suffering from IAN injury associated with routine intraoral procedures. Patients with shorter duration of paresthesia tended to respond more favorably to PBM therapy.
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Affiliation(s)
- Neda Hakimiha
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Rokn
- Dental Implant Research Center, Dentistry Research Institute, Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Younespour
- Assistant Professor, PhD of Biostatistics, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Moslemi
- Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Ravera S, Colombo E, Pasquale C, Benedicenti S, Solimei L, Signore A, Amaroli A. Mitochondrial Bioenergetic, Photobiomodulation and Trigeminal Branches Nerve Damage, What's the Connection? A Review. Int J Mol Sci 2021; 22:4347. [PMID: 33919443 PMCID: PMC8122620 DOI: 10.3390/ijms22094347] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Injury of the trigeminal nerve in oral and maxillofacial surgery can occur. Schwann cell mitochondria are regulators in the development, maintenance and regeneration of peripheral nerve axons. Evidence shows that after the nerve injury, mitochondrial bioenergetic dysfunction occurs and is associated with pain, neuropathy and nerve regeneration deficit. A challenge for research is to individuate new therapies able to normalise mitochondrial and energetic metabolism to aid nerve recovery after damage. Photobiomodulation therapy can be an interesting candidate, because it is a technique involving cell manipulation through the photonic energy of a non-ionising light source (visible and NIR light), which produces a nonthermal therapeutic effect on the stressed tissue. METHODS The review was based on the following questions: (1) Can photo-biomodulation by red and NIR light affect mitochondrial bioenergetics? (2) Can photobiomodulation support damage to the trigeminal nerve branches? (preclinical and clinical studies), and, if yes, (3) What is the best photobiomodulatory therapy for the recovery of the trigeminal nerve branches? The papers were searched using the PubMed, Scopus and Cochrane databases. This review followed the ARRIVE-2.0, PRISMA and Cochrane RoB-2 guidelines. RESULTS AND CONCLUSIONS The reliability of photobiomodulatory event strongly bases on biological and physical-chemical evidence. Its principal player is the mitochondrion, whether its cytochromes are directly involved as a photoacceptor or indirectly through a vibrational and energetic variation of bound water: water as the photoacceptor. The 808-nm and 100 J/cm2 (0.07 W; 2.5 W/cm2; pulsed 50 Hz; 27 J per point; 80 s) on rats and 800-nm and 0.2 W/cm2 (0.2 W; 12 J/cm2; 12 J per point; 60 s, CW) on humans resulted as trustworthy therapies, which could be supported by extensive studies.
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Affiliation(s)
- Silvia Ravera
- Department of Experimental Medicine, University of Genoa, 16132 Genoa, Italy;
| | - Esteban Colombo
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (E.C.); (C.P.); (S.B.); (L.S.); (A.S.)
| | - Claudio Pasquale
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (E.C.); (C.P.); (S.B.); (L.S.); (A.S.)
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (E.C.); (C.P.); (S.B.); (L.S.); (A.S.)
| | - Luca Solimei
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (E.C.); (C.P.); (S.B.); (L.S.); (A.S.)
| | - Antonio Signore
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (E.C.); (C.P.); (S.B.); (L.S.); (A.S.)
- Department of Therapeutic Dentistry, Faculty of Dentistry, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Andrea Amaroli
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132 Genoa, Italy; (E.C.); (C.P.); (S.B.); (L.S.); (A.S.)
- Department of Orthopaedic Dentistry, Faculty of Dentistry, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
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Nunes T, Caetano C, Pimenta M, Saraiva J, Rocha S, Freitas P, Figueiredo J, Pereira SA, Corte-Real A. UC-USP collaborative exercise on photobiomodulation therapy in neurological orofacial disturbances. J Clin Exp Dent 2020; 12:e650-e655. [PMID: 32904953 PMCID: PMC7462374 DOI: 10.4317/jced.56839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/26/2020] [Indexed: 11/08/2022] Open
Abstract
Background Neurosensory peripheral disorders are one of the most common risks associated with iatrogenic and/or post-traumatic injuries. It is often related to disability. Photobiomodulation therapy (PBMT) is a nonsurgical and safe procedure which can accelerate and improve the regeneration of injured biological tissue. This study aims to analyze the impact of PBMT, in the quality of life and impairment of individuals with orofacial neurological peripheral disturbance.
Material and Methods A retrospective analysis in the database of the dental traumatology clinic of the Hospital Centre of the University of Coimbra/Faculty of Medicine of the University of Coimbra was performed.5 out of 50 individuals were selected, according to the selection criteria. The neurosensory activity was assessed by a pinprick nociceptive test and the EQ-5D-5L self-report questionnaire was used to analyse the quality of life. The study was performed in two phases:1) inactive laser or placebo phase, for one month and 2) active laser or treatment phase. A diode low-level laser device (SIROLaserBlue;Sirona,Germany) was used, according to our protocol. A collaborative protocol in the PBMT influence in individuals with neurosensory peripheral disturbances was studied.
Results There was no improvement in the neurosensory activity nor in the quality of life, in the placebo phase. After the treatment phase, the EQ-5D-5L final results reported no problems in all of the five dimensions, except for anxiety/depression in individuals with long-standing neurosensory peripheral disturbances. The EQ-VAS scores increased in all the individuals.
Conclusions Our results supported the improvement of quality of life and impairment reduction in the individuals submitted to PBMT. Key words:Low-level light therapy, peripheral nerve injuries, sensation disorders, quality of life, forensic medicine.
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Affiliation(s)
- Tiago Nunes
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Catarina Caetano
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Forensic Dentistry Laboratory, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Pimenta
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - José Saraiva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Salomão Rocha
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Patrícia Freitas
- Special Laboratory of Lasers in Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - José Figueiredo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Ana Corte-Real
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Forensic Dentistry Laboratory, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Bozkaya S, Cakir M, Peker Tunc E, Ogutlu F. Effect of Photobiomodulation Therapy on Inferior Alveolar and Lingual Nerve Injuries After Dental Procedures. Photobiomodul Photomed Laser Surg 2020. [DOI: 10.1089/photob.2020.4816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Suleyman Bozkaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Merve Cakir
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
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Abdelkarim Elafifi H, Acevedo Carrero M, Parada Avendaño I, España-Tost A, Arnabat-Domínguez J. Effect of Photobiomodulation (Diode 810 nm) on Long-Standing Neurosensory Alterations of the Inferior Alveolar Nerve: A Case Series Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 39:4-9. [PMID: 32758072 DOI: 10.1089/photob.2019.4780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: To evaluate and describe the results of photobiomodulation (PBM) therapy on the treatment of long-standing neurosensory inferior alveolar nerve (IAN) alterations after third molar extraction. Background: The use of PBM is an acceptable alternative method to improve the therapeutic outcomes of neural lesions. Materials and methods: Longitudinal case study research. Patients with >6 months of inferior alveolar neurosensory disturbance after third molar extraction were included. Fifteen laser sessions were done, irradiating intra- and extraoral points along the distribution of this nerve area. A semiconductor Ga,Al,As diode laser (Thor laser®) was used. Before and after the treatment, variables such as Zuniga-Essick score, British Medical Research Council (BRC) scale, visual analog scale (VAS), and mapping of the affected area were described. Gender, age, and duration of the lesion were analyzed. Descriptive statistical study was carried out with SPSS 19.0. Results: Eleven patients with a mean age of 38.5 years [standard deviation (SD) ±15.22]. Average duration of the lesion was 13.2 (SD ±4) months. The results obtained with the Zuniga-Essick scale before treatment showed mild alteration in 36.3% (4), moderate in 18.2% (2), and severe in 45.4% (5). After treatment, the percentage score improved, obtaining normality in 54.5% (6) of the patients and mild degree in 27.2% (3). In the BRC score, before the treatment, 45.4% (5) of grade S2+ and 27% (3) of S3 and S3+ were obtained. The final percentage after treatment reached an improvement of S4 in a total of 36% (4) of cases and a recovery of S3+ in 54.5% (6). Reduction of the mapped altered area and an upturn of VAS were noted. Conclusions: The laser parameters and application protocol used result in subjective and objective improvement in mechanical sensory perception in long-standing neurosensory deficit in the IAN.
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Affiliation(s)
- Haitham Abdelkarim Elafifi
- Department of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Montserrat Acevedo Carrero
- Department of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Isabel Parada Avendaño
- Department of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Antonio España-Tost
- Department of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Group of Odontological and Maxillofacial Pathology and Therapeutics, Barcelona, Spain
| | - Josep Arnabat-Domínguez
- Department of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Group of Odontological and Maxillofacial Pathology and Therapeutics, Barcelona, Spain
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16
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Talbot CE, Zhao K, Ward M, Kandinov A, Mammis A, Paskhover B. Neuromodulation of the lingual nerve: a novel technique. J Neurosurg 2020; 134:1271-1275. [PMID: 32330885 DOI: 10.3171/2020.2.jns193109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 02/24/2020] [Indexed: 11/06/2022]
Abstract
Acute injury of the trigeminal nerve or its branches can result in posttraumatic trigeminal neuropathy (PTTN). Affected patients suffer from chronic debilitating symptoms long after they have recovered from the inciting trauma. Symptoms vary but usually consist of paresthesia, allodynia, dysesthesia, hyperalgesia, or a combination of these symptoms. PTTN of the trigeminal nerve can result from a variety of traumas, including iatrogenic injury from various dental and maxillofacial procedures. Treatments include medications, pulsed radiofrequency modulation, and microsurgical repair. Although trigeminal nerve stimulation has been reported for trigeminal neuropathy, V3 implantation is often avoided because of an elevated migration risk secondary to mandibular motion, and lingual nerve implantation has not been documented. Here, the authors report on a patient who suffered from refractory PTTN despite multiple alternative treatments. He elected to undergo novel placement of a lingual nerve stimulator for neuromodulation therapy. To the best of the authors' knowledge, this is the first documented case of lingual nerve stimulator implantation for lingual neuropathy, a technique for potentially reducing the risk of electrode migration.
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Affiliation(s)
- Christopher E Talbot
- Departments of1Neurological Surgery and.,2Rutgers New Jersey Medical School, Newark, New Jersey
| | - Kevin Zhao
- Departments of1Neurological Surgery and.,2Rutgers New Jersey Medical School, Newark, New Jersey
| | - Max Ward
- 2Rutgers New Jersey Medical School, Newark, New Jersey
| | - Aron Kandinov
- 2Rutgers New Jersey Medical School, Newark, New Jersey.,3Otolaryngology-Head & Neck Surgery
| | - Antonios Mammis
- Departments of1Neurological Surgery and.,2Rutgers New Jersey Medical School, Newark, New Jersey
| | - Boris Paskhover
- 2Rutgers New Jersey Medical School, Newark, New Jersey.,3Otolaryngology-Head & Neck Surgery
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Abstract
Surgical adjunctive instruments and devices are now available for the up-to-date dental/oral surgical office to help mitigate possible surgical complications. Both the laser and Piezo instruments are unique devices that can offer the clinician certain advantages that may prove beneficial in the treatment of his or her patients.
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Affiliation(s)
- Tarun Kirpalani
- Department of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
| | - Harry Dym
- Department of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA.
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Hakimiha N, Dehghan MM, Manaheji H, Zaringhalam J, Farzad-Mohajeri S, Fekrazad R, Moslemi N. Recovery of inferior alveolar nerve by photobiomodulation therapy using two laser wavelengths: A behavioral and immunological study in rat. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 204:111785. [PMID: 31954267 DOI: 10.1016/j.jphotobiol.2020.111785] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 11/29/2022]
Abstract
Postoperative sensory disturbances of inferior alveolar nerve (IAN) are major challenges in dental procedures. We aimed to investigate the effect of photobiomodulation therapy (PBMT) with 810 nm and 980 nm diode lasers on behavioral and immunological factors in a rat IAN crush model. Seventy-two rats were randomly assigned to the four groups of 810 nm laser (crush injury+810 nm laser; 6 J/cm2, 15 sessions, every 48 h), 980 nm laser (crush injury+980 nm laser; same protocol), control (crush injury without irradiation), and sham surgery (no crush injury and no irradiation). The neurosensory response of IAN was evaluated by Von Frey behavioral test before (baseline) and post-surgery in a period of one month. Changes of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), nuclear factor-kappa B (NF-κB), TNF-α, and IL-1β, were assessed on days 2 and 30 post injury. Data were analyzed for significant differences by repeated measures and one-way ANOVA (p < .05). One day after surgery, all rats subjected to nerve injury showed significant increase in the withdrawal threshold of von Frey test compared to the baseline (p = .02 for control and p = .03 for laser groups). The threshold gradually returned to the baseline scores in 810 nm, 980 nm, and control groups from days 11, 17, and 29, respectively. There was a significant lower withdrawal threshold in 810 nm and 980 nm laser groups compared to the control group in days 11 to 19 and 9 to 23, respectively. At both time points, the levels of NGF and BDNF were significantly higher in 810 nm laser group compared to the control group. There was a significant difference between laser and control groups regarding NF-κB expression (all p values<.001). TNF-α and IL-1β were significantly lower in laser groups compared to the control group (all p values < .001). PBMT with 810 and 980 nm diode laser protocol used in this study, promoted the neurosensory recovery of IAN after crush injury in rats. In addition, application of 810 nm diode laser was associated with more improvement in immunological responses compared to that of 980 nm laser.
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Affiliation(s)
- Neda Hakimiha
- Laser Research Center of Dentistry, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Dehghan
- Department of Surgery & Radiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran; Institute of Biomedical Research, University of Tehran, Tehran, Iran
| | - Homa Manaheji
- Physiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalal Zaringhalam
- Physiology Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Neurophysiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.; International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and ResearchNetwork (USERN), Tehran, Iran
| | - Neda Moslemi
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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19
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Comparative effects of photobiomodulation therapy at wavelengths of 660 and 808 nm on regeneration of inferior alveolar nerve in rats following crush injury. Lasers Med Sci 2019; 35:413-420. [PMID: 31273571 DOI: 10.1007/s10103-019-02838-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022]
Abstract
The aim of the present study was to investigate the therapeutic effects of 660-nm and 880-nm photobiomodulation therapy (PBMT) following inferior alveolar nerve (IAN) crush injury. Following the nerve crush injuries of IAN, 36 Wistar rats were randomly divided into three groups as follows: (1) control, (2) 660-nm PBMT, and (3) 808-nm PBMT (GaAlAs laser, 100 J/cm2, 70 mW, 0.028-cm2 beam). PBMT was started immediately after surgery and performed once every 3 days during the postoperative period. At the end of the 30-day treatment period, histopathological and histomorphometric evaluations of tissue sections were made under a light and electron microscope. The ratio of the inner axonal diameter to the total outer axonal diameter (g-ratio) and the number of axons per square micrometer were evaluated. In the 808-nm PBMT group, the number of nerve fibers with suboptimal g-ratio ranges of 0-0.49 (p < 0.001) is significantly lower than expected, which indicates better rate of myelinization in the 808-nm PBMT group. The number of axons per square micrometer was significantly higher in the 808-nm PBMT group when compared with the control (p < 0.001) and 660-nm PBMT group (p = 0.010). The data and the histopathological investigations suggest that the PBMT with the 808-nm wavelength along with its settings was able to enhance IAN regeneration after nerve crush injury.
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