Is the pharmacological treatment associated with low-level laser therapy effective in neurosensorial recovery after BSSO? A randomized clinical trial

O tratamento farmacológico associado à terapia a laser de baixa intensidade é eficaz na recuperação neurossensorial após OSRM? Ensaio clínico randomizado.

Autores

Resumo

Bilateral sagittal split osteotomy may cause injury to the inferior alveolar nerve resulting in neurosensory abnormality. Low-Level Laser Therapy (LLLT) and pharmacological therapy (PT) consisting of the administration of vitamin B12 and nucleotides are options for the treatment of this complication. The present study aimed to evaluate the efficacy of isolated PT therapy and its combination with LLLT in sensorineural recovery after bilateral sagittal split osteotomy. Twenty-four patients were divided into two groups and subdivided according to the face side: Group 1: No PT (G1A- No LLLT e G1B - LLLT); Group 2: PT (G2A- No LLLT e G2B - LLLT). Each patient received 5 LLLT/control sessions with intervals of three to four weeks between the sessions. The G1A and G2A received placebo LLLT therapy. The neurosensorial response was analyzed before the first session and after each subsequent session using the Semmes-Weinstein monofilament test. The session numbers directly influenced the patient response. Better results were achieved on the fifth session in the pharmacological therapy alone and pharmacological therapy associated with LLLT. Patients treated using PT alone showed improved sensibility from the third session. Pharmacological therapy associated or not with LLLT was effective in sensorineural disorders recovery.

Downloads

Não há dados estatísticos.

Referências

AHONEN, M.; TJÄDERHANE, L. Endodontic-related Paresthesia: A Case Report and Literature Review. Journal of Endodontics, v. 37, n. 10, p. 1460–1464, out. 2011.

BELL, R. B. A History of Orthognathic Surgery in North America. Journal of Oral and Maxillofacial Surgery, v. 76, n. 12, p. 2466–2481, dez. 2018.

BERAN, R. Paraesthesia and peripheral neuropathy. Australian Family Physician, v. 44, n. 3, p. 92-95, mar. 2015.

BHANDARI, P. S. Management of peripheral nerve injury. Journal of Clinical Orthopaedics and Trauma, v. 10, n. 5, p. 862–866, set. 2019.

COLELLA, G. et al. Neurosensory disturbance of the inferior alveolar nerve after bilateral sagittal split osteotomy: a systematic review. Journal of Oral and Maxillofacial Surgery, v. 65, p. 1707-1715, set. 2007.

D'AGOSTINO, A. et al. Complications of Orthognathic Surgery. Journal of Craniofacial Surgery, v. 21, n. 4, p. 1189–1195, jul. 2010.

FAGNER, T.S. et al. Is Low-Level Laser Therapy Effective on Sensorineural Recovery After Bilateral Sagittal Split Osteotomy? Randomized Trial. Journal of Oral and Maxillofacial Surgery, v. 77, n. 1, p. 164–173, jan. 2019.

FAVARO-PIPI, E. et al. Low-Level Laser Therapy Induces Differential Expression of Osteogenic Genes During Bone Repair in Rats. Photomedicine and Laser Surgery, v. 29, n. 5, p. 311–317, mai. 2011.

FUHRER-VALDIVIA, A. et al. Low-level laser effect in patients with neurosensory impairment of mandibular nerve after sagittal split ramus osteotomy. Randomized clinical trial, controlled by placebo. Medicina Oral Patología Oral y Cirugia Bucal, v. 19, n. 4, p. 327–334, jul. 2014.

GIANNI, A.B. et al. Neurosensory alterations of the inferior alveolar and mental nerve after genioplasty alone or associated with sagittal osteotomy of the mandibular ramus. Journal of Cranio-Maxillofacial Surgery, v. 30, n. 5, p. 295–303, out. 2002.

GIGO-BENATO, D. et al. Low-power laser biostimulation enhances nerve repair after end-to-side neurorrhaphy: a double-blind randomized study in the rat median nerve model. Lasers in Medical Science, v. 19, n. 1, p. 57–65, jul. 2004.

GOLDBERG, H. et al. A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias. Journal of Pain Research, v. 10, p. 397–404, fev. 2017.

JEROSCH-HEROLD, C. Assessment of Sensibility after Nerve Injury and Repair: A Systematic Review of Evidence for Validity, Reliability and Responsiveness of Tests. Journal of Hand Surgery, v. 30, n. 3, p. 252–264, jun. 2005.

JONES, D.L.; WOLFORD, L.M.; HARTOG, J.M. Comparison of methods to assess neurosensory alterations following orthognathic surgery. The International Journal of Adult Orthodontics and Orthognathic Surgery, v. 5, n. 1, p. 35-42. 1990.

KARAS, N. D.; BOYD, S. D.; SINN, D. P. Recovery of neurosensory function following orthognathic surgery. Journal of Oral and Maxillofacial Surgery, v. 48, n. 2, p. 124–134, fev. 1990.

KHULLAR, S.M. et al. Effect of low-level laser treatment on neurosensory deficits subsequent to sagittal split ramus osteotomy. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, v. 82, n. 2, p. 132–138, ago. 1996.

KIM, Y.K.; KIM, S.G.; KIM, J.H. Altered Sensation After Orthognathic Surgery. Journal of Oral and Maxillofacial Surgery, v. 69, n. 3, p. 893–898, mar. 2011.

MIDAMBA, E. D.; HAANAES, H. R. Low Reactive-Level 830 Nm Gaalas Diode Laser Therapy (Lllt) Successfully Accelerates Regeneration of Peripheral Nerves in Human. Laser Therapy, v. 5, n. 3, p. 125–129, 1993.

MILORO, M.; REPASKY, M. Low-level laser effect on neurosensory recovery after sagittal ramus osteotomy. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, v. 89, n. 1, p. 12–18, jan. 2000.

MONNAZZI, M.S. et al. Cutaneous Sensibility Impairment After Mandibular Sagittal Split Osteotomy: A Prospective Clinical Study of the Spontaneous Recovery. Journal of Oral and Maxillofacial Surgery, v. 70, n. 3, p. 696–702, mar. 2012.

MULLER, D. Treatment of neuropathic pain syndrome. Results of an open study on the efficacy of a pyrimidine nucleotide preparation. Fortschritter der Medizin Originalien, v. 120, n. 4, p. 131–133, dez. 2002.

NESARI, S.; KAHNBERG, K.E.; RASMUSSON, L. Neurosensory function of the inferior alveolar nerve after bilateral sagittal ramus osteotomy: a retrospective study of 68 patients. International Journal of Oral and Maxillofacial Surgery, v. 34, n. 5, p. 495–498, jul. 2005.

NISHIOKA, G. J.; ZYSSET, M. K.; VAN, J. E. Neurosensory disturbance with rigid fixation of the bilateral sagittal split osteotomy. Journal of Oral and Maxillofacial Surgery, v. 45, n. 1, p. 20–26, jan. 1987.

OZEN, T. et al. Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve. Head & Face Medicine, v. 2, n. 1, fev. 2006.

O’RYAN, F. Complications of orthognathic surgery. Oral and Maxillofacial Surgery Clinics of North America, v. 2, p. 593-601. 1990.

PATEL, M.; BASSINI, L. A Comparison of Five Tests for Determining Hand Sensibility. Journal of Reconstructive Microsurgery, v. 15, n. 07, p. 523–526, out. 1999.

SEDDON, H. J. Three Types of Nerve Injury. Brain, v. 66, n. 4, p. 237–288, 1943.

SEO, H.J.; CHOI, Y.K. Current trends in orthognathic surgery. Archives of Craniofacial Surgery, v. 22, n. 6, p. 287–295, dez. 2021.

TAKASAKI, Y. et al. A clinical analysis of the recovery from sensory disturbance after sagittal splitting ramus osteotomy using a Semmes-Weinstein pressure aesthesiometer. The Bulletin of Tokyo Dental College, v. 39, n. 3, p. 189-197, ago. 1998.

TRAUNER, R.; OBWEGESER, H. The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty. II. Operating methods for microgenia and distoclusion. Oral Surgery, Oral Medicine, Oral Pathology, v. 10, p. 899-909, set. 1957.

VRIENS, J. P. M.; VAN DER GLAS, H. W. Extension of normal values on sensory function for facial areas using clinical tests on touch and two-point discrimination. International Journal of Oral and Maxillofacial Surgery, v. 38, n. 11, p. 1154–1158, nov. 2009.

WALTER, J.M.; GREGG, J.M. Analysis of postsurgical neurologic alteration in the trigeminal nerve. Journal of Oral Surgery, v. 37, n. 6, p. 410-414, jun. 1979.

WATTING, B. et al. Nucloetides accelerate nerve regeneration. Zeitschrift für Klinische Medizin, v. 46, p. 1371-1373. 1991.

WEINSTEIN, S. Fifty years of somatosensory research: from the Semmes-Weinstein monofilaments to the Weinstein Enhanced Sensory Test. Journal of Hand Therapy, v. 6, n. 1, p. 11-22, jan-mar. 1993.

WESTERMARK, A.; BYSTEDT, H.; VON KONOW, L. Inferior alveolar nerve function after sagittal split osteotomy of the mandible: correlation with degree of intraoperative nerve encounter and other variables in 496 operations. British Journal of Oral and Maxillofacial Surgery, v. 36, n. 6, p. 429–433, dez. 1998.

WIJBENGA, J.G. et al. Long-lasting neurosensory disturbance following advancement of the retrognathic mandible: distraction osteogenesis versus bilateral sagittal split osteotomy. International Journal of Oral and Maxillofacial Surgery, v. 38, n. 7, p. 719–725, jul. 2009.

YAMAMOTO, T. et al. Hypoesthesia associated with mandibular movement after sagittal split ramus osteotomy. Oral and Maxillofacial Surgery, v. 21, n. 3, p. 313–319, jun. 2017.

YLIKONTIOLA, L. et al. Prediction of recovery from neurosensory deficit after bilateral sagittal split osteotomy. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, v. 90, n. 3, p. 275–281, set. 2000.

Downloads

Publicado

2024-09-04

Como Citar

Pizzol, K. E. D. C., Santos , P. L. ., Santos, M., Queiroz , T. P. ., Anunzio, I. A. de ., & Monnazzi, M. S. (2024). Is the pharmacological treatment associated with low-level laser therapy effective in neurosensorial recovery after BSSO? A randomized clinical trial : O tratamento farmacológico associado à terapia a laser de baixa intensidade é eficaz na recuperação neurossensorial após OSRM? Ensaio clínico randomizado. Concilium, 24(18), 58–76. Recuperado de http://clium.org/index.php/edicoes/article/view/4075

Edição

Seção

Articles