Low-level laser therapy in the treatment of inferior alveolar nerve paresthesia after surgical exeresis of a complex odontoma

Orofacial paresthesia is due to trauma to the neural structure of a particular nerve. In dentistry alterations caused by nerve damage in most cases are presented with transient symptomatology. However, it has been agreed by several authors that persistent inferior alveolar sensory aberrations for more than 6 months leave some degree of disability or are considered permanent. The objective of the present study is to report the clinical case of a young patient submitted to low-level laser therapy for the treatment of paresthesia of the inferior alveolar nerve after removal of a complex odontoma in the posterior region of the mandible.

Twenty-four hours after the surgical procedure the patient started the low-level laser therapy with the following parameters: 100 mW of potency, 140 J/cm² of energy density, 4 J of energy per application point, 40 seconds of application per point and 0.028 cm² of spot area. For this particular case, the technique of alternation of laser wavelengths was used, in the first session of which visible red of 660 nm was applied, followed by near-infrared of 808 nm and so on.

In the first session, the score on the visual analog scale (VAS) was “3”. In the tenth and last sessions, the patient reported a VAS “9”.

It seems that the early initiation of the low-level laser therapy favors a better outcome in cases like the one presented in this paper. The technique of alternation of laser wavelengths between sessions seems to have some role in the outcome possibly because of the constant stimulation of different chromophores along the treatment course. These two factors need further confirmation and validation through randomized clinical trials.