Photobiomodulation therapy for management of inferior alveolar nerve injury post-extraction of impacted lower third molars

Lasers Dent Sci. 2020 Mar;4(1):25-32. doi: 10.1007/s41547-019-00075-6. Epub 2019 Dec 17.


Purpose: Inferior alveolar nerve (IAN) injury is one of the most serious complications after extraction of impacted lower third molars. Photobiomodulation (PBM) therapy has been noted to reduce pain and inflammation while promoting tissue healing. This study examined the efficacy of PBM therapy tested in a case series of patients with postoperative IAN injury.

Material and methods: 20 patients with post-extraction IAN injury were involved in this study and divided into two groups. In the study group, PBM therapy (808-nm laser, 16 mW, 3 J/cm2) was used every other day for 2 weeks solely on post-extraction sockets in 10 patients diagnosed with IAN injury. In the control group, mecobalamine was prescribed to 10 patients with IAN injury. Objective and subjective recovery of IAN paresthesia was evaluated using clinical neurosensory testing and visual analog score.

Results: All patients showed improvement in both objective and subjective examination. Notably, the visual analog score was significantly improved after PBM treatment compared to the mecobalamine treatment (p < 0.05).

Conclusion: PBM therapy with 808-nm laser appears to be an effective approach to manage paresthesia post-IAN injury following impacted third molar surgery. Given the limited sample size in this study, large-scale, placebo-controlled, multi-center randomized controlled trials are needed for further validation of this innovative treatment.

Keywords: Extraction socket irradiation; Inferior alveolar nerve injury; LM3 extraction; Paresthesia; Photobiomodulation.