Effectiveness of lasertherapy and laseracupuncture for the treatment of paresthesia in patients who underwent implants and third molars surgeries

Abstract

Lower third molar extractions and implant surgeries are common in the odontologic clinical practice who can promote, even with precautions, the paresthesia, by the anatomical proximity of the tooth to the inferior alveolar nerve. The low-power laser (fotobiomodulation - FBM ) stimulates tissue repair from the absorption of light by the irradiated tissue. The FBM can be performed with the application of the laser over the entire trajectory of the compromised nerve (laser therapy) or only in acupuncture face points. The laser therapy demands a much longuer clinical session time when compared to the second treatment. In this way, this randomized, blinded, parallel, controlled trial aims to evaluate the sensitive return of the inferior alveolar nerve when one of the two FBM techniques are used in patients with paresthesia, after the lower third molar extraction or implant surgery. 90 volunteers who had sensory deficiency, after the extraction of the third molar inferior, to the inferior alveolar nerve will be selected. Volunteers will be randomly divided into three groups (n=30): Group 1 - will be treated with a medication of pyrimidine ribonucleotides CMP and UTP (ETNA®, 01 capsule, 8/8 hrs, 30 days); Group 2 -- irradiated with laser therapy (808 nm, 100 mw, 40 seconds/point, power of 4 J/point, distance of 1 cm between each point of irradiation, continuous mode, spotsize of 0.028 cm2) all over route of inferior alveolar nerve in the affected side; Group 3 -- irradiated by laseracupuncture - irradiated under the same conditions as group 2, but only in the following acupuncture points on the affected side: E4 (Stomach 4), M -HN-18 (extra point), VC -24 (vessel - design 24), E5 (stomach 5), E6 (stomach 6) and point A (craniopuntura) cm2). All subjects will be interviewed as the complaints of numb and/or dysesthesia, as the taste and/or smell abnormalities, and as the habits such as tobacco or alcohol. Then they will undergo a standardized assessment protocol, which consists of eight tests, grouped as follows: visal analog scale (VAS), gustatory and olfactory thresholds; thermal perception thresholds to cold and heat; thresholds of touch and vibration mechanical perception; pain perception with pain thresholds on the surface and two points discrimination test. The evaluation will be done before the first, tenth and twentieth clinical treatment session (pre-therapy intervention) and after 6 months from the last irradiation. A comparative and descriptive analysis of the data and statistics tests will be performed with ANOVA and Shapiro-Wilk, adopting the significance 5%. (AU)