Super-pulsed Diode Laser in the Therapy of Inferior Alveolar Nerve Paresthesia After Mandibular Third Molar Extraction: A Case Report

Abstract

Oral paresthesia occurs when one of the nerves in the region is injured, usually the inferior alveolar and/or lingual nerve, after dental procedures such as the extraction of lower third molars. The objective of this study was to describe the case of a patient who received photobiomodulation (PBM) therapy for paresthesia of the inferior alveolar nerve (IAN) caused by the extraction of mandibular third molars. The protocol used involved a super-pulsed diode laser with dual wavelengths of 810 nm and 980 nm, 1 W, 60 seconds, 12.15 J/cm², with a spot size of 25 mm in the extraoral area. In the intraoral region, 0.3 W, 60 seconds, 46.77 J/cm², with a 7 mm tip, was applied. Before starting each PBM session, mapping of the area was performed to delineate the regions with paresthesia, and the degree of sensitivity was evaluated using a visual analog scale (VAS). On the first day, before the first laser therapy session, the VAS assessment was 7, indicating partial loss of sensitivity. After 48 hours and before the second PBM session, the patient reported a slight tingling sensation and substantial improvement in chin sensitivity, with a VAS score of 4.5. After nine sessions, the patient reported recovery of sensitivity in all affected regions (VAS = 0), with positive and normal responses to touch with a dental explorer. Within the parameters established for this clinical case, our results suggest that PBM therapy may improve the loss of sensation observed in IAN paresthesia following injury or surgical trauma.