LLLT Effects on Inferior Alveolar Nerve (IAN) Recovery Post-orthognathic Surgery

Low-level laser therapy (LLLT) is a well-studied technique that has been shown to improve recovery time and reduce pain and swelling in patients undergoing surgery, including orthognathic surgery, and has no known negative effects. This study will use two groups with patients randomly assigned to either the study group, receiving LLLT, or one receiving a placebo treatment, after they have lower jaw surgery. Measurements will be taken at 24 hours, 1 week, 2 week, 3 week, 4 week, 5 week, and 6 week post-op exams to check pain, swelling and nerve function, and the two groups will be compared to see if the LLLT group has any difference

Low-level laser therapy (LLLT) is a well-studied technique to induce biomodulation of pain and wound healing. The technique has been shown to improve recovery time and reduce pain and swelling in patients undergoing surgery, including orthognathic surgery, and has no known negative effects. Previous studies have used split-mouth designs, short follow-up periods or, often, both. This study aims to have two groups, one receiving LLLT and one receiving a dummy treatment, at 24 hours, 1 week, 2 week, 3 week, 4 week, 5 week, and 6 week post-op exams. At each visit, pain (via VAS), swelling (measured from the midpoint of the chin to the base of the ear, bilaterally), and nerve function (using a soft and hard sensory test, in 8 regions of the mandible and lower lip) will be performed, with additional measurements at 8 weeks and 20 weeks. The measurements will be analyzed for statistical differences between the LLLT intervention group and non-intervention group.

Patients will receive low-level laser therapy on the skin overlying the mandible for 40 seconds per side. All other post-operative care will be as per clinic routine.

Patients will receive no dose of laser, but the handpiece will be used against their skin top mimic the LLLT. All other post-operative care will be as per clinic routine.

The proposed LLLT protocol will use the Biolase Epic X, an InGaAsP diode laser (940nm) using the pain relief handpiece, a device which has received FDA approval (GUDID 00647529002537) for the treatment of pain, muscle relaxation and healing via increased local circulation. The LLLT will be administered to the experimental group at 30 j/cm2. The laser will be applied extraorally, on the skin overlying the mandible. Application will be for 40 seconds per side, with 10 seconds administered in four places along the jawline, 1 cm apart starting from the gonial angle.

The Biolase Epic X with pain relief handpiece will be applied with no power extraorally, on the skin overlying the mandible. Application will be for 40 seconds per side, with 10 seconds administered in four places along the jawline, 1 cm apart starting from the gonial angle.

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

Pain indicated by visual analogue scale of 1 (least pain) to 10 (most pain possible), per side of mandible

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

A soft measuring tape, in mm, overlying skin from soft tissue menton to the base of the earlobe, bilaterally.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Cotton swab brushed in 2cm path onto skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Toothpick pressed into skin of mandible and lower lip in 8 regions along the lower jaw. Regions right and left 1, 2 and 3 are on the skin of lower face, 1 cm apart, starting on the midline, and right and left region 4 is the lower lip, separated at the midline.

Inclusion Criteria: Patients undergoing mandibular surgery with bilateral sagittal split osteotomies Exclusion Criteria: patients must be free from pre-operative inferior alveolar neurosensory deficiencies intra-operative accidental fracture or rupture of the inferior alveolar nerve

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