Management of inferior alveolar nerve paresthesia after third molar extraction using laser therapy: a review
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Published:
Jul 28, 2025
Keywords:
tooth extraction, molar third, laser, photobiomodulation therapy, paresthesia, inferior alveolar nerve.
Main Article Content
Abstract
Introduction: The extraction of mandibular third molars is a common intervention that can cause complications such as damage to adjacent teeth, swelling, bleeding, infection, and nerve damage, with significant injury to the inferior alveolar nerve (NAI). Low-level laser therapy is presented as a promising option for the regeneration of damaged nervous tissue. Methodology: A narrative review was conducted with a comprehensive search of databases such as Science Direct, PubMed, and Google Scholar using validated DeCS descriptors between 2019 and 2024. Inclusion criteria included publications in Portuguese, English, and Spanish, while studies on other surgical procedures were excluded. Results: 13 representative articles were identified. Low-level laser therapy (LLLT) was shown to be effective in regenerating nerve tissue and relieving pain, with significant improvements in healing and neurosensory recovery. Discussion: The literature agrees that LLLT is effective in treating postoperative paresthesia, although protocols need to be standardized. Some studies suggest combining LLLT with vitamin B12 as an added benefit. Conclusions: LLLT has enormous potential to treat paresthesia after extraction of third molars. However, the lack of standardization in protocols limits their clinical implementation, recommending more studies in this area. General area of study: Dentistry. Specific area of study: Oral Surgery. Type of article: narrative bibliographic review.
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How to Cite
Calle, S., Ojeda Arechua, E. G., & Pineda Álvarez, D. M. (2025). Management of inferior alveolar nerve paresthesia after third molar extraction using laser therapy: a review. Anatomía Digital, 8(3.2), 60-75. https://doi.org/10.33262/anatomiadigital.v8i3.2.3461
Section
Articulos de revisión bibliográfica
References
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9. Lu Zhu, Bingquan H, Jun T, Fei G. Effectiveness of concentrated growth factor and laser therapy on wound healing, inferior alveolar nerve injury and periodontal bone defects post-mandibular impacted wisdom tooth extraction: a randomized clinical trial. International Wound Journal [Online]. 2024 [cited 2025 May 18]; 21(1), e14651. https://doi.org/10.1111/iwj.14651
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11. Yari A, Fasih P, Sadeghi S, Movahed E, Hallajmoghaddam Sarand S, Goodarzi A. The effect of delayed photobiomodulation therapy on inferior alveolar nerve recovery after third molar removal: a triple-blinded randomized clinical trial. Photobiomodulation Photomedicine and Laser Surgery [Online]. 2024 [cited 2025 May 18]; 42(7): 463–472. Available from: https://pubmed.ncbi.nlm.nih.gov/38900722/
12. El Mobadder M, Nammour S, Ortega M, Grzech-Leśniak K. Photobiomodulation Therapy applied after 6 months for the management of a severe inferior alveolar nerve injury. Life [Online]. 2021 [cited 2025 May 18]; 11(12):1420. Available from: https://doi.org/10.3390/life11121420
13. Matos FX, Ladeia Júnior LF, Góes Ladeia FD. Laser therapy for lower alveolar nerve parestesia after lower thir molar extractions: literature review. IdOnline Revista de Psicologia [Online]. 2019 [cited 2025 May 21]; 13(48):1–13. Available from: https://idonline.emnuvens.com.br/id/article/view/2115
14. Martins Melo MT, Araújo Costa TS, Moura Rocha MC, Ribeiro de Carvalho Reis EN, Ferreira Lima Verde GM. The use of low-level laser therapy in the treatment of paresthesia of the inferior alveolar nerve due to third molar extraction. Research Society and Development [Online]. 2024 [cited 2025 May 21];13(11): e13131147226. Available from: https://rsdjournal.org/index.php/rsd/article/view/47226
15. Fernandes-Neto JA, Simões TMS, Araújo Batista AL, Lacerda-Santos JT, Souza-Santos Palmeira PT, Chaves-de Vasconcelos Catão MH. Laser therapy as treatment for oral paresthesia arising from mandibular third molar extraction. Journal of Clinical and Experimental Dentistry [Online]. 2020 [cited 2025 May 21];12(6): e603–e606. Available from: https://pubmed.ncbi.nlm.nih.gov/32665821/
16. Almeida Neiva S, Carvalho Silva JB, Oliveira Batista V, Silva Meireles Lemos GC. Low intensity laser in the treatment of paresthesis of the inferior alveolar nerve: current evidence. Brazilian Journal of Health Review [Online]. 2023 [cited 2025 May 21];44(3):55-62. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/51364
17. Keykha E, Tahmasebi E, Hadilou M. Therapeutic modalities for iatrogenic late paresthesia in oral tissues innervated by mandibular branch of trigeminal nerve: a systematic review. Maxillofacial Plastic and Reconstructive Surgery [Online]. 2024 [cited 2025 May 21] 46(25). Available from: https://doi.org/10.1186/s40902-024-00438-5
18. Olkoski LE, Bonai N, Pavelski MD, Magro Filho O, Alves Luciano A, Frigo L, et al. Low intensity laserterapy and its effects on pain, edema, trism and paresthesia: an integrative literature review. Research, Society and Development [Online]. 2021 [cited 2025 May 25]; 10(2): e9210212159. Available from: https://rsdjournal.org/index.php/rsd/article/view/12159
19. Bastos CE de J, Souza Ferro Gomes AV, Leite TF, Rebouças e Cerqueira CC, Sousa Flor LC de, Noguera Bazán JM. Laser therapy in the treatment of lesions to the inferior alveolar nerve. Research, Society and Development [Online]. 2021 [cited 2025 May 15]; 10(7): e50110716881. Available from: https://rsdjournal.org/index.php/rsd/article/view/16881
20. Brito AV, Angulo A, Almon R. Super-pulsed diode laser in the therapy of inferior alveolar nerve paresthesia after mandibular third molar extraction: a case report. Cureus [Online]. 2025 [cited 2025 May 21]; 16(12): e76147. Available from: https://pubmed.ncbi.nlm.nih.gov/39835038/
2. Daware SN, Balakrishna R, Deogade SC, Ingole YS, Patil SM, Naitam DM. Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: a prospective study. Journal of Family Medicine and Primary Care [Online]. 2021 [cited 2025 May 18];10(4): 1712–1717. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144789/
3. Korkmaz YT, Kayıpmaz S, Senel FC, Atasoy KT, Gumrukcu Z. Does additional cone beam computed tomography decrease the risk of inferior alveolar nerve injury in high-risk cases undergoing third molar surgery? Does CBCT decrease the risk of IAN injury? International Journal of Oral and Maxillofacial Surgery [Online]. 2017 [cited 2025 May 18]; 46(5):628–635. Available from: https://pubmed.ncbi.nlm.nih.gov/28174060/
4. Ravera S, Colombo E, Pasquale C, Benedicenti S, Solimei L, Signore A, et al. Mitochondrial bioenergetic, photobiomodulation and trigeminal branches nerve damage, what’s the connection? A review. International Journal of Molecular Sciences [Online]. 2021 [cited 2025 May 18]; 22(9):4347. Available from: https://www.mdpi.com/1422-0067/22/9/4347
5. Sampaio Trajano dos Santos PG, Oliveira Laluce S, Cavalcanti de Lima Félix L, Almeida Barbosa R, Martins Correia L, Barreto Silva L, et al. The use low laser therapy on oral nerve injuries in dental specialities: literature review. Research, Society and Development [Online]. 2024 [cited 2025 May 18]; 13(7): e2913746268. Available from: https://rsdjournal.org/index.php/rsd/article/view/46268/36722
6. Santana de Aquino T, Oliveira Rocha A, Oliveira Lima T, Ramos Araujo TM, Ramos Oliveira TM. Laserterapia de baja potencia en el tratamiento de la paresesia oral - una revisión sistemática. Revista Eletrônica Acervo Odontológico [Internet]. 2020 [citado 18 de mayo de 2025];1(e3753):1-7. Disponible en: https://acervomais.com.br/index.php/odontologico/article/view/3753/2685
7. Yongqing M, Yang M, Chen X, Qu W, Qu X, He P. The effectiveness of photobiomodulation therapy on inferior alveolar nerve injury: a systematic review and META-analysis. PLOS ONE [Online]. 2023 [cited 2025 May 18];18(8): e0287833. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10414610/
8. De Fátima Vieira A, Martini Reis AD, Afonso Sommer A. Use of laser therapy for the treatment of paresthesia after extraction of lower third molars. Revista Mineira de Ciências da Saúde [Online]. 2023 [cited 2025 May 18]; 10:16-27. Available from: https://revistas.unipam.edu.br/index.php/revistasaude/article/view/5128/3044%20en:%20https://revistas.unipam.edu.br/index.php/revistasaude/article/view/5128/3044
9. Lu Zhu, Bingquan H, Jun T, Fei G. Effectiveness of concentrated growth factor and laser therapy on wound healing, inferior alveolar nerve injury and periodontal bone defects post-mandibular impacted wisdom tooth extraction: a randomized clinical trial. International Wound Journal [Online]. 2024 [cited 2025 May 18]; 21(1), e14651. https://doi.org/10.1111/iwj.14651
10. Miloro M. Does low level laser therapy affect recovery of lingual and inferior alveolar nerve injuries? Journal of Oral and Maxillofacial Surgery [Online]. 2018 [cited 2025 May 18]; 76(12): 2669-2675. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0278239118305159?via%3Dihub
11. Yari A, Fasih P, Sadeghi S, Movahed E, Hallajmoghaddam Sarand S, Goodarzi A. The effect of delayed photobiomodulation therapy on inferior alveolar nerve recovery after third molar removal: a triple-blinded randomized clinical trial. Photobiomodulation Photomedicine and Laser Surgery [Online]. 2024 [cited 2025 May 18]; 42(7): 463–472. Available from: https://pubmed.ncbi.nlm.nih.gov/38900722/
12. El Mobadder M, Nammour S, Ortega M, Grzech-Leśniak K. Photobiomodulation Therapy applied after 6 months for the management of a severe inferior alveolar nerve injury. Life [Online]. 2021 [cited 2025 May 18]; 11(12):1420. Available from: https://doi.org/10.3390/life11121420
13. Matos FX, Ladeia Júnior LF, Góes Ladeia FD. Laser therapy for lower alveolar nerve parestesia after lower thir molar extractions: literature review. IdOnline Revista de Psicologia [Online]. 2019 [cited 2025 May 21]; 13(48):1–13. Available from: https://idonline.emnuvens.com.br/id/article/view/2115
14. Martins Melo MT, Araújo Costa TS, Moura Rocha MC, Ribeiro de Carvalho Reis EN, Ferreira Lima Verde GM. The use of low-level laser therapy in the treatment of paresthesia of the inferior alveolar nerve due to third molar extraction. Research Society and Development [Online]. 2024 [cited 2025 May 21];13(11): e13131147226. Available from: https://rsdjournal.org/index.php/rsd/article/view/47226
15. Fernandes-Neto JA, Simões TMS, Araújo Batista AL, Lacerda-Santos JT, Souza-Santos Palmeira PT, Chaves-de Vasconcelos Catão MH. Laser therapy as treatment for oral paresthesia arising from mandibular third molar extraction. Journal of Clinical and Experimental Dentistry [Online]. 2020 [cited 2025 May 21];12(6): e603–e606. Available from: https://pubmed.ncbi.nlm.nih.gov/32665821/
16. Almeida Neiva S, Carvalho Silva JB, Oliveira Batista V, Silva Meireles Lemos GC. Low intensity laser in the treatment of paresthesis of the inferior alveolar nerve: current evidence. Brazilian Journal of Health Review [Online]. 2023 [cited 2025 May 21];44(3):55-62. Available from: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/51364
17. Keykha E, Tahmasebi E, Hadilou M. Therapeutic modalities for iatrogenic late paresthesia in oral tissues innervated by mandibular branch of trigeminal nerve: a systematic review. Maxillofacial Plastic and Reconstructive Surgery [Online]. 2024 [cited 2025 May 21] 46(25). Available from: https://doi.org/10.1186/s40902-024-00438-5
18. Olkoski LE, Bonai N, Pavelski MD, Magro Filho O, Alves Luciano A, Frigo L, et al. Low intensity laserterapy and its effects on pain, edema, trism and paresthesia: an integrative literature review. Research, Society and Development [Online]. 2021 [cited 2025 May 25]; 10(2): e9210212159. Available from: https://rsdjournal.org/index.php/rsd/article/view/12159
19. Bastos CE de J, Souza Ferro Gomes AV, Leite TF, Rebouças e Cerqueira CC, Sousa Flor LC de, Noguera Bazán JM. Laser therapy in the treatment of lesions to the inferior alveolar nerve. Research, Society and Development [Online]. 2021 [cited 2025 May 15]; 10(7): e50110716881. Available from: https://rsdjournal.org/index.php/rsd/article/view/16881
20. Brito AV, Angulo A, Almon R. Super-pulsed diode laser in the therapy of inferior alveolar nerve paresthesia after mandibular third molar extraction: a case report. Cureus [Online]. 2025 [cited 2025 May 21]; 16(12): e76147. Available from: https://pubmed.ncbi.nlm.nih.gov/39835038/