Therapy of Neurophysiological Changes after Oral and Maxillofacial Surgery—A Systematic Review

Abstract

Introduction: The purpose of this systematic review was to critically analyze the recent literature to present a guideline for management of neurophysiological changes after implant placement and oral and maxillofacial surgical procedures. Materials and methods: Three electronic databases and manual search approaches were used to identify relevant articles on neurophysiological changes. Only studies with a randomized controlled study design were included. Primary outcome was defined as the status of recovery and relief of pain states under various therapies. Two independent reviewers evaluated the data. Results: A total of eight studies from 2891 records identified met the inclusion criteria. Therapy options for patients with neurophysiological changes after implant placement and oral and maxillofacial surgery were low-level laser (LLL), stellate ganglion block (SGB), medication, and surgical removal of implants. Six studies dealt with LLL, providing a significant improvement in mechanical sensation. Only one study revealed the whole neurosensory profile including neuropathic pain states. All the included RCT studies presented at least one bias, and a considerable heterogeneity of the included studies was revealed. Conclusions: Reduced thermal sensation may be due to irritation of small fibers. LLL might help to improve nerve recovery.

Keywords

• neurophysiological disturbances
• altered sensation
• neuropathic pain
• low-level laser
• small fibers