Abstract：
BACKGROUND: The present systematic review intended to evaluate the current evidence on the modalities used for treating iatrogenic late paresthesia in the oral tissues innervated by the mandibular branch of the trigeminal nerve.
METHODS: As a common side effect of dental procedures, paresthesia can exert a profound adverse effect on patients\' quality of life. The inferior alveolar nerve (IAN) and lingual nerve (LN) have the highest chance of injury during several dental procedures, including mandibular orthognathic surgeries, implant placement, extraction of the third molar, anesthetic injections, flap elevation, and endodontic treatments. Moreover, several methods have been proposed for treating iatrogenic late paresthesia, including photobiomodulation (PBM), microsurgery, medication, and close observation until achieving spontaneous recovery of sensation. However, no gold standard treatment for iatrogenic paresthesia has been agreed upon up to now. The present study included a comprehensive search of the databases of PubMed, Embase, Scopus, and Web of Science up to December 04, 2023, resulting in a total of 3122 related studies. Then, the titles, abstracts, and full texts of the studies were evaluated. Ultimately, seven controlled randomized trials (RCTs) were included in the final analysis. Also, the risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Among all fields, randomization, allocation concealment, and data analysis were found to have the highest chance of bias in the included studies.
CONCLUSIONS: In conclusion, PBM, vitamin B12, and corticosteroids could accelerate the recovery of late paresthesia. However, considering the low sample size of the included studies and the high risk of methodological bias, it is recommended to perform further RCTs with robust study designs following Good Clinical Practice (GCP) guidelines to achieve more reliable results.
METHODS: As a common side effect of dental procedures, paresthesia can exert a profound adverse effect on patients\' quality of life. The inferior alveolar nerve (IAN) and lingual nerve (LN) have the highest chance of injury during several dental procedures, including mandibular orthognathic surgeries, implant placement, extraction of the third molar, anesthetic injections, flap elevation, and endodontic treatments. Moreover, several methods have been proposed for treating iatrogenic late paresthesia, including photobiomodulation (PBM), microsurgery, medication, and close observation until achieving spontaneous recovery of sensation. However, no gold standard treatment for iatrogenic paresthesia has been agreed upon up to now. The present study included a comprehensive search of the databases of PubMed, Embase, Scopus, and Web of Science up to December 04, 2023, resulting in a total of 3122 related studies. Then, the titles, abstracts, and full texts of the studies were evaluated. Ultimately, seven controlled randomized trials (RCTs) were included in the final analysis. Also, the risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Among all fields, randomization, allocation concealment, and data analysis were found to have the highest chance of bias in the included studies.
CONCLUSIONS: In conclusion, PBM, vitamin B12, and corticosteroids could accelerate the recovery of late paresthesia. However, considering the low sample size of the included studies and the high risk of methodological bias, it is recommended to perform further RCTs with robust study designs following Good Clinical Practice (GCP) guidelines to achieve more reliable results.
摘要：
背景：本系统综述旨在评估目前关于治疗由三叉神经下颌支支配的口腔组织中医源性晚期感觉异常的方法的证据。
方法：作为牙科手术的常见副作用，感觉异常会对患者的生活质量产生深远的不良影响。下牙槽神经（IAN）和舌神经（LN）在几次牙科手术中受伤的机会最高。包括下颌正颌手术，植入物放置,第三磨牙的提取，麻醉剂注射,襟翼标高,和牙髓治疗。此外，已经提出了几种治疗医源性晚期感觉异常的方法，包括光生物调节(PBM)，显微外科,药物,并密切观察，直到达到自发的感觉恢复。然而,到目前为止，尚未就医源性感觉异常的黄金标准治疗达成一致。本研究包括对PubMed数据库的全面搜索，Embase,Scopus,和WebofScience截至2023年12月4日，共进行了3122项相关研究。然后，标题,摘要,并对研究的全文进行了评估。最终,7项随机对照试验(RCT)纳入最终分析.此外，使用JoannaBriggs研究所(JBI)关键评估检查表评估偏倚风险.在所有领域中,随机化，分配隐藏，在纳入的研究中,数据分析出现偏倚的可能性最高.
结论：结论：PBM,维生素B12和皮质类固醇可以加速后期感觉异常的恢复。然而,考虑到纳入研究的样本量低，方法学偏倚的风险高，建议按照良好的临床实践规范(GCP)指南,采用稳健的研究设计进行进一步的RCT,以获得更可靠的结果.
方法：作为牙科手术的常见副作用，感觉异常会对患者的生活质量产生深远的不良影响。下牙槽神经（IAN）和舌神经（LN）在几次牙科手术中受伤的机会最高。包括下颌正颌手术，植入物放置,第三磨牙的提取，麻醉剂注射,襟翼标高,和牙髓治疗。此外，已经提出了几种治疗医源性晚期感觉异常的方法，包括光生物调节(PBM)，显微外科,药物,并密切观察，直到达到自发的感觉恢复。然而,到目前为止，尚未就医源性感觉异常的黄金标准治疗达成一致。本研究包括对PubMed数据库的全面搜索，Embase,Scopus,和WebofScience截至2023年12月4日，共进行了3122项相关研究。然后，标题,摘要,并对研究的全文进行了评估。最终,7项随机对照试验(RCT)纳入最终分析.此外，使用JoannaBriggs研究所(JBI)关键评估检查表评估偏倚风险.在所有领域中,随机化，分配隐藏，在纳入的研究中,数据分析出现偏倚的可能性最高.
结论：结论：PBM,维生素B12和皮质类固醇可以加速后期感觉异常的恢复。然而,考虑到纳入研究的样本量低，方法学偏倚的风险高，建议按照良好的临床实践规范(GCP)指南,采用稳健的研究设计进行进一步的RCT,以获得更可靠的结果.
