Related Experiment Video
Updated: Jun 4, 2026
Using a 1064-nm Picosecond Neodymium-Doped Yttrium Aluminum Garnet Laser for Periorbital Hyperpigmentation
Published on: May 23, 2025
Nd:YAG and Diode Laser Biostimulation in Infraorbital and Inferior Alveolar Neurosensory Recovery After Orthognathic
Yaşar Tolga Kayim1, Nilüfer Özkan2, Nihat Akbulut3
1Department of Periodontology, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Türkiye.
Background:
Neurosensory deficits affecting inferior alveolar nerve (IAN) and infraorbital nerve (ION) are expected side effects of bimaxillary orthognathic surgery. Photobiomodulation using neodymium-doped yttrium aluminum garnet (Nd:YAG) and diode lasers has been proposed to accelerate nerve regeneration; however, evidence with standardized functional outcome measures remains limited.
Purpose:
To measure and compare neurosensory recovery following Nd:YAG laser, diode laser, or no laser biostimulation after orthognathic surgery.
Study Design, Setting, Sample:
Randomized, controlled, assessor-blinded trial was conducted at Ondokuz Mayis University, Samsun, Turkiye (February 2024 to February 2025) and included subjects aged 18 to 30 years who developed neurosensory disturbances, excluding systemic neural diseases, prior laser therapy, or smoking.
Predictor Variables:
Predictor variable was biostimulation status. Subjects were randomly assigned to Nd:YAG laser (1064 nm, 0.5 W, 4 J/cm2), diode laser (810 nm, 0.5 W, 4 J/cm2), or no laser (control) twice weekly for 3 weeks.
Main Outcome Variables:
Outcome variable was time to functional sensory recovery (FSR), defined as first achievement of British Medical Research Council grade S3 or higher in lateral IAN territory (lower canine and second premolar regions) and ION region.
Covariates:
Demographic covariates included age and sex. Operative covariates included treatment group and time from surgery to enrollment.
Analyses:
Time to FSR was analyzed using Kaplan-Meier survival analysis and log-rank test; predictors analyzed using Cox proportional hazards regression. Statistical significance was set at P < .05.
Results:
Of 39 eligible subjects, 30 were enrolled (mean age 24.6 [4.8] years; 12 [40%] male), all completed 12-month follow-up. Median time to IAN FSR was 4 months (interquartile range [IQR]: 0 to 7) in Nd:YAG group, 5 months (IQR: 2 to 7.75) in diode group, not reached within 12 months in control group (log-rank P = .001); adjusted hazard ratio for Nd:YAG 8.0 (95% CI: 2.0 to 31.9; P = .003), for diode 7.6 (95% CI: 2.0 to 29.4; P = .003). Median time to ION FSR was 4 months (IQR: 1.25 to 7) in diode group and 2 months (IQR: 0 to 5) in Nd:YAG group, not reached in control group (log-rank P = .001); adjusted hazard ratio for diode: 10.7 (95% CI: 2.4 to 47.5; P = .002), for Nd:YAG 3.25 (95% CI: 0.80 to 13.27; P = .101).
Conclusion And Relevance:
Both laser modalities statistically significantly reduced time to IAN FSR, demonstrating clinically meaningful ION recovery compared with no treatment. Laser biostimulation warrants consideration as adjunct in postoperative neurosensory rehabilitation following orthognathic surgery.
