Sensory retraining after orthognathic surgery: effect on patients' perception of altered sensation.
OBJECTIVE
The primary research hypothesis was that the magnitude and duration of the perceived burden from altered sensation reported by patients after bilateral sagittal split osteotomy and trauma to the third division of the trigeminal nerve are decreased when facial sensory retraining exercises are performed in conjunction with standard opening exercises as compared with standard opening exercises alone.


METHODS
A total of 186 subjects were enrolled in a multicenter, double-blind, 2 parallel group-stratified block randomized clinical trial. Oral and facial pain, unusual sensations, numbness, and loss of sensitivity were scored from "no problem" to "serious problem" before surgery and 1 month, 3 months, and 6 months after surgery. A proportional odds model for the ordered multinomial response was used to compare the responses of the 2 exercise groups.


RESULTS
The 2 exercise groups did not differ significantly at any postsurgical time in terms of perceived problem level from intraoral of facial pain. The difference between the 2 groups at each visit was not statistically significant for unusual sensations, although the trend was for the sensory retraining group to have a higher likelihood of reporting fewer problems. By 6 months, the likelihood of a subject reporting lower problem or interference level related to numbness or decreased lip sensitivity was significantly higher in the sensory-retraining group, approximately twice that of the opening exercise-only group.


CONCLUSIONS
Our results support the premise that a simple noninvasive exercise program initiated shortly after orthognathic surgery can lessen the objectionable impression of negative altered sensations.
Phillips
Ceib
C
Department of Orthodontics, University of North Carolina, Chapel Hill, NC 27599, USA. ceib_phillips@dentistry.unc.edu
Essick
Greg
G
Preisser
John S
JS
Turvey
Timothy A
TA
Tucker
Myron
M
Lin
Dongming
D
D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D005081:Exercise Therapy; D005157:Facial Pain / Q000534:rehabilitation; D030141:Feedback, Psychological; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000534:rehabilitation; D008047:Lip Diseases / Q000534:rehabilitation; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000502:physiology; D012677:Sensation / Q000502:physiology*; D012678:Sensation Disorders / Q000534:rehabilitation*; D012684:Sensory Thresholds / Q000502:physiology; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome