title: Trials needed to identify best management of iatrogenic inferior alveolar and lingual nerve injuries.
abstract: METHODS
  The Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase databases were searched with no language or date restrictions.
  
  
  METHODS
  Three reviewers independently selected studies. Randomised controlled trials (RCTs) involving interventions to treat patients with neurosensory defect of the inferior alveolar or lingual nerve or both as a sequela of iatrogenic injury were considered.
  
  
  METHODS
  Standard Cochrane methodological procedures were followed.
  
  
  RESULTS
  Two studies considered at high risk of bias, reporting data from 26 analysed patients were included. Both studies investigated the effectiveness of low-level laser treatment compared to placebo laser therapy on inferior alveolar sensory deficit as a result of iatrogenic injury. Two studies assessed as at high risk of bias, reporting data from 26 analysed participants were included in this review. The age range of participants was from 17 to 55 years. Both trials investigated the effectiveness of low-level laser treatment compared to placebo laser therapy on inferior alveolar sensory deficit as a result of iatrogenic injury.Patient-reported altered sensation was partially reported in one study and fully reported in another. Following treatment with laser therapy, there was some evidence of an improvement in the subjective assessment of neurosensory deficit in the lip and chin areas compared to placebo, though the estimates were imprecise: a difference in mean change in neurosensory deficit of the chin of 8.40 cm (95% confidence interval (CI) 3.67 to 13.13) and a difference in mean change in neurosensory deficit of the lip of 21.79 cm (95% CI 5.29 to 38.29). The overall quality of the evidence for this outcome was very low. No studies reported on the effects of the intervention on the remaining primary outcomes of pain, difficulty eating, speaking or taste. No studies reported on quality of life or adverse events.
  
  
  CONCLUSIONS
  There is clearly a need for randomised controlled clinical trials to investigate the effectiveness of surgical, medical and psychological interventions for iatrogenic inferior alveolar and lingual nerve injuries. Primary outcomes of this research should include: patient-focused morbidity measures including altered sensation and pain, pain, quantitative sensory testing and the effects of delayed treatment.
authors.affiliation: NYU College of Dentistry, New York, USA.
authors.forename: Analia
authors.initials: A
authors.lastname: Veitz-Keenan
authors.affiliation: NYU College of Dentistry, New York, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Keenan
mesh_terms: D006801:Humans; D007049:Iatrogenic Disease; D061222:Lingual Nerve Injuries / Q000532:radiotherapy*; D028022:Low-Level Light Therapy / Q000379:methods*; D020886:Somatosensory Disorders / Q000532:radiotherapy*; D061221:Trigeminal Nerve Injuries / Q000532:radiotherapy*