Parathesia Reversal

[Swpmn]

Bump:

Have a friend who has experienced parasthesia of the inferior alveolar nerve post operatively of root canal therapy on a mandibular second molar. Patient reported a “shock” sensation to the lip during administration of anesthesia. More than one injection was required to obtain profound anesthesia. I do not have access to any radiographs or clinical details as the patient does not live in my area.

According to the patient, procedure was unremarkable and was completed in one visit. Next day, patient reported still having a “numb lip” but having severe pain with the second molar. Penicillin and Vicodin were given and in a few days the tooth became asymptomatic. The lip remained “numb” but the patient reports normal sensation in areas innervated by the lingual nerve.

After approximately ten days, the patient was administered some sort of oral steroid therapy with no improvement in the condition. The parasthesia is now at thirty days, with no burning, tingling or “hot spots”. Complete parasthesia from commissure to mandibular midline and one-half of mentalis area.

For those of you who have had success treating this condition, can you please write and offer suggestions? Even if I had a pulsed Nd:YAG, I could not treat the patient due to geographic distance.

Thanks for your help,

Al

[kmarshall]

one of the contra-indications of biostim is steroids.
I don’t know how long you would have to wait for it to clear.
I’d call Millenium for the nearest laser user and then it’s up to the pt.

Keith

[Swpmn]

Thanks for the thoughts Keith.

Why is steroid therapy a contraindication for biostimulation?

Al

[Robert Gregg DDS]

Emperical evidence suggests they block the very mechanisms at the cellular level that allows biostim to work in the first place–even makes pain worse in muscular-tendon injuries.

Bob

[Swpmn]

QUOTE

Emperical evidence suggests they block the very mechanisms at the cellular level that allows biostim to work in the first place–even makes pain worse in muscular-tendon injuries.

Bob

Thanks Bob. Like Keith had mentioned, any idea on how long after steroid therapy the biostimulation could be initiated?

Al

[JanetCentury]

Hey Bob – another paresthesia question.

I started treating a patient who lost feeling after implant placement 6 years ago. She started getting feeling back after the first biostim and was delighted. Today was her 4th time. She says that after the last one, she started getting a burning sensation in the lip. I am running with – that means it’s helping since there is more feeling, but obviously burning isn’t desirable. We did more treatment today. Is my thinking ok or flawed? Should we keep going?

Thanks

Janet

[Robert Gregg DDS]

Keep going, both proximal and distal aspects.

Bob

[jkim]

Could y'all give me a 2 year status report of your patients' parasthesia.

[Anonymous]

I can offer an almost 4 year followup on mine.
Still same as last time we treated. Area of parasthesia had decreased greatly with treatment. Not 100% but enought to be able to eat and drink w/o difficulty.

[Tooth8kdoc]

Hi Ron-

I am a four year user of the periolase. I just had my first parathesia case after a particularly bad lower molar endo. She has numbness on the left tip of the tongue, a triangular area of 2.5 X 2.5 X 3.0 cm. At what setting are you reccommending the biostim? For how long? Should we try to aim for the area of injection mainly, or more diffuse. Extraoral, intraoral or both. What kind of informed consent should we use? ANy forms around here that would work? Thanks for the help getting me logged on. Lastly, this patient was never treated with the laser prior to this incident. Thanks, Forrest

[admin]

Forrest, the very first post of this thread has the parameters listed in between the pix. You can use the parameters and calculate the time needed e.g. 3.6W= 3.6J/sec so that = 216 J/minute and if you want to put in 4000J then 4000J/216=roughly 19 minutes.

I didn’t use any informed consent and don’t know of any. I doubt that it would do any good even if you do find one as this is what I’d consider ‘really off label’ use.

I don’t think I’ve heard as many successes with tongues as I have with lips when it comes to reversing parathesia.

Check at the bottom at the page when viewing this thread. You will see a “similar thread’ section that lists 4 other threads dealing with parathesia reversal. If memory serves me correctly there is something in one of those regarding treating the tongue.

[Author]

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