Photobiomodulation Therapy for Neurosensory Disturbances in Orthognathic Surgery Patients: A Systematic Review
In recent years, there has been a growing focus among patients on enhancing facial esthetics and optimizing the functionality of the stomatognathic system . Achieving these goals often requires more than orthodontic treatment alone, necessitating the integration of surgical interventions. Procedures such as orthognathic surgery have become increasingly common and accessible to a broader patient population . These treatments are inherently complex, involving multiple stages, and the surgical procedures themselves are not without physiological impact . Surgical interventions affect both soft tissues (e.g., mucous membranes, muscles, nerves, and blood vessels) and hard tissues (e.g., bones and teeth). Given the high innervation and vascularization of the operative area, there is an increased risk of complications, including pain, swelling, delayed wound healing, and neurosensory disturbances (NSDs) . Postoperative complications, including dysaesthesia, hypoaesthesia, and anesthesia, are prevalent and often distressing for patients, with up to 87% experiencing subjective NSDs, some of which may be permanent [ , , ]. To enhance recovery following surgical procedures, the most widely utilized and standard approach remains pharmacotherapy, including anti-inflammatory drugs, antibiotics, and analgesics [ , , , ]. However, this conventional method is associated with several undesirable side effects, including gastrointestinal complications, hepatotoxicity, skin rashes, neutropenia, and postoperative nausea and vomiting [ , , ]. As a result, alternative methods are gaining traction, such as kinesiotaping, hilotherapy, vitamin C supplementation, manual lymphatic drainage, and acupuncture (including electroacupuncture) [ , , , , , ]. Among these emerging interventions, physical laser biostimulation—specifically low-level laser therapy (LLLT)—has gained attention for its potential to support postoperative recovery (see ). Low-level laser therapy (LLLT), also known as photobiomodulation (PBM), is increasingly used in physical therapy and medicine to stimulate cellular processes to achieve therapeutic benefits. This technique involves precise or diffuse irradiation of body surfaces to facilitate cellular biostimulation [ , , , ]. LLLT enhances bioenergetics, modulates cell membrane potential, and disrupts the synthesis of prostaglandins and tumor necrosis factor (TNF). It activates signaling molecules, stimulates gene expression, regulates reactive oxygen species (ROS) levels, adjusts intracellular redox states and pH, and promotes nitric oxide (NO) release, supporting cell growth and repair [ , , , , , , , ]. The therapeutic advantages of LLLT include anti-inflammatory and analgesic effects, improved bone regeneration, expedited wound healing, reduction in trismus and edema, enhanced microcirculation and vascularization, endorphin release, and nerve regeneration [ , , , , , ]. Beyond orthognathic surgery, LLLT is effective in treating arthritis, sciatica, neuralgia, acne vulgaris, and periodontal diseases [ , , , ]. Photobiomodulation (PBM) has been used for decades to manage neurosensory disturbances (NSDs) following orthognathic surgeries, with continuous advancements in therapeutic techniques and patient recovery. While several systematic reviews have examined the effects of low-level light therapy (LLLT) on pain, trismus, edema, and NSDs in maxillofacial surgery [ , , , ], recent reviews specifically focusing on NSD recovery are lacking. This highlights the need to re-evaluate the role of LLLT in improving NSD outcomes and to consolidate current findings, aiming to standardize treatment protocols and enhance patient recovery. 

2.1. Focused Question This systematic review adhered to the PICO framework to formulate the research question : PICO Question: In patients undergoing orthognathic surgeries (Population), does laser therapy (Intervention) enhance neurosensory recovery (Outcome) compared to the natural postoperative recovery process (Comparison)? 2.2. Protocol The selection process for articles included in the systematic review was meticulously designed and documented in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines , as illustrated in . The systematic review was registered on the Open Science Framework under the following link: https://doi.org/10.17605/OSF.IO/6XJ7T (accessed 16 December 2024). 2.3. Eligibility Criteria Studies were deemed eligible for inclusion in the review if they met the following criteria : Orthognathic surgery procedures; The use of photobiomodulation, low-level laser therapy, or LED light; In vivo studies; Studies with a control group; Case reports; Studies published in English; Prospective case series; Non-randomized controlled clinical trials (NRS); and Randomized controlled clinical trials (RCTs). The reviewers established the following exclusion criteria : Oral surgery procedures that were not orthognathic surgeries; Absence of laser treatment; Non-English papers; Opinions; Editorial articles; Review articles; No full-text access; and Duplicated publications. No restrictions were applied regarding the year of publication. 2.4. Information Sources, Search Strategy, and Study Selection In November 2024, a comprehensive search was performed in the PubMed, Scopus, and Web of Science (WoS) databases to identify articles that met the predefined inclusion criteria. The search targeted titles and abstracts, employing specific keywords to locate studies on laser therapy for neurosensory recovery following orthognathic surgeries. The search terms included: orthognathic surgery AND (physiotherapy OR physical therapy OR laser OR LLLT OR PBM OR light OR LED OR acupuncture) AND (nerve OR neurosensory OR paresthesia). Additionally, the reference lists of included articles were reviewed to identify further relevant studies. All searches adhered strictly to the eligibility criteria, and only studies with full-text availability were considered for inclusion. 2.5. Data Collection Process and Data Items The articles that met the inclusion criteria were independently reviewed and extracted by three researchers (M.W., A.K., J.K.). The extracted data included the first author, year of publication, study design, article title, type of laser used in the study, and its effectiveness and outcomes related to the healing process and pain relief. The collected information was systematically organized and recorded in a standardized Excel spreadsheet. 2.6. Risk of Bias and Quality Assessment In the initial phase of study selection, each reviewer independently screened the titles and abstracts to minimize potential bias. Cohen’s kappa (κ) test was employed to assess the level of inter-reviewer agreement . Any disagreements regarding the inclusion or exclusion of articles were resolved through thorough discussions among the authors until a consensus was reached. 2.7. Quality Assessment Three reviewers (M.W., A.K., J.K.) independently evaluated the quality of the included studies. The assessment considered key aspects such as study design, execution, and analysis, using specific criteria: a minimum sample size of 10 patients, the presence of a control group, randomization, blinding, and sample size calculation. Studies were scored on a 0 to 6-point scale, with higher scores indicating better quality. The risk of bias was categorized as follows: 0–2 points signified a high risk of bias, 3–4 points indicated a moderate risk, and 5–6 points represented a low risk. Disagreements in scoring were resolved through discussion among the reviewers until consensus was reached . 

This systematic review adhered to the PICO framework to formulate the research question : PICO Question: In patients undergoing orthognathic surgeries (Population), does laser therapy (Intervention) enhance neurosensory recovery (Outcome) compared to the natural postoperative recovery process (Comparison)? 

The selection process for articles included in the systematic review was meticulously designed and documented in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines , as illustrated in . The systematic review was registered on the Open Science Framework under the following link: https://doi.org/10.17605/OSF.IO/6XJ7T (accessed 16 December 2024). 

Studies were deemed eligible for inclusion in the review if they met the following criteria : Orthognathic surgery procedures; The use of photobiomodulation, low-level laser therapy, or LED light; In vivo studies; Studies with a control group; Case reports; Studies published in English; Prospective case series; Non-randomized controlled clinical trials (NRS); and Randomized controlled clinical trials (RCTs). The reviewers established the following exclusion criteria : Oral surgery procedures that were not orthognathic surgeries; Absence of laser treatment; Non-English papers; Opinions; Editorial articles; Review articles; No full-text access; and Duplicated publications. No restrictions were applied regarding the year of publication. 

In November 2024, a comprehensive search was performed in the PubMed, Scopus, and Web of Science (WoS) databases to identify articles that met the predefined inclusion criteria. The search targeted titles and abstracts, employing specific keywords to locate studies on laser therapy for neurosensory recovery following orthognathic surgeries. The search terms included: orthognathic surgery AND (physiotherapy OR physical therapy OR laser OR LLLT OR PBM OR light OR LED OR acupuncture) AND (nerve OR neurosensory OR paresthesia). Additionally, the reference lists of included articles were reviewed to identify further relevant studies. All searches adhered strictly to the eligibility criteria, and only studies with full-text availability were considered for inclusion. 

The articles that met the inclusion criteria were independently reviewed and extracted by three researchers (M.W., A.K., J.K.). The extracted data included the first author, year of publication, study design, article title, type of laser used in the study, and its effectiveness and outcomes related to the healing process and pain relief. The collected information was systematically organized and recorded in a standardized Excel spreadsheet. 

In the initial phase of study selection, each reviewer independently screened the titles and abstracts to minimize potential bias. Cohen’s kappa (κ) test was employed to assess the level of inter-reviewer agreement . Any disagreements regarding the inclusion or exclusion of articles were resolved through thorough discussions among the authors until a consensus was reached. 

Three reviewers (M.W., A.K., J.K.) independently evaluated the quality of the included studies. The assessment considered key aspects such as study design, execution, and analysis, using specific criteria: a minimum sample size of 10 patients, the presence of a control group, randomization, blinding, and sample size calculation. Studies were scored on a 0 to 6-point scale, with higher scores indicating better quality. The risk of bias was categorized as follows: 0–2 points signified a high risk of bias, 3–4 points indicated a moderate risk, and 5–6 points represented a low risk. Disagreements in scoring were resolved through discussion among the reviewers until consensus was reached . 

3.1. Study Selection The initial database search across PubMed (66 articles), WoS (92 articles), Scopus (264 articles), and reference lists (2 articles) yielded a total of 424 potentially relevant articles for the review. After the removal of duplicates, 297 articles remained for screening. During the initial screening of titles and abstracts, 278 articles were excluded for not meeting the inclusion criteria. Subsequently, 19 articles underwent a detailed full-text analysis. Of these, four articles were excluded for failing to meet the inclusion criteria, and one article was excluded due to the lack of accessible full text. Ultimately, 14 articles were included in the qualitative synthesis of this review [ , , , , , , , , , , , , , ]. 3.2. General Characteristics of the Included Studies This systematic review included an analysis of 14 studies encompassing various study designs. These comprised randomized controlled trials (RCTs), one retrospective analysis  involving 125 participants, one case report , and one prospective observational study  with six patients, all of whom received identical treatment protocols. Control groups were employed in 11 studies, utilizing either a split-mouth design [ , , , ] or separate control groups [ , , , , , , ]. Sample sizes varied widely, ranging from a single case report  to larger cohorts of up to 40 participants . Regarding surgical interventions, bilateral sagittal split osteotomy (BSSO) was the most commonly performed procedure, featured in seven studies [ , , , , , , , ], while sagittal split osteotomy (SSO) was reported in three studies [ , , ]. More complex surgical approaches included combinations such as orthognathic surgery with genioplasty , BSSO with mentoplasty and Le Fort I osteotomy , and BSSO with genioplasty and Le Fort I osteotomy . Additionally, one retrospective study encompassed a broader range of procedures, including orthognathic surgery, third molar extractions, dental implant placement, trauma-related surgeries, and other minor oral surgical procedures . In terms of laser procedures, most studies utilized a single diode laser wavelength approach, with ten studies employing a specific wavelength consistently throughout their treatment protocols [ , , , , , , , , , ]. However, some researchers adopted more complex approaches. Baydan et al. implemented two different wavelengths (904 nm and 650 nm vs. 940 nm) in separate treatment groups . De Oliveira et al. employed a two-stage protocol, starting with an 808 nm laser and transitioning to a 660 nm wavelength if necessary after ten sessions . One study used a dual approach, applying a 660 nm laser intraorally and an 810 nm laser extraorally . Additionally, Mohajerani et al. combined laser therapy with LED treatment . The wavelengths used across the studies ranged from 780 nm to 940 nm, with the 808–830 nm range being the most common. Two studies utilized a wavelength of 780 nm . The 808 nm wavelength was used in two studies , while 810 nm was implemented in another two . Single studies explored various other wavelengths: 820 nm , 820–830 nm , 830 nm , and 940 nm . In connection with the affected nerve areas, ten studies specifically focused on the inferior alveolar nerve [ , , , , , , , , , ]. Some studies examined broader regions: Travassos Prazeres et al.  investigated both the upper and lower lip, along with the chin area, while Pimenta D’Avilla et al.  focused on an extensive region extending from the preauricular area to the mandibular body, including the paranasal areas, lips, and chin. Morais Filho et al.  targeted the nose, nasal folds, lower lip, and chin regions, whereas Santos et al.  concentrated on the mandibular region (see ). 3.3. Main Study Outcomes The efficacy analysis predominantly demonstrated positive outcomes in laser-treated groups, with the majority of studies reporting significantly superior results compared to control interventions. Notably, only one study found no statistically significant differences between the intervention groups . Assessment methods included objective measures alone , subjective measures alone , or combined approaches [ , , , , , , , , , , ]. Evidence suggests recovery rates of up to 85% in laser-treated groups compared to 70–75% in control groups . Multiple studies reported significant improvements in two-point discrimination [ , , ], tactile sensitivity , pain response , and mechanical sensitivity . Recovery patterns varied by anatomical location, with the lips and teeth demonstrating better recovery outcomes compared to the chin region . Complete resolution of paresthesia was observed in a laser-treated group within six months post-surgery . Follow-up periods ranged from immediate postoperative assessments to two years . Several factors were identified as influencing treatment outcomes. Early intervention, particularly within 30 days post-surgery, was associated with improved recovery outcomes. Patient age also played a significant role, with younger individuals (14–25 years) exhibiting superior recovery rates. An analysis of treatment frequency indicated that weekly sessions were more effective than bi-weekly treatments . Furthermore, in studies employing a split-mouth design, laser-treated sites demonstrated faster recovery compared to untreated sites [ , , ] (see ). 3.4. Quality Assessment of the Included Studies Ten articles included in the review were predominantly of high quality, with scores of 5/6 [ , , , ] or 6/6 [ , , , , , ]. However, three studies [ , , ] were categorized as low quality. Additionally, only one study, scoring 4/6 points, was identified as having a moderate risk of bias  (see ). 

The initial database search across PubMed (66 articles), WoS (92 articles), Scopus (264 articles), and reference lists (2 articles) yielded a total of 424 potentially relevant articles for the review. After the removal of duplicates, 297 articles remained for screening. During the initial screening of titles and abstracts, 278 articles were excluded for not meeting the inclusion criteria. Subsequently, 19 articles underwent a detailed full-text analysis. Of these, four articles were excluded for failing to meet the inclusion criteria, and one article was excluded due to the lack of accessible full text. Ultimately, 14 articles were included in the qualitative synthesis of this review [ , , , , , , , , , , , , , ]. 

This systematic review included an analysis of 14 studies encompassing various study designs. These comprised randomized controlled trials (RCTs), one retrospective analysis  involving 125 participants, one case report , and one prospective observational study  with six patients, all of whom received identical treatment protocols. Control groups were employed in 11 studies, utilizing either a split-mouth design [ , , , ] or separate control groups [ , , , , , , ]. Sample sizes varied widely, ranging from a single case report  to larger cohorts of up to 40 participants . Regarding surgical interventions, bilateral sagittal split osteotomy (BSSO) was the most commonly performed procedure, featured in seven studies [ , , , , , , , ], while sagittal split osteotomy (SSO) was reported in three studies [ , , ]. More complex surgical approaches included combinations such as orthognathic surgery with genioplasty , BSSO with mentoplasty and Le Fort I osteotomy , and BSSO with genioplasty and Le Fort I osteotomy . Additionally, one retrospective study encompassed a broader range of procedures, including orthognathic surgery, third molar extractions, dental implant placement, trauma-related surgeries, and other minor oral surgical procedures . In terms of laser procedures, most studies utilized a single diode laser wavelength approach, with ten studies employing a specific wavelength consistently throughout their treatment protocols [ , , , , , , , , , ]. However, some researchers adopted more complex approaches. Baydan et al. implemented two different wavelengths (904 nm and 650 nm vs. 940 nm) in separate treatment groups . De Oliveira et al. employed a two-stage protocol, starting with an 808 nm laser and transitioning to a 660 nm wavelength if necessary after ten sessions . One study used a dual approach, applying a 660 nm laser intraorally and an 810 nm laser extraorally . Additionally, Mohajerani et al. combined laser therapy with LED treatment . The wavelengths used across the studies ranged from 780 nm to 940 nm, with the 808–830 nm range being the most common. Two studies utilized a wavelength of 780 nm . The 808 nm wavelength was used in two studies , while 810 nm was implemented in another two . Single studies explored various other wavelengths: 820 nm , 820–830 nm , 830 nm , and 940 nm . In connection with the affected nerve areas, ten studies specifically focused on the inferior alveolar nerve [ , , , , , , , , , ]. Some studies examined broader regions: Travassos Prazeres et al.  investigated both the upper and lower lip, along with the chin area, while Pimenta D’Avilla et al.  focused on an extensive region extending from the preauricular area to the mandibular body, including the paranasal areas, lips, and chin. Morais Filho et al.  targeted the nose, nasal folds, lower lip, and chin regions, whereas Santos et al.  concentrated on the mandibular region (see ). 

The efficacy analysis predominantly demonstrated positive outcomes in laser-treated groups, with the majority of studies reporting significantly superior results compared to control interventions. Notably, only one study found no statistically significant differences between the intervention groups . Assessment methods included objective measures alone , subjective measures alone , or combined approaches [ , , , , , , , , , , ]. Evidence suggests recovery rates of up to 85% in laser-treated groups compared to 70–75% in control groups . Multiple studies reported significant improvements in two-point discrimination [ , , ], tactile sensitivity , pain response , and mechanical sensitivity . Recovery patterns varied by anatomical location, with the lips and teeth demonstrating better recovery outcomes compared to the chin region . Complete resolution of paresthesia was observed in a laser-treated group within six months post-surgery . Follow-up periods ranged from immediate postoperative assessments to two years . Several factors were identified as influencing treatment outcomes. Early intervention, particularly within 30 days post-surgery, was associated with improved recovery outcomes. Patient age also played a significant role, with younger individuals (14–25 years) exhibiting superior recovery rates. An analysis of treatment frequency indicated that weekly sessions were more effective than bi-weekly treatments . Furthermore, in studies employing a split-mouth design, laser-treated sites demonstrated faster recovery compared to untreated sites [ , , ] (see ). 

Ten articles included in the review were predominantly of high quality, with scores of 5/6 [ , , , ] or 6/6 [ , , , , , ]. However, three studies [ , , ] were categorized as low quality. Additionally, only one study, scoring 4/6 points, was identified as having a moderate risk of bias  (see ). 

Orthognathic surgery encompasses a range of procedures aimed at improving both functional outcomes and facial esthetics. Despite these therapeutic benefits, the procedures carry inherent risks, with neurosensory disturbances being among the most prevalent complications. To mitigate these issues and enhance postoperative recovery, various therapeutic approaches have been explored. Among these, low-level laser therapy (LLLT) has demonstrated promising efficacy in promoting neurosensory recovery. This systematic review evaluated fourteen studies investigating the application of LLLT in post-orthognathic surgery care. The included studies comprised eleven randomized controlled trials [ , , , , , , , , , , ], one retrospective analysis , one case report , and one prospective observational study . Bilateral sagittal split osteotomy (BSSO) was the predominant surgical procedure, featured in seven studies [ , , , , , , ], while sagittal split osteotomy (SSO) was utilized in three. Clinical outcomes indicated recovery rates of up to 85% in laser-treated groups, compared to 70–75% in control groups . Early intervention, particularly within 30 days post-surgery and weekly treatment sessions, were associated with greater efficacy . Studies employing a split-mouth design [ , , ] reported significantly faster recovery in laser-treated sites compared to untreated areas . Follow-up durations ranged from immediate postoperative assessments to two years , with complete resolution of paresthesia observed at six months in one laser-treated cohort . Paresthesia treatment is a common postoperative complication following maxillofacial and orthognathic surgeries, and various studies demonstrated significant success with its ability to promote nerve regeneration and resolving paresthesia [ , , , ]. Alternative therapeutic approaches include acupuncture , electroacupuncture , and pharmacological interventions. Notably, steroid administration has shown potential for neurosensory recovery [ , , ], while combination therapy using uridine triphosphate, cytidine monophosphate, and hydroxocobalamin has also been proposed as a promising option . It should be mentioned that the anatomical regions most commonly affected by paresthesia align with the distribution of the inferior alveolar nerve, as highlighted in several studies [ , , , , , , , , , ]. Other studies, however, examined broader facial areas, including both the upper and lower lips along with the chin , extensive regions spanning from the preauricular area to the mandibular body and paranasal regions , and areas such as the nose, nasal folds, lower lip, and chin . The biological mechanism of photobiomodulation (PBM) underlying its efficacy involves the enhancement of cellular energy production through increased adenosine triphosphate (ATP) synthesis [ , , ] and the mitigation of oxidative stress . Additionally, PBM facilitates tissue repair by augmenting mitochondrial function  and stimulating nitric oxide production . In the context of orthognathic surgery, its clinical benefits include reduced postoperative pain and swelling , accelerated wound healing [ , , ], and improved neurosensory recovery . The effectiveness of PBM is significantly influenced by the careful selection of laser parameters  and the timing of application, with immediate postoperative use producing the most favorable outcomes . Pain is one of the most significant and distressing postoperative complications following orthognathic surgery and, indeed, most surgical procedures. It is such a consistent and inherent aspect of surgical intervention that it is almost not classified as a complication. Low-level laser/light therapy has shown promising results in mitigating acute postoperative pain, achieving reductions of up to 50% within the first two days after surgery while also accelerating recovery. Studies included in this review that assessed pain outcomes [ , , , , , ] consistently reported both short- and long-term improvements in Visual Analog Scale (VAS) scores, aligning with findings from other reviews on the subject . Pain management often relies on pharmacological interventions, with opioid prescriptions being the most common approach. However, while opioids are effective, their use carries the significant risks of dependency, addiction, and abuse, posing a major public health challenge in the United States . Alternative medications have shown varying degrees of success , but all pharmacological treatments are associated with potential side effects . Among these alternatives, melatonin has demonstrated promise, showing similar reductions in oxidative stress to those observed with photobiomodulation . Preemptive analgesia is another effective strategy for managing pain and reducing the need for painkillers; however, it remains more invasive compared to the significantly less invasive and highly effective LLLT . Furthermore, patients undergoing LLLT report higher satisfaction , attributed to reduced pain perception, which correlates with improved physical health and quality of life following major surgeries. Neurosensory disturbance following orthognathic surgery is primarily characterized by changes in, or a complete loss of, sensitivity in areas supplied by branches of the trigeminal nerve, most commonly the inferior alveolar nerve after bilateral sagittal split osteotomy (BSSO) . Preoperative factors and surgical technique employed significantly influence postoperative neural outcomes, with piezosurgery demonstrating superior results . Numerous treatment protocols have been proposed to enhance sensory recovery in affected areas, though complete recovery remains uncertain. Combined studies reviewed here indicate that low-level laser/light therapy (LLLT) consistently accelerates improvements in sensory recovery, including heat/cold perception, pain stimulus response, and reductions in neurosensory disturbances, compared to control groups. Notably, the study by F. de Oliveira et al.  was an exception, showing no significant differences. However, in cases of severe nerve damage, no significant improvement was observed . These findings align with previous reviews of LLLT in neurosensory disturbances, such as the one conducted by Firoozi P. et al. . A study by Navarro-Fernández G. et al. , which compared various therapeutic modalities, found moderate evidence supporting the efficacy of laser and LED therapy in sensitivity rehabilitation, while halotherapy showed no benefit . The most recent study by Pourdanesh F. et al.  highlighted the effectiveness of transcutaneous electrical nerve stimulation, corroborating the findings of F. de Oliveira et al. . Pharmacological interventions following surgery show mixed results. Positive outcomes have been reported with melatonin, which aids sensitivity recovery . Steroids demonstrated neutral effects on sensitivity but contributed to edema reduction [ , , ]. Conversely, combination therapy using uridine triphosphate (UTP), cytidine monophosphate (CMP), and hydroxocobalamin (vitamin B12) showed no significant improvement in neurosensory recovery . More direct interventions, such as stellate ganglion blockade , have demonstrated effectiveness. However, less invasive approaches like Xenon light irradiation and other photobiomodulation therapies reviewed here are advantageous, being easier to perform, better tolerated by patients, and associated with fewer risks. Although many studies were included in this review, certain limitations were identified. The scope was restricted to articles published in English, and not all available databases were comprehensively searched, potentially leading to selection bias. Additionally, only 50% of the included studies were classified as high-quality, while nearly 30% were considered low-quality. There is a clear need for further clinical trials with more standardized and precise treatment protocols. These should account for consistent laser parameters—such as wavelength, dosage, and power—and uniform time spans for irradiation across the pre-, intra-, and postoperative periods. Future studies should also adopt standardized assessments for neurosensory disorder testing, enabling consistent comparisons and facilitating advancements in the field. While some studies included overlapping assessments, none encompassed all the relevant tests comprehensively. Moreover, the diversity in the types of surgeries performed and the anatomical regions targeted adds complexity to the analysis. The inferior alveolar nerve was the most frequently addressed nerve in the studies, but the application sites varied significantly. Considering these limitations, further research is essential to develop a precise and standardized laser/light therapy protocol for treating neurosensory disturbances in orthognathic surgery patients. Such efforts are crucial for maximizing the therapeutic potential of this promising modality. Moreover, the considerable heterogeneity among the included studies precludes the possibility of conducting a meta-analysis. To obtain more precise results and facilitate a meta-analysis, additional studies with greater homogeneity in terms of laser types and their parameters are needed. 

Based on the reviewed literature, low-level laser therapy (LLLT) is a safe and effective modality for enhancing neurosensory recovery following orthognathic surgery, particularly when initiated early and administered consistently. While outcomes may vary depending on individual factors and specific treatment protocols, 13 out of 14 reviewed studies indicate that LLLT promotes the restoration of sensory function, especially when infrared wavelengths are employed with regular treatment sessions. However, the lack of standardized protocols and the limited number of large, controlled trials highlight the need for further research to establish an optimal treatment regimen. 

