Dynamic electrical nerve stimulation as part of rehabilitation in patients with maxillomandibular size and position abnormalities

Orthognathic surgery is an invasive procedure accompanied by: impaired sensitivity of the n. alveolaris inferior, severe edema, limited mouth opening and pain. Therefore, an important element of treatment is rehabilitation of patients at the postoperative stage. The goal is to develop and justify the use of the dynamic electrical nerve stimulation (DENS) method to improve the efficiency of rehabilitation of patients after orthognathic surgeries. Materials and methods. The study involved 58 patients with skeletal class II (group II) and class III (group III) malocclusions according to Angle’s classification, who were treated at the clinic. During the study, 2 patients were excluded. Patients of the studied subgroups IIA (n=11) and IIIA (n=16) underwent DENS therapy. Patients of the control subgroups IIB (n=13) and IIIB (n=16) underwent standard postoperative rehabilitation. The effectiveness of DENS was assessed by measuring maximal mouth opening and pain intensity using VAS. Results. After 1 month, maximal mouth opening was significantly greater in group IIA compared with group IIB (14.9 mm vs. 10.0 mm, p<0.05). Similarly, group IIIA showed greater improvement compared with group IIIB (18.3 mm vs. 13.1 mm, p<0.05). Three months after the operation, patients of group IIA retained a statistically significant greater mouth opening (40.2 versus 36.8 mm; p<0.05). According to the results of pain assessment, patients in subgroups A showed statistically significantly better indicators than patients of the control subgroups B: on the 3rd day after surgery IIA group — 4.3 points, IIB — 5.9 points, IIIA group — 4.8 points, IIIB — 6.2 points; a week after surgery IIA group — 2.4 points, IIB — 3.9 points, IIIA group — 2.1 points, IIIB — 2.9 points; 1 month after surgery IIA group — 1.4 points, IIB — 2.3 points, IIIA group — 1.4 points, IIIB — 2.4 points (p<0.05). Conclusion. Dynamic electrical stimulation has a positive effect on the recovery process of patients after orthognathic surgeries: it reduces the level of pain on the visual analogue scale and promotes faster recovery of the maximum mouth opening. Further research is needed to formulate recommendations and optimize the use of DENS in patients after orthognathic surgery.