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Laser-Assisted aPDT Protocols in Randomized Controlled Clinical Trials in Dentistry: A Systematic Review

Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis

Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK
School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham B5 7EG, UK
School of Dental Medicine, University of Nevada, Las Vegas, NV 89154, USA
Author to whom correspondence should be addressed.
Dent. J. 2020, 8(4), 114;
Received: 24 July 2020 / Revised: 20 September 2020 / Accepted: 29 September 2020 / Published: 6 October 2020
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
Objective: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. Background: Clinical photobiomodulation (PBM) therapy has achieved a high level of evidence-based acceptance in the mitigation of oral mucositis associated with cancer radiotherapy and chemotherapy, and supportive clinical research in relation to orthodontic tooth movement, oral medical conditions, including burning mouth syndrome, xerostomia and lichen planus. Inconsistent outcomes have been reported not withstanding a substantial body of primary supportive research from clinical, in vitro and animal studies. Materials and Methods: PubMed, Cochrane Database of Reviews and Google Scholar search engines were applied to identify human clinical trials of PBM therapy in clinical dentistry. A total of 766 articles between February 2009 and June 2020 were identified and following a full text evaluation, 38 papers with sufficient data to permit analyses are included in this investigation. Results: Following a detailed assessment of potential factors that may have an influence in clinical outcome, a clear trend is apparent associating optical spot size to a positive or negative effect. Furthermore, there is a clear difference in the reported results in relation to total energy applied, delivery techniques and optical parameters, which merits further investigation. Factorial statistical analyses identified an association between smaller optical surface applications and an overall lower level of reported clinical success in treating superficial and deeper targets, and correspondingly sub-surface larger target tissues were found to be more responsive to therapy by use of a larger optical surface spot size. Moreover, use of multiple small diameter probe applications was found to provide inconsistent results. Conclusions: Many factors can confound clinical success including variations in anatomy, site location, clinical condition and subject individuality. To achieve higher levels of predictable outcome, a mature appreciation of these factors, plus an expanded understanding of laser parametry, tissue volume and target depth to deliver an adequate dose within current recommended guidelines, is essential. View Full-Text
Keywords: diode laser; low-level laser therapy (LLLT); dentistry; photobiomodulation (PBM); systematic review diode laser; low-level laser therapy (LLLT); dentistry; photobiomodulation (PBM); systematic review
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MDPI and ACS Style

Cronshaw, M.; Parker, S.; Anagnostaki, E.; Mylona, V.; Lynch, E.; Grootveld, M. Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis. Dent. J. 2020, 8, 114.

AMA Style

Cronshaw M, Parker S, Anagnostaki E, Mylona V, Lynch E, Grootveld M. Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis. Dentistry Journal. 2020; 8(4):114.

Chicago/Turabian Style

Cronshaw, Mark, Steven Parker, Eugenia Anagnostaki, Valina Mylona, Edward Lynch, and Martin Grootveld. 2020. "Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis" Dentistry Journal 8, no. 4: 114.

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