Effectiveness of low-intensity laser photobiomodulation in reducing inflammatory events (pain, edema, and trismus) after orthognathic surgery: a systematic review and meta-analysis of randomized clinical trials.

Autor: Passos RM; Academic of Dentistry, Christus University (UNICHRISTUS), João Adolfo Gurgel Street, 133, Cocó, Fortaleza, Ceará, 60190-180, Brazil., Pimentel KF; Postgraduate Program in Dentistry, UNICHRISTUS, João Adolfo Gurgel Street, 133, Cocó, Fortaleza, Ceará, 60190-180, Brazil., de Barros Silva PG; Division of Oral Pathology, UNICHRISTUS, João Adolfo Gurgel Street, 133, Cocó, Fortaleza, Ceará, 60190-180, Brazil. paulo_goberlanio@yahoo.com.br., Sousa FB; Division of Oral Pathology, UNICHRISTUS, João Adolfo Gurgel Street, 133, Cocó, Fortaleza, Ceará, 60190-180, Brazil., Costa FWG; Division of Oral and Maxillofacial Surgery, Postgraduate Program in Dentistry, Federal University of Ceará, Monsenhor Furtado, S/N. Rodolfo Teófilo, Fortaleza, Ceará, 60430-355, Brazil., Cetira Filho EL; Academic of Dentistry, Christus University (UNICHRISTUS), João Adolfo Gurgel Street, 133, Cocó, Fortaleza, Ceará, 60190-180, Brazil.; Division of Oral and Maxillofacial Surgery, Postgraduate Program in Dentistry, Federal University of Ceará, Monsenhor Furtado, S/N. Rodolfo Teófilo, Fortaleza, Ceará, 60430-355, Brazil.
Jazyk: angličtina
Zdroj: Clinical oral investigations [Clin Oral Investig] 2023 Oct; Vol. 27 (10), pp. 5771-5792. Date of Electronic Publication: 2023 Aug 23.
DOI: 10.1007/s00784-023-05222-9
Abstrakt: Objective: This systematic review aimed to answer whether, in (P) individuals undergoing orthognathic surgery, (I) low-level laser therapy (LLLT) during or shortly after the surgical procedure compared to (C) pharmacologic therapy alone or no therapy for improvement of post-intervention complications relieves (O) postoperative inflammatory events in (S) randomized clinical trials.
Material and Methods: A preliminary electronic search was conducted for references with language following a Latin (Roman) alphabet in seven databases index, and gray literature without restriction on language or publication period. Risk of bias was performed by RoB 2.0 tool, and meta-analysis used mean differences (MD) for edema and mouth opening and standardized mean differences (SMD) for pain scores (p < 0.05, Revman®).
Results: A total of 91 control patients and 114 LLLT patients were included. The wavelengths ranged from 660 to 940 nm, and the applied energy density was between 5 and 100 J/cm 2 at mostly extraoral distributed points. LLLT significantly reduced edema (MD =  - 4.27, CI95% - 5.13 to - 3.41 mm) in the period from 5 days to 2 weeks postoperatively (p < 0.001) and showed strongly reduced pain scores (SMD =  - 1.37, I95% =  - 1.99 to - 0.75) between 1 day and 5 weeks (p < 0.001), without significantly interfering with mouth opening (p = 0.110). Despite the low risk of bias, high heterogeneity among studies (I 2  > 70%) and small sample sizes made the certainty of GRADE evidence low.
Conclusion: This SR demonstrated that LLLT effectively controls pain and edema after orthognathic surgery.
Clinical Relevance: Systematic review that summarizes the use of photobiomodulation on orthognathic surgery.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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