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Background: This systematic review was performed to analyze the therapeutic efficacy of photobiomodulation (PBM) in managing oral mucositis (OM) that appears in this context. Material and Methods: The search strategy of the systematic review was conducted according to PRISMA guidelines. The eligibility criteria according to PICO process has been defined as follows: Population (P): adult patients with head and neck cancer; Intervention (I): PBM; Comparison (C): placebo group; Outcome (O): pain, oral quality of life (QoL), evolution of the grade OM and pain. The set criteria for inclusion were peer-reviewed articles. Results: The following database were searched from November 2021 to February 2022, for clinical trials: Pubmed, Scopus and Cochrane. From 296 records, 10 studies were included involving in the systematic review. Data from 759 patients who received chemoradiotherapy were analyzed. These studies used different classifications for oral mucositis (WHO, NCI, RTOF/EORTC), pain (VAS) and quality of life (EORTC QLQ-C30, UW-QOL (v4), FACT-HN). PBM therapy protocol used five different lasers (GaAlAs, InGaAlP, He-Ne, diode laser, red and near-IR LED probe) with wavelengths ranging from 632,8nm to 850nm. Pain evaluation in was based on the visual analogue scale (VAS) mainly. Prophylactic PBM was effective as it reduced the incidence of grades 3-4 and reduced the overall mean grade of OM during the chemoradiotherapy course compared to the control group. On the other hand, when PBM was used for treatment purposes, it decreased the mean duration of OM compared to the placebo arm. Conclusions: PBM reduced the incidence of more severe grade of OM induced by chemoradiotherapy. Also, PBM therapy reduced the mean duration of severe OM, mean pain scores and subsequently improved QoL. Key words:Oral mucositis, photobiomodulation, low-level laser therapy, chemotherapy, radiotherapy.
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Background: To determine whether photodynamic laser therapy or photothermal laser therapy demonstrates greater improvements in the clinical signs of peri-implant mucositis as an adjuvant to mechanical debridement. Material and Methods: Electronic databases were used to select articles on February 10th, 2022. The clinical outcomes analysed were the plaque index (PI), probing depth (PD) and bleeding of probing index (BoP). The following PICO question was formulated: Among patients with peri-implant mucositis, does photothermal laser therapy (PT) demonstrate greater improvement in clinical inflammatory signs in comparison to antimicrobial photodynamic therapy (aPDT) as an adjuvant to conventional therapy? Results: Seven randomized controlled trials (RCTs) were included in the systematic review. The clinical parameters were compared amongst all studies at baseline and 3-month follow-up appointment. aPDT reduced both PI and PD great than PT. PT showed greater reductions in BoP. Conclusions: Conclusions are difficult to generalize due to the heterogeneity in the methodology of the included studies. However, this systematic review suggests that aPDT alongside mechanical debridement demonstrated greater improvements in the PI and PD. Other factors besides the laser therapy itself may account for these findings. As for BoP index, PT demonstrated greater improvements due to its photo-biomodulating effects. Clinical Relevance: In patients with peri-implant mucositis, the combination of photothermal diode laser therapy and mechanical debridement entails promising results in treating and preventing the progression of the pathology. Key words:Peri-implant mucositis, Photothermal diode laser therapy, Photodynamic diode laser therapy, Bleeding on probing.
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BACKGROUND: The present study systematically reviewed randomized controlled trials (RCT) to investigate the effect of diode laser therapy in the management of peri-implant mucositis. MATERIAL AND METHODS: The electronic databases were searched until January 2020. Outcome measures were bleeding on probing (BOP), plaque index (PI) and probing depth (PD). The addressed PICO question was: Is the diode laser therapy effective reducing the signs of inflammation as an adjunctive element in the non-surgical treatment of peri-implant mucositis?. RESULTS: Eight randomized clinical trials (RCTs) were included in the systematic review for qualitative synthesis and three in the meta-analysis for quantitative synthesis. All studies included in the quantitative synthesis have low risk of bias according to the Cochrane collaborations' tool. Diode laser as coadyuvant therapy significantly reduced plaque index (SMD: -1.24; -0.47/-1.53) but not in bleeding on probing (SMD: -0.84; -0.31/-1.53) or probing pocket depth (SMD: -1.36; -0.28/-1.69). Non-statistically significant reductions in peri-implant bleeding on probing and in probing pocket depth were also observed in the test groups of most studies included in the meta-analysis. CONCLUSIONS: The results should be interpreted cautiously due to the great heterogeneity in the methodology of the studies included in the systematic review. However the meta-analysis suggests that the use of diode lasers, as an adjunct in conventional non-surgical treatment of peri-implant mucositis, is promising in reducing the clinical signs of peri-implant mucositis, especially reducing the perii-implant plaque index. Key words:Peri-implant diseases, peri-implant mucositis, laser therapy, diode laser.
RESUMO
BACKGROUND: The aim of this study is to evaluate the response to the non-surgical treatment of peri-implant mucositis using the diode laser as an adjuvant therapy in patients with implant-supported restorations, in terms of clinical variables, with respect to those patients in whom conventional non-surgical therapy is used. MATERIAL AND METHODS: Randomized controlled clinical trial with simple blind 3 months follow-up. Two groups of patients were established, the non-surgical mechanical debridement of the affected implants was performed in the control group (n = 34) and the diode laser therapy was also performed in the test group (n = 34). The implant was considered the study subject; the variables considered were plaque index, bleeding on probing depth, depth of probing and recession of the peri-implant mucosa. The t-Student test was used to establish the intergroup statistical differences and the analysis of variance (ANOVA) was used to measures intragroup differences over time. RESULTS: In the revaluation at 6 weeks, we observed statistically significant differences (p<0.05) between the variables of plaque index and depth of probing between both groups. The test group obtained an average of 0.248 ± 0.3155 in plaque index and 0.833 ± 0.374mm in the depth of probing compared to the results obtained in the control group that was 0.558 ± 0.526 and 1,137 ± 0.222mm respectively. In the 3-month reevaluation, was also obtained great statistical significance between both groups for bleeding on probing (p<0.001), with values of 0.568 ± 0.282 for the control group and 0.480 ± 0.336 for the test group. CONCLUSIONS: The use of diode laser as an adjunctive therapy to the conventional treatment of peri-implant mucositis showed promising results, being more effective reducing the inflammation of the peri-implant tissue, positioning itself as a valuable tool for the treatment of peri-implant pathologies. Key words:Peri-implant diseases, peri-implant mucositis, laser therapy, diode laser, biostimulation.