Efficacy of photobiomodulation in the treatment of oral mucositis in patients undergoing antineoplastic therapy: systematic review and meta-analysis.

PURPOSE: To evaluate the effectiveness of photobiomodulation in the treatment of oral mucositis. METHODS: Systematic review and meta-analysis encompassing in the electronic databases: LILACS, MEDLINE, EMBASE, COCHRANE, SCOPUS, WEB OF SCIENCE, and CINAHL and in http://clinicaltrials.gov . Eligibility criteria were randomized, non-randomized, and observational studies that used photobiomodulation for the treatment of oral mucositis. The endpoints were reduction in the severity of oral mucositis, duration of lesions, and pain reduction. For data analysis, the Review Manager 5.4 program was used. RESULTS: A total of 316 studies were identified, 297 in the electronic databases and 19 in http://clinicaltrials.gov . After removing duplicates, 260 studies were selected for title and abstract reading, of which 223 were excluded. A total of 37 studies were chosen for full reading, of which 6 were included in the review, totaling 299 patients. The treatment used was photobiomodulation. The patients were divided into two groups: the laser group used only photobiomodulation or associated with other therapies, and the control group did not use photobiomodulation. For the endpoint reduction in the severity of oral mucositis (OM), the chance of reduction of the OM was greater in the laser group as compared to the control group. For the endpoints duration of OM lesions and pain reduction, it was not possible to carry out a meta-analysis due to the high heterogeneity between studies. In the interpretation of the meta-analysis, the reduction in the severity of oral mucositis was greater in the group that received photobiomodulation. CONCLUSION: Photobiomodulation was effective in the treatment of oral mucositis.

Efeito da variação dos parâmetros de potência e energia por pulso na resistência de união à dentina de sistema adesivo irradiado com laser de diodo / Effect of the variation of the parameters of output power and pulse energy on bond strength to dentin irradiated of conventional adhesive system with diode laser

O uso do laser previamente à polimerização de sistemas adesivos aplicados sobre a dentina tem sido proposto para melhorar a resistência de união à dentina. O objetivo foi avaliar o efeito da variação da potência (P) e da energia por pulso (Ep) na resistência de união à dentina de um sistema adesivo convencional irradiado com laser previamente à fotoativação. Duzentos terceiros molares foram distribuídos aleatoriamente em 10 grupos (n=20) sendo um grupo sem irradiação (Controle) e nove grupos irradiados com laser de Diodo (970 nm) (SiroLaser - Sirona Dental Systems - Benshein, Alemanha), de acordo com a potência (P) e energia por pulso (Ep) utilizados: 1 - 0,5W/0,05J; 2 - 0,5W/0,08J; 3 - 0,5W/0,1J; 4 - 0,8W/0,05J; 5 - 0,8W/0,08J; 6 - 0,8W/0,1J; 7 - 1W/0,05J; 8 - 1W/0,08J; 9 - 1W/0,1J. Em todos os grupos fez-se o condicionamento com ácido fosfórico, aplicação do sistema adesivo convencional de dois passos AdperTM Single Bond 2 (3M ESPE, St Paul, MN, EUA) e restauração com resina composta Z250 (3M). Para avaliar a resistência de união foi realizado teste de microtração obtendo-se os valores em MPa. Os resultados foram analisados pelo ANOVA a dois critérios, seguido de Dunnett t (p < 0,001) para comparação entre os grupos. Os grupos irradiados foram avaliados pelo ANOVA a um critério, seguido dos testes de comparações múltiplas Bonferroni e Tamhane. Os valores de resistência de união ± desvio padrão de todos os grupos foram, respectivamente: 0 - Controle (34,60±10,76); 1 - (19,62±8,65); 2 - (27,56±9,20); 3 - (30,34±7,92); 4 - (23,31±5,96); 5 - (20,93±7,46); 6 - (24,67±8,59); 7 - (23,61±7,04); 8 - (25,94±6,82) e 9 - (21,48±3,59). O laser de Diodo influencia na resistência de união entre os grupos irradiados e não irradiado. A potência de 0,5W e energia por pulso de 0,1J influenciam positivamente nos valores de resistência de união quando o sistema adesivo é irradiado previamente a sua fotoativação.(AU)

The use of the laser prior to polymerisation of adhesive systems applied to the dentin has been proposed to improve the bond strength of dentin. The aim of this study was to investigate the effect of the variation of the output power (P) and pulse energy (Ep) on bond strength to dentin irradiated of conventional adhesive system with laser. Two hundred third molars were randomly distributed in 10 groups (n = 20): a group without laser irradiation (group control) and nine groups irradiated with diode laser (970 nm) (SiroLaser Sirona Dental Systems-Benshein, Germany), according to the output power (P) and pulse energy (Ep): 1 - 0,5W/0,05J; 2 - 0,5W/0,08J; 3 - 0,5W/0,1J; 4 - 0,8W/0,05J; 5 - 0,8W/0,08J; 6 - 0,8W/0,1J; 7 - 1W/0,05J; 8 - 1W/0,08J; 9 - 1W/0,1J. It was used in all groups etching with phosphoric acid, application of conventional adhesive system AdperTM Single Bond 2 (3M ESPE, St. Paul, MN, USA) and restoration with composite resin Z250 (3M). Microtensile test was performed obtaining bond strength values in MPa. Results were analyzed by two-ways ANOVA test, followed by Dunnett t (p < 0.001) for comparison between groups. The groups laser irradiated were assessed by one-way ANOVA test and subsequent t test with Bonferroni and Tamhane corrections. Bond strength values ± standard deviation for the groups were, respectively: 0 ­ group control (34.60 ± 10.76); 1 - (19.62 ± 8.65); 2 - (27.56 ± 9.20); 3 - (30.34 ± 7.92); 4 - (23.31 ± 5.96); 5 - (20.93 ± 7.46); 6 - (24.67 ± 8.59); 7 - (7.04 ± 23.61); 8 - (25.94 ± 6.82) and 9 - (3.59 ± 21.48). The Diode laser influences on bond strength between irradiated and without irradiated groups. The output power 0.5W and energy per pulse 0.1J influence positively in the bond strength values when the adhesive system is irradiated prior to their light curing.(AU)