The Effect of Charcoal-Based Dentifrice and Conventional Whitening Toothpaste on the Color Stability and Surface Roughness of Composite Resin: A Systematic Review of In Vitro Studies.

The objective was to systematically review studies that evaluated the effect of charcoal-based dentifrices (CbDs) and conventional whitening toothpastes (CWTs) on the color stability (CS) and/or surface roughness (SR) of composite resin (CR). The question we focused on was "Do CbD and CWT affect the CS and/or SR of CR?" Indexed databases were searched without language and time restrictions up to and including May 2023 using different keywords. Original experimental studies were included. The risk of bias (RoB) was assessed using the Quality Assessment Tool for In Vitro Studies. Ten in vitro studies performed on CR were included. The number of CR samples assessed ranged between 18 and 200. In one study, CbDs altered the CS and SR of CR, whereas another study showed no difference in changes in the SR and CS of CR when CbDs were compared with CWTs. One study showed that compared with CWTs, CbDs caused changes in the CS of CR but changes in SR were similar between the two dentifrices. One study showed that CbDs and CWTs improved the overall color and enhanced the SR of CR. Three studies had a high RoB, five had a medium RoB, and two had a low RoB. Compared to CWTs, CbDs appeared to affect the CS of CR, but the SR of CR induced by both dentifrices remained consistent. Further well-designed and power-adjusted studies are needed.

Editorial bullying: an exploration of acts impacting publication ethics and related environment.

Bullying and misconduct in the realm of scientific and scholarly publishing have the potential to jeopardize the transparency and integrity of academic discourse. While misconduct issues among authors have been extensively discussed, the role of editors in perpetuating or mitigating such problems has garnered less attention. Scientific publishing serves as the gateway for disseminating innovative research findings globally, and the role of editors, especially Editor/s-in-chief, is pivotal in safeguarding the rigor and credibility of published research. Editor bullying and misconduct involve behaviors that undermine the scientific process, compromise research integrity, and harm the careers and wellbeing of individuals. These actions may manifest as biased decision-making, suppression of dissenting voices, or the exploitation of power dynamics in the peer review process. To address these issues, preventive and therapeutic approaches are suggested, including enhancing awareness, recognizing and mitigating exacerbating factors, and upholding professionalism. Moreover, the importance of a conflict-of-interest declaration for editors is highlighted to ensure transparency and integrity in the editorial process. The present mini-review aims to shed light on editor bullying, illuminating its gravity and the urgency to address these issues within the academic publishing domain/s. This review underscores the more subtle, yet equally significant, issue of professional misconduct in the editorial realm of scientific journals.

Probing the antinociceptive and therapeutic potential of probiotics in managing temporomandibular joint arthritis.

This literature review explored the antinociceptive and therapeutic effects of probiotic therapy (PT) in the treatment of arthritic conditions affecting the temporomandibular joint (TMJ). Indexed databases were searched without time and language restrictions up to and including February 2023, to identify studies addressing the question: "Is PT effective for the management of TMJ arthritis?" The following keywords were used in different combinations with Boolean operators: arthritis, osteoarthritis, pain, probiotic, rheumatoid, temporomandibular disorders, and temporomandibular joint. Original clinical and experimental studies assessing the therapeutic efficacy of PT in the management of osteoarthritis were eligible for inclusion. Letters to the editor, reviews, commentaries, perspectives, and expert opinions were not sought. The structure of the current review was tailored to encapsulate relevant information. A total of 297 relevant studies were identified during the initial literature search, and the full text and reference lists of these studies were scrutinized. To date, the potential role of PT in managing osteoarthritis of the TMJ region remains uninvestigated. No clinical trials in the indexed literature have assessed the efficacy of PT in managing TMJ arthritis; however, this finding does not preclude a potential role of probiotics as antinociceptive and therapeutic agents in susceptible populations.

2023-2024 American Board of Orthodontics practice analysis study: Part 1.

As a specialty board, the American Board of Orthodontics (ABO) serves to protect the public and the orthodontic specialty by certifying orthodontists. The demonstration of commitment to lifelong learning and self-improvement is critical to achieving the highest level of patient care. The ABO completed a practice analysis study in 2023 to ensure all examinations represent current assessments of proficiency in orthodontics at a level of quality that satisfies professional expectations. The practice analysis is essential to providing a demonstrable relationship between the examination content and orthodontic practice and provides a critical foundation for ABO's examination programs.

Influence of psychostimulants on bone mineral density and content among children with attention deficit hyperactivity disorder. A systematic review.

There is a controversy over the influence of psychostimulant medications on bone mineral density (BMD) and bone mineral content (BMC) among children with attention-deficit-hyperactivity-disorder (ADHD). The aim of the present systematic review was to assess the influence of psychostimulant medications on BMD and BMC among children with ADHD. A comprehensive search of electronic databases, including PubMed, Scopus, Embase, and Cochrane Library, was conducted to identify relevant studies published up until July 2023. Clinical studies that addressed the focused question "Do psychostimulant medications affect bone mineral density and content in children with ADHD?" were included. Letters to the Editor, studies on animal-models, ex-vivo and in-vitro studies, commentaries and reviews were excluded. The primary outcome measures were changes in BMD and BMC. Study quality was assessed using the risk of bias for non-randomized studies-exposure tool. Five non-randomized clinical studies were included. The number of participants ranged from 18 to 6489 with mean ages ranging from 7.3 to 13.75 years. The study durations ranged between five and seven years. In all studies osseous evaluation was done using dual-energy X-ray absorptiometry. The bone locations examined included total body, lumbar-spine, femur, femoral-neck, femoral body, and pelvis. Two studies reported that psychostimulant medications reduce BMC and BMD. In one study, bone turnover, serum leptin and fat levels were reduced in children using psychostimulant medications but no unusual reduction recorded among controls. In general, 80 % of the studies concluded that psychostimulant medications compromise BMC and BMD. Power analysis was done in one study. One study had a low RoB and the remaining demonstrated some concerns. Given the methodological concerns observed in the included studies, arriving at a definitive conclusion regarding the effects of psychostimulant medications on BMC, BMD, and bone turnover in children with ADHD is challenging. However, it is important to acknowledge that an association between psychostimulant medications and these bone-related parameters cannot be disregarded.

Antinociceptive Efficacy of Shamanic Healing for the Management of Temporomandibular Disorders: An Evidence-Based Review.

The aim of this evidence-based review was to assess the antinociceptive efficacy of shamanic healing (SH) for management of temporomandibular disorders (TMD). The addressed focused question was "Is SH effective for the management of TMD?" Indexed databases were searched without time and language restrictions up to and including January 2023 using the following keywords: "disc displacement disorders"; "healing"; "inflammation"; "pain"; "shamanic"; "therapy"; "temporomandibular joint"; "temporomandibular disorders" and "temporomandibular joint disorders". Clinical studies were considered eligible for inclusion. Editorials, case-reports, case-series and commentaries were excluded. Literature search was performed in accordance with the guidelines of the preferred reporting items for systematic review and meta-analysis. Pattern of this evidence-based review was customized to summarize the pertinent information. In the present review, three studies were included and processed for data extraction. All participants were females with a mean age of 38.3 ± 8.3 years (range 25-55 years). Self-rated pain was assessed before application of SH (baseline) and after 9 months of follow-up. In one study, SH significantly reduced self-rated TMD pain scores (P < 0.001) at 9-months' follow-up interview. In all studies patients reported that management of TMD via SH helped improve their quality of life. In one study patients perceived improvements in sleep, energy levels, digestion, and back pain at follow-up. In another study patients reported that they felt "calmer" and "at peace" at follow-up interview. The possible contribution of SH for managing pain among TMD patients warrants additional research. There is a dire need for well-designed and power-adjusted randomized clinical trials with adequate groups and long-term follow-up.

"Testosterone decreases temporomandibular joint nociception"- A systematic review of studies on animal models.

OBJECTIVE: The aim of the present systematic review was to assess the effect of testosterone on temporomandibular joint (TMJ) nociception. DESIGN: A systematic review of pertinent indexed literature was performed. The focused question addressed was "Is there a connection between testosterone and TMJ nociception?" Original studies were included. In-vitro and ex-vivo studies, case-reports/series, letters to the Editor and commentaries were not sought. Indexed databases were searched without time and language restrictions up to and including September 2021 using different free text key words: testosterone OR "male sex hormones" OR "gonadal hormones" AND "temporomandibular joint" OR "temporomandibular dysfunction" AND nociception AND males. The literature search was performed in accordance with the preferred reporting outcomes of systematic reviews and meta-analysis guidelines. The risk of bias (RoB) was assessed using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) tool. RESULTS: Out of the 406 studies identified, seven studies on animal-models were included. All studies were performed in rats with age and weight ranging between 21 and 90 days and 200-300 g, respectively. Testosterone was administered in concentrations ranging between 1 and 10 mg/Kg. Results from all studies showed that testosterone administration in gonadectomized male rats reduces induced TMJ nociception. The RoB was high in 3 and unclear in 4 studies. CONCLUSION: Testosterone offers protection against TMJ nociception in male rats; however, from a clinical perspective, potential contribution of testosterone therapy towards the management of TMD remains indeterminate.

Potential adjunct therapies for the management of temporomandibular disorders: An evidence-based review.

OBJECTIVE: The aim was to review the role of adjuvant therapies that may potentially contribute toward the management of temporomandibular disorders (TMD). METHODS: The addressed focused question was, "Are there any adjuvant therapies that may contribute toward the management of TMD?". Indexed databases were searched up to June 2021. The eligibility criteria were the following: (a) original clinical studies and (b) randomized controlled clinical trials (RCTs). RESULTS: Adjuvant therapies were comprised of acupuncture, manual therapy, jaw exercises, dietary modifications, botulinum toxin therapy, and photobiomodulation. Short-term follow-up results from each of these RCTs showed beneficial effects in terms of pain reduction and improvements in jaw movement among patients with TMD. There are no long-term follow-up results in this regard. CONCLUSION: The most effective adjunct treatment for managing TMD remains unknown, primarily due to a lack of sufficient scientific evidence.

Efficacy of herbal- versus chlorhexidine-based mouthwashes towards oral hygiene maintenance in patients undergoing fixed orthodontic therapy: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: The review aims to fill the gap in literature by comparing the efficacy of herbal and chlorhexidine-based mouthwashes towards oral hygiene maintenance (OHM) in patients undergoing fixed orthodontic treatment (OT). METHODS: Indexed databases were searched electronically to include randomized controlled trials (RCTs) for data gathering. The protocol was registered in PROSPERO (CRD42020182497). Risk of bias assessment, quality of evidence investigation and meta-analysis were performed to evaluate reported OHM-related parameters at time points before and after the use of chlorhexidine (control group) and herbal mouthwashes (intervention group). With 95% confidence intervals, mean difference (MD) or standardized mean difference (SMD) was used to estimate effect size. RESULTS: Out of eight RCTs, results from one RCT favoured chlorhexidine and the results from a second RCT favoured herbal mouthwashes. Results from three RCTs showed comparable effects for the respective investigated OHM-related parameters. Chlorhexidine demonstrated higher antimicrobial efficacy against Streptococcus mutans (S. mutans) in two studies, and one RCT found comparable antimicrobial efficacies. Risk of bias was low in two studies, and moderate and high in two studies each. Quality of evidence was very low to moderate for the respective investigated parameters. Sub-group analysis for parameters colony forming units (CFU) {SMD (0.40) [95% CI (-0.22, 1.03)], gingival index (GI) {MD (0.06) [95% CI (-0.08, 0.20)]}, plaque index (PI) {SMD 0.22 [95% CI (-0.23, 0.67)]} before the use of chlorhexidine and herbal mouthwashes remained inconclusive. CONCLUSION: The comparison between efficacy of herbal and chlorhexidine towards OHM in patients undergoing fixed OT remains debatable.

Role of Essential Oil-Based Mouthwashes in Controlling Gingivitis in Patients Undergoing Fixed Orthodontic Treatment. A Review of Clinical Trials.

Essential oil (EO)-based mouthwashes have been used for oral health maintenance due to their antimicrobial and anti-inflammatory properties. The aim was to review clinical trials that assessed the role of EO-based mouthwashes in controlling gingivitis in patients undergoing fixed orthodontic treatment (OT). The Patients, Interventions, Control and Outcome (PICO) format was based on the following: (a) P: Patients undergoing fixed OT (b) Intervention: EO-based mouth-wash; Control: Mouthwashes that did not contain EOs or no mouthwash (d) Outcome: Control of gingivitis measured by clinical indices. Databases were searched manually and electronically up to and including May 2021 using different medical subject subheadings. Data screening and extraction were performed. The risk of bias within randomized controlled trials was assessed using the revised Cochrane Collaboration's risk of bias tool (RoB 2). The Risk of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool was used for non-randomized controlled trials. Disagreements related to literature search and RoB evaluations were resolved via discussion. Six clinical studies were included. Four studies showed that Listerine® is effective in controlling gingivitis in patients undergoing fixed OT. One study reported that the use of 5% Fructus mume mouthwash resulted in a significant reduction in gingival bleeding. Two mouthwashes that contained 1% Matricaria chamomilla L. and 0.5% Zingiber officinale were also found to be efficient in controlling gingival bleeding. Four, one and one studies had a low, moderate and high RoB, respectively. In conclusion, EO-based mouthwashes seem to be effective for the management of gingivitis among patients undergoing fixed OT. Further well-designed and power-adjusted clinical trials are needed.

Cone beam computed tomographic evaluation of the changes in condylar position in growing patients with unilateral posterior crossbite undergoing rapid maxillary expansion followed by fixed orthodontic therapy.

PURPOSE: This study aimed at assessing changes in condylar position (CP) in growing patients with unilateral posterior crossbite (UPC) undergoing rapid maxillary expansion (RME) followed by fixed orthodontic treatment (FOT) (experimental-group); and growing patients without posterior crossbite (PC) treated with FOT alone (control-group). METHODS: Cone beam computed tomography (CBCT) images were obtained before treatment (T0), 6 months after RME (T1) and after FOT (T2) for the experimental-group (n = 19); and at T0 and T2 for the control-group (n = 22). Condylar position-related measurements including the anterior joint space (AJS), superior joint space (SJS), posterior joint space (PJS), lateral position of condyle (LC) and condylar angle (CA) were measured. Non-parametric tests were used. RESULTS: On the crossbite side, significant increases were found in LC (P = 0.039) and CA (P = 0.007), and on the non-crossbite side significant increases were observed in SJS (P = 0.027) and LC (P = 0.001) between T0, T1 and T2 in patients with UPC. On the right and left sides in the control-group, significant increases were identified in LC (P < 0.001 and P = 0.012, respectively) between T0 and T2. CONCLUSIONS: In growing patients with UPC, RME followed by FOT is associated with significant changes in CP-related measurements.

An evidence-based review of the scope and potential ethical concerns of teleorthodontics.

PURPOSE: The aim was to evaluate the scope and potential ethical concerns related to the use of teledentistry in clinical orthodontics. METHODS: Indexed databases were searched up to and including October 2020. The eligibility criteria were as follows: (a) original clinical studies, and (b) case reports/series. Historic reviews, commentaries, experimental studies, and letters to the editor, were excluded. The pattern of the present review was customized to summarize the relevant information. RESULTS: A total of 4 clinical studies (out of 1016) were included in the present evidence-based review. Three studies reported that teledentistry is useful in clinical orthodontics. In 1 study, a clear conclusion could not be derived regarding the benefits of teledentistry in clinical orthodontics. Two out of 4 studies did not obtain prior approval from an Institutional Review Board or Ethical Committee. Three studies did not report any measures that were undertaken to safeguard the electronic transfer of patient-related health information. CONCLUSIONS: Teleorthodontics facilitates treatment planning/monitoring by sharing orthodontics-based patient records among oral healthcare providers; however, the importance of direct patient supervision and routine follow-ups during orthodontic therapy cannot be overlooked. Further studies are needed to establish ethical guidelines and a standard of care in this emerging field.

A retrospective comparison of dental and skeletal ages between African American, Caucasian, and Hispanic subjects.

OBJECTIVE: To compare dental and skeletal ages among African American (AA), Caucasian (C) and Hispanic (H) subjects (chronological ages 9 to 15-years). MATERIAL AND METHODS: A total of 168 subjects (9 to 15 years old) were equally divided into AA, C, and H groups, with an equal number of males and females. Each group was divided equally into 7 chronological age-groups, ranging from 9 to 15 years. Dental age was determined from panoramic radiographs as primary, early mixed, late mixed, or permanent dentition (scored as 1-4). Skeletal age was calculated from hand-wrist radiographs using Fishman's Skeletal Maturation Index (SMI 1-11). One-way analysis of variance and Tukey's test were used to compare skeletal and dental ages among AA, C and H subjects; and AA, C and H subjects in each chronological age-group. The two-sample t-test was used to compare SMI and dental age among females and males. RESULTS: Skeletal and dental age were not significantly different between AA, C and H subjects. Mean SMI was higher in females than males; and there were no significant gender differences regarding dental age. Mean SMI and dental age were significantly different among AA, C and H subjects in the 12-year-old and 11-year-old age groups, respectively. CONCLUSIONS: Dental and skeletal maturation are fairly similar among AA, C and H subjects (aged 9 to 15 years).

Role of Probiotics in Oral Health Maintenance Among Patients Undergoing Fixed Orthodontic Therapy: a Systematic Review of Randomized Controlled Clinical Trials.

The aim was to assess the role of probiotics in oral health maintenance among patients undergoing fixed orthodontic therapy (OT). An unrestricted search of indexed databases was performed until April 2020 using the following Mesh-terms: (1) probiotic and (2) orthodontic. Randomized controlled clinical trials (RCTs) evaluating the influence of probiotic therapy (PT) towards oral health maintenance/improvement in patients undergoing fixed OT were included. Data screening, selection, and extraction were performed; and the risk of bias was assessed using the Cochrane Collaboration's tool. All evaluations were performed by 2 independent researchers; and disagreements were resolved via discussion. Nine RCTs were included. Eight studies reported that PT improves oral health in patients undergoing fixed OT. Seven studies showed that PT reduces the counts of oral pathogenic bacteria in the oral biofilm and/or saliva. One study reported that PT reduces halitosis in patients undergoing fixed OT. One study found that PT reduces the scores of plaque index (PI) and gingival index (GI); and one study reported that PT has no significant influence on PI and GI in patients undergoing fixed OT. One study reported that PT does not prevent the formation of white spot lesions during fixed OT. Three and 6 studies had a moderate and low risk of bias, respectively. A power analysis was performed in 4 studies. In conclusion, probiotics exhibit antimicrobial activity against oral pathogenic bacteria; however, due to the limitations of the studies assessed, further well-designed RCTs are needed.

Influence of increased body mass index on orthodontic tooth movement and related parameters in children and adolescents: A systematic review of longitudinal controlled clinical studies.

OBJECTIVES: To assess the impact of increased body mass index (BMI) on orthodontic tooth movement (OTM) and related parameters in children and adolescents. SEARCH SOURCES: A search of six electronic databases and manual searching were performed up to June 2019 without language and time restrictions. DATA SELECTION: Eligibility criteria were as follows: (1) longitudinal controlled clinical studies; (2) children and adolescents undergoing orthodontic therapy (OT); (3) no systemic diseases; (4) experimental group: patients with increased BMI; and (5) control group: patients with normal BMI. DATA EXTRACTION: Screening, study selection and data extraction were performed; bias within studies was assessed using the Risk of Bias In Non-randomised Studies (ROBINS-I) tool. RESULTS: Seven studies were included. One study showed that an increased BMI is associated with less wear-time of removable orthodontic appliances and one study found no significant association. One study showed that an increased BMI is associated with less cooperation during OT; however, not with the treatment results. One study reported higher pain experience during OT in adolescents with than without increased BMI. Two studies showed that increased BMI in adolescents is related to OTM, one with increased and one with decreased rates of OTM, respectively. One study reported an association between increased BMI and incidence of white spot lesions and gingivitis during OT. The ROBINS-I tool showed low to moderate risk of bias within studies. CONCLUSIONS: The influence of BMI on OTM and related parameters in children and adolescents remains debatable.

Overbite depth indicator and anteroposterior dysplasia indicator cephalometric norms for African Americans.

OBJECTIVES: To examine normal Overbite Depth Indicator (ODI) and Anteroposterior Dysplasia Indicator (APDI) values in African Americans and to compare them with mean values from white patients. Secondary aims were to compare mean ODI and APDI values among different age, gender, and combined age-gender groups in African American patients. MATERIALS AND METHODS: Lateral cephalometric radiographs of 160 African American patients (97 boys and 63 girls; age, 7 to 14 years) with normal occlusion and no history of orthodontic treatment were collected from the Bolton-Brush Growth Center. Cephalometric images were hand traced, and ODI and APDI values were assessed. Two-sample t tests were used to compare mean ODI and APDI values between African American and white patients; and between male and female African American patients. One-way analysis of variance, followed by the Tukey test, was used to compare mean ODI and APDI values among different African American age and combined age-gender groups. RESULTS: Mean ODI and APDI values were significantly lower (P < .0001) in African American than white patients with normal occlusion and no history of orthodontic treatment. Mean ODI and APDI values increased with age in African American patients, and there were no significant gender differences. CONCLUSIONS: The mean ODI and APDI values in 7- to 14-year-old African Americans with normal occlusion and no history of orthodontic treatment were 70.9° and 78.1°, respectively, and were significantly lower than the mean values for white patients in the same age range.

Orthodontic Treatment in a Patient With Kniest Dysplasia: A Case Study and Review of Literature.

Kniest dysplasia is a rare autosomal dominant chondrodysplasia that is characterized by distinct musculoskeletal and craniofacial irregularities. These craniofacial abnormalities include cleft palate, midface anomalies, tracheomalacia, and hearing loss. This article illustrates a case of Kniest dysplasia that presented for orthodontic treatment. The purpose of this literature review is to describe clinical manifestations, radiographic features, histopathological features, genetic mutation, and management of Kniest dysplasia.

Scope of antimicrobial photodynamic therapy in Orthodontics and related research: A review.

BACKGROUND: The aim of the present study was to comprehensively review indexed literature regarding the potential role of antimicrobial photodynamic therapy (aPDT) in Orthodontics. METHODS: Indexed databases were searched up to and including January 2019 using the following key words: (a) antimicrobial photodynamic therapy; (b) antimicrobial photodynamic chemotherapy; (c) orthodontic; and (d) orthodontics. Original (clinical and experimental) studies, case-reports, and case-series were included. Letters to the Editor, commentaries and review articles were excluded. RESULTS: Out of the 29 studies identified in the initial search, 4 studies were processed for data extraction. Three studies were randomized clinical trials performed in humans and 1 study was experimental. Results from 2 studies showed that aPDT is effective in the treatment of gingival inflammation in patients undergoing orthodontic therapy (OT). One study showed that oral decontamination can be successfully performed using aPDT among patients undergoing OT. Results of the experimental study showed that aPDT helps in surface decontamination of orthodontic instruments. CONCLUSION: There is insufficient evidence in indexed literature to justify the potential role of aPDT in OT. Hence, further studies are required in this regard.

Influence of low-level laser therapy on orthodontically-induced inflammatory root resorption. A systematic review.

OBJECTIVE: The aim was to assess the influence of low-level laser therapy (LLLT) on orthodontically-induced inflammatory root resorption (OIIRR). METHODS: A systematic search was conducted in indexed databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The eligibility criteria were as follows: (a) original clinical and animal/experimental studies; (b) prospective studies; (c) intervention: effect of LLLT on OIIRR; (d) control group (OIIRR without LLLT); (e) statistical analysis; and (f) tomographic or histologic assessment of OIIRR. Quality assessment of the experimental and clinical studies was performed following the Animal Research Reporting In-vivo Experiments (ARRIVE) and Consolidated Standards of Reporting Trials (CONSORT) guidelines, respectively. The risk of bias of the included studies was also determined. RESULTS: Nine (7 experimental and 2 clinical) of the initially identified 39 studies were included. One clinical and 2 experimental studies showed that LLLT during orthodontic tooth movement (OTM) significantly reduces OIIRR. One experimental study reported that LLLT during OTM in sockets treated with alloplastic materials significantly reduces OIIRR. One experimental study found that LLLT after OTM significantly repairs OIIRR, whereas one clinical study did not report a significant reparative affect. Three experimental studies showed that LLLT increases OIIRR during OTM, corticotomized-OTM, and OTM into grafted defects, respectively. The minimum, median and highest ARRIVE scores (out of 20) of the included experimental studies were 15, 17 and 19, respectively. The mean CONSORT score of the included clinical studies was 23 (out of 25). CONCLUSIONS: In conclusion, the influence of LLLT on OIIRR remains debatable.