Student Research Committee, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
BMC Oral Health. 2021 May 13;21(1):258. doi: 10.1186/s12903-021-01611-2.
Photobiomodulation is widely being used to improve the wound healing process in dentistry and a vast majority of studies have proven its benefits. But there are plenty of knowledge gaps according to the optimal laser characteristics which should be used to maximize the healing effects of lasers. The goal of this systematic review and meta-analysis was to determine the effect of photobiomodulation (PBM) as an adjunctive treatment to periodontal therapies to evaluate secondary intention gingival wound healing and post-operative pain.
Five databases (PubMed, Embase, Scopus, ProQuest, and Web of Sciences) were searched up to November 30, 2020, for clinical trials that reported the result of the application of PBM on secondary gingival healing wounds and post-operative pain and discomfort after periodontal surgeries. Two independent reviewers selected the eligible studies and the outcomes of interest were extracted. The quality of eligible studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions.
Ultimately, twelve studies were included in this review. The application of PBM as an adjunct to periodontal surgeries resulted in a significant improvement in wound healing indices. The Landry wound healing index at the 7th post-operative day was significantly improved (SMD = 1.044 [95% CI 0.62-1.46]; p < 0.01) in PBM + surgery groups compared to the control groups. There was also a statistically significant increase in the complete wound epithelialization (RR = 3.23 [95% CI 1.66-6.31]; p < 0.01) at the 14th post-operative day compared to the control groups. The methods used to assess the post-operative pain were heterogeneous, and therefore the results were limited which made the meta-analysis for post-operative pain assessment not possible.
Based on the results of this review, PBM can be effectively used as a method to improve secondary intention wound healing. High-quality randomized clinical trials, however, are needed in the future to identify the optimal PBM irradiation parameters and the effect of PBM on post-operative pain.
光生物调节被广泛用于改善牙科中的伤口愈合过程，绝大多数研究已经证明了其益处。但是，根据应该使用的最佳激光特性，仍然存在很多知识空白，以最大限度地提高激光的愈合效果。本系统评价和荟萃分析的目的是确定光生物调节（PBM）作为牙周治疗的辅助治疗，以评估二次意图牙龈伤口愈合和术后疼痛的效果。
截至 2020 年 11 月 30 日，我们在五个数据库（PubMed、Embase、Scopus、ProQuest 和 Web of Sciences）中搜索了报告 PBM 应用于牙周手术后二次牙龈愈合伤口和术后疼痛和不适结果的临床试验。两名独立审查员选择了合格的研究，并提取了感兴趣的结果。使用 Cochrane 干预系统评价手册评估合格研究的质量。
最终，本综述纳入了 12 项研究。将 PBM 作为牙周手术的辅助手段应用可显著改善伤口愈合指数。与对照组相比，第 7 天术后 Landry 伤口愈合指数显著改善（SMD=1.044 [95%CI 0.62-1.46]；p<0.01）。在第 14 天术后，完全伤口上皮化的比例也有统计学意义的增加（RR=3.23 [95%CI 1.66-6.31]；p<0.01）。评估术后疼痛的方法具有异质性，因此meta 分析结果受到限制，无法对术后疼痛进行评估。
根据本综述的结果，PBM 可以有效地用作改善二次意图伤口愈合的方法。但是，未来需要高质量的随机临床试验来确定最佳的 PBM 辐射参数和 PBM 对术后疼痛的影响。
