Effectiveness of Photobiomodulation as an Adjunct to Nonsurgical Periodontal Therapy in the Management of Periodontitis‐ A Systematic Review of in vivo Human Studies

Abstract

Photobiomodulation therapy (PBMT) has anti‐inflammatory, analgesic and regenerative properties. This systematic review aimed to critically appraise the published data of in vivo human randomized clinical trials (RCTs), and present a comprehensive overview of the efficacy of PBMT, as an adjunct to the nonsurgical periodontal therapy (NSPT) in the management of periodontitis. The systematic review protocol is registered in the Prospective Register Of Systematic Reviews (PROSPERO) (http://www.crd.york.ac.uk/PROSPERO/; ref CRD 42020169108). With the help of the appropriate key words, structured electronic and manual search strategies were applied to gather the relevant published data on in vivo human RCTs based on this topic. Seventeen papers that met the eligibility criteria were included in this review and subjected to a qualitative assessment. Current evidence lacks adequate information regarding the photobiomodulation (PBM) dosimetry, which is fundamental in establishing a standardized and replicable protocol for future researches. Furthermore, substantial discrepancies in the study methodology and a high risk of bias, arising from the majority of the included papers, abet to the inferior quality of these studies. Ultimately, there is an urgent necessity to conduct further well‐designed RCTs in order to determine the effectiveness of PBMT, if any, by taking into consideration the abovementioned confounding factors.

Macrophages Modulated by Red/NIR Light: Phagocytosis, Cytokines, Mitochondrial Activity, Ca2+ Influx, Membrane Depolarization and Viability

“…Light power density was adjusted to be 0.1 W cm À2 and the light irradiation time was in 1 s -5 min interval (1 min of irradiation is equivalent to a dose of 6 J cm À2 , so the maximum irradiation dose was 30 J cm À2 ). These light power density and doses were chosen because red/NIR light with such parameters was shown to provide positive effects on cells and tissues, while not causing cell phototoxicity (1)(2)(3)(4)(5)(6)(7)(8)(31)(32)(33)(34)(35)(36).…”

“…Low-level light therapy (LLLT), or photobiomodulation (PBM), utilizes low-intensity red and near-infrared (NIR) light from specialized lasers or light-emitting diodes to treat a variety of human conditions (1). Multiple experimental and clinical studies on light treatment with red/NIR irradiation ranging from 600 to 1100 nm showed promising results for muscle recovery (2,3), wound healing (4,5), reduction of inflammation (1,6), pain (7), as well as neurotrauma and neurodegenerative diseases (8,9). In case of PBM, red/NIR light is absorbed by cytochrome c oxidase (CCO), resulting in the activation of mitochondria and the subsequent generation of reactive oxygen species (ROS) through a chain of reactions (10,11).…”

Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)—Three-Month Interim Results

“…The dual-light aPDT promotes not only the antibacterial action to sustain the oral hygiene reached but, potentially, an effect of PBMT, possibly leading to improved wound healing. PBMT is a complex process where the photon energy is absorbed within tissues, mainly in cytochrome-c-oxidase, and leads to induced ATP production, DNA and RNA synthesis, nitric oxide production, and modification of cellular membrane activity [ 28 ]. PBMT has been most prominently used in oral mucositis and has been recognized in the treatment recommendations [ 29 ].…”

A Randomized Trial of Home-Applied Dual-Light Photodynamic Therapy in Stable Chronic Periodontitis -Three-Month Interim Results

“…The dual-light aPDT promotes not only the antibacterial action to sustain the oral hygiene reached but, potentially, an effect of PBMT, possibly leading to improved wound healing. PBMT is a complex process where the photon energy is absorbed within tissues, mainly in cytochrome-c-oxidase, and leads to induced ATP production, DNA and RNA synthesis, nitric oxide production, and modification of cellular membrane activity [26]. PBMT has been most prominently used in oral mucositis and has been recognized in the treatment recommendations [27].…”