Photobiomodulation in Oral Surgery: A Review

Objective: This article presents a review of current data on the applications of photobiomodulation (PBM) in the field of oral and maxillofacial surgery (OMFS), to guide future research. Background data: Photobiomodulation therapy (PBMT) has been reported to be effective for various postoperative conditions, including pain relief, improvement of mastication, neurosensory recovery, and wound healing. There is a need for identifying the therapeutic irradiation windows for these conditions, based upon the available literature. Materials and methods: All original articles related to PBM for oral surgery in MEDLINE (NCBI PubMed and PMC), EMBASE, Scopus, Cochrane library, Web of Science, and Google Scholar were reviewed until December 2018. Results: Forty-six clinical trials were included in this study. These trials were categorized into three different types of PBM applications. After reviewing all these studies, the most effective physical properties for PBM pain reduction after tooth extraction were as follows: wavelength 650-980 nm; power 4-300 mW; and energy density 3-85.7 J/cm2. PBMT at 660-910 nm with 4-500 mW power and 2-480 J/cm2 energy density was effective for decreasing facial swelling. At the same wavelength and power range with 4-106 J/cm2 energy density, PBM was effective for alleviating trismus after tooth extraction. Conclusions: Most papers suggested that PBM seemed to be effective in reducing pain, swelling, and trismus after third molar tooth extraction, neurosensory and nerve recovery after mandibular ramus osteotomy. The heterogeneity of the standardization regarding the parameters of laser calls for caution in interpretation of these results. However, this evidence-based review regarding the best protocols for OMFS applications can be beneficial for both future research and clinical applications.