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Effectiveness of low-intensity laser photobiomodulation in reducing inflammatory events (pain, edema, and trismus) after orthognathic surgery: a systematic review and meta-analysis of randomized clinical trials

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Abstract

Objective

This systematic review aimed to answer whether, in (P) individuals undergoing orthognathic surgery, (I) low-level laser therapy (LLLT) during or shortly after the surgical procedure compared to (C) pharmacologic therapy alone or no therapy for improvement of post-intervention complications relieves (O) postoperative inflammatory events in (S) randomized clinical trials.

Material and methods

A preliminary electronic search was conducted for references with language following a Latin (Roman) alphabet in seven databases index, and gray literature without restriction on language or publication period. Risk of bias was performed by RoB 2.0 tool, and meta-analysis used mean differences (MD) for edema and mouth opening and standardized mean differences (SMD) for pain scores (p < 0.05, Revman®).

Results

A total of 91 control patients and 114 LLLT patients were included. The wavelengths ranged from 660 to 940 nm, and the applied energy density was between 5 and 100 J/cm2 at mostly extraoral distributed points. LLLT significantly reduced edema (MD =  − 4.27, CI95% − 5.13 to − 3.41 mm) in the period from 5 days to 2 weeks postoperatively (p < 0.001) and showed strongly reduced pain scores (SMD =  − 1.37, I95% =  − 1.99 to − 0.75) between 1 day and 5 weeks (p < 0.001), without significantly interfering with mouth opening (p = 0.110). Despite the low risk of bias, high heterogeneity among studies (I2 > 70%) and small sample sizes made the certainty of GRADE evidence low.

Conclusion

This SR demonstrated that LLLT effectively controls pain and edema after orthognathic surgery.

Clinical relevance

Systematic review that summarizes the use of photobiomodulation on orthognathic surgery.

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References

  1. Zamboni R, Moura FRR, Cerveja MC, Rivaldo EG, Braz MA, Grossmann E, Bavaresco CS (2019) Impacts of orthognathic surgery on patient satisfaction, overall quality of life, and oral health-related quality of life: a systematic literature review. Int J Dent 2019:2864216. https://doi.org/10.1155/2019/2864216

  2. Alanko O, Tuimisto MT, Peltomaki T, Tolvanen M, Soukka T, Svedstrom-Oristo AL (2017) A longitudinal study of changes in psychosocial well-being during orthognathic treatment. Int J Cirurgia Bucomaxilofac Oral 46:1380–1386. https://doi.org/10.1016/j.ijom.2017.05.004

    Article  Google Scholar 

  3. Thiem DGE, Shineider D, Hammel M, Saka B, Frerich B, Al-Nawas B, Kammerer PW (2021) Complications or rather side effects? Quantification of patient satisfaction and complications after orthognathic surgery—a retrospective, cross-sectional long-term analysis. Clin Oral Investig 25:3315–3327. https://doi.org/10.1007/s00784-020-03664-z

    Article  PubMed  Google Scholar 

  4. Brignardello‐Petersen R, Carrasco-Labra A, Araya I, Yanine N, Jara LC, Villanueva (2015) Antibiotic prophylaxis for preventing infectious complications in orthognathic surgery. Cochrane Syst Rev 1(1):CD010266. https://doi.org/10.1002/14651858.CD010266.pub2

  5. Olkun HK, Borzabadi-farahani A, Uçkan S (2019) Orthognathic surgery treatment need in a Turkish adult population: a retrospective study. Int J Environ Res Public Health 16:1881. https://doi.org/10.3390/ijerph16111881

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hullihen SP (1849) Case of elongation of the under jaw and distortion of the face and neck, caused by a burn, successfully treated. J Dent Sci 9:157

    Google Scholar 

  7. American Association of Oral and Maxillofacial Surgeons. Cirurgia Corretiva de Mandíbula. http://www.aaoms.org/jaw_surgery.php 2008. [Accessibility verified October 5, 2021]

  8. Bell WH (1975) Le Forte I osteotomy for correction of maxillary deformities. J Oral Surg 33:412–426

    PubMed  Google Scholar 

  9. Trauner R, Obwegeser H (1957) The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty: part I. Surgical procedures to correct mandibular prognathism and reshaping of the chin. Oral Surg Oral Med Oral Pathol 10:677–689. https://doi.org/10.1016/s0030-4220(57)80063-2

    Article  PubMed  Google Scholar 

  10. Dal GP (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg 19:42–47

    Google Scholar 

  11. Hunsuck EH (1968) A modified intraoral sagittal splitting technique for correction of mandibular prognathism. J Oral Surg 25:249–252

    Google Scholar 

  12. Epker BN (1977) Modifications in the sagittal osteotomy of the mandible. J Oral Surg 35:157–159

    PubMed  Google Scholar 

  13. Rana M, Gellrich NC, See CV, Weiskopf C, Gerressen M, Ghassemi A, Modabber A (2013) 3D evaluation of postoperative swelling in treatment of bilateral mandibular fractures using 2 different cooling therapy methods: a randomized observer blind prospective study. J Craniomaxillofac Surg 41:17–23. https://doi.org/10.1016/j.jcms.2012.04.002

    Article  Google Scholar 

  14. Merry AF, Gibbs RD, Edwards J, Ting GS, Frampton C, Davies E, Anderson BJ (2010) Combined acetaminophen and ibuprofen for pain relief after oral surgery in adults: a randomized controlled trial. Br J Anaesth 104:80–88. https://doi.org/10.1093/bja/aep338

    Article  PubMed  PubMed Central  Google Scholar 

  15. Markovic U, Todorovic LJ (2007) Effectiveness of dexamethasone and low-power laser in minimizing oedema after third molar surgery: a clinical trial. Int J Oral Maxillofac Surg 36:226–229. https://doi.org/10.1016/j.ijom.2006.10.006

    Article  PubMed  Google Scholar 

  16. Ozen T, Orhan K, Gorur I, Ozturk A (2006) Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve. Head Face Med 2:1–9. https://doi.org/10.1186/1746-160X-2-3

    Article  Google Scholar 

  17. Oliveira RF, Silva AC, Simões A, Youssef MN, Freitas PM (2015) Laser therapy in the treatment of paresthesia: a retrospective study of 125 clinical cases. Photomed Laser Sug 33:415–423. https://doi.org/10.1089/pho.2015.3888

    Article  Google Scholar 

  18. Lievens PC (1991) The effect of a combined HeNe and IR laser treatment on the regeneration of the lymphatic system during the process of wound healing. Lasers Med Sci 6:193–199

    Article  Google Scholar 

  19. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hrobjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71

  20. Moher D, Shamsser L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1–9. https://doi.org/10.1186/2046-4053-4-1

    Article  PubMed  PubMed Central  Google Scholar 

  21. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 350:g7647. https://doi.org/10.1136/bmj.g7647

  22. Haddaway NR, Collins AM, Coughlin D, Kirk S (2015) The role of Google Scholar in evidence reviews and its applicability to grey literature searching. PLoS One 10:0138237. https://doi.org/10.1371/journal.pone.0138237

    Article  Google Scholar 

  23. Stone PW (2002) Popping the (PICO) question in research and evidence-based practice. Appl Nurs Res 15:197–198. https://doi.org/10.1053/apnr.2002.34181

    Article  PubMed  Google Scholar 

  24. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A (2016) Rayyan-a web and mobile app for systematic reviews. Syst Rev 5:210. https://doi.org/10.1186/s13643-016-0384-4

    Article  PubMed  PubMed Central  Google Scholar 

  25. Drevon D, Fursa SR, Malcolm AL (2017) Intercoder reliability and validity of WebPlotDigitizer in extracting graphed data. Behav Modif 41:323–339. https://doi.org/10.1177/0145445516673998

    Article  PubMed  Google Scholar 

  26. Schünemann H, Brozek J, Guyatt G, Oxman A (2013) GRADE handbook for grading quality of evidence and strength of recommendations. Updated October 2013. The GRADE Working Group. Available from: guidelinedevelopment.org/handbook

  27. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schunemann HJ (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336:924–926. https://doi.org/10.1136/bmj.39489.470347.AD

    Article  PubMed  PubMed Central  Google Scholar 

  28. D’ávila RP, Espinola LV, Freitas PM, Silva AC, Landes C, Luz JGC (2019) Longitudinal evaluation of the effects of low-power laser phototherapy on mandibular movements, pain, and edema after orthognathic surgery. J Craniomaxillofac Surg 47(758):765. https://doi.org/10.1016/j.jcms.2019.01.038

    Article  Google Scholar 

  29. Camacho AD, Velasquez SA, Marulanda NJB, Moreno M (2020) Photobiomodulation as oedema adjuvant in post-orthognathic surgery patients: a randomized clinical trial. Int Orthod 18:69–78. https://doi.org/10.1016/j.ortho.2019.09.004

    Article  Google Scholar 

  30. Sadighi A, Momeni H, Shirani AM (2019) Effect of low-level laser therapy on wound recovery and sequelae after orthognathic surgery: a randomized controlled trial. Dental Hypotheses 10:58. https://doi.org/10.4103/denthyp.denthyp_52_19

    Article  Google Scholar 

  31. De Rezende RA, Silva DN, Frigo L (2018) Effect of GaAlAs low-level laser therapy on mouth opening after orthognathic surgery. Lasers Med Sci 33:1271–1277. https://doi.org/10.1007/s10103-018-2477-x

    Article  PubMed  Google Scholar 

  32. Gasperini G, De Siqueira ICR, Costa LR (2014) Does low-level laser therapy decrease swelling and pain resulting from orthognathic surgery? Int J Oral Maxillofac Surg 43:868–873. https://doi.org/10.1016/j.ijom.2014.02.015

    Article  PubMed  Google Scholar 

  33. Semper-Hogg W, Fuessinger MA, Dirlewanger TW, Cornelius CP, Metzger MC (2017) The influence of dexamethasone on postoperative swelling and neurosensory disturbances after orthognathic surgery: a randomized controlled clinical trial. Head Face Med 13:1–9. https://doi.org/10.1186/s13005-017-0153-1

    Article  Google Scholar 

  34. Enwemeka CS, Parker JC, Dowdy DS, Harkness EE, Sanford LEM, Woodruff LD (2004) The efficacy of low-power lasers in tissue repair and pain control: a meta-analysis study. Photomed Laser Surg 22:323–329. https://doi.org/10.1089/pho.2004.22.323

    Article  PubMed  Google Scholar 

  35. Reddy GK (2004) Photobiological basis and clinical role of low-intensity lasers in biology and medicine. J Clin Laser Med Surg 22:141–150. https://doi.org/10.1089/104454704774076208

    Article  PubMed  Google Scholar 

  36. Bjordal JM, Johnson M, Iversen V, Aimbire F, Lopes-Martins RAB (2006) Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg 24:158–168. https://doi.org/10.1089/pho.2006.24.158

    Article  PubMed  Google Scholar 

  37. Paschoal MAB, Santos-Pinto L (2012) Therapeutic effects of low-level laser therapy after premolar extraction in adolescents: a randomized double-blind clinical trial. Photomed Laser Surg 30:559–564. https://doi.org/10.1089/pho.2012.3243

    Article  PubMed  Google Scholar 

  38. Carroll JD, Milward MR, Cooper PR, Hadis M, Palin WM (2014) Developments in low level light therapy (LLLT) for dentistry. Dent Mater 30:465–475. https://doi.org/10.1016/j.dental.2014.02.006

    Article  PubMed  Google Scholar 

  39. Kahraman SA (2004) Low-level laser therapy in oral and maxillofacial surgery. Oral Maxillofac Surg Clin North Am 16:277–288. https://doi.org/10.1016/j.coms.2004.02.002

    Article  PubMed  Google Scholar 

  40. Vernon LF, Hasbun RJ (2008) Low-level laser therapy for trigeminal neuralgia. Pract Pain Manag 8:1

    Google Scholar 

  41. Kumar MVSRV, Gulivindala D (2014) A case report of Ranula treated with marsupialization and low level laser therapy. Int J Sci Res 705:1–3

    Google Scholar 

  42. Bandari AB, Hajmohammadi S, Mafi S (2022) Therapeutic effect of a low-level laser on acute pain and post-operative mouth opening after closed reduction of mandibular-condylar fracture. J Lasers Med Sci 13:30–30. https://doi.org/10.34172/jlms.2022.30

    Article  Google Scholar 

  43. Baek WY, Byun IH, Yun IS, Kim JY, Roh TS, Lew DH, Kim YS (2017) The effect of light-emitting diode (590/830 nm)− based low-level laser therapy on posttraumatic edema of facial bone fracture patients. J Craniomaxillofac Surg 45:1875–1877. https://doi.org/10.1016/j.jcms.2017.08.027

    Article  PubMed  Google Scholar 

  44. Barbosa LM, Gomes JML, Laureano Filho JR, Vasconcelos BCE, Moraes SLD, Pellizzer EP (2022) Does the use of low-level light therapy postoperatively reduce pain, oedema, and neurosensory disorders following orthognathic surgery? A systematic review. Int J Oral Maxillofac Surg 51:355–365. https://doi.org/10.1016/j.ijom.2021.06.006

    Article  PubMed  Google Scholar 

  45. Paranhos LR, Bittencourt MAV, Martins-Filho PRS (2017) Low-level laser therapy for treatment of neurosensory disorders after orthognathic surgery: a systematic review of randomized clinical trials. Med Oral Patol Oral Cir Bucal 22:780–787. https://doi.org/10.4317/medoral.21968

    Article  PubMed  Google Scholar 

  46. Schünemann HJ (2016) Interpreting GRADE’s levels of certainty or quality of the evidence: GRADE for statisticians, considering review information size or less emphasis on imprecision? J Clin Epidemiol 75:6–15. https://doi.org/10.1016/j.jclinepi.2016.03.018

    Article  PubMed  Google Scholar 

  47. Jenkins PA, Carroll JD (2011) How to report low-level laser therapy (LLLT)/photomedicine dose and beam parameters in clinical and laboratory studies. Photomed Laser Surg 29:785–787. https://doi.org/10.1089/pho.2011.9895

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Academic of Dentistry, Christus University (UNICHRISTUS), João Adolfo Gurgel Street, 133, Cocó, Fortaleza, Ceará, 60190-180, Brazil

    Renan Maia Passos & Edson Luiz Cetira Filho

  2. Postgraduate Program in Dentistry, UNICHRISTUS, João Adolfo Gurgel Street, 133, Cocó, Fortaleza, Ceará, 60190-180, Brazil

    Kamila França Pimentel

  3. Division of Oral Pathology, UNICHRISTUS, João Adolfo Gurgel Street, 133, Cocó, Fortaleza, Ceará, 60190-180, Brazil

    Paulo Goberlânio de Barros Silva & Fabricio Bitu Sousa

  4. Division of Oral and Maxillofacial Surgery, Postgraduate Program in Dentistry, Federal University of Ceará, Monsenhor Furtado, S/N. Rodolfo Teófilo, Fortaleza, Ceará, 60430-355, Brazil

    Fabio Wildson Gurgel Costa & Edson Luiz Cetira Filho

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All authors conducted the study read the articles, interpreted, and analyzed the data. All authors reviewed and approved the final manuscript.

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Correspondence to Paulo Goberlânio de Barros Silva.

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Passos, R.M., Pimentel, K.F., de Barros Silva, P.G. et al. Effectiveness of low-intensity laser photobiomodulation in reducing inflammatory events (pain, edema, and trismus) after orthognathic surgery: a systematic review and meta-analysis of randomized clinical trials. Clin Oral Invest 27, 5771–5792 (2023). https://doi.org/10.1007/s00784-023-05222-9

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