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Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis

Objective: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. Background: Clinical ph...

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Autores principales: Cronshaw, Mark, Parker, Steven, Anagnostaki, Eugenia, Mylona, Valina, Lynch, Edward, Grootveld, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711492/
https://www.ncbi.nlm.nih.gov/pubmed/33036145
http://dx.doi.org/10.3390/dj8040114
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author Cronshaw, Mark
Parker, Steven
Anagnostaki, Eugenia
Mylona, Valina
Lynch, Edward
Grootveld, Martin
author_facet Cronshaw, Mark
Parker, Steven
Anagnostaki, Eugenia
Mylona, Valina
Lynch, Edward
Grootveld, Martin
author_sort Cronshaw, Mark
collection PubMed
description Objective: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. Background: Clinical photobiomodulation (PBM) therapy has achieved a high level of evidence-based acceptance in the mitigation of oral mucositis associated with cancer radiotherapy and chemotherapy, and supportive clinical research in relation to orthodontic tooth movement, oral medical conditions, including burning mouth syndrome, xerostomia and lichen planus. Inconsistent outcomes have been reported not withstanding a substantial body of primary supportive research from clinical, in vitro and animal studies. Materials and Methods: PubMed, Cochrane Database of Reviews and Google Scholar search engines were applied to identify human clinical trials of PBM therapy in clinical dentistry. A total of 766 articles between February 2009 and June 2020 were identified and following a full text evaluation, 38 papers with sufficient data to permit analyses are included in this investigation. Results: Following a detailed assessment of potential factors that may have an influence in clinical outcome, a clear trend is apparent associating optical spot size to a positive or negative effect. Furthermore, there is a clear difference in the reported results in relation to total energy applied, delivery techniques and optical parameters, which merits further investigation. Factorial statistical analyses identified an association between smaller optical surface applications and an overall lower level of reported clinical success in treating superficial and deeper targets, and correspondingly sub-surface larger target tissues were found to be more responsive to therapy by use of a larger optical surface spot size. Moreover, use of multiple small diameter probe applications was found to provide inconsistent results. Conclusions: Many factors can confound clinical success including variations in anatomy, site location, clinical condition and subject individuality. To achieve higher levels of predictable outcome, a mature appreciation of these factors, plus an expanded understanding of laser parametry, tissue volume and target depth to deliver an adequate dose within current recommended guidelines, is essential.
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spelling pubmed-77114922020-12-04 Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis Cronshaw, Mark Parker, Steven Anagnostaki, Eugenia Mylona, Valina Lynch, Edward Grootveld, Martin Dent J (Basel) Review Objective: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. Background: Clinical photobiomodulation (PBM) therapy has achieved a high level of evidence-based acceptance in the mitigation of oral mucositis associated with cancer radiotherapy and chemotherapy, and supportive clinical research in relation to orthodontic tooth movement, oral medical conditions, including burning mouth syndrome, xerostomia and lichen planus. Inconsistent outcomes have been reported not withstanding a substantial body of primary supportive research from clinical, in vitro and animal studies. Materials and Methods: PubMed, Cochrane Database of Reviews and Google Scholar search engines were applied to identify human clinical trials of PBM therapy in clinical dentistry. A total of 766 articles between February 2009 and June 2020 were identified and following a full text evaluation, 38 papers with sufficient data to permit analyses are included in this investigation. Results: Following a detailed assessment of potential factors that may have an influence in clinical outcome, a clear trend is apparent associating optical spot size to a positive or negative effect. Furthermore, there is a clear difference in the reported results in relation to total energy applied, delivery techniques and optical parameters, which merits further investigation. Factorial statistical analyses identified an association between smaller optical surface applications and an overall lower level of reported clinical success in treating superficial and deeper targets, and correspondingly sub-surface larger target tissues were found to be more responsive to therapy by use of a larger optical surface spot size. Moreover, use of multiple small diameter probe applications was found to provide inconsistent results. Conclusions: Many factors can confound clinical success including variations in anatomy, site location, clinical condition and subject individuality. To achieve higher levels of predictable outcome, a mature appreciation of these factors, plus an expanded understanding of laser parametry, tissue volume and target depth to deliver an adequate dose within current recommended guidelines, is essential. MDPI 2020-10-06 /pmc/articles/PMC7711492/ /pubmed/33036145 http://dx.doi.org/10.3390/dj8040114 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Cronshaw, Mark
Parker, Steven
Anagnostaki, Eugenia
Mylona, Valina
Lynch, Edward
Grootveld, Martin
Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis
title Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis
title_full Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis
title_fullStr Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis
title_full_unstemmed Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis
title_short Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis
title_sort photobiomodulation dose parameters in dentistry: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711492/
https://www.ncbi.nlm.nih.gov/pubmed/33036145
http://dx.doi.org/10.3390/dj8040114
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