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Parker S, Anagnostaki E, Mylona V, Cronshaw M, Lynch E, Grootveld M. Systematic Review of Post-Surgical Laser-Assisted Oral Soft Tissue Outcomes Using Surgical Wavelengths Outside the 650-1350 nm Optical Window. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:591-606. [PMID: 33026973 DOI: 10.1089/photob.2020.4847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To explore via systematic review the validation of uneventful post-surgical healing, associated with shorter and longer laser wavelength applications in minor oral surgery procedures. Methods: From April 28 to May 11, 2020, PubMed, Cochrane Database of Systemic Reviews, and Google Scholar search engines were applied to identify human clinical trials of photobiomodulation (PBM) therapy in clinical dentistry. The searches were carried out with reference to (1) dental laser wavelengths shorter than 650 nm; (2) wavelengths localized within the 2780-2940 nm; and (3) the 9300-10,600 nm range. Selected articles were further assessed by three independent reviewers for strict compliance with PRISMA guidelines and modified Cochrane Risk of Bias to determine eligibility. Results: Using selection filters of randomized clinical trials, moderate/low risk of bias, and the applied period, and following PRISMA guidelines, 25 articles were selected and examined. A risk of bias was completed, where 11 out of 25 publications were classified as low risk of bias, and 14 out of 25 were classified as medium risk status. In total, 6 out of 13 (46% of) studies comparing the examined laser wavelengths with scalpel-based treatment showed positive results, whereas 6 out of 13 (46%) showed no difference, and only 1 out of 13 (7.7%) presented a negative outcome. In addition, 5 out of 6 (83% of) studies comparing the examined laser wavelengths with other diodes (808-980 nm) showed positive results, whereas 1 out of 6 (17%) had negative outcomes. Conclusions: A detailed and blinded examination of published studies has been undertaken, applying strict criteria to demonstrate research outcome data, which suggests positive or at worst neutral comparatives when a given laser wavelength system is used against an alternative control therapy. As such, substantiated evidence for laser surgery in delivering uneventful healing and analgesic effects, as an expression of a PBM-like (quasi-PBM) influence, has been shown.
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Affiliation(s)
- Steven Parker
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Eugenia Anagnostaki
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Valina Mylona
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Mark Cronshaw
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.,School of Dentistry, College of Medical and Dental Sciences, Birmingham University, Birmingham, United Kingdom
| | - Edward Lynch
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.,School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Martin Grootveld
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.,School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
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Gul M, Hameed MH, Nazeer MR, Ghafoor R, Khan FR. Most effective method for the management of physiologic gingival hyperpigmentation: A systematic review and meta-analysis. J Indian Soc Periodontol 2019; 23:203-215. [PMID: 31143000 PMCID: PMC6519100 DOI: 10.4103/jisp.jisp_555_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background and Aim: Gingival hyperpigmentation is an esthetic problem. The aim of the present study was to identify most effective treatment modality for managing generalized physiological gingival pigmentation. Materials and Methods: A systematic review and meta-analysis were done (1919 to October 2018) using PubMed, CINHAL, Dental and Oral Science, and manual searches. Twenty-five articles were finally reviewed. Only human clinical trials were considered with physiological gingival pigmentation treated with different depigmentation methods and compared with surgical stripping. The outcome was the achievement of gingival depigmentation and its recurrence. RevMan software was used for data analysis. Results: Of 26,132 articles, 25 met the inclusion criteria. Seventeen were randomized control trials and 8 were nonrandomized control trials. Most of the studies were on laser. The control group was scalpel surgery. Majority of studies showed no difference in compared treatment modality. A meta-analysis compared laser ablation with surgical stripping revealed a nonsignificance difference regarding recurrence (P = 0.75) and depigmentation (P = 0.23) and a statistically significant difference regarding postoperative pain favoring laser ablation (P ≤ 0.05). Conclusions: Surgical stripping has been the conventional treatment of choice, but our review showed that new techniques are equally effective or even better. Laser especially diode laser was the most frequently used technique and showed better esthetic outcomes, less pain, faster healing, and patients' preference and satisfaction after treatment. However, laser showed more regimentation at 6-month evaluation. More good quality randomized controlled trials with different depigmentation methods are needed to draw strong conclusions.
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Affiliation(s)
- Meisha Gul
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Hasan Hameed
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Rizwan Nazeer
- Department of Operative Dentistry, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Robia Ghafoor
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| | - Farhan Raza Khan
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
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