Effect of low-level laser therapy in tooth bleaching sensitivity:

Tooth bleaching is a popular cosmetic procedure known for its effective whitening results. However, it may cause tooth sensitivity. Various desensitizing therapies, including laser treatments, are used to alleviate pain and improve patient comfort. This study aims to conduct a systematic review to evaluate the effectiveness of low-level laser therapy for treating tooth sensitivity following bleaching therapy. A comprehensive search was conducted across 13 electronic databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science, Ovid, BMJ evidence-based medicine, proQuest, Greylit.org, Ethos, Livivo, Clinical trials gov, and Meta register of controlled trials) to identify relevant studies according to specific eligibility criteria, following the PRISMA guidelines. Two independent reviewers screened and selected the studies, performed data extraction, and assessed the risk of bias using the revised Cochrane risk-of-bias tool for randomized clinical trials (RCTs). The initial search yielded 2875 articles, which were subsequently screened to remove duplicates. After evaluating 1532 articles based on title and 136 by abstract, 21 studies remained for full-text assessment. Ultimately, only six RCTs met all of the eligibility criteria. The application of low-level laser therapy appears to reduce tooth sensitivity following tooth bleaching. Despite the positive reported effects, further research is necessary to determine the optimal use of low-level laser therapy for effective pain relief.

Consensus Agreement on the Design and Conduct of Clinical Studies with Low-Level Laser Therapy and Light Therapy for Musculoskeletal Pain and Disorders

This study aimed to investigate the effect of low-level laser therapy (LLLT) on tooth sensitivity induced by in-office bleaching. Sixty-six patients enrolled in this randomized clinical trial. Following the in-office procedure with 40% hydrogen peroxide, the participants were randomly divided into three groups. The patients in group 1 received irradiation from a low-level red laser (LLRL; 660 nm, 200 mW, 15 s, 12 J/cm(2)), whereas participants in group 2 were subjected to a low-level infrared laser (LLIL; 810 nm) under similar conditions as in group 1. In group 3 (placebo), the laser treatment was the same as that in groups 1 and 2, but without energy output. The degree of tooth sensitivity was recorded at 1, 24, and 48 h after bleaching using a visual analog scale (VAS). The change in tooth shade was measured 30 days after tooth whitening. The intensity of tooth sensitivity was not significantly different between groups at 1 h after bleaching (p > 0.05). At 24 h after therapy, pain level was significantly lower in the LLIL group compared to the LLRL and placebo groups (p < 0.05). At 48 h after bleaching, VAS scores in the LLIL and LLRL groups were comparable to each other (p > 0.05) and both were significantly lower than that of the placebo group (p < 0.05). There was no significant difference in the efficacy of tooth whitening among groups (p > 0.05). LLLT with an infrared diode laser could be recommended as a suitable strategy to reduce the intensity of tooth sensitivity after in-office bleaching.

The authors aimed to conduct a systematic review to assess data from the current literature on the effectiveness of low-level laser therapy (LLLT) in preventing tooth sensitivity (TS) after tooth whitening (DB). PRISMA guidelines for systematic reviews were followed. Clinical trials evaluating the treatment of LLLT in patients with sensitivity after tooth whitening were selected. A full bibliographic search was performed on May 4, 2021, in the following databases: Embase, MEDLINE via PubMed, SciELO, VHL Regional Portal, Web of Science, Gray Literature, Scopus, ClinicalTrials.gov and Cochrane Library. This study followed Cochrane's recommendations for analyzing risk of bias. A total of 1054 studies were found (255 studies were excluded because they were duplicates and 785 because of titles and abstracts). Only 14 articles were selected for analysis, of which eight were excluded because they had one or more exclusion criteria, resulting in six articles included in this systematic review, the vast majority being classified as low risk of bias. The studies reviewed indicated that LLLT showed promise in preventing TS after TB. However, evidence is limited and more clinical trials with low risk of bias are needed to reach a definitive conclusion on the action of LLLT in pain control after TB.

AIM: The aim of this randomized controlled clinical trial was to clinically evaluate and compare the effect of ozonated water and Low level laser therapy (LLLT) on the early wound healing period of gingivectomy and gingivoplasty wounds by clinical analysis. Materials &amp; Methods: Forty-five patients were randomly allocated into 3 groups, test group 1 (ozone therapy n=15), test group 2 (LLLT application n=14) and control group (no treatment n=15). Ozone irrigation was done on the surgical site with a concentration of 4ppm for 5-10 minutes, LLLT application was performed with diode LASER (810 nm) immediately after the surgical therapy and on day 3, day 7, day 21. Wound surface area, wound healing index, quality of life, plaque index, sulcus bleeding index were investigated. Results: At day 21 statistically significant smaller wounds were observed in both ozone and LLLT groups compared to control group. However, intergroup comparison between the ozone and LLLT group did not show statistically significant difference in wound surface area evaluated by staining technique and image J analysis. The wound healing index, VAS score OHIP -14 questionnaire, analgesics consumed, plaque index, sulcus bleeding index showed a statistically significant reduction from baseline to day 21in all groups. Conclusion: Ozone therapy is safe and effective in promoting wound healing during the 1st 3 weeks post-surgery. Ozone therapy and LLLT application enhanced wound healing after gingivectomy and gingivoplasty procedures, accompanied by better quality of life and reduced pain .

This study compared tooth sensitivity, bleaching efficacy, and the impact on oral health-related quality of life between at-home and in-office tooth bleaching in adults and young individuals. Eighty participants, 40 young people (14-20 years) and 40 adults (40-60 years), were randomly assigned to receive either at-home or in-office bleaching. Tooth sensitivity was assessed using the visual analog scale and numerical rating scale. Color change was evaluated using the VITA Bleachedguide 3D-MASTER and VITA Classical shade guides and digital photographic analysis. Oral health-related quality of life was measured using the OHIP-14 questionnaire. Statistical analyses included two-way and repeated-measures ANOVA, Kruskal-Wallis, and Friedman tests (α = 0.05). Tooth sensitivity increased during treatment but returned to baseline within 7 days post-bleaching. The absolute risk of sensitivity was similar across age groups and techniques. After 1 month, bleaching was more effective in young people than in adults based on photographic assessments; however, this difference was not detected using shade guides. No significant differences were observed in oral health-related quality of life between groups. Tooth sensitivity resolved after treatment in both age groups. Although bleaching efficacy was greater in young people, this did not result in differences in oral health-related quality of life. Tooth bleaching in young people with fully erupted permanent dentition, when performed under professional supervision, appears to be safe and effective. Although young people showed greater bleaching efficacy than adults, tooth sensitivity and short-term quality of life outcomes were similar between age groups and techniques. These findings support the cautious, individualized, and ethically guided use of bleaching in this population.

The aim of this study was to systematically evaluate the effectiveness of low level laser therapy (LLLT) as an adjunct to connective tissue graft (CTG) procedure for the treatment of gingival recession (GR). The addressed PICO question was; "In patients with Miller Class I or II recession defects (Population), what is the effect of LLLT as adjunct to CTG (Intervention) in comparison to CTG alone (Comparison) on gingival recession depth (Outcome)" Electronic databases were searched up to December 2017. Primary outcomes included gingival recession depth (GRD), whereas secondary outcomes were width of keratinized tissue (WKT) and relative clinical attachment level gain (RCAL). The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. Four randomized clinical studies were included. Two studies showed significantly greater improvements with LLLT whereas, 2 studies showed comparable outcomes between LLLT and CTG group. Considering the effects of adjunctive LLLT as compared to CTG, a high degree of heterogeneity for GRD (Q value = 9.40, P = .02, I2 =68.11%) and WKT ((Q value = 16.04, P = .001, I2 =81.31%) was noticed among both the groups. Meta-analysis showed a statistically significant GRD (WMD= -0.61, 95% CI= -1.23 to 0.004, P = .05) for LLLT + CTG treatment versus CTG alone only. LLLT improves clinical and patient-centered outcomes of CTG procedures for the treatment of GR remains debatable. However, due to the small number of included studies and high heterogeneity in the laser parameters, precautions must be exercised when interpreting the results of the present systematic review. Gingival recessions in dentistry are of major esthetic concern. Minimal gingival recessions can be treated by flap operations, but the predictability and stability of the outcomes is debatable. In the present review, low level laser therapy (LLLT) adjunct to connective tissue graft (CTG) depicted a significant improvement in the predictability and stability of root coverage outcomes compared with CTG alone.

Introduction: This systematic review was conducted to evaluate the effectiveness of low-level laser therapy (LLLT) in orthodontic separator pain. Methods: This article was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Electronically and manually 3 databases, namely PubMed, Scopus and Google Scholar, were searched by the keywords that were selected based on population, intervention, comparison and outcome (PICO) on October 10, 2020. Studies were appraised by Cochrane version 5.2.0 with 7 domains and were checked by these inclusion criteria: 1. Randomized clinical trial (RCT) that examined the efficacy of LLLT in separator pain, 2. Split-mouth design, 3. LLLT application in the first hours after separator placement, 4. LLLT application to both sides of the teeth, 5. Patients receiving elastomeric separators between the premolars and molars, 6. Lasers with a wavelength of 800-899 nm, 7. Studies conducted from 2010 to 2020, and 8. Participants who went through orthodontic treatment without limitation in gender, age and social-economic status. Results: 299 studies were screened. 34 full-text papers were read by 2 authors independently. In the end, 4 articles met the inclusion criteria. All 4 articles showed LLLT has a significant impact on pain reduction. Conclusion: The exact protocol for laser therapy is still not clear. Therefore, more studies with a meticulously designed method are needed.

Low-level laser therapy

The objective of our overview of systematic reviews was to critically analyze the evidence from existing systematic reviews investigating the effectiveness and safety of low-level laser therapy (LLLT) in patients with breast cancer–related lymphedema (BCRL). In addition, an updated and comprehensive systematic review was conducted, which aimed to provide updated evidence about this topic. PubMed, EMBASE, and Cochrane Library databases were systematically searched for systematic reviews and randomized controlled trials (RCTs) investigating the effectiveness and safety of LLLT in patients with BCRL. The methodological quality for each of included systematic reviews or RCTs was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR 2) tool or Cochrane risk of bias tool, respectively. The updated systematic review separately compared the effectiveness of LLLT to each of active or negative interventions. Data were pooled with random-effects models for each outcome per comparison. The evidence quality of outcomes was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) or GRADE-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) for quantitative studies and qualitative studies, respectively. Seven systematic reviews and ten RCTs met the eligibility criteria. Conflicting results regarding the effectiveness of LLLT were presented by the overview of systematic reviews. The AMSTAR 2 showed that the methodological quality of included systematic reviews was low or critically low quality due to one or more critical weaknesses. The GRADE and GRADE-CERQual showed that the evidence quality was low to very low for most outcomes. The updated systematic review showed that LLLT may offer additional benefits as compared to compression therapies (pneumatic compression or compression bandage), placebo laser, or no treatment for patients with BCRL. However, when compared to other types of active interventions, LLLT did not improve outcomes significantly. None of the treatment-related adverse event was reported. Many trials had a high or unclear risk of bias for two or more items, and our updated systematic review showed low quality of evidence per outcome using GRADE approach. Due to insufficient data and poor quality of evidence, there is uncertain to reach these conclusions that LLLT is superior to another active or negative intervention and is safe. More RCTs of high methodological quality, with large sample sizes and long-term follow-up, are needed to inform clinical guidelines and routine practice.

Athletes must maintain their peak state of strength. Previous studies have investigated the effect of low-level laser therapy (LLLT) on muscular performance. A previous systematic review and meta-analysis has investigated this issue in healthy participants but not in physically active athletes. To investigate whether LLLT can improve muscular performance and soreness recovery in athletes. PubMed, EMBASE, and Cochrane Library. Published randomized controlled trials and crossover studies till December 2020. Systematic review and meta-analysis. Level 3. Assessment of study quality was rated using the risk of bias assessment method for randomized trials (Cochrane Handbook for Systematic Reviews of Interventions). A total of 24 studies were included. LLLT application before exercise significantly improved lower-limb muscle strength in 24-hour, 48-hour, 96-hour, and 8-week follow-up groups. Furthermore, decreased soreness index, serum creatine kinase concentrations, interleukin-6, and thiobarbituric acid reactive substance concentrations and a trend toward the improvement of contract repetition number and VO2 kinetic outcomes were observed. Although a definite therapeutic effect of LLLT is yet to be established, the current evidence supports that LLLT use improves muscular performance in physically active athletes. Additional trials with large sample sizes and robust design should be conducted before strong recommendations are made.

The effects of low-level laser therapy and photodynamic therapy on oral health of fixed orthodontics patients. A systematic review and meta-analysis

Low-level laser therapy increases interleukin-1β in gingival crevicular fluid and enhances the rate of orthodontic tooth movement.

The aim of this study was to evaluate the acute effects of low-level laser therapy (LLLT) on the functional capacity to exercise tested by incremental shuttle walking test (ISWT) after coronary artery bypass graft (CABG) surgery. Fifteen male patients (60 ± 9 years) were crossed over during the experiment, to compare the outcomes after active LLLT and placebo LLLT treatments. LLLT (850 nm, 200 mW, 30 J to each point, resulting in a total of 240 J per quadriceps muscle), using a multidiode cluster (five spots; 6 J/spot) in eight points per leg was performed 3 min before the ISWT. We analyzed distance walked, Borg scale of perceived exertion, heart rate, and brachial arterial blood pressure. Markers of tissue damage [lactate dehydrogenase (LDH)] and oxidative stress [lipid peroxidation, total thiol levels, and antioxidant enzyme activity of superoxide dismutase (SOD) and catalase (CAT)] were also measured in peripheral blood. Comparison of the distances walked revealed no significant differences between the LLLT and placebo LLLT groups (p = 0.779). Regarding the Borg scale (p = 0.567), heart rate (p = 0.506) as well as systolic and diastolic blood pressure (p = 0.164 and p = 0.140, respectively), no differences were observed between LLLT and placebo LLLT groups. Application of LLLT was not able to change levels of LDH (p = 0.214), oxidative lipid damage (p = 0.733), total thiol levels (p = 0.925), SOD (p = 0.202), and CAT (p = 0.825) enzyme activities. Acute LLLT improved neither functional capacity to exercise nor the markers of oxidation after CABG. Registered as a clinical trial (NCT02688426).

Objective: This systematic review aimed to determine whether the use of photobiomodulation (PBM) with low-level laser therapy prevents tooth sensitivity induced by in-office tooth bleaching with hydrogen. Methods: Placebo-controlled clinical trials were included to evaluate the efficacy of PBM with low-level laser therapy in the prevention of tooth sensitivity after in-office tooth bleaching. Searches were conducted on the Medline database via PubMed, Scopus, Web of Science, EBSCO, SciELO, LILACS, Cochrane, DOSS, and Google Scholar until July 2020, and fixed-effects meta-analysis was performed for tooth sensitivity [standardized mean differences (MDs)] and color changes (MDs). Results: Five studies were included in this systematic review and meta-analysis, with a total of 288 patients, 123 patients in the PBM group and 165 patients in the placebo group. In the meta-analysis, despite high heterogeneity, PBM significantly reduced the tooth sensitivity after the first [p < 0.001; Cohen's d = -0.32, 95% confidence interval (CI) = -0.46 to -0.18], second (p < 0.001; Cohen's d = -0.30, 95% CI = -0.46 to -0.15), and third (p < 0.001; Cohen's d = -0.82, 95% CI = -1.06 to -0.58) sessions of in-office tooth bleaching, without impairing the ΔE (p = 0.300). Conclusions: The results of this systematic review and meta-analysis suggest that PBM significantly prevents pain-related symptoms after the first three weekly sessions of in-office tooth bleaching with hydrogen.