Influence of Low‐Level Laser Therapy on Postoperative Pain After Dental Implant Placement: Results From 2 Randomised Controlled Trials

Background:Low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are effective in alleviating pain and improving functionality in patients with adhesive capsulitis (AC); however, no study has compared the efficacy of these two laser treatments.Objective:To compare the effectiveness of LLLT and HILT in improving the shoulder joint range of motion and functional status and in reducing pain level in patients with AC.Trial Design:Prospective, randomized, parallel group, patient- and assessor-blinded.Methods:A total of 45 patients (aged: 18–65 years) with complaint of shoulder pain were evaluated for inclusion criteria, which included being aged 18–65 years and a diagnosis of AC based on physical examinations. Using computer-generated random numbers, eligible patients were randomized into two groups: HILT + stretching exercise and LLLT + stretching exercise groups. Both HILT and LLLT were performed three times/week for 3 weeks. Functional status and pain of the patients were evaluated with Shoulder Pain and Disability Index (SPADI) and Visual Analog Scale (VAS), while shoulder joint range of motion was measured with goniometry. All assessments were done before and 3 weeks after treatment.Results:A total of 40 patients (20 in each group) completed the study. At baseline, there was no statistically significant difference in the demographic and clinical characteristics between both groups. Both the LLLT and HILT groups showed significant improvement in the VAS and SPADI scores 3 weeks after treatment; however, the improvement was significantly higher in the HILT group than the LLLT group. There was no significant improvement in goniometric scores in both groups compared with baseline. No injury or other musculoskeletal complications were recorded during or after the treatments.Conclusion:HILT + stretching exercise treatment was more effective than LLLT + stretching exercise for improving functional parameters and pain in patients with AC.Trial Registration:ClinicalTrials.gov Identifier: NCT05469672.Funding:None

Low-Level Laser and Light Therapy After Total Knee Arthroplasty Improves Postoperative Pain and Functional Outcomes: A Three-Arm Randomized Clinical Trial

The purpose of the present study was to determine the effect of low level laser therapy (LLLT) treatment before knee extensor eccentric exercise on indirect markers of muscle damage. Thirty-six healthy men were randomized in LLLT group (n = 18) and placebo group (n = 18). After LLLT or placebo treatment, subjects performed 75 maximal knee extensors eccentric contractions (five sets of 15 repetitions; velocity = 60° seg(-1); range of motion = 60°). Muscle soreness (visual analogue scale--VAS), lactate dehydrogenase (LDH) and creatine kinase (CK) levels were measured prior to exercise, and 24 and 48 h after exercise. Muscle function (maximal voluntary contraction--MVC) was measured before exercise, immediately after, and 24 and 48 h post-exercise. Groups had no difference on kineanthropometric characteristics and on eccentric exercise performance. They also presented similar baseline values of VAS (0.00 mm for LLLT and placebo groups), LDH (LLLT = 186 IU/l; placebo = 183 IU/l), CK (LLLT = 145 IU/l; placebo = 155 IU/l) and MVC (LLLT = 293 Nm; placebo = 284 Nm). VAS data did not show group by time interaction (P = 0.066). In the other outcomes, LLLT group presented (1) smaller increase on LDH values 48 h post-exercise (LLLT = 366 IU/l; placebo = 484 IU/l; P = 0.017); (2) smaller increase on CK values 24 h (LLLT = 272 IU/l; placebo = 498 IU/l; P = 0.020) and 48 h (LLLT = 436 IU/l; placebo = 1328 IU/l; P < 0.001) post-exercise; (3) smaller decrease on MVC immediately after exercise (LLLT = 189 Nm; placebo = 154 Nm; P = 0.011), and 24 h (LLLT = 249 Nm; placebo = 205 Nm; P = 0.004) and 48 h (LLLT = 267 Nm; placebo = 216 Nm; P = 0.001) post-exercise compared with the placebo group. In conclusion, LLLT treatment before eccentric exercise was effective in terms of attenuating the increase of muscle proteins in the blood serum and the decrease in muscle force.

Introduction: Osteoarthritis (OA) of the knee causes disability due to pain and will affect the functional ability to walk. Low-Level Laser Therapy (LLLT) has been shown to reduce pain in knee OA, while High Intensity Laser Therapy (HILT) is able to reach deeper joint areas. Method: This study aimed to compare the effect differences between LLLT and HILT on pain and functional capacity in knee OA. Methods: This is a double-blind randomized controlled trial with 61 subjects randomized into LLLT (n=31) and HILT (n=30) groups. All the subjects were knee OA patient with Visual Analog Scale (VAS) ≥ 4. The laser therapy and exercise were given 3 times per week for 6 sessions. The pain scale evaluated using VAS and functional ability evaluated using 50-feet walk test. Result: After 6 sessions, both LLLT and HILT group showed reduced VAS score [∆VAS Score LLLT = 3 (2 – 4), HILT = 3 (2 – 5)] and increased walking speed (∆ walking speed for LLLT = 0.23 (0.02 – 1.24) m/s, HILT = 0.22 (0.08 – 0.7) m/s) which were statistically (p &lt; 0.001) and clinically significant. HILT group had faster walking speed and greater VAS reduction compared to LLLT group (p &lt; 0.001), but there was no significant difference in walking speed between two groups (p=0.655). Conclusion: HILT and LLLT combined with exercise were effective in reducing pain and increasing functional ability in knee OA after 6 sessions of intervention. Pain and functional ability improvement was faster and greater in HILT group than LLLT group.

the aim of the present study was to evaluate the efficacy of low level laser therapy (LLLT) in patients with rheumatoid arthritis (RA) with carpal tunnel syndrome (CTS). a total of 19 patients with the diagnosis of CTS in 19 hands were included and randomly assigned to two treatment groups; LLLT (Group 1) (10 hands) with dosage 1.5 J/ per point and placebo laser therapy group (Group 2) (9 hands). A Galium-Aluminum-Arsenide diode laser device was used as a source of low power laser with a power output of 50 mW and wavelength of 780 nm. All treatments were applied once a day on week days for a total period of 10 days. Clinical assessments were performed at baseline, at the end of the treatment and at month 3. Tinel and Phalen signs were tested in all patients. Patients were evaluated for such clinical parameters as functional status scale (FSS), visual analogue scale (VAS), symptom severity scale (SSS) and grip-strength. However, electrophysiological examination was performed on all hands. Results were given with descriptive statistics and confidence intervals between group means at 3 months adjusted for outcome at baseline and for the difference between unadjusted group proportions. clinical and electrophysiological parameters were similar at baseline in both groups. Improvements were significantly more pronounced in the LLLT group than placebo group. A comparison between groups showed significant improvements in pain score and functional status scale score. Group mean differences at 3 months adjusted at baseline were found to be statistically significant for pain score and functional status scale score. The 95% significant confidence intervals were [-15 - (-5)] and [-5 - (-2)] respectively. There were no statistically significant differences in other clinical and electrophysiological parameters between groups at 3 months. our study results indicate that LLLT and placebo laser therapy seems to be effective for pain and hand function in CTS. We, therefore, suggest that LLLT may be used as a good alternative treatment method in CTS patients with RA.

the aim of the present study was to evaluate the efficacy of low level laser therapy (LLLT) in patients with rheumatoid arthritis (RA) with carpal tunnel syndrome (CTS). a total of 19 patients with the diagnosis of CTS in 19 hands were included and randomly assigned to two treatment groups; LLLT (Group 1) (10 hands) with dosage 1.5 J/ per point and placebo laser therapy group (Group 2) (9 hands). A Galium-Aluminum-Arsenide diode laser device was used as a source of low power laser with a power output of 50 mW and wavelength of 780 nm. All treatments were applied once a day on week days for a total period of 10 days. Clinical assessments were performed at baseline, at the end of the treatment and at month 3. Tinel and Phalen signs were tested in all patients. Patients were evaluated for such clinical parameters as functional status scale (FSS), visual analogue scale (VAS), symptom severity scale (SSS) and grip-strength. However, electrophysiological examination was performed on all hands. Results were given with descriptive statistics and confidence intervals between group means at 3 months adjusted for outcome at baseline and for the difference between unadjusted group proportions. clinical and electrophysiological parameters were similar at baseline in both groups. Improvements were significantly more pronounced in the LLLT group than placebo group. A comparison between groups showed significant improvements in pain score and functional status scale score. Group mean differences at 3 months adjusted at baseline were found to be statistically significant for pain score and functional status scale score. The 95% significant confidence intervals were [-15 - (-5)] and [-5 - (-2)] respectively. There were no statistically significant differences in other clinical and electrophysiological parameters between groups at 3 months. our study results indicate that LLLT and placebo laser therapy seems to be effective for pain and hand function in CTS. We, therefore, suggest that LLLT may be used as a good alternative treatment method in CTS patients with RA.

The aim of this study was to compare the rate of tooth displacement, quantity of root resorption, and alveolar bone changes in five groups: corticopuncture (CP), low-level laser therapy (LLLT), CP combined with LLLT (CP + LLLT), control (C), and negative control (NC). A total of 60 half-maxilla from 30 male Wistar rats (10weeks old) were divided randomly into five groups: three (CP, LLLT, and CP + LLLT) test groups with different stimulation for accelerated-tooth-movement (ATM), one control (C) group, and one negative control (NC) group with no tooth movement. Nickel-titanium coil springs with 50g of force were tied from the upper left and right first molars to micro-implants placed behind the maxillary incisors. For the CP and CP + LLLT groups, two perforations in the palate and one mesially to the molars were performed. For the LLLT and CP + LLLT groups, GaAlAs diode laser was applied every other day for 14days (810nm, 100mW, 15s). The tooth displacements were measured directly from the rat's mouth and indirectly from microcomputer (micro-CT) tomographic images. Bone responses at the tension and compression sites and root resorption were analyzed from micro-CT images. The resulting alveolar bone responses were evaluated by measuring bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular thickness (TbTh). Root resorption crater volumes were measured on both compression and tension sides of mesial and distal buccal roots. The tooth displacement in the CP + LLLT group was the greatest when measured clinically, followed by the CP, LLLT, and control groups (C and NC), respectively (p <0.05). The tooth movements measured from micro-CT images showed statistically higher displacement in the CP and CP + LLLT groups compared to the LLLT and control groups. The BMD, BV/TV, and TbTh values were lower at the compression side and higher at the tension side for all three test groups compared to the control group. The root resorption crater volume of the distal buccal root was higher in the control group, followed by CP, LLLT, and CP + LLLT, mostly at the compression site. Combining corticopuncture and low-level laser therapy (CP + LLLT) produced more tooth displacement and less root resorption at the compression side. The combined technique also promoted higher alveolar bone formation at the tension side.

We aimed to compare the efficacy of low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) in the treatment of plantar fasciitis (PF). Seventy patients were randomized into either the LLLT (8 men, 27 women; mean age 48.65 ± 10.81years) or HILT (7 men, 28 women; mean age 48.73 ± 11.41years) groups. LLLT (904nm) and HILT (1064nm) were performed three times per week, over a period of 3weeks. Each treatment combined with silicone insole and stretching exercises. Patients' pain and functional status were evaluated with Visual Analog Scale, Heel Tenderness Index, and Foot and Ankle Outcome Score before and after treatment. A chi-square test was performed to compare demographic and clinical characteristics. Within-group and between-group differences were also investigated. Paired samples t test was used to analyze the differences between baseline and after treatment values, while independent samples t test was used to compare the two groups. Both groups contained similar demographic characteristics including age, sex, and body mass index (all p > 0.05). Three and two patients in the HILT and LLLT group, respectively, were lost to follow-up. At the study onset, there were no statistically significant differences between the two groups in the Visual Analog Scale, Heel Tenderness Index, and Foot And Ankle Outcome Scores. Three weeks later, both groups showed significant improvement in all parameters (p < 0.05). The HILT group demonstrated better improvement in all parameters than the LLLT group. Although both treatments improved the pain levels, function, and quality of life in patients with PF, HILT had a more significant effect than LLLT.

Effect of Low-level Laser Therapy on Postoperative Pain in Molars with Symptomatic Apical Periodontitis: A Randomized Placebo-controlled Clinical Trial

Introduction: Chemotherapy-induced oral mucositis (COM) is a common, debilitating complication of cancer therapy. The aims of this study were to evaluate the effect of low level laser therapy (LLLT) on prevention of COM in patients with hematologic malignancies. Methods: Fifty-five patients hospitalized to undergo chemotherapy in Imam Hospital were included into the study. These patients were divided into two groups. The oral cavity of the patients were illuminated by continues laser beam using a GaAlAs laser device with wavelength of 630 nm, power output 30 mW, and dose of 5 J/cm 2 for six days (LLLT group). The patients in the second group underwent placebo irradiation (power output equal to zero) with the similar protocol. The severity of the COM was clinically evaluated based on WHO grading scale. The patientys’ quality of life was assessed before and after the intervention according to EORTC QLQ-C30 questionnaire. Results: The incidence of COM in LLLT group (31%) was less than the placebo group (41%). Mean duration of COM healing was 4.8 and 12 days in LLLT and placebo groups, respectively (p=0.03). Xereostomia was significantly less severe in LLLT group in comparison with the placebo group (p=0.007). Conclusion: Our findings showed that LLLT significantly reduced the incidence of oral mucositis of WHO grade 3 and 4 as the most debilitating form of oral mucositis, in which oral alimentation is impossible. Also, LLLT could reduce duration of oral mucositis, decreased the risk of secondary infection, and accelerated return to normal nutrition. Lasers; Laser Therapy, Low Level; Mucositis, Oral; Chemotherapy; Quality of life; Disease Management; therapy; Prophylaxis

This study aims to analyze the effect of the low-level laser therapy (LLLT) and ozone therapy on the bone healing of critical size defect (CSD) in rat calvaria. A total of 30 Wistar male rats were used. A 5-mm-diameter trephine bur was used to create CSD on the right side of the parietal bone of each rat calvarium. Once the bone was excised, a synthetic biphasic calcium phosphate graft material was implanted to all the bone defect sites. The animals were randomly divided into 3 groups as follows: the control group (n = 10), which received no LLLT or ozone therapy; the LLLT group (n = 10), which received only LLLT (120 seconds, 3 times a week for 2 weeks); and the ozone therapy group (n = 10) (120 seconds, 3 times a week for 2 weeks). After 1 month, all the rats were killed, and the sections were examined to evaluate the presence of inflammatory infiltrate, connective tissue, and new bone formation areas. Histomorphometric analyses showed that in the LLLT and ozone groups, the new bone areas were significantly higher than in the control group (P < 0.05). In the LLLT group, higher new bone areas were found than in the ozone group (P < 0.05). This study demonstrated that both ozone and laser therapies had a positive effect on bone formation in rat calvarial defect, compared with the control group; however, ozone therapy was more effective than LLLT (808 nm; 0.1 W; 4 J/cm(2); 0.028 cm(2), continuous wave mode).

Background and purpose Diabetic foot ulcers (DFU) and concurrent infections are the most frequent complications in patients with diabetes mellitus. Both low-level laser therapy (LLLT), photobiomodulation (PBM), and hyperbaric oxygen therapy (HBOT) promote the healing of wounds. The purpose of this study was to compare the effectiveness of LLLT versus HBOT on the healing of chronic DFU. Patients and methods: Seventy-five patients with chronic diabetic ulcers aged ranging from 40–65 years were recruited and assigned randomly into three groups. HBOT group received 100% pure oxygen 2.5 ATA delivered for 60 min per session for 30 sessions (5 sessions per week for 6 successive weeks). LLLT group received GaAlAs diode laser producing a total power output of 1440 mW with following wavelengths: 5 × 850 nm (200 mW), 12 × 670 nm (10 mW),8 × 880 nm (25 mW), and 8 × 950 nm (15 mW); the energy density (fluency) was adjusted for 4 J/cm2 with a pulse frequency of 10 kHz. Each session lasted 8 min every two days. The control group received conventional wound care only (wound cleansing twice daily using saline or similar dressing). Both LLLT and HBOT groups received conventional wound care in addition to their program. Measurements for ulcer surface area (USA; transparency method) and ulcer volume (volumetric method) were performed before starting the study and in the second, fourth, and sixth-weeks post-treatment. Results: Within group comparisons demonstrated a statistically significant decrease in USA and ulcer volume in both HBOT and LLLT groups (p-value = 0.0001 in all measurements). The multiple comparisons between groups for USA, there was insignificant difference between HBOT and LLLT groups after 2-, 4-, and 6-weeks (p-value = 0.48, 0.813, and 0.629, respectively), while for ulcer volume, there was a statistically significant difference in favor of the LLLT group only after 2- and 4-weeks (p = 0.037 and 0.042, respectively) while an insignificant difference after 6-weeks (p-value = 0.911). Conclusion: Both LLLT and HBOT accelerate healing in chronic DFU, but the LLLT is more favorable in decreasing ulcer volume after during the first 4-weeks.

Photobiomodulation (PBM) is a promising non-pharmacological approach for managing postoperative pain after dental im-plant placement, yet comparative data on red (650 nm) and near-infrared (810 nm) diode lasers remain limited and inconclu-sive. This double-blind, randomized controlled trial evaluated the short-term analgesic efficacy of 650 nm and 810 nm PBMon postoperative pain, analgesic intake, and oral health-related quality of life (OHRQoL) following single-implant placementin the posterior maxilla. Sixty patients were randomly assigned to receive PBM with 650 nm, PBM with 810 nm, or a shamcontrol. Laser therapy (18 J total energy) was administered immediately postoperatively and again at 48 hours. Pain intensity(11-point Numeric Rating Scale) and analgesic use were recorded at 2, 6, 12, 24, 48, and 72 hours post-surgery. OHRQoLwas assessed using the OHIP-14 questionnaire at baseline, one week, and after crown delivery. At 2 hours, both PBM groupsreported significantly lower pain scores compared to the sham group (p &lt; 0.05), with no severe pain observed in the PBMgroups. The 650 nm group exhibited significantly reduced analgesic consumption at 2 and 6 hours (p &lt; 0.05), indicating supe-rior early analgesic effect. Pain scores and medication use converged across groups after 12 hours. While overall OHRQoLscores did not differ significantly, the 810 nm group showed improvement in the physical disability domain. These resultssuggest that PBM with both wavelengths alleviates acute postoperative pain, with the 650 nm laser offering enhanced short-term pain control. PBM, particularly at 650 nm, may serve as an effective adjunct to improve early postoperative outcomes inminimally invasive implant procedures. Trial registration: The study is retrospectively registered at ClinicalTrials.gov (https://clinicaltrials.gov/study/NCT06988722; Identifier: NCT06988722, registered on 25/05/2025).

The aim of this study is to evaluate the effect of low-level laser therapy (LLLT) as an adjunct to non-surgical periodontal therapy of smoking and non-smoking patients with moderate to advanced chronic periodontitis. All 36 systemically healthy patients who were included in the study initially received non-surgical periodontal therapy. The LLLT group (n = 18) received GaAlAs diode laser therapy as an adjunct to non-surgical periodontal therapy. A diode laser with a wavelength of 808 nm was used for the LLLT. Energy density of 4 J/cm(2) was applied to the gingival surface after periodontal treatment on the first, second, and seventh days. Each of the LLLT and control groups was divided into two groups as smoking and non-smoking patients to investigate the effect of smoking on treatment. Gingival crevicular fluid samples were collected from all patients and clinical parameters were recorded on baseline, the first, third, and sixth months after treatment. Matrix metalloproteinase-1, tissue inhibitor matrix metalloproteinase-1, transforming growth factor-β1, and basic-fibroblast growth factor levels in the collected gingival crevicular fluid were measured. The primary outcome variable in this study was change in gingival bleeding and inflammation. At all time points, the LLLT group showed significantly more improvement in sulcus bleeding index (SBI), clinical attachment level, and probing depth (PD) levels compared to the control group (P <0.001). There were clinically significant improvements in the laser-applied smokers' PD and SBI levels compared to smokers to whom a laser was not applied, between the baseline and all time points (P <0.001) (SBI score: control group 1.12, LLLT group 1.49; PD: control group 1.21 mm, LLLT group 1.46 mm, between baseline and 6 months). Transforming growth factor-β1 levels and the ratio of matrix metalloproteinase-1 to tissue inhibitor matrix metalloproteinase-1 decreased significantly in both groups at 1, 3, and 6 months after periodontal therapy (P <0.001). Basic-fibroblast growth factor levels significantly decreased in both groups in the first month after the treatment, then increased in the third and sixth months (P <0.005). No marker level change showed significant differences between the groups (P <0.05). LLLT as an adjunctive therapy to non-surgical periodontal treatment improves periodontal healing.

Postoperative endodontic pain (PEP) is crucial in clinical practice. Recently, the effects of various laser adjuvant therapies in endodontic treatments have been widely evaluated. However, as a virtually side-effect-free treatment, its effect on postoperative pain management during endodontic treatment remains controversial. This review aimed to compare the efficacy of laser adjuvant therapy for pain management after endodontic treatment. The Cochrane Library, PubMed, Embase, Scopus and Web of Science databases were systematically searched for articles published until 12 February 2023. The risk of bias in the included studies was evaluated based on the Cochrane risk-of-bias assessment tool. Data on continuous outcomes of visual analogue scale pain scores are expressed as standard mean difference (SMD) and dichotomous outcomes of pain prevalence as relative risk (RR). We included 22 studies, of which 15 enrolled 892 patients with visual analogue scale pain scores and 7 enrolled 422 patients with pain prevalence. Of the 22 studies, seven studies had a low risk of bias, 10 had a moderate risk of bias and 5 had a high risk of bias. For pain level, the pooled outcomes indicated reduced pain scores in all laser adjuvant therapy, including low-level laser therapy (SMD = -0.86 [95% CI: -1.16, -0.55] in 24 h and SMD = -0.64 [95% CI: -0.84, -0.43] in 48 h), diode laser therapy (SMD = -0.27 [95% CI: -0.50, -0.04] in 48 h) and photodynamic therapy (SMD = -1.12 [95% CI: -2.18, -0.05] in 24 h). For postoperative pain incidence, a significant correlation was observed with reduced pain incidence rates in the photodynamic therapy group (pooled RR = 0.47 [95% CI: 0.31, 0.72]) but not in the low-level laser therapy group (RR = 0.89 [95% CI: 0.30, 2.70] at 12 h and RR = 0.57 [95% CI: 0.09, 3.72] at 24 h). High-quality evidence suggests that laser adjuvant therapies such as low-level laser therapy, diode laser therapy and photodynamic therapy have a positive impact on reducing postoperative endodontic pain intensity. However, the differences in PEP management effects between laser therapies are unknown, and no significant differences were observed among the subgroups. CRD 42023402872 (PROSPERO).