title: Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review.
abstract: The aim of this systematic review was to assess a potential benefit of laser use in the treatment of recurrent aphthous stomatitis (RAS). The primary outcome variables were pain relief, duration of wound healing and reduction in episode frequency. A PICO approach was used as a search strategy in Medline, Embase and Cochrane databases. After scanning and excluding titles, abstracts and full texts, 11 studies (ten RCTs and one non-randomised controlled trial) were included. Study selection and data extraction was done by two observers. Study participants varied between 7-90 for the laser and 5-90 for the control groups. Laser treatment included Nd:YAG laser ablation, CO2laser applied through a transparent gel (non-ablative) and diode laser in a low-level laser treatment (LLLT) mode. Control groups had placebo, no therapy or topical corticosteroid treatment. Significant pain relief immediately after treatment was found in five out of six studies. Pain relief in the days following treatment was recorded in seven studies. The duration of RAS wound healing was also reduced in five studies. However, criteria of evaluation differed between the studies. The episode frequency was not evaluated as only one study addressed this outcome parameter, but did not discriminate between the study (LLLT) and control (corticosteroid) groups. Jadad scores (ranging from 0 to 5) for quality assessment of the included studies range between 0 and 2 (mean = 1.0) for studies analysing pain relief and between 0 and 3 (mean = 1.1) for studies evaluating wound healing. The use of lasers (CO2laser, Nd:YAG laser and diode laser) to relieve symptoms and promote healing of RAS is a therapeutic option. More studies for laser applications are necessary to demonstrate superiority over topical pharmaceutical treatment and to recommend a specific laser type, wavelength, power output and applied energy (ablative versus photobiomodulation).
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
authors.forename: Valerie G A
authors.initials: VGA
authors.lastname: Suter
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
authors.forename: Sophia
authors.initials: S
authors.lastname: Sjölund
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. michael.bornst@hku.hk.|Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, SAR, China. michael.bornst@hku.hk.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bornstein
mesh_terms: D006801:Humans; D053685:Laser Therapy; D054020:Lasers, Gas / Q000627:therapeutic use; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D053844:Lasers, Solid-State / Q000627:therapeutic use; D010146:Pain / Q000532:radiotherapy*; D012008:Recurrence; D013281:Stomatitis, Aphthous / Q000532:radiotherapy*; D014945:Wound Healing / Q000528:radiation effects*
keywords: Aphthous ulcer; CO2 laser; Diode laser; Low-level laser; Nd:YAG laser; Photobiomodulation; Photobiostimulation