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      Effectiveness of Laser Therapy in the Management of Recurrent Aphthous Stomatitis: A Systematic Review

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          Abstract

          Objectives. Laser therapy is a promising new treatment for patients with recurrent aphthous stomatitis (RAS). However, the clinical effect and security issue of laser therapy remain controversial. This systematic review was conducted to evaluate the clinical effectiveness and security of laser treatment in RAS patients. Methods. Five electronic databases were searched (MEDLINE (PubMed), EMBASE, ScienceDirect, the Cochrane Library, and Web of Science) to identify all studies that were about randomized controlled clinical trials, involving the effect of laser therapy in RAS patients. Conclusion. Twenty-three studies were retained for full-text analysis after screening the titles and abstracts of potential articles, but only 10 studies satisfied the inclusion criteria after the full texts were reviewed. The included studies reported a comparison of the effectiveness between the laser treatment and placebo laser therapy (or conventional drug therapy) when managing the RAS patients. It can be concluded that laser therapy has the superiority in relieving ulcer pain and shortening healing time when compared with placebo group or medical treatment group. Although laser therapy is a promising effective treatment for RAS, high-quality clinical studies with large sample size must be further performed to confirm the effectiveness of this therapy.

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          Most cited references47

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          Biphasic dose response in low level light therapy.

          The use of low levels of visible or near infrared light for reducing pain, inflammation and edema, promoting healing of wounds, deeper tissues and nerves, and preventing cell death and tissue damage has been known for over forty years since the invention of lasers. Despite many reports of positive findings from experiments conducted in vitro, in animal models and in randomized controlled clinical trials, LLLT remains controversial in mainstream medicine. The biochemical mechanisms underlying the positive effects are incompletely understood, and the complexity of rationally choosing amongst a large number of illumination parameters such as wavelength, fluence, power density, pulse structure and treatment timing has led to the publication of a number of negative studies as well as many positive ones. A biphasic dose response has been frequently observed where low levels of light have a much better effect on stimulating and repairing tissues than higher levels of light. The so-called Arndt-Schulz curve is frequently used to describe this biphasic dose response. This review will cover the molecular and cellular mechanisms in LLLT, and describe some of our recent results in vitro and in vivo that provide scientific explanations for this biphasic dose response.
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            Oral mucosal disease: recurrent aphthous stomatitis.

            Recurrent aphthous stomatitis (RAS; aphthae; canker sores) is common worldwide. Characterised by multiple, recurrent, small, round, or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or grey floors, it usually presents first in childhood or adolescence. Its aetiology and pathogenesis is not entirely clear, but there is genetic predisposition, with strong associations with interleukin genotypes, and sometimes a family history. Diagnosis is on clinical grounds alone, and must be differentiated from other causes of recurrent ulceration, particularly Behçet disease - a systemic disorder in which aphthous-like ulcers are associated with genital ulceration, and eye disease (particularly posterior uveitis). Management remains unsatisfactory, as topical corticosteroids and most other treatments only reduce the severity of the ulceration, but do not stop recurrence.
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              Mucosal disease series. Number VI. Recurrent aphthous stomatitis.

              Recurrent aphthous stomatitis (RAS; aphthae; canker sores) is a common condition which is characterized by multiple recurrent small, round or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or grey floors typically presenting first in childhood or adolescence. RAS occurs worldwide although it appears most common in the developed world. The aetiology of RAS is not entirely clear. Despite many studies trying to identify a causal microorganism, RAS does not appear to be infectious. A genetic predisposition is present, as shown by strong associations with genotypes of IL-1beta; IL-6 in RAS patients, and a positive family history in about one-third of patients with RAS. Haematinic deficiency is found in up to 20% of patients. Cessation of smoking may precipitate or exacerbate RAS in some cases. Ulcers similar to RAS may be seen in human immunodeficiency virus disease and some other immune defects, and drugs, especially non-steroidal anti-inflammatory drugs and nicorandil may produce lesions clinically similar to RAS. Topical corticosteroids can often control RAS. However, the treatment of RAS remains unsatisfactory, as most therapies only reduce the severity of the ulceration and do not stop recurrence.
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                Author and article information

                Journal
                Scientifica (Cairo)
                Scientifica (Cairo)
                SCIENTIFICA
                Scientifica
                Hindawi Publishing Corporation
                2090-908X
                2016
                18 December 2016
                : 2016
                : 9062430
                Affiliations
                1College & Hospital of Stomatology, Key Lab of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei 230032, China
                2The 2nd Hospital Affiliated to Anhui Medical University, Hefei 230601, China
                3The Hospital of Anhui Province, Hefei 230001, China
                Author notes

                Academic Editor: Umit Tursen

                Author information
                http://orcid.org/0000-0002-4288-1534
                http://orcid.org/0000-0002-3546-5663
                Article
                10.1155/2016/9062430
                5203897
                28078164
                a3630104-2e60-46ab-95fb-a9c02e23f356
                Copyright © 2016 Min Han et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 July 2016
                : 15 November 2016
                Funding
                Funded by: National Natural Science Foundation of China
                Award ID: 81571018
                Categories
                Review Article

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