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Meta-Analysis
. 2015 Sep;30(7):1881-93.
doi: 10.1007/s10103-015-1743-4. Epub 2015 Mar 24.

The effectiveness of low-level diode laser therapy on orthodontic pain management: a systematic review and meta-analysis

Chong Ren  1 , Colman McGrath, Yanqi Yang
Affiliations
Meta-Analysis

The effectiveness of low-level diode laser therapy on orthodontic pain management: a systematic review and meta-analysis

Chong Ren et al. Lasers Med Sci. 2015 Sep.

Abstract

To assess the effectiveness of diode low-level laser therapy (LLLT) for orthodontic pain control, a systematic and extensive electronic search for randomised controlled trials (RCTs) investigating the effects of diode LLLT on orthodontic pain prior to November 2014 was performed using the Cochrane Library (Issue 9, 2014), PubMed (1997), EMBASE (1947) and Web of Science (1956). The Cochrane tool for risk of bias evaluation was used to assess the bias risk in the chosen data. A meta-analysis was conducted using RevMan 5.3. Of the 186 results, 14 RCTs, with a total of 659 participants from 11 countries, were included. Except for three studies assessed as having a 'moderate risk of bias', the RCTs were rated as having a 'high risk of bias'. The methodological weaknesses were mainly due to 'blinding' and 'allocation concealment'. The meta-analysis showed that diode LLLT significantly reduced orthodontic pain by 39 % in comparison with placebo groups (P = 0.02). Diode LLLT was shown to significantly reduce the maximum pain intensity among parallel-design studies (P = 0.003 versus placebo groups; P = 0.000 versus control groups). However, no significant effects were shown for split-mouth-design studies (P = 0.38 versus placebo groups). It was concluded that the use of diode LLLT for orthodontic pain appears promising. However, due to methodological weaknesses, there was insufficient evidence to support or refute LLLT's effectiveness. RCTs with better designs and appropriate sample power are required to provide stronger evidence for diode LLLT's clinical applications.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the study inclusion process
Fig. 2
Fig. 2
a Risk of bias summary: review authors’ judgments about each risk of bias item for each included study. b Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies
Fig. 3
Fig. 3
Comparison: laser versus placebo, outcome: prevalence of pain (studies with parallel design)
Fig. 4
Fig. 4
a Comparison: laser versus placebo, outcome: end of pain (studies with parallel design). b Comparison: laser versus control, outcome: end of pain (studies with parallel design)
Fig. 5
Fig. 5
a Comparison: laser versus placebo, outcome: maximum pain intensity, subgroup analysis: split-mouth versus parallel design. b Comparison: laser versus control, outcome: maximum pain intensity (studies with parallel design). c Comparison: laser versus placebo, outcome: mean pain intensity, subgroup analysis: split-mouth versus parallel design
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