Laser therapy versus placebo treatment for aphthous ulcers: a systematic review and meta‑analysis

Abstract

Background: Aphthous ulcer is a common, painful oral mucosal condition. Laser therapy for these ulcers offers potential benefits in pain relief and mucosal healing. However, its clinical utility remains to be systematically evaluated.

Methods: A systematic search was performed for randomized controlled trials (RCTs) published between 2020 and 2025, examining the efficacy of laser therapy in patients with aphthous ulcers. Five databases were searched, and data on pain intensity, healing time, and ulcer size were extracted and synthesized. Mean differences (MDs) in tandem with 95% confidence intervals (CIs) were calculated.

Results: Fourteen RCTs involving 517 participants were included. Laser therapy significantly reduced pain intensity compared to placebo (MD, 3.31; 95% CI, 1.52 to 5.09; p < 0.001) and was associated with a shorter healing time (MD, - 5.86 days; 95% CI, - 9.47 to - 2.26; p < 0.001). Changes in ulcer size were not significant (MD, - 0.87 mm; 95% CI, - 3.53 to 1.78; p = 0.52). Heterogeneity was substantial across all outcomes (I² > 89%), reflecting variability in study designs, patient characteristics, and laser parameters.

Conclusions: Laser therapy provides significant reductions in pain and healing time in patients with aphthous ulcers, supporting its role as a promising adjunctive treatment. The high heterogeneity among trials underscores the need for standardized protocols and further high-quality research to define optimal treatment parameters.

Keywords: Aphthous ulcers; Corticosteroids; Inflammation; Laser therapy; Oral mucosa; Pain.