Impact of Photobiomodulation on the Clinical Outcomes of Nonsurgical Periodontal Therapy: A Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials
Restricted accessReview articleFirst published online November, 2025
Impact of Photobiomodulation on the Clinical Outcomes of Nonsurgical Periodontal Therapy: A Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials
The aim of this study was to assess the impact of photobiomodulation (PBM) on clinical outcomes when combined with nonsurgical periodontal therapy (NSPT).
Materials and Methods:
A comprehensive electronic search was conducted using keywords from databases such as PubMed, LILACS, Web of Science, and Scopus. Six randomized control trials assessing the clinical efficacy of adjunctive PBM, including probing pocket depth (PPD) and clinical attachment level (CAL), at 3- and 6-month intervals were included. Heterogeneity was reported using the I2 values, and the random-effects model and meta-analysis using mean and standard deviations were performed.
Results:
The effect size was –0.27 (confidence interval (CI): –1.01, 0.46), –0.44 (CI: –0.81, –0.06) for CAL at 3 and 6 months. Similarly, pooled effect size was –0.36 (CI: –1.85, 1.13), –0.94 (CI: –1.36, –0.52) for PPD at 3 and 6 months, suggesting that the treatment group (low-level laser) has a better outcome than the NSPT.
Conclusion:
Adjunctive PBM to NSPT alone has shown a CAL gain and PPD reduction.
BoytsanyukSI, LevkivMO, ManashchukNV, . Current tendencies in non-surgical periodontal treatment. Literature review. Clini Exp Pathol, 2024; 23(1) (87): 64–69.
2.
MujawarFS, ZopeSA, SuragimathG, . Salivary macrophage inflammatory protein-1α levels in periodontitis subjects receiving non-surgical periodontal therapy with and without photo-biomodulation: A prospective interventional controlled trial. Cureus, 2024; 16(9): e68980.
3.
RanaA, PalwankarP and GopalL.Effectiveness of photobiomodulation versus local drug delivery as an adjunct to non-surgical periodontal therapy in the management of periodontal pockets: A case report. Cureus, 2024; 16(9): e68719.
4.
AkanselF, SakallioğluU, LütfioğluM, . Adjunctive use of laser biostimulation with nonsurgical periodontal therapy: A split mouth, randomized, case-control study in diabetic and nondiabetic periodontitis patients. Turkish J Med Sci, 2024; 54(1): 348–356.
5.
DalviS, BenedicentiS and HannaR.Effectiveness of photobiomodulation as an adjunct to nonsurgical periodontal therapy in the management of periodontitis: A systematic review of in vivo human studies. Photochem Photobiol, 2021; 97(2): 223–242.
6.
EtemadiA, AghaieM, SayarF, . Effect of photobiomodulation therapy with 660 and 980 nm diode lasers on differentiation of periodontal ligament mesenchymal stem cells. Sci Rep, 2024; 14(1): 20587.
7.
WalshLJ. The current status of low level laser therapy in dentistry. Part 1. Soft tissue applications. Aust Dent J, 1997; 42: 247–254.
CobbCM, LowSB and ColuzziDJ. Lasers and the treatment of chronic periodontitis. Dent Clin North Am. 2010; 54: 35–53.
10.
PostenW, WroneDA, DoverJS, . Low–level laser therapy for wound healing: Mechanism and efficacy. Dermatol Surg, 2005; 31: 334–340.
11.
SunG and TunérJ. Low–level laser therapy in dentistry. Dent Clin North Am, 2004; 48: 1061–1076.
12.
SilveiraPCL, StreckEL and PinhoRA. Evaluation of mitochondrial respiratory chain activity in wound healing by low–level laser therapy. J Photochem Photobiol B2007; 86: 279–282.
13.
HakkiSS and BozkurtSB. Effects of different setting of diode laser on the mRNA expression of growth factors and type I collagen of human gingival fibroblasts. Lasers Med Sci, 2012; 27: 325–331.
14.
SakuraiY, YamaguchiM and AbikoY.Inhibitory effect of low–level laser irradiation on LPS–stimulated prostaglandin E2 production and cyclooxygenase–2 in human gingival fibroblasts. Eur J Oral Sci, 2000; 108: 29–34.
15.
LimW, ChoiH, KimJ, . Anti–inflammatory effect of 635 nm irradiations on in vitro direct/indirect irradiation model. J Oral Pathol Med, 2015; 44: 94–102.
16.
NomuraK, YamaguchiM and AbikoY.Inhibition of interleukin–1β production and gene expression in human gingival fibroblasts by low–energy laser irradiation. Lasers Med Sci, 2001; 16: 218–223.
17.
SafaviSM, KazemiB, EsmaeiliM, . Effects of low–level He–Ne laser irradiation on the gene expression of IL–1β, TNF–α, IFN–γ, TGF–β, bFGF, and PDGF in rat’s gingiva. Lasers Med Sci, 2008; 23: 331–335.
18.
SchafferM, BonelH, SrokaR, . Effects of 780 nm diode laser irradiation on blood microcirculation: Preliminary findings on time–dependent T1–weighted contrast–enhanced magnetic resonance imaging (MRI). J Photochem Photobiol B, 2000; 54: 55–60.
19.
Abd-ElhaleemOthman MA, ZakyAA, EltayebEA, . A radiographic and histological study to compare red (650 nm) versus near infrared (810 nm) diode lasers photobiomodulation for alveolar socket preservation. Sci Rep, 2024; 14(1): 6871.
20.
AngelovN, PesevskaS, NakovaM, . Periodontal treatment with a low–level diode laser: clinical findings. Gen Dent, 2009; 57: 510–513.
21.
PesevskaS, NakovaM, GjorgoskiI, . Effect of laser on TNF–alpha expression in inflamed human gingival tissue. Lasers Med Sci, 2012; 27: 377–381.
22.
AykolG, BaserU, MadenI, . The effect of low–level laser therapy as an adjunct to non–surgical periodontal treatment. J Periodontol, 2011; 82: 481–488.
23.
CalderínS, García–NúñezJA and GómezC. Short–term clinical and osteoimmunological effects of scaling and root planning complemented by simple or repeated laser phototherapy in chronic periodontitis. Lasers Med Sci, 2013; 28: 157–166.
24.
LaiSM, ZeeKY, LaiMK, . Clinical and radiographic investigation of the adjunctive effects of a low–power He–Ne laser in the treatment of moderate to advanced periodontal disease: A pilot study. Photomed Laser Surg, 2009; 27: 287–293.
25.
MakhloufM, DahabaMM, TunérJ, . Effect of adjunctive low level laser therapy (LLLT) on nonsurgical treatment of chronic periodontitis. Photomed Laser Surg, 2012; 30: 160–166.
26.
QadriT, MirandaL, TunérJ, . The short–term effects of low–level lasers as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol, 2005; 32: 714–719.
27.
RibeiroIW, SbranaMC, EsperLA, . Evaluation of the effect of the GaAlAs laser on subgingival scaling and root planning. Photomed Laser Surg, 2008; 26: 387–391.
28.
De MicheliG, de AndradeAK, AlvesVT, . Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment: A randomized controlled trial. Laser Med Sci, 2011; 26: 43–48.
29.
DilsizA and SevincS.KTP laser therapy as an adjunctive to scaling and root planning in treatment of chronic periodontitis. Acta Odontol Scand, 2014; 72(8): 681–686.
30.
NguyenNT, ByarlayMR, ReinhardtRA, . Adjunctive non–surgical therapy of inflamed periodontal pockets during maintenance therapy using diode laser: A randomized clinical trial. J Periodontol, 2015; 86(10): 1133–1140.
31.
GündoğarH, ŞenyurtSZ, ErciyasK, . The effect of low-level laser therapy on non-surgical periodontal treatment: A randomized controlled, single blind, split-mouth clinical trial. Lasers Med Sci, 2016; 31: 1767–1773.
32.
CiurescuCE, DimaL, CiurescuVA, . Laser therapy effects on periodontal status: A randomized study using gaussian network analysis and structural equation modeling approach. Medicina, 2024; 60(3): 437.
33.
AlghafriM, FadhulI, ShahM, . Diode laser as an adjunctive treatment for periodontitis: A randomized controlled trial. Int J Dent Hyg, 2024; 22(4): 959–970.
34.
FreireBL, AbreuLG, CostaFO, . Effect of photobiomodulation adjunct to periodontal therapy on individuals with type 2 diabetes mellitus regarding periodontal clinical parameters: A systematic review and meta-analysis. Lasers Med Sci, 2023; 38(1): 116.
35.
Da SilvaRC, da SilvaLG, MartinsAA, . Adjunctive photobiomodulation to Basic Periodontal therapy using different low-power laser application techniques: A systematic review and meta-analysis. Lasers Med Sci, 2024; 39(1): 207.
36.
HayashiS, TakeuchiY, HiratsukaK, . Effects of various light-emitting diode wavelengths on periodontopathic bacteria and gingival fibroblasts: An in vitro study. Photodiagnosis Photodyn Ther, 2023; 44: 103860.
37.
YoshidaA, SasakiH, ToyamaT, . Antimicrobial effect of blue light using Porphyromonas gingivalis pigment. Sci Rep, 2017; 7(1): 5225.
