Photobiomodulation (PBM) therapy involves the use of low-dose, nonionizing light to reduce pain and inflammation, promote wound healing, and enhance tissue regeneration. PBM-based therapy of various dental conditions is associated with improved treatment outcomes. This study aims to critically review the literature to highlight the underlying molecular biological mechanisms and clinical applications of PBM in modern dental practice.
Methods:
This critical review employed literature search in PubMed/Medline, Google Scholar, and ScienceDirect databases to determine biological basis of PBM with a particular focus on its clinical dental applications. English literature published in the past 25 years were eligible for inclusion. Selected studies were analyzed to evaluate the therapeutic biochemical effects of PBM, with a focus on its dental applications.
Results:
PBM exerts its biological effects by influencing cytochrome c oxidase, increasing adenosine triphosphate, and improving DNA replication and RNA transcription. Various transcription factors and signaling pathways are involved through the activation of secondary messengers such as reactive oxygen species, nitric oxide, and cyclic adenosine monophosphate. The favorable biological effects of PBM can be beneficial for various dental applications in pulp therapy, management of postsurgical complications, and temporomandibular joint disorders.
Conclusions:
PBM represents a promising and effective treatment modality for the management of several challenging dental problems in the pediatric and adult populations, offering improved treatment outcomes, namely enhanced wound healing and reduced inflammation. Further research is recommended to optimize technical settings and standardize current protocols in the aim of enhancing clinical outcomes, exploring more applications, and improving patient satisfaction.
Get full access to this article
View all access options for this article.
References
1.
BaxterGD, LiuL, PetrichS, et al.Low level laser therapy (Photobiomodulation therapy) for breast cancer-related lymphedema: A systematic review. BMC Cancer, 2017; 17(1):833; doi: 10.1186/s12885-017-3852-x
2.
ChenZ, LiM, WuC, et al.Photobiomodulation therapy alleviates repeated closed head injury-induced anxiety-like behaviors. J Biophotonics, 2024; 17(2):e202300343; doi: 10.1002/jbio.202300343
3.
Hernández-BuleML, Naharro-RodríguezJ, BacciS, Fernández-GuarinoM. Unlocking the power of light on the skin: A comprehensive review on photobiomodulation. Int J Mol Sci, 2024; 25(8):4483; doi: 10.3390/ijms25084483
4.
De SouzaV, CruzMdP, MelloDC, et al.Exploring photobiomodulation in the management of bowel diseases: A concise critical review. Lasers Med Sci, 2024; 39(1):265; doi: 10.1007/s10103-024-04217-6
5.
MineroffJ, MaghfourJ, OzogDM, LimHW, KohliI, JagdeoJ. Photobiomodulation CME part II: Clinical applications in dermatology. J Am Acad Dermatol, 2024; 91(5):805–815; doi: 10.1016/j.jaad.2023.10.074
6.
GanjaliM, SeifalianAM, MozafariM. Effect of laser irradiation on cell cycle and mitosis. J Lasers Med Sci, 2018; 9(4):249–253; doi: 10.1517/1/jlms.2018.45
7.
DiasWCFG da S, CavalcantiRVA, Magalhães JúniorHV, PernambucoL de A, AlvesGÂDS. Effects of photobiomodulation combined with orofacial myofunctional therapy on the quality of life of individuals with temporomandibular disorder. Codas, 2022; 34(5):e20200313; doi: 10.1590/2317-1782/20212020313
8.
AnsariS, CharantimathS, Lagali-JirgeV, KeluskarV. Comparative efficacy of low-level laser therapy (LLLT) to TENS and therapeutic ultrasound in management of TMDs: A systematic review & meta-analysis. Cranio, 2024; 42(6):752–761; doi: 10.1080/08869634.2022.2050975
9.
CialdaiF, RisalitiC, MoniciM. Role of fibroblasts in wound healing and tissue remodeling on Earth and in space. Front Bioeng Biotechnol, 2022; 10:958381; doi: 10.3389/fbioe.2022.958381
10.
HamblinMR. Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation. Photochem Photobiol, 2018; 94(2):199–212; doi: 10.1111/php.12864
11.
FurquimLR, MéloAM, BarbosaAFS, et al.Application of photobiomodulation for chronic pain-related TMD on pain points versus pre-established points: Randomized clinical trial. J Photochem Photobiol B, 2023; 238:112612; doi: 10.1016/j.jphotobiol.2022.112612
12.
DinsdaleA, CostinB, DharamdasaniS, PageR, PursN, TreleavenJ. What conservative interventions improve bite function in those with temporomandibular disorders? A systematic review using self-reported and physical measures. J Oral Rehabil, 2022; 49(4):456–475; doi: 10.1111/joor.13307
13.
Al-JobairA. Dental laser education and knowledge among final year dental students at King Saud University in Riyadh, Saudi Arabia. The Saudi Journal for Dental Research, 2014; 5(2):98–103; doi: 10.1016/j.sjdr.2013.11.001
14.
YadavS, ChaudhryS, TalwarS, VermaM. Knowledge and practices of dental lasers among dental professionals in India: A survey-based study. J Dent Lasers, 2018; 12(2):50.
15.
AshifaN, SrinivasanS, ViswanathanK, PavithranVK. Knowledge and practice of dentists toward dental lasers and their use during and Post-COVID-19 pandemic scenario in South India: A cross-sectional analytical study. J Health Allied Sci NU, 2025; 15(1):80–85; doi: 10.1055/s-0044-1787847
ChenAC-H, AranyPR, HuangY-Y, et al.Low-level laser therapy activates NF-kB via generation of reactive oxygen species in mouse embryonic fibroblasts. PLoS One, 2011; 6(7):e22453; doi: 10.1371/journal.pone.0022453
18.
AbijoA, LeeC-Y, HuangC-Y, HoP-C, TsaiK-J. The Beneficial Role of Photobiomodulation in Neurodegenerative Diseases. Biomedicines, 2023; 11(7):1828; doi: 10.3390/biomedicines11071828
19.
GuzikTJ, WestNEJ, PillaiR, TaggartDP, ChannonKM. Nitric oxide modulates superoxide release and peroxynitrite formation in human blood vessels. Hypertension, 2002; 39(6):1088–1094; doi: 10.1161/01.HYP.0000018041.48432.B5
20.
HamblinMR. Photobiomodulation for traumatic brain injury and stroke. J Neurosci Res, 2018; 96(4):731–743; doi: 10.1002/jnr.24190
21.
MigliarioM, PittarellaP, FanuliM, RizziM, RenòF. Laser-induced osteoblast proliferation is mediated by ROS production. Lasers Med Sci, 2014; 29(4):1463–1467; doi: 10.1007/s10103-014-1556-x
MartinTJ, SimsNA. RANKL/OPG; Critical role in bone physiology. Rev Endocr Metab Disord, 2015; 16(2):131–139; doi: 10.1007/s11154-014-9308-6
24.
Incerti ParentiS, ChecchiL, FiniM, TschonM. Different doses of low-level laser irradiation modulate the in vitro response of osteoblast-like cells. J Biomed Opt, 2014; 19(10):108002; doi: 10.1117/1.JBO.19.10.108002
25.
NascimentoMFd, AlmeidaBMd, CunhaJLS, et al.Improvement of bone repair in diabetic rats subjected to ƛ780 nm low-level laser therapy. Acta Cir Bras, 2015; 30(10):660–667; doi: 10.1590/S0102-865020150100000002
26.
WangY, HuangYY, WangY, LyuP, HamblinMR. Photobiomodulation (blue and green light) encourages osteoblastic-differentiation of human adipose-derived stem cells: Role of intracellular calcium and light-gated ion channels. Sci Rep, 2016; 6:33719; doi: 10.1038/srep33719
27.
CuryV, MorettiAIS, AssisL, et al.Low level laser therapy increases angiogenesis in a model of ischemic skin flap in rats mediated by VEGF, HIF-1α and MMP-2. J Photochem Photobiol B, 2013; 125:164–170; doi: 10.1016/j.jphotobiol.2013.06.004
28.
ZhangL, ZhangY, XingD. LPLI inhibits apoptosis upstream of Bax translocation via a GSK-3beta-inactivation mechanism. J Cell Physiol, 2010; 224(1):218–228; doi: 10.1002/jcp.22123
29.
MaT. GSK3 in Alzheimer’s disease: Mind the isoforms. J Alzheimers Dis, 2014; 39(4):707–710; doi: 10.3233/JAD-131661
30.
HelbigD, SimonJC, PaaschU. Photodynamic therapy and the role of heat shock protein 70. Int J Hyperthermia, 2011; 27(8):802–810; doi: 10.3109/02656736.2011.569966
31.
de LimaFM, AlbertiniR, DantasY, et al.Low-level laser therapy restores the oxidative stress balance in acute lung injury induced by gut ischemia and reperfusion. Photochem Photobiol, 2013; 89(1):179–188; doi: 10.1111/j.1751-1097.2012.01214.x
32.
ZingarelliB, HakePW, MangeshkarP, et al.Diverse cardioprotective signaling mechanisms of peroxisome proliferator-activated receptor-gamma ligands, 15-deoxy-Delta12,14-prostaglandin J2 and ciglitazone, in reperfusion injury: Role of nuclear factor-kappaB, heat shock factor 1, and Akt. Shock, 2007; 28(5):554–563; doi: 10.1097/shk.0b013e31804f56b9
33.
BakshiPV, SettySB, KulkarniMR. Photobiomodulation of human gingival fibroblasts with diode laser—A systematic review. J Indian Soc Periodontol, 2022; 26(1):5–12.
34.
Gonçalves de FariaCM, CiolH, Salvador BagnatoV, PratavieiraS. Effects of photobiomodulation on the redox state of healthy and cancer cells. Biomed Opt Express, 2021; 12(7):3902–3916; doi: 10.1364/boe.421302
35.
HolderMJ, MilwardMR, PalinWM, HadisMA, CooperPR. Effects of red light-emitting diode irradiation on dental pulp cells. J Dent Res, 2012; 91(10):961–966; doi: 10.1177/0022034512456040
36.
KocherovaI, BryjaA, BłochowiakK, et al.Photobiomodulation with red and near-infrared light improves viability and modulates expression of mesenchymal and apoptotic-related markers in human gingival fibroblasts. Materials, 2021; 14(12):3427; doi: 10.3390/ma14123427
37.
ChangLY, FanSMY, LiaoYC, WangWH, ChenYJ, LinSJ. Proteomic analysis reveals anti-fibrotic effects of blue light photobiomodulation on fibroblasts. Lasers Surg Med, 2020; 52(4):358–372; doi: 10.1002/lsm.23137
38.
KhadraM, LyngstadaasSP, HaanaesHR, MustafaK. Effect of laser therapy on attachment, proliferation and differentiation of human osteoblast-like cells cultured on titanium implant material. Biomaterials, 2005; 26(17):3503–3509; doi: 10.1016/j.biomaterials.2004.09.033
39.
MignonC, UzunbajakavaNE, Castellano-PellicenaI, BotchkarevaNV, TobinDJ. Differential response of human dermal fibroblast subpopulations to visible and near-infrared light: Potential of photobiomodulation for addressing cutaneous conditions. Lasers Surg Med, 2018; 50(8):859–882; doi: 10.1002/lsm.22823
40.
Almeida-LopesL, RigauJ, ZângaroRA, Guidugli-NetoJ, JaegerMMM. Comparison of the low level laser therapy effects on cultured human gingival fibroblasts proliferation using different irradiance and same fluence. Lasers Surg Med, 2001; 29(2):179–184; doi: 10.1002/lsm.1107
41.
PandeshwarP, RoaMD, DasR, ShastrySP, KaulR, SrinivasreddyMB. Photobiomodulation in oral medicine: A review. J Investig Clin Dent, 2016; 7(2):114–126; doi: 10.1111/jicd.12148
42.
PalaretiG, LegnaniC, CosmiB, et al.; DULCIS (D-dimer-ULtrasonography in Combination Italian Study) Investigators. Comparison between different D-Dimer cutoff values to assess the individual risk of recurrent venous thromboembolism: Analysis of results obtained in the DULCIS study. Int J Lab Hematol, 2016; 38(1):42–49; doi: 10.1111/ijlh.12426
43.
MukherjeeT, KanvahS, KlymchenkoAS, CollotM. Probing variations of reduction activity at the plasma membrane using a targeted Ratiometric FRET Probe. ACS Appl Mater Interfaces, 2021; 13(34):40315–40324; doi: 10.1021/acsami.1c11069
44.
SorbelliniE, RuccoM, RinaldiF. Photodynamic and photobiological effects of light-emitting diode (LED) therapy in dermatological disease: An update. Lasers Med Sci, 2018; 33(7):1431–1439; doi: 10.1007/s10103-018-2584-8
45.
ZamaniARN, SaberianpourS, GeranmayehMH, BaniF, HaghighiL, RahbarghaziR. Modulatory effect of photobiomodulation on stem cell epigenetic memory: A highlight on differentiation capacity. Lasers Med Sci, 2020; 35(2):299–306; doi: 10.1007/s10103-019-02873-7
46.
MontoroLA, TurrioniAPS, BassoFG, de Souza CostaCA, HeblingJ. Infrared LED irradiation photobiomodulation of oxidative stress in human dental pulp cells. Int Endod J, 2014; 47(8):747–755; doi: 10.1111/iej.12211
47.
GünaydınA, ÇakıcıEB. Effect of Photobiomodulation therapy following direct pulp capping on postoperative sensitivity by thermal stimulus: A retrospective study. Med Princ Pract, 2021; 30(4):347–354; doi: 10.1159/000516342
48.
YazdanfarI, BarekatainM, Zare JahromiM. Combination effects of diode laser and resin-modified tricalcium silicate on direct pulp capping treatment of caries exposures in permanent teeth: A randomized clinical trial. Lasers Med Sci, 2020; 35(8):1849–1855; doi: 10.1007/s10103-020-03052-9
49.
NieE, YuJ, JiangR, et al.Effectiveness of direct pulp capping bioactive materials in dentin regeneration: A systematic review. Materials (Basel), 2021; 14(22):6811; doi: 10.3390/ma14226811
50.
NammourS, El MobadderM, NamourM, et al.Success rate of direct pulp capping with conventional procedures using Ca (OH)2 and bioactive Tricalcium silicate paste vs. laser-assisted procedures (Diode 980 nm, CO2, and Er: YAG). Photonics, 2023; 10(7):834; doi: 10.3390/photonics10070834
51.
MarsilioAL, RodriguesJR, BorgesAB. Effect of the clinical application of the GaAlAs laser in the treatment of dentine hypersensitivity. J Clin Laser Med Surg, 2003; 21(5):291–296; doi: 10.1089/104454703322564505
52.
TengrungsunT, SangklaW. Comparative study in desensitizing efficacy using the GaAlAs laser and dentin bonding agent. J Dent, 2008; 36(6):392–395; doi: 10.1016/j.jdent.2008.02.012
53.
ShanZ, JiJ, McGrathC, GuM, YangY. Effects of low-level light therapy on dentin hypersensitivity: A systematic review and meta-analysis. Clin Oral Investig, 2021; 25(12):6571–6595; doi: 10.1007/s00784-021-04183-1
54.
RezazadehF, DehghanianP, JafarpourD. Laser effects on the prevention and treatment of dentinal hypersensitivity: A systematic review. J Lasers Med Sci, 2019; 10(1):1–11; doi: 10.1517/1/jlms.2019.01
55.
CarneiroAMP, BarrosAPO, de OliveiraRP, et al.The effect of photobiomodulation using low-level laser therapy on tooth sensitivity after dental bleaching: A systematic review. Lasers Med Sci, 2022; 37(7):2791–2804; doi: 10.1007/s10103-022-03578-0
56.
SathornC, ParashosP, MesserH. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: A systematic review. Int Endod J, 2008; 41(2):91–99; doi: 10.1111/j.1365-2591.2007.01316.x
57.
IsmailHH, ObeidM, HassanienE. Efficiency of diode laser in control of post-endodontic pain: A randomized controlled trial. Clin Oral Investig, 2023; 27(6):2797–2804; doi: 10.1007/s00784-023-04864-z
58.
KaplanT, SezginGP, Sönmez KaplanS. Effect of a 980-nm diode laser on post-operative pain after endodontic treatment in teeth with apical periodontitis: A randomized clinical trial. BMC Oral Health, 2021; 21(1):41–49; doi: 10.1186/s12903-021-01401-w
59.
GuimarãesLdS, CostaLdCM, AraujoAC, et al.Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: A randomised placebo-controlled trial. Pain, 2021; 162(6):1612–1620; doi: 10.1097/j.pain.0000000000002189
60.
RamalhoKM, de SouzaLMP, TortamanoIP, AddeCA, RochaRG, de Paula EduardoC. A randomized placebo-blind study of the effect of low power laser on pain caused by irreversible pulpitis. Lasers Med Sci, 2016; 31(9):1899–1905; doi: 10.1007/s10103-016-2068-7
61.
ShahD, PonappaMC, PonnappaKC. Evaluation of effect of low level laser therapy with intracanal medicament on periapical healing: A randomised control trial. Indian J Dent Res, 2021; 32(3):299–304; doi: 10.4103/ijdr.IJDR_896_20
62.
MetinR, TatliU, EvliceB. Effects of low-level laser therapy on soft and hard tissue healing after endodontic surgery. Lasers Med Sci, 2018; 33(8):1699–1706; doi: 10.1007/s10103-018-2523-8
63.
MasilionyteM, GutknechtN. Outcome of 940-nm diode laser-assisted endodontic treatment of teeth with apical periodontitis: A retrospective study of clinical cases. Laser Dent Sci, 2018; 2(3):169–179; doi: 10.1007/s41547-018-0035-2
64.
GrissomAC, HernandezIA, KirkpatrickTC, PatelSA, BarrosJA, StanleyE. Treating nerve injury after endodontic microsurgery using laser photobiomodulation: A report of 2 cases. J Endod, 2023; 49(5):597–603; doi: 10.1016/j.joen.2023.01.011
65.
MarquesMM, DinizIMA, de CaraSPHM, et al.Photobiomodulation of Dental Derived Mesenchymal Stem Cells: A Systematic Review. Photomed Laser Surg, 2016; 34(11):500–508; doi: 10.1089/pho.2015.4038
66.
MoreiraMS, SarraG, CarvalhoGL, et al.Physical and biological properties of a chitosan hydrogel scaffold associated to photobiomodulation therapy for dental pulp regeneration: An in vitro and in vivo study. Biomed Res Int, 2021; 2021:6684667; doi: 10.1155/2021/6684667
67.
ZaccaraIM, JardineAP, MestieriLB, et al.Influence of photobiomodulation therapy on root development of rat molars with open apex and pulp necrosis. Brazilian Oral Research, 2019; 33:e084–e13; doi: 10.1590/1807-3107BOR-2019.VOL33.0084
68.
ArasMH, GüngörmüşM. The effect of low-level laser therapy on trismus and facial swelling following surgical extraction of a lower third molar. Photomed Laser Surg, 2009; 27(1):21–24; doi: 10.1089/pho.2008.2258
69.
López-RamírezM, Vílchez-PérezMA, Gargallo-AlbiolJ, Arnabat-DomínguezJ, Gay-EscodaC. Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction. A preliminary study. Lasers Med Sci, 2012; 27(3):559–566; doi: 10.1007/s10103-011-0936-8
70.
HosseinpourS, TunérJ, FekrazadR. Photobiomodulation in oral surgery: A review. Photobiomodul Photomed Laser Surg, 2019; 37(12):814–825; doi: 10.1089/photob.2019.4712
71.
de Oliveira RossoMP, BuchaimDV, KawanoN, FurlanetteG, PominiKT, BuchaimRL. Photobiomodulation Therapy (PBMT) in peripheral nerve regeneration: A systematic review. Bioengineering, 2018; 5(2):44.
72.
DipalmaG, InchingoloAM, PatanoA, et al.Photobiomodulation and growth factors in dentistry: A systematic review. Photonics, 2023; 10(10):1095.
73.
KotbS. Photobiomodulation and Its Application in Dentistry. SSRN Journal, 2023.
74.
RochkindS. Photobiomodulation in neuroscience: A summary of personal experience. Photomed Laser Surg, 2017; 35(11):604–615.
75.
AndreoL, SolderaCB, RibeiroBG, et al.Effects of photobiomodulation on experimental models of peripheral nerve injury. Lasers Med Sci, 2017; 32(9):2155–2165.
FernandesMP, VidalCL, de OliveiraTT, BotelhoAL, ValenteMLdC, Dos ReisAC. Effects of photobiomodulation on auriculotherapy points for sleep disorders, anxiety, and temporomandibular dysfunctions. Cranio, 2023; 41(4):362–367; doi: 10.1080/08869634.2020.1853896
78.
MáximoCFGP, CoêlhoJF, BenevidesSD, AlvesGÂDS. Effects of low-level laser photobiomodulation on the masticatory function and mandibular movements in adults with temporomandibular disorder: A systematic review with meta-analysis. Codas, 2022; 34(3):e20210138; doi: 10.1590/2317-1782/20212021138
79.
da SilveiraRB, FerreiraI, BotelhoAL, Dos ReisAC. Effect of photobiomodulation treatment on pain control in patients with temporomandibular dysfunction disorder: Systematic review. Cranio, 2025; 43(1):117–127; doi: 10.1080/08869634.2022.2086599
80.
CarvalhoFR, BarrosRQ, GonçalvesAS, FreitasPM. Photobiomodulation therapy on the palliative care of temporomandibular disorder and orofacial/cervical skull pain: Study protocol for a randomized controlled clinical trial. Trials, 2019; 20(1):200–208; doi: 10.1186/s13063-019-3294-7
81.
NadershahM, Abdel-AlimHM, BayoumiAM, JanAM, ElatrouniA, JaduFM. Photobiomodulation therapy for myofascial pain in temporomandibular joint dysfunction: A double-blinded randomized clinical trial. J Maxillofac Oral Surg, 2020; 19(1):93–97; doi: 10.1007/s12663-019-01222-z
82.
HerpichCM, Leal-JuniorECP, PolittiF, et al.Intraoral photobiomodulation diminishes pain and improves functioning in women with temporomandibular disorder: A randomized, sham-controlled, double-blind clinical trial: Intraoral photobiomodulation diminishes pain in women with temporomandibular disord. Lasers Med Sci, 2020; 35(2):439–445; doi: 10.1007/s10103-019-02841-1
83.
BorgesRMM, CardosoDS, FloresBC, et al.Effects of different photobiomodulation dosimetries on temporomandibular dysfunction: A randomized, double-blind, placebo-controlled clinical trial. Lasers Med Sci, 2018; 33(9):1859–1866; doi: 10.1007/s10103-018-2533-6
84.
FarshidfarN, FarzinniaG, SamiraninezhadN, et al.The effect of photobiomodulation on temporomandibular pain and functions in patients with temporomandibular disorders: An updated systematic review of the current randomized controlled trials. J Lasers Med Sci, 2023; 14:e24; doi: 10.3417/2/jlms.2023.24
