Laser-Based Photobiomodulation in Postoperative Tissue Healing in Oral and Maxillofacial Surgery: Systematic Review of RCTs

Abstract

Background: Postoperative bone healing can be impaired by systemic factors and surgical trauma, leading to delayed recovery. Photobiomodulation therapy (PBMT) has been proposed as a non-invasive method to enhance osteogenesis, but variability in protocols and outcomes limits its clinical use. Aim: To systematically review and synthesize evidence from randomized controlled trials (RCTs) evaluating PBMT’s effectiveness in promoting postoperative osteogenesis. Methods: A systematic search of PubMed, Embase, Scopus, and Cochrane Library was conducted following the PRISMA 2020 guidelines. Only RCTs comparing PBMT with sham treatment or standard care were included. Data on laser parameters, surgical indications, and outcomes such as bone regeneration, healing time, and implant stability were extracted. The risk of bias of the included randomized studies was evaluated using the Cochrane Risk of Bias 2 (RoB version 2) tool. Results: Twelve RCTs were included. PBMT consistently improved early soft tissue healing and reduced postoperative inflammation and edema. Some studies showed accelerated bone maturation, especially in grafted sockets and distraction osteogenesis, while others reported no significant long-term effects on implant stability or chronic lesion healing. Heterogeneity in laser parameters limited comparability. Conclusions: PBMT is a safe adjunct that reliably enhances early postoperative healing and may promote bone remodeling in selected cases. Standardized protocols and larger, high-quality RCTs are needed to confirm long-term benefits and optimize treatment parameters.