The Effect of Photobiomodulation on Periodontal Clinical Status of Patients with Cancer During Chemotherapy: A Randomized Clinical Trial.

Abstract

Objective: This interventional prospective double-blind randomized study investigated the adjunctive inflammation-modulatory effects of photobiomodulation therapy on the periodontal clinical parameters of patients undergoing chemotherapy. Methods: Twenty diagnosed patients with cancer were enrolled in this split-mouth trial. Patients were randomized to implantation with either SRP alone in one quadrant or with five sessions of adjunctive photobiomodulation using a diode laser (density of energy = 2 J/cm² | wavelength = 635 nm | power = 50 mW | spot diameter = 4 mm | exposure time = 5 s | continuous mode) on the other quadrant. The gingiva was radiated buccally and lingually. The laser beam was positioned 3 mm vertically away from the gingival surface and at a right angle to it. Before chemotherapy, all participants were given oral hygiene training and received SRP. In the same session, the patient's baseline clinical measures were taken immediately after the beginning of one chemotherapy session, interventions for each side were started and clinical parameters including gingival index (GI), plaque index (PI), clinical attachment level (CAL), and pain/burning sensation after one chemotherapy session were obtained. Results: Regarding GI and PI, both control and test groups showed favorable results compared with baseline. However, the adjunctive photobiomodulation group outperformed the control group in one chemotherapy session regarding both abovementioned indices (p < 0.05). The photobiomodulation+scaling and root planing (SRP) group showed promising results in terms of gingival discomfort reduction and SRP alone was not effective. No significant effect was observed regarding CAL in both groups (p > 0.05). Conclusion: Based on the results of this study, it can be concluded that photobiomodulation promotes gingival health and reduces PI and GI indices. Photobiomodulation also alleviates pain or burning in the gingiva. Accordingly, adjunctive photobiomodulation therapy may be suggested as a supplementary treatment in patients with cancer.