Laser therapy for the management of oral mucositis: An umbrella review - official recommendations of the Polish Society for Laser Dentistry.

Kinga Grzech-Leśniak, Jakub Fiegler-Rudol, Zuzanna Grzech-Leśniak, Jacek Matys, Grzegorz Marek, Dariusz Skaba, Bartłomiej Pokrzywka, Halina Bubała, Krzysztof Dowgierd, Mariusz Szuta, Marzena Dominiak, Marek Ussowicz, Tomasz Wróbel, Rafał Wiench

Journal: Dental and medical problems 2025;62(6):1157-1175

PMID: 41410110

Abstract

Oral mucositis (OM) is a common and debilitating side effect of cancer therapy that impairs nutrition, increases infection risk, and often disrupts oncologic treatment. Photobiomodulation therapy (PBMT) has emerged as an effective, non-invasive method for OM prevention and management.This umbrella review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Joanna Briggs Institute (JBI) methodology. A comprehensive search of PubMed®/MEDLINE, Embase, Scopus, and Cochrane Library identified systematic reviews and meta-analyses on laser therapy for OM published through July 2025. The data extraction process centered on clinical outcomes, laser parameters and safety.Twenty-two reviews met the inclusion criteria. Photobiomodulation therapy significantly reduced the incidence of OM, disease severity, pain, and healing time across adult and pediatric populations. Preventive PBMT decreased the risk of severe OM (grade 3-4) by 40-80%, while therapeutic PBMT shortened ulcer duration by 4-7 days. The combination of PBMT and photodynamic therapy (PDT) enhanced mucosal healing and alleviated pain. Optimal outcomes were achieved when wavelengths of 630-670 nm (intraoral) and 780-850 nm (extraoral) were used, with fluences of 2-6 J/cm2. No serious adverse events were reported.Photobiomodulation therapy demonstrates strong efficacy and safety in the management of OM, improving quality of life and treatment continuity in oncology patients. The Polish Society for Laser Dentistry (PTSL) endorses PBMT as a standard supportive care modality, particularly in the context of hematopoietic stem cell transplantation (HSCT) and head and neck chemoradiation. Protocol adherence and parameter standardization are essential to ensure the reproducibility and clinical effectiveness of research findings.

Address: Laser Laboratory, Department of Integrated Dentistry, Faculty of Medicine and Dentistry, Wroclaw Medical University, Poland.; Department of Periodontal and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.; Department of Experimental Dentistry, Faculty of Medicine and Dentistry, Wroclaw Medical University, Poland.; Department of Dental Surgery, Faculty of Medicine and Dentistry, Wroclaw Medical University, Poland.; 2nd Clinical Department of General Surgery and Surgical Oncology, Wroclaw Medical University, Poland.; University of the National Education Commission, Krakow, Poland.; Department of Pediatric Hematology and Oncology, Prof. Stanisław Szyszko Independent Public Clinical Hospital No. 1, Medical University of Silesia, Katowice, Poland.; Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury in Olsztyn, Poland.; Department of Oral Surgery, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.; Clinical Department of Paediatric Bone Marrow Transplantation, Oncology and Haematology, Faculty of Medicine, Wroclaw Medical University, Poland.; Clinical Department of Hematology, Cell Therapies and Internal Diseases, Faculty of Medicine, Wroclaw Medical University, Poland.
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