Terapia por fotobiomodulação no controle da dor em doenças da cavidade oral – mapa de evidências e sua implementação na medicina tradicional complementar integrativa

Abstract

Photobiomodulation therapy (PBMT) is known for its effects on the control of the inflammatory process, tissue repair and pain relief. In dentistry, PBMT has been used to treat diseases of the oral cavity. Complementary integrative health practices (CIHP) are indicated by Traditional Complementary Integrative Medicine (CTIM). However, PBM has not yet been included in this sector, despite being considered an effective treatment. Objective: To build a map of evidences of Laser therapy in photobiomodulation (PBMT) in dentistry and to analyze the pain outcome, organizing information that shows the necessary efficacy for its implementation in Integrative Traditional Complementary Medicine (CTIMI). Methodology: A bibliographic survey was carried out following the steps of an overview of Systematic Reviews (OoRs) in order to compile scientific evidence to identify, organize, synthesize and describe the results by presenting an evidence map following the recommendations of the International Initiative for Impact Evaluation (3ie). Results: 121 systematic reviews were selected, published between 2008 and 2020 and the information was tabulated considering 27 characterizations. As for the type of intervention with LASER, photobiomodulation therapy had 59.7% of the total systematic reviews and of this total, 28.3% used infrared (IR) laser. As for the quality of the effect, it was considered positive or potentially positive in 85.9% of the studies, with pain as the most common primary outcome in 19.2% of the studies. Regarding the design of the review, less than 1% evaluated cost effectiveness and safety. Of the selected studies, 55% were randomized controlled clinical trials. Most of the analyzed data, 31.8%, were studies developed in the USA. Conclusion: The Evidence Map on the Clinical Effectiveness of PBMT in the control of pain in Diseases of the Oral Cavity provided a clear visualization of the clinical evidence, the degree of confidence of the study and of future approaches. However, the lack of dosimetric information and methodological problems in certain studies hinder its clinical application and make it difficult to include PBMT as a CIHP in pain control in diseases of the oral cavity.