Safety parameters of diode laser therapy for the treatment of recurrent aphthous ulcers: a systematic review and meta-analysis

The aim of this study is to evaluate the safety parameters of diode laser (DL) therapy on treating recurrent aphthous ulcer (RAU). We conducted a systematic review in accordance with the PRISMA guidelines. Studies from PubMed, Embase, WOS, Cochrane, Google Scholar, CNKI, Wanfang Data and VIP were searched by hand. The search terms encompassed both Medical Subject Headings terms (Stomatitis, aphthous; Lasers, semiconductor) and their corresponding text words. The meta-analysis was performed using Review Manager 5.4. 16 studies were included in this review with no high-risk studies and no significant publication bias. In this review, we found DL therapy was more effective than medication or placebo in reducing Visual Analog Scale (MD = 2.79, 95% CI: 1.40 to 4.17, P < 0.0001), shrinking ulcer size (MD = 2.62, 95% CI: 1.15 to 4.09, P = 0.0005) and accelerating healing time (MD = -3.72, 95% CI: -4.86 to -2.59, P < 0.00001). Moreover, subgroup analyses demonstrated that DL therapy effectively alleviated immediate pain in patients (MD = 2.88, 95% CI: 1.53 to 4.23, P < 0.0001), and a single exposure significantly shortened the healing time of RAU (MD = -4.20, 95% CI: -5.76 to -2.64, P < 0.00001). DL therapy is an effective treatment for RAU without any adverse effects. A single session (or two) with low-energy density irradiation significantly alleviates RAU symptoms. Consequently, there is no need to pursue longer durations and higher parameters of DL therapy, which also aligns with the economic interests of patients. RAU is typically painful and can impair quality of life. Suitable DL therapy represents a promising strategy.