Supportive Care in Cancer

, Volume 28, Issue 2, pp 867–876 | Cite as

Comparison of photobiomodulation using either an intraoral or an extraoral laser on oral mucositis induced by chemotherapy in rats

  • Stéfanie Thieme
  • Julia Turra Ribeiro
  • Bernardo Gindri dos Santos
  • Renata de Almeida Zieger
  • Mara Luana Batista Severo
  • Marco Antonio Trevizani Martins
  • Cristiane Matté
  • Manoela Domingues MartinsEmail author
Original Article



The aim of the present study was to compare the effect of intraoral (IO) and extraoral (EO) diode laser irradiation on oral mucositis (OM) induced by 5-fluorouracil (5-FU) in rats.


Animals (n = 78) were divided into the following groups: negative control (NC), positive control (PC), IO 6 J/cm2, EO with 6 J/cm2 (EO 6 J/cm2), and 12 J/cm2 (EO 12 J/cm2). OM was induced with an intraperitoneal injection of 5-FU and scarification of the buccal mucosa. Over the following 14 days, animals received photobiomodulation (PBM) daily. Clinical and histological evaluation was done by scores at days 8, 10, and 14. The redox state was evaluated by reactive species levels, antioxidant network, and immunohistochemistry analysis.


Clinically, on day 8, PBM groups showed lower scores of OM with EO 6 J/cm2 presenting a significantly lower degree compared to PC (p < 0.05). On days 10 and 14, all PBM groups exhibited improvement of OM compared to PC (p < 0.01). On day 8, all PBM groups exhibited an accelerated healing process compared to PC (p < 0.01) and reduction of reactive species (p < 0.001). Also, all PBM groups demonstrated higher levels of antioxidant GPx compared to PC (p < 0.001). Analysis of nitrotyrosine revealed that on day 14, this protein damage marker was significantly reduced in the EO 6 J/cm2 group (p > 0.05).


An EO diode laser protocol promoted positive effects in the clinical, histopathological, and redox state in OM induced by 5-FU in rats. Among the EO protocols, EO 6 J/cm2 showed the most encouraging results.


Diode lasers Oral mucositis Low-level laser therapy Oxidative stress 



The authors are grateful to Marta Justina Giotti Cioato and Flavia Rejane Giusti for technical support.

Funding information

This study was funded by the Postgraduate Research Group of Porto Alegre Clinics Hospital (GPPG/FIPE: 2018-0096) and Azena Medical (providing laser equipment and research funding). We also thank Brazilian National Council for Scientific and Technological Development (CNPq student scholarship), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES)-finance code 001. Cristiane Matté and Manoela Domingues Martins are research fellows funded by the Brazilian National Council for Scientific and Technological Development (CNPq).

Compliance with ethical standards

This study was approved by the Ethics Committee on Animal Use (CEUA, 2018-0096).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Stéfanie Thieme
    • 1
  • Julia Turra Ribeiro
    • 1
  • Bernardo Gindri dos Santos
    • 2
  • Renata de Almeida Zieger
    • 1
  • Mara Luana Batista Severo
    • 1
  • Marco Antonio Trevizani Martins
    • 1
    • 3
  • Cristiane Matté
    • 2
    • 4
  • Manoela Domingues Martins
    • 1
    • 3
    • 5
    • 6
    Email author
  1. 1.Department of Oral Pathology, School of DentistryFederal University of Rio Grande do SulPorto AlegreBrazil
  2. 2.Postgraduate Program in Biological Sciences: Biochemistry, ICBSFederal University of Rio Grande do SulPorto AlegreBrazil
  3. 3.Department of Oral MedicinePorto Alegre Clinics Hospital (HCPA/UFRGS)Porto AlegreBrazil
  4. 4.Postgraduate Program in Biological Sciences: Physiology, ICBSFederal University of Rio Grande do SulPorto AlegreBrazil
  5. 5.Experimental Pathology Unit, Porto Alegre Clinics HospitalFederal University of Rio Grande do SulPorto AlegreBrazil
  6. 6.Faculdade de OdontologiaUniversidade Federal do Rio Grande do SulPorto AlegreBrazil

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